A model of care for Aboriginal and Torres Strait Islander prisoner health and wellbeing in South Australia.

PURPOSE: Aboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to respond to the broad needs of the Aboriginal prisoner population within the nine adult prisons across South Australia. The purpose of this paper is to describe the methods and findings of the Model of Care for Aboriginal and Torres Strait Islander Prisoner Health and Wellbeing for South Australia. DESIGN/METHODOLOGY/APPROACH: The project used a qualitative mixed-method approach, including a rapid review of relevant literature, stakeholder consultations and key stakeholder workshop. The project was overseen by a Stakeholder Reference Group, which met monthly to ensure that the specific needs of project partners, stakeholders and Aboriginal communities were appropriately incorporated into the planning and management of the project and to facilitate access to relevant information and key informants. FINDINGS: The model of care for Aboriginal prisoner health and wellbeing is designed to be holistic, person-centred and underpinned by the provision of culturally appropriate care. It recognises that Aboriginal prisoners are members of communities both inside and outside of prison. It notes the unique needs of remanded and sentenced prisoners and differing needs by gender. SOCIAL IMPLICATIONS: Supporting the health and wellbeing of Indigenous prison populations can improve health outcomes, community health and reduce recidivism. ORIGINALITY/VALUE: Only one other model of care for Aboriginal prisoner health exists in Australia, an Aboriginal Community Controlled Health Organisation-initiated in-reach model of care in one prison in one jurisdiction. The South Australian model of care presents principles that are applicable across all jurisdictions and provides a framework that could be adapted to support Indigenous peoples in diverse prison settings.

Prison overcrowding and ill-treatment: sentence reduction as a reparation measure. A view from Latin America and Europe.

INTRODUCTION: In recent years mass protest movements have taken to the streets in many countries across the world. Despite strong international and domestic legal protections for the right to freedom of peaceful assembly and other fundamental human rights, entire assemblies are frequently labelled violent and less lethal weapons are used to disperse them. METHODS: This article examines the weapons often used by police against public assemblies. Focusing on striking weapons (batons), chemical irri-tants, kinetic impact projectiles and stun grenades, the article uses examples from various countries to illustrate how these weapons are being used and the associated human rights and health impacts. Re-sults: Worrying trends identified include the use of dangerous or untested equipment, such as thermal foggers to deploy chemical irritants; the use of inherently abusive weapons, such as whips or sjam-boks; and the increasing use of certain types of munitions, specifically indiscriminate kinetic impact projectiles. DISCUSSION: The article seeks to support medical and legal professionals becoming more familiar with the weapons being used in the countries they practice in, the effects of those weapons, and clinical aspects in the presentation and care of those exposed.

Aggravated solitary confinement in Turkey. A form of institutionalised torture.

Last January 2023, 36 international jurists, journalists and pol-iticians from 8 countries were part of the International Delega-tion Against Isolation that travelled to Turkey to hold meetings with civil society organisations and political circles regarding the prison situation1 . The Delegation was divided into three groups travelling to different cities: Ankara, Amed and Istan-bul. The three groups met on 28 January in Istanbul for an International Forum against Isolation.

Ill-treatment in the Chilean prison system - an analysis of reports presented by the National Institute of Human Rights (INDH) and their handling by the legal actors.

INTRODUCTION: Prisons in Latin America are often described as violent and lawless places. This article analyses the Chilean case. We want to find out how complaints of ill-treatment are investigated if the victim is in prison. Our hypothesis is that the response to the phenomenon, both in the prose-cution of the perpetrators and in the protection of its victims, does not take into consideration the guidelines established in international standards, especially those contained in the Istanbul Proto-col. METHODS: We analysed a total of 124 complaints of ill-treatment filed by the Chilean National Human Rights Institute (INDH). RESULTS: An excessive amount of time elapses between the alleged ill treatment, the filing of complaints, the use of protective measures, and the termination of the cases. There are serious deficiencies in the investigations carried out by the Public Prosecutor's Office, and therefore, most of the complaints are not clarified and end up being shelved. We conclude that, through both the actions of the judges and the prosecutors in the processing of the complaints, when it comes to investigating acts of ill-treatment inside Chilean prisons, the standards of the Istanbul Protocol are not met.

Degradation as salvation: Reflections on El Salvador's punitive prison model.

The pictures of shaven men with naked upper bodies, sitting in rows back-to-back with fellow prisoners in close proximity, sur-rounded by heavily armed guards, encapsulates the essence of El Salvador's ongoing "war on gangs".

Receipt of Opioid Agonist Treatment in provincial correctional facilities in British Columbia is associated with a reduced hazard of nonfatal overdose in the month following release.

BACKGROUND: In many jurisdictions, policies restrict access to Opioid Agonist Treatment (OAT) in correctional facilities. Receipt of OAT during incarceration is associated with reduced risk of fatal overdose after release but little is known about the effect on nonfatal overdose. This study aimed to examine the association between OAT use during incarceration and nonfatal overdose in the 30 days following release. METHODS AND FINDINGS: Using linked administrative healthcare and corrections data for a random sample of 20% of residents of British Columbia, Canada we examined releases from provincial correctional facilities between January 1, 2015 -December 1, 2018, among adults (aged 18 or older at the time of release) with Opioid Use Disorder. We fit Andersen-Gill models to examine the association between receipt of OAT in custody and the hazard of nonfatal following release. We conducted secondary analyses to examine the association among people continuing treatment initiated prior to their arrest and people who initiated a new episode of OAT in custody separately. We also conducted sex-based subgroup analyses. In this study there were 4,738 releases of 1,535 people with Opioid Use Disorder. In adjusted analysis, receipt of OAT in custody was associated with a reduced hazard of nonfatal overdose (aHR 0.55, 95% CI 0.41, 0.74). This was found for prescriptions continued from community (aHR 0.49, 95%CI 0.36, 0.67) and for episodes of OAT initiated in custody (aHR 0.58, 95%CI 0.41, 0.82). The effect was greater among women than men. CONCLUSIONS: OAT receipt during incarceration is associated with a reduced hazard of nonfatal overdose after release. Policies to expand access to OAT in correctional facilities, including initiating treatment, may help reduce harms related to nonfatal overdose in the weeks following release. Differences in the effect seen among women and men indicate a need for gender-responsive policies and programming.

Assessment of tuberculosis transmission probability in three Thai prisons based on five dynamic models.

This study aimed to assess and compare the probability of tuberculosis (TB) transmission based on five dynamic models: the Wells-Riley equation, two Rudnick & Milton-proposed models based on air changes per hour (ACH) and liters per second per person (L/s/p), the model proposed by Issarow et al, and the Applied Susceptible-Exposed-Infected-Recovered (SEIR) TB transmission model. This study also aimed to determine the impact of model parameters on such probabilities in three Thai prisons. A cross-sectional study was conducted using data from 985 prison cells. The TB transmission probability for each cell was calculated using parameters relevant to the specific model formula, and the magnitude of the model agreement was examined by Spearman's rank correlation and Bland-Altman plot. Subsequently, a multiple linear regression analysis was conducted to investigate the influence of each model parameter on the estimated probability. Results revealed that the median (Quartiles 1 and 3) of TB transmission probability among these cells was 0.052 (0.017, 0.180). Compared with the pioneered Wells-Riley's model, the remaining models projected discrepant TB transmission probability from less to more commensurate to the degree of model modification from the pioneered model as follows: Rudnick & Milton (ACH), Issarow et al., and Rudnick & Milton (L/s/p), and the applied SEIR models. The ventilation rate and number of infectious TB patients in each cell or zone had the greatest impact on the estimated TB transmission probability in most models. Additionally, the number of inmates in each cell, the area per person in square meters, and the inmate turnover rate were identified as high-impact parameters in the applied SEIR model. All stakeholders must urgently address these influential parameters to reduce TB transmission in prisons. Moreover, further studies are required to determine their relative validity in accurately predicting TB incidence in prison settings.

Prison food and the carceral experience: a systematic review.

PURPOSE: This study aims to focus on studies that qualitatively explore prison food experience. The goal is to elaborate a framework to better understand how prison food shapes the worldwide carceral experience. DESIGN/METHODOLOGY/APPROACH: This systematic literature review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. It consists of four phases: identifying the studies, screening the studies, evaluating the eligibility of screened studies and inclusion of studies. After the four phases, ten studies (nine qualitative studies and one with mixed methods) were included in the review. FINDINGS: There is a consensus among the researchers in the reviewed literature that prison food shapes the carceral experience. More specifically, four themes that encompass the experience of people with prison food emerged from the reviewed literature: food appreciation (taste of the prison food and perceived nutritional value), food logistics (preparation, distribution and consumption), food variety (institutional menu and commissary store) and food relationships (symbol of caring or power or punishment). ORIGINALITY/VALUE: The literature reviewed demonstrated that when incarcerated individuals have a negative view of prison food, the carceral experience is negatively impacted. This systematic review identified four dimensions that encompass the food experience within the prison environment, providing a framework for navigating this subject.

Suicide, suicide attempts and self-harm in Moroccan prisons.

PURPOSE: High rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts. DESIGN/METHODOLOGY/APPROACH: The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution. FINDINGS: Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations. RESEARCH LIMITATIONS/IMPLICATIONS: To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent. PRACTICAL IMPLICATIONS: This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.

The role and effectiveness of occupational therapy in prison rehabilitation programs: systematic review.

PURPOSE: The purpose of this study was to research studies in the literature regarding the role of the occupational therapist within penitentiary facilities. DESIGN/METHODOLOGY/APPROACH: The study design is a systematic review using five different databases. FINDINGS: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society. RESEARCH LIMITATIONS/IMPLICATIONS: It is necessary for clinical practice, and especially to increase the health of people within prisons, to update the occupational therapist interventions in the literature that are effective within prisons. PRACTICAL IMPLICATIONS: According to this study, the intervention of occupational therapists in the prison setting reduces recidivism and contributes to social and work reintegration. This has positive effects in terms of costs related to incarceration. ORIGINALITY/VALUE: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society.

"I feel like it should be but I know it's really not": exploring physical fitness priorities at the correctional training program in Canadian federal corrections.

The correctional training program (CTP), composed of three stages, includes a 14 week in-person component that Correctional Officer Recruits (CORs) must complete prior to their employment as a federal Correctional Officer (CO) for Correctional Service Canada (CSC). The CTP prepares recruits for a plethora of CO responsibilities, some dependent on physical fitness, such as responding to codes being called, physical altercations, or violent situations. Unlike other public safety positions (e.g. policing, border services, or coast guard) CSC does not require occupational fitness testing. In the current article, we use data from a multiyear longitudinal study of federal COs from across Canada to unpack how CORs manage physical fitness expectations at CTP; CSCs' expectations of COR physical fitness; and outline what types of physical fitness (e.g. weightlifting, cardiovascular, self-defence) are taught, thus valued most, during CTP. We situate the voices of CORs regarding physical fitness within the broader "body" literature and discuss policy recommendations tied to physical fitness, specifically COs' interest in reinstating pre-employment physical fitness screening.

Insights into SARS-CoV-2 Surveillance among Prison Populations in Mato Grosso do Sul, Brazil, in 2022.

This study examines the epidemiological and genomic characteristics, along with the transmission dynamics, of SARS-CoV-2 within prison units I and II in Campo Grande, Mato Grosso do Sul, Brazil. Conducted between May and October 2022, it reveals how the virus spreads in the confined settings of prisons, emphasizing the roles of overcrowded cells, frequent transfers, and limited healthcare access. The research involved 1927 participants (83.93% of the total prison population) and utilized nasopharyngeal swabs and RT-qPCR testing for detection. Contact tracing monitored exposure within cells. Out of 2108 samples, 66 positive cases were identified (3.13%), mostly asymptomatic (77.27%), with the majority aged 21-29 and varying vaccination statuses. Next-generation sequencing generated 28 whole genome sequences, identifying the Omicron variant (subtypes BA.2 and BA.5) with 99% average coverage. Additionally, the study seeks to determine the relationship between immunization levels and the incidence of SARS-CoV-2 cases within this enclosed population. The findings underscore the necessity of comprehensive control strategies in prisons, including rigorous screening, isolation protocols, vaccination, epidemiological monitoring, and genomic surveillance to mitigate disease transmission and protect both the incarcerated population and the broader community.

Reaching for 90:90:90 in Correctional Facilities in South Africa and Zambia: Virtual Cross-Section of Coverage of HIV Testing and Antiretroviral Therapy During Universal Test and Treat Implementation.

BACKGROUND: People in correctional settings are a key population for HIV epidemic control. We sought to demonstrate scale-up of universal test and treat in correctional facilities in South Africa and Zambia through a virtual cross-sectional analysis. METHODS: We used routine data on 2 dates: At the start of universal test and treat implementation (time 1, T1) and 1 year later (time 2, T2). We obtained correctional facility census lists for the selected dates and matched HIV testing and treatment data to generate virtual cross-sections of HIV care continuum indicators. RESULTS: In the South African site, there were 4193 and 3868 people in the facility at times T1 and T2; 43% and 36% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 1803 (43%) and 1386 (36%) had known HIV status, 804 (19%) and 845 (21%) were known to be living with HIV, and 60% and 56% of those with known HIV were receiving antiretroviral therapy (ART). In the Zambian site, there were 1467 and 1366 people in the facility at times T1 and T2; 58% and 92% were matched with HIV testing or treatment data, respectively. At T1 and T2, respectively, 857 (59%) and 1263 (92%) had known HIV status, 277 (19%) and 647 (47%) were known to be living with HIV, and 68% and 68% of those with known HIV were receiving ART. CONCLUSIONS: This virtual cross-sectional analysis identified gaps in HIV testing coverage, and ART initiation that was not clearly demonstrated by prior cohort-based studies.

Healthy prison cultures: factors influencing male prisoners' engagement in exercise and subsequent healthy behaviours.

PURPOSE: The purpose of this paper is to identify the factors which influence male prisoners' motivation for, and engagement in, exercise and subsequent healthy behaviours. DESIGN/METHODOLOGY/APPROACH: The first authors conducted 20 semi-structured interviews with male prisoners inside an English medium-security male prison. Interviews were recorded and transcribed, themes were identified using thematic analysis and a critical realist perspective applied to understand objective processes behind prisoners' experiences and shared meanings of exercise and engaging in healthy behaviours in prison. FINDINGS: Emerging themes indicate that in the context of healthy behaviours male prisoners aspired to a masculine ideal that was characterised by a culture of either adaptive behaviours, or maladaptive behaviours. The former fostered an adaptive exercise culture which promoted psychological well-being through an autonomy-supportive environment, consequently internalising motivation and minimising perceived barriers to engaging in healthy behaviours. Conversely, a culture of maladaptive behaviours fostered a maladaptive exercise culture which led to negative psychological well-being, underpinned by external forms of motivation which emphasised barriers to engaging in healthy behaviours. PRACTICAL IMPLICATIONS: Findings emphasise the need for prisons to promote an internal perceived locus of control for male prisoners when engaging in healthy behaviours. ORIGINALITY/VALUE: The authors adopt a rare interdisciplinary approach combining a psychological theory of motivation and criminological perspectives of prison culture to understand how best to minimise the impact of prisons as an institution on the psychological well-being of male prisoners.

COVID-related disruptions and adaptations to prison-based mental health and substance use services: a narrative review.

PURPOSE: Public health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide - an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study. DESIGN/METHODOLOGY/APPROACH: The authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic. FINDINGS: The authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic - predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.

"We don't even know where it's kept": exploring perspectives on naloxone administration by provincial correctional workers in Manitoba, Canada.

PURPOSE: Prisonersare at disproportionate risk of suffering substance-related harms. The administration of naloxone is essential to reversing opioid overdose and minimizing substance-related harms in prison and the community. The purpose of this study is to examine how naloxone administration is practiced and perceived in prison settings. DESIGN/METHODOLOGY/APPROACH: The authors conducted surveys with correctional workers in Manitoba, Canada (n = 257) to examine how they understand and feel about the need for and practice of administering naloxone in their everyday work with criminalized populations. FINDINGS: Respondents reported feeling a great need to administer naloxone, but most did not feel adequately trained to administer naloxone, creating the perception that criminalized populations remain at enhanced risk. ORIGINALITY/VALUE: Findings provide emerging evidence of the need for training and accompanying policies and procedures for correctional workers on how to access and administer naloxone.

Cardiovascular disease in Sub-Saharan African prisons: a scoping review.

PURPOSE: The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic. DESIGN/METHODOLOGY/APPROACH: A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed. FINDINGS: Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.