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2.
Int J Prison Health ; 15(2): 138-152, 2019 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-31172852

RESUMO

PURPOSE: Opioid substitution treatment (OST), such as Buprenorphine, has become a well-established evidence-based approach for the treatment of inmates with opioid use disorder (OUD) in most of the developed world. However, its application in Lebanon remains mainly as a community-based intervention. The purpose of this paper is to highlight the need of its implementation within the Lebanese correctional system. DESIGN/METHODOLOGY/APPROACH: The work is a pilot cross-sectional study that compares two groups: 30 male adult prisoners with OUD convictions receiving symptomatic treatment and 30 male adult community patients with OUD receiving Buprenorphine. The objective was to measure the difference in the patients' general perception and satisfaction of the treatments available. OUD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria and the level of satisfaction was measured by "Treatment Perceptions Questionnaire (TPQ)." FINDINGS: The prison group reported significantly lower satisfaction when compared to the community group (total TPQ mean scores: M=34.73, SD =4.12 and M=16.67, SD =4.78, respectively, with t (56.76) =15.68, p=0.000). Furthermore, age, marital status, education level and elapsed time in treatment had no significant interactions with the total TPQ score. ORIGINALITY/VALUE: The major principles of the ethics of care and evidence-based safe practices will be proposed for the introduction of Buprenorphine to Lebanese prisons. This work provides an opportunity for the expansion of the Lebanese OST program and consequently other countries in the region could benefit from this experience.


Assuntos
Buprenorfina/uso terapêutico , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Satisfação do Paciente/estatística & dados numéricos , Prisioneiros/psicologia , Adulto , Estudos Transversais , Humanos , Líbano , Masculino , Projetos Piloto , Prisões/normas , Adulto Jovem
3.
Work ; 62(4): 525-541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31104039

RESUMO

BACKGROUND: Violence and threats of violence against personnel at psychiatric wards as well as in the prison service is a major work environment problem. To date results from interventions to prevent violence and threats in these sectors have been inconclusive or of small effect. One of the reasons may be that violence and threats of violence occur as a consequence of a complex interaction between employee-level and management-level factors. OBJECTIVE: To design a tailored and theory-based intervention program directed at violence prevention in psychiatric wards and prisons that integrates the employee-level and management-level, and development of an evaluation design building on the Context, Process, and Outcome Evaluation Model. METHODS: The study follows a stepped-wedged design with 16 work units entering the intervention in four groups with differing start dates from September 2017 to January 2019. The context and process evaluation includes: calculating the implementation degree; mapping of contextual factors; interviews with unit-leaders and employees before and after the intervention. The outcome evaluation includes performing multi-level statistical analysis on data from a three-monthly questionnaire to employees at the participating workplaces. RESULTS: The first results will be available in 2020. CONCLUSIONS: The comprehensive evaluation of the intervention will give insight into the processes and effects of the intervention.


Assuntos
Hospitais Psiquiátricos/normas , Prisões/normas , Violência no Trabalho/prevenção & controle , Grupos Focais/métodos , Hospitais Psiquiátricos/tendências , Humanos , Entrevistas como Assunto/métodos , Prisões/tendências , Avaliação de Programas e Projetos de Saúde/métodos , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normas
4.
BMC Int Health Hum Rights ; 19(1): 17, 2019 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118008

RESUMO

BACKGROUND: Treatment and special protection of the rights of incarcerated young people in prisons are mandated under the Sustainable Development Goals (SDG), as well as under United Nations (UN) human rights instruments. METHODS: A scoping review mapped what is currently known about prison conditions and health situation of detained and incarcerated young people in sub- Saharan African (SSA) prisons. A systematic search collected and reviewed all available and relevant published and grey literature. Following application of exclusion measures, 54 records remained, which represented 37 of the 49 SSA countries. These records were charted and thematically analysed. RESULTS: The ages of children and adolescents held in SSA prisons ranged from 12 to 18 years. Three main themes were generated during the charting exercise; the prison environment for young people; availability and accessibility of basic necessities and navigating the prison system for health care and outside continuum of care. CONCLUSIONS: The review highlights the grave and continuing deplorable situation of young people held in SSA prisons. The violation of international human rights norms is observed in the systemic abuse and detention of young people with adults. Basic needs are not met in relation to sanitation, ventilation, safe spaces, protection from physical and sexual violence, clothing, food and access to HIV and medical care.


Assuntos
Acesso aos Serviços de Saúde/normas , Direitos Humanos/normas , Prisioneiros/psicologia , Prisões/normas , Adolescente , África ao Sul do Saara , Criança , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Direitos Humanos/legislação & jurisprudência , Humanos , Saneamento/normas
5.
Psychopathology ; 52(1): 2-9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30654380

RESUMO

BACKGROUND: High rates of mental disorders have been reported for prison populations. Understanding patterns of comorbidity may be essential for the development of adequate treatment interventions. The present study aimed to assess the underlying structure of comorbidity between mental health and substance use disorders in prison populations. METHODS: Current mental disorders were assessed using the Mini-International Neuropsychiatric Interview in a cross-sectional observational study of 427 individuals consecutively committed to prison facilities in Santiago, Chile. Five alternative structural models were tested using confirmatory factor analysis (CFA). Latent class analysis of comorbid mental health and substance use disorders was carried out. RESULTS: CFA indicated the best fit for a bifactor model with a general psychopathology P factor and specific internalizing and externalizing factors. Borderline personality disorder loaded highest on the P factor (0.85). The latent comorbidity structure showed a four-class solution representing one class without relevant comorbidities (48% prevalence) and three classes representing the following comorbidities: (1) externalizing disorders including substance use and antisocial personality disorder (31%), (2) internalizing disorders including anxiety disorders (10%), and (3) all types of disorders co-occurring (11%). Major depression and borderline personality disorder were present across all three latent classes of comorbidity. CONCLUSIONS: Prison mental health services need to serve a highly comorbid population. Specific approaches may be useful for an externalizing and an internalizing spectrum of disorders. An important group of individuals with all types of mental disorders co-occurring may need new approaches in treatment development.


Assuntos
Comorbidade/tendências , Saúde Mental/normas , Prisões/normas , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência
6.
J Ment Health ; 28(2): 189-197, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29706102

RESUMO

BACKGROUND: Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. AIMS: This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. METHOD: We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. RESULTS: We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. CONCLUSIONS: Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Prisões/normas , Cuidado Transicional/estatística & dados numéricos , Humanos , Avaliação de Programas e Projetos de Saúde
7.
Nurs Ethics ; 26(5): 1424-1441, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29458312

RESUMO

BACKGROUND: The United Kingdom has the highest incarceration rate in Western Europe. It is known that women in prison are a vulnerable female population who are at risk of mental ill-health due to disadvantaged and chaotic life experiences. Accurate numbers of pregnant women held in UK prisons are not recorded, yet it is estimated that 6%-7% of the female prison population are at varying stages of pregnancy and around 100 babies are born to incarcerated women each year. There are limited published papers that document the departure of the researcher following closure of fieldwork with women in prison. This article identifies the dilemmas and challenges associated with the closure of prison fieldwork through the interwoven reflections of the researcher. Departure scenarios are presented which illuminate moments of closure talk with five women, supported by participant reflections regarding abandonment and loss, making pledges for the future, self-affirmation, incidental add-ons at the end of an interview and red flags, alerting the researcher to potential participant harm through ill health or self-injury. OBJECTIVES: The primary intention of the study was to observe the pregnant woman's experience with the English prison system through interviews with pregnant women and field observations of the environment. RESEARCH DESIGN: Ethnographic design enabled the researcher, a practising midwife, to engage with the prisoners' pregnancy experiences in three English prisons, which took place over 10 months during 2015-2016. Data collection involved semi-structured, audio-recorded interviews with 28 female prisoners in England who were pregnant or had recently given birth while imprisoned, 10 members of staff and a period of non-participant observation. Follow-up interviews with 5 women were undertaken as their pregnancies progressed. Computerised qualitative data analysis software was used to generate and analyse pregnancy-related themes. ETHICAL CONSIDERATIONS: Favourable ethical opinion was granted by National Offender Management Services through the Health Research Authority Integrated Research Application System and permission to proceed was granted by the University of Hertfordshire, UK. FINDINGS: Thematic analysis enabled the identification of themes associated with the experience of prison pregnancy illuminating how prison life continues with little consideration for their unique physical needs, coping tactics adopted and the way women negotiate entitlements. On researcher departure from the field, the complex feelings of loss and sadness were experienced by both participants and researcher. DISCUSSION: To leave the participant with a sense of abandonment following closure of fieldwork, due to the very nature of the closed environment, risks re-enactment of previous emotional pain of separation. Although not an ethical requirement, the researcher sought out psychotherapeutic supervision during the fieldwork phase with 'Janet', a forensic psychotherapist, which helped to highlight the need for careful closure of research/participant relationships with a vulnerable population. This article brings to the consciousness of prison researchers the need to minimise potential harm by carefully negotiating how to exit the field. Reflections of the researcher are interlinked with utterances from some participants to illustrate the types of departure behaviours. CONCLUSION: Closure of fieldwork and subsequent researcher departure involving pregnant women in prison requires careful handling to uphold the ethical research principle 'do no harm'.


Assuntos
Prisioneiros/psicologia , Pesquisadores/psicologia , Relações Pesquisador-Sujeito , Adulto , Antropologia Cultural/métodos , Inglaterra , Feminino , Humanos , Entrevistas como Assunto/métodos , Prisões/normas , Pesquisa Qualitativa , Sujeitos da Pesquisa/psicologia
8.
Encephale ; 45(2): 139-146, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30126611

RESUMO

OBJECTIVES: The UHSA (UHSA) are French psychiatric units for inmates which admit detainees suffering from a psychiatric disorder requiring full-time hospital care. Non-psychiatric pathologies are overrepresented in patients with psychiatric disorders but also in detainees. As a result, patients hospitalized in UHSA are largely exposed to non-psychiatric conditions, and exploring the organization of general medical care for these patients appears very relevant. The aim of this study is to review the general medical care in all French UHSA. METHODS: A descriptive study was carried out through a survey of the nine facilities. RESULTS: All UHSA benefit from the intervention of a general practitioner. The physical clinical examination, the biological assessment and the electrocardiogram are systematically performed at the patient's admission in 7, 5 and 9 establishments, respectively. However, the offer of general medical care in UHSA seems disparate and sometimes insufficient. Specialized consultations are regularly requested during hospitalizations, but no establishment benefits from a telemedicine system or specialized consultations on site. The extraction of the patient to the general hospital is therefore systematic when such a consultation is needed. But the number of penitentiary escorts per day is limited. In 6 UHSA, medical extractions are thus regularly canceled by the penitentiary administration, sometimes without a medical opinion. Finally, the patient's regular physician is only contacted in 3 UHSA during hospitalizations. CONCLUSION: Based on these results, ways of improving the organization of general medical care in UHSA are proposed through four main axes: the structure and general organization; the general medical care; the link with the healthcare partners and the articulation with the penitentiary administration.


Assuntos
Medicina Geral , Hospitais Especializados , Transtornos Mentais/terapia , Prisioneiros , Unidade Hospitalar de Psiquiatria , Internação Compulsória de Doente Mental/legislação & jurisprudência , Internação Compulsória de Doente Mental/normas , Internação Compulsória de Doente Mental/estatística & dados numéricos , Psiquiatria Legal/métodos , Psiquiatria Legal/organização & administração , Psiquiatria Legal/normas , Psiquiatria Legal/estatística & dados numéricos , França/epidemiologia , Medicina Geral/organização & administração , Medicina Geral/normas , Medicina Geral/estatística & dados numéricos , Clínicos Gerais/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Unidades Hospitalares/organização & administração , Unidades Hospitalares/normas , Unidades Hospitalares/estatística & dados numéricos , Hospitais Especializados/métodos , Hospitais Especializados/organização & administração , Hospitais Especializados/normas , Hospitais Especializados/estatística & dados numéricos , Humanos , Medicina Interna/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Prisioneiros/psicologia , Prisioneiros/estatística & dados numéricos , Prisões/organização & administração , Prisões/normas , Prisões/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/organização & administração , Unidade Hospitalar de Psiquiatria/normas , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Psiquiatria/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
9.
Int J Prison Health ; 14(3): 163-174, 2018 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-30274557

RESUMO

Purpose The purpose of this paper is to develop and evaluate the Standards of Healthcare Facility for Thai Female Inmates (SHF-TFI) through healthcare service improvement. Design/methodology/approach This research and quality improvement project was comprised of three phases. Surveying healthcare facilities and in-depth interviews with female inmates as well as prison nurses were employed in Phase I. Expert reviews and public hearing meetings were used for developing the SHF-TFI in Phase II. Satisfaction questionnaires, focus group interviews of the female inmates, and in-depth interviews with nurses and prison wardens were utilized to evaluate feasibility and effectiveness of SHF-TFI implementation in Phase III. Findings The SHF-TFI was elaborated in order to be more specific to the context of the correctional institutes and correspond with healthcare as to the needs of female inmates. It was divided into three main aspects: administrative standards, health service standards and outcome standards. After implementation, nurses reflected on the feasibility and benefits of the SHF-TFI on the organizations, inmates and nurses. The female inmates perceived remarkable improvement in the healthcare services including physical activity promotion and screening programs for non-communicable diseases, the physical environment and sufficiency of medical equipment. Moreover, the pregnant inmates and incarcerated mothers with children shared their views on better antenatal and child developmental care, as well as availability of baby supplies. Originality/value The findings support the feasibility and effectiveness of the SHF-TFI for quality care improvement and applicability of the Bangkok Rules in women's correctional institutes.


Assuntos
Assistência à Saúde/organização & administração , Prisões/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Dieta , Meio Ambiente , Exercício , Feminino , Promoção da Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Humanos , Entrevistas como Assunto , Programas de Rastreamento/organização & administração , Satisfação do Paciente , Gestantes , Prisões/normas , Melhoria de Qualidade/organização & administração , Qualidade da Assistência à Saúde/normas , Encaminhamento e Consulta/organização & administração , Tailândia
10.
Rev Bras Enferm ; 71(suppl 3): 1373-1380, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29972537

RESUMO

OBJECTIVE: To understand the meaning of being institutionalized and in conflict with the law for the institutionalized adolescent. METHOD: A qualitative, phenomenological-comprehensive study carried out in a Socio-educational Service Foundation in the northern region of Brazil, with 05 institutionalized adolescents. The analysis was carried out under the understanding of the content suggested by Heidgger, thus allowing the construction of analytical categories for a hermeneutical interpretation. RESULTS: Conflicting with the law means something negative and bad for the institutionalized adolescents, in which they understand that although there is deprivation of liberty, the period of hospitalization is an important moment for the reflection on the need to start over. CONCLUSION: The meaning of conflicting with the law goes far beyond a simple word, act or behaviour, it is something that only those who experience the phenomenon are able to unveil, arouse deep feelings and provide reflection to the adolescent about the damages caused by the infraction.


Assuntos
Comportamento do Adolescente/psicologia , Institucionalização/normas , Prisões/normas , Adolescente , Brasil , Feminino , Humanos , Masculino , Pesquisa Qualitativa
11.
J Correct Health Care ; 24(3): 253-263, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29938550

RESUMO

It is estimated that one third to one half of the 2.3 million individuals inside U.S. jails and prisons have a mental illness in contrast to 18.3% of the general population. The implications of this on training mental health professionals to provide efficacious treatment inside correctional facilities, as well as planning for the rehabilitation and reintegration of incarcerated individuals, are significant and numerous. This article will present a brief history and overview of mental health services in the U.S. correctional system, as well as a discussion of the barriers to and potential facilitators of providing effective care in the future.


Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Prisões/organização & administração , Humanos , Saúde Mental , Serviços de Saúde Mental/normas , Prisioneiros , Prisões/normas , Estados Unidos
15.
Rev Bras Enferm ; 71(suppl 1): 538-545, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29562009

RESUMO

OBJECTIVE: To estimate the prevalence of depression and to identify the main risk factors associated with depression in wives of convicted men. METHOD: Descriptive, cross - sectional, quantitative approach. The data were collected with 349 female partners of convicted patients in three penitentiaries in the state of Paraná, with a semistructured research, between January and June of 2016, being compiled in a database and analyzed using SPSS® 20.0 software. RESULTS: It was possible to identify vulnerability to depression among wives of convicted men, most were young and 42.2% have or already had depression. It was verified that the variables to depression were ages equal to or above 30 years (50.3%, p <0.001), smoking (61.1%, p <0.013) and alcoholism (16.1%, p <0.001). CONCLUSION: It is the responsibility of the nurse with the multidisciplinary health team to invest in health promotion and prevention actions against these risk factors that were associated with depression in this population.


Assuntos
Depressão/epidemiologia , Prevalência , Prisões/normas , Cônjuges/psicologia , Adulto , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Prisioneiros/psicologia , Psicometria/instrumentação , Psicometria/métodos , Fatores de Risco , Comportamento Sexual/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
16.
Disabil Rehabil ; 40(10): 1119-1126, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28637141

RESUMO

PURPOSE: The prevalence of traumatic brain injury (TBI) among offender populations is significantly higher than among the general population. Despite this, no study has yet assessed the knowledge of members of the probation service surrounding TBI. METHOD: Knowledge was assessed among members of the Probation Board for Northern Ireland (PBNI) using a cross-sectional online version of the Common Misconceptions about TBI (CM-TBI) questionnaire. Mean total misconception scores, along with scores on four subdomains (recovery, sequelae, insight, and hidden injury) were calculated. Analysis of variance was used to explore differences in misconceptions based on the collected demographic information. RESULTS: The overall mean percentage of misconceptions for the group was 22.37%. The subdomain with the highest rate of misconceptions (38.21%) was insight into injury which covered misconceptions around offenders' self-awareness of injuries. Those who knew someone with a brain injury scored significantly higher in the CM-TBI total score, F(1,63) = 6.639, p = 0.012, the recovery subdomain, F(1,63) = 10.080, p = 0.002, and the insight subdomain, F(1,63) = 5.834, p = 0.019. Additionally, significant training deficits around TBI were observed among the probation service. CONCLUSIONS: This study is the first of its kind to examine the level of understanding around TBI within probation services. The findings reflect potential barriers to identification and rehabilitation of TBI for offenders coming into contact with the criminal justice system. A lack of identification coupled with misconceptions about TBI could lead to inaccurate court reporting with a subsequent impact on sentencing. Implications for Rehabilitation Despite being one of the first points of contact for offenders entering the criminal justice system, members of the probation service reported having no formal training on traumatic brain injury (TBI). The subdomain with the highest rate of misconceptions (insight into injury) revealed an over-reliance on survivors of brain injury to identify, understand, and communicate the extent and severity of their injuries. Probation service personnel require training on TBI to improve awareness of the potential outcomes of the condition, ensuring injuries are identified and referred to the appropriate care pathways.


Assuntos
Lesões Encefálicas Traumáticas , Criminosos , Polícia/educação , Adulto , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/reabilitação , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Irlanda do Norte , Prevalência , Prisões/normas , Melhoria de Qualidade , Inquéritos e Questionários
17.
Work ; 58(3): 319-331, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29154302

RESUMO

BACKGROUND: Within a Job Demands-Resources Model framework, formal mentoring can be conceived as a job resource expressing the organization's support for new members, which may prevent their being at risk for burnout. OBJECTIVE: This research aims at understanding the protective role of formal mentoring on burnout, through the effect of increasing learning personal resources. Specifically, we hypothesized that formal mentoring enhances newcomers' learning about job and social domains related to the new work context, thus leading to lower burnout. METHODS: In order to test the hypotheses, a multiple regression analysis using the bootstrapping method was used. RESULTS: Based on a questionnaire administered to 117 correctional officer newcomers who had a formal mentor assigned, our results confirm that formal mentoring exerts a positive influence on newcomers' adjustment, and that this in turn exerts a protective influence against burnout onset by reducing cynicism and interpersonal stress and also enhancing the sense of personal accomplishment. CONCLUSIONS: Confirming previous literature's suggestions, supportive mentoring and effective socialization seem to represent job and personal resources that are protective against burnout. This study provides empirical support for this relation in the prison context.


Assuntos
Esgotamento Profissional/prevenção & controle , Tutoria/métodos , Polícia/psicologia , Prisões/normas , Adulto , Esgotamento Profissional/psicologia , Feminino , Humanos , Satisfação no Emprego , Masculino , Cultura Organizacional , Análise de Regressão , Apoio Social , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
18.
Int J Prison Health ; 13(3-4): 192-199, 2017 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-28914118

RESUMO

Purpose Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time. Design/methodology/approach A commentary on the value of standardizing screening programs across facilities by mandating all facilities (universal) to implement opt-out testing policies for all prisoners upon entry to the correctional facilities. Findings Current variability in facility-level testing programs results in inconsistent testing levels across correctional facilities, and therefore makes estimating the actual number of HCV-infected adults in the USA difficult. The authors argue that universal opt-out testing policies ensure earlier diagnosis of HCV among a population most affected by the disease and is more cost-effective than selective testing policies. Originality/value The commentary explores the current limitations of selective testing policies in correctional systems and provides recommendations and implications for public health and correctional organizations.


Assuntos
Hepatite C/diagnóstico , Programas de Rastreamento/organização & administração , Prisões/organização & administração , California , Análise Custo-Benefício , Hepatite C/tratamento farmacológico , Humanos , Programas de Rastreamento/economia , Programas de Rastreamento/normas , Prisões/economia , Prisões/normas , Saúde Pública , Fatores de Risco , Estados Unidos
19.
Int J Prison Health ; 13(3-4): 200-206, 2017 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-28914121

RESUMO

Purpose The purpose of this paper is to describe standards for evidence-based reproductive healthcare for incarcerated women. Design/methodology/approach The literature on reproductive healthcare in the US criminal justice system and recommendations from professional organizations were reviewed and critical areas of concern were identified. Within these areas, studies and expert opinion were synthesized and policy recommendations were formulated through an iterative process of group discussion and document revision. This brief specifically addresses women's incarceration in the USA, but the recommendations are grounded in a human rights framework with global relevance. Findings Women who are incarcerated have health needs that are distinct from those of men, and there is a clear need for gender-responsive reproductive healthcare within the criminal justice system. This brief identifies five core domains of reproductive healthcare: routine screening, menstruation-related concerns, prenatal and postpartum care, contraception and abortion, and sexually transmitted infections. The recommendations emphasize the continuity between the criminal justice system and the community, as well as the dignity and self-determination of incarcerated women. Originality/value This brief provides a unique synthesis of the available evidence with concrete recommendations for improving the reproductive healthcare for incarcerated women.


Assuntos
Prisões/organização & administração , Serviços de Saúde Reprodutiva/organização & administração , Saúde da Mulher , Aborto Induzido , Anticoncepção , Prática Clínica Baseada em Evidências , Feminino , Política de Saúde , Direitos Humanos , Humanos , Menstruação , Educação de Pacientes como Assunto/organização & administração , Cuidado Pós-Natal/organização & administração , Cuidado Pré-Natal/organização & administração , Prevenção Primária/organização & administração , Prisões/normas , Serviços de Saúde Reprodutiva/normas , Doenças Sexualmente Transmissíveis/tratamento farmacológico
20.
Int J Prison Health ; 13(3-4): 139-167, 2017 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-28914122

RESUMO

Purpose The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry. Design/methodology/approach A rapid the evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches. Findings The review found that English prison healthcare has undergone "transformation" during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources. Research limitations/implications Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered small number of countries, which may limit the transferability of findings. The lack of qualitative data necessitated the use of quantitative data gathered from key informants. However, this enabled a good understanding of current practice. Practical implications The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the "whole prison approach" recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community. Originality/value This is unique research which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes.


Assuntos
Prisões/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Humanos , Entrevistas como Assunto , Políticas , Prisões/normas , Melhoria de Qualidade/organização & administração , Qualidade da Assistência à Saúde/normas , Reino Unido
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