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1.
BMC Infect Dis ; 20(1): 806, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33129259

RESUMO

BACKGROUND: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16. METHODS: The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11,988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes. RESULTS: The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52 and 2.46%, respectively. The prevalence of HCV was associated with age ≥ 30 years, being single, illiteracy and low level of education, prison term> 5 years, history of piercing, and extramarital sex in lifetime (P < 0.05). CONCLUSIONS: The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Prisioneiros , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Estudos Transversais , Feminino , Hepacivirus , Hepatite B/complicações , Hepatite B/prevenção & controle , Vírus da Hepatite B , Hepatite C/complicações , Hepatite C/prevenção & controle , Humanos , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Prevalência , Prisioneiros/estatística & dados numéricos , Prisões , Fatores de Risco , Vacinas contra Hepatite Viral/administração & dosagem
2.
Soins Psychiatr ; 41(329): 37-44, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33129405

RESUMO

To try to understand acting out, it depends of conciliation between the reality of the act and the psychic life. For that, it is necessary to listen the word of the criminal authors. What transgression represents for them? Based on clinical experience in a correctional center, this article takes a closer look about prisoner, incarcerated after having committed criminal acts. This clinical material could help to raise a new perspective around modern psychopathology. What is the act's difference between neurosis, perversion, borderline and psychosis? Our research will try to differentiate the psychic issues.


Assuntos
Encenação , Transtornos Psicóticos , Humanos , Prisioneiros/psicologia , Psicopatologia
3.
Rev Saude Publica ; 54: 105, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33146297

RESUMO

OBJECTIVE: To evaluate the prevalence of HIV, syphilis and hepatitis B infection among women deprived of liberty in the state of Roraima, Brazil, and its correlation with perceptions, knowledge and behavioral factors. METHOD: This is a cross-sectional study, with simple systematic sampling, conducted at the Public Female Prison in Boa Vista, State of Roraima, in 2017. A total of 168 inmates (93.8% of the population) were evaluated by in-person interviews and rapid tests. RESULTS: The prevalence of sexually transmitted infections (STI) was 20.2%, being 4.7% HIV, 15.5% syphilis, and 0.0% hepatitis B. Multivariate analysis confirmed as risk factors for acquiring an STI: being over 30 years of age [adjusted odds ratio (OR): 2.57; 95%CI 1.03-6.40); low schooling (adjusted OR: 2.77; 95%CI 1.08-5.05); little knowledge about condom use (adjusted OR: 2.37; 95%CI 1.01-7.31); and believing that there is no risk of contracting syphilis (adjusted OR: 2.36; 95%CI 1.08-6.50). CONCLUSION: The population deprived of liberty is a group of highly vulnerable to STI. The high prevalence of these infections can be explained by knowledge deficits on the subject, distorted perceptions and conditions peculiar to imprisonment, which result in risky behavior. We emphasize the need to implement educational programs for preventing, diagnosing and treating STI for this population.


Assuntos
Infecções por HIV/epidemiologia , Prisioneiros/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Sífilis/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos
4.
J Subst Abuse Treat ; 119: 108147, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33138930

RESUMO

Many states have responded to the spread of COVID-19 by implementing policies which have led to a dramatic reduction in jail populations. We consider the benefits associated with providing the population of individuals who would, but for these policies, be incarcerated with substance use disorder (SUD) treatment. We discuss problems that may prevent this population from receiving SUD treatment as well as policies which may mitigate these problems.


Assuntos
Infecções por Coronavirus , Acesso aos Serviços de Saúde , Pandemias , Pneumonia Viral , Prisões/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Humanos , Políticas , Prisioneiros , Governo Estadual
5.
Rev Lat Am Enfermagem ; 28: e3392, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-33174996

RESUMO

OBJECTIVE: to analyze in the scientific literature the educational technologies on sexually transmitted infections used in health education for incarcerated women. METHOD: an integrative review carried out by searching for articles in the following databases: Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Latin American Literature in Health Sciences, Cochrane, and the ScienceDirect electronic library. There were no language and time restrictions. A search strategy was developed in PubMed and later adapted to the other databases. RESULTS: a total of 823 studies were initially identified and, after applying inclusion and exclusion criteria, eight articles were selected. Most of them were developed in the United States with a predominance of randomized clinical trials. The technologies identified were of the printed materials type, isolated or associated to simulators of genital organs, videos, and games. CONCLUSION: the technologies on sexually transmitted infections used in health education for incarcerated women may contribute to adherence to the prevention of this serious public health problem in the context of deprivation of liberty.


Assuntos
Prisioneiros , Doenças Sexualmente Transmissíveis , Tecnologia Educacional , Feminino , Educação em Saúde , Humanos , Idioma , Doenças Sexualmente Transmissíveis/prevenção & controle
6.
Artigo em Inglês | MEDLINE | ID: mdl-33142740

RESUMO

(1) Background: The emergency linked to the spread of COVID-19 in Italy has led to inevitable consequences on the penitentiary system. The risks of this emergency in prisons is mainly related to the problem of persistent overcrowding that makes social distancing difficult and the isolation of any contagion hard to arrange. The Department of Protection for Adults and Minors of the ASL Salerno Criminal Area has taken steps in order to perform screening operations and minimize the risks for prisoners and operators. (2) Methods: We conducted a two-phase observational study. In the first phase, we offered and then executed serum COVID-19 screening to all the convicted inmates. For those who had a doubtful or positive result, a swab was executed in the shortest time possible. In the second phase, a pharyngeal swab was offered and executed to all the police officers, the penitentiary administrative staff and the medical personnel working in the prison. (3) Results: In the first phase, we executed 485 COVID-19 blood tests on prisoners, 3 (0.61%) of which were positive. The three positive inmates underwent nasopharyngeal swabbing, which ultimately were negative. After that, we executed 276 nasopharyngeal swabs on the prison personnel, penitentiary administrative staff and medical personnel-all were negative. (4) Conclusion: All tests (blood tests and swabs) that were carried out on the prisoners and on the staff were negative for COVID-19. We believe that all prisons in Italy and in the world should take action to ensure preventive and control measures in order to safeguard the health of the prison population and of all the people who work there.


Assuntos
Infecções por Coronavirus/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Nasofaringe/virologia , Pandemias , Pneumonia Viral/diagnóstico , Prisioneiros , Gestão de Riscos/métodos , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Itália , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Prisões
8.
J Int AIDS Soc ; 23(10): e25632, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33119183

RESUMO

INTRODUCTION: Key populations at elevated risk to contract or transmit HIV may also be at higher risk of COVID-19 complications and adverse outcomes associated with public health prevention measures. However, the conditions faced by specific populations vary according to social, structural and environmental factors, including stigma and discrimination, criminalization, social and economic safety nets and the local epidemiology of HIV and COVID-19, which determine risk of exposure and vulnerability to adverse health outcomes, as well as the ability to comply with measures such as physical distancing. This commentary identifies common vulnerabilities and cross-cutting themes in terms of the impacts of COVID-19 on key populations before addressing issues and concerns specific to particular populations. DISCUSSION: Cross-cutting themes include direct impacts such as disrupted access to essential medicines, commodities and services such as anti-retroviral treatment, HIV pre-exposure prophylaxis, opioid agonist treatment, viral load monitoring, HIV and sexually transmitted infections testing, condoms and syringes. Indirect impacts include significant collateral damage arising from prevention measures which restrict human rights, increase or impose criminal penalties, and expand police powers to target vulnerable and criminalized populations. Significant heterogeneity in the COVID-19 pandemic, the underlying HIV epidemic and the ability of key populations to protect themselves means that people who inject drugs and sex workers face particular challenges, including indirect impacts as a result of police targeting, loss of income and sometimes both. Geographical variations mean that transgender people and men who have sex with men in regions like Africa and the middle east remain criminalized, as well as stigmatized and discriminated against, increasing their vulnerability to adverse outcomes in relation to COVID-19. CONCLUSIONS: Disruptions to both licit and illicit supply chains, loss of income and livelihoods and changes in behaviour as a result of lockdowns and physical distancing have the potential to exacerbate the impacts of the COVID-19 pandemic on key populations. While these impacts will vary significantly, human-rights approaches to COVID-19 emergency laws and public health prevention measures that are population-specific and sensitive, will be key to reducing adverse health outcomes and ensuring that no one is left behind.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por HIV/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Minorias Sexuais e de Gênero , Populações Vulneráveis , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Feminino , Infecções por HIV/complicações , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Renda , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Profilaxia Pré-Exposição , Prisioneiros , Saúde Pública , Fatores de Risco , Profissionais do Sexo , Doenças Sexualmente Transmissíveis/prevenção & controle , Estigma Social , Carga Viral
9.
J Addict Med ; 14(6): e290-e292, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33021554

RESUMO

: Correctional settings can be vectors of infectious diseases due to overcrowding, unsanitary living conditions, and very little capacity to engage in social distancing. In the US, COVID-19 outbreaks were first identified in the New York City and Cook County jails, with infection rates far exceeding community rates. Each day new cases are being identified across the country in correctional facilities. People who are incarcerated are at increased risk of experiencing severe COVID-19 symptoms because of the increased prevalence of other underlying illnesses. Jails and prisons have begun initiating facility-level policies to help stop the spread of COVID-19. As a result, correctional agencies have reoriented staff to stem transmission in their facilities. This could translate into limited resources for other programming such as medications for opioid use disorder (MOUD) programs. In this commentary, we highlight risk mitigation practices for delivering MOUD in correctional settings during COVID-19 and note how to ensure quality of care while still preparing for the possibility of future pandemics.


Assuntos
Infecções por Coronavirus/epidemiologia , Tratamento de Substituição de Opiáceos , Pneumonia Viral/epidemiologia , Prisões , Infecções por Coronavirus/prevenção & controle , Humanos , Controle de Infecções/métodos , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prisioneiros , Prisões/organização & administração , Telemedicina
10.
PLoS One ; 15(10): e0238510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035215

RESUMO

We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae.


Assuntos
Avaliação do Impacto na Saúde , Prisioneiros/psicologia , Isolamento Social/psicologia , Adulto , Doença Crônica , Disparidades nos Níveis de Saúde , Humanos , Masculino , Grupos Minoritários , Saúde das Minorias , Dor Musculoesquelética/etiologia , Prisões , Autorrelato , Inquéritos e Questionários , Washington
13.
PLoS One ; 15(9): e0239046, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941496

RESUMO

The increasing recidivism rate of sex offenders indicates potential problems in existing recidivism programs. The present study was conducted to determine whether the polygraph examination is a useful technique to obtain a sex offender's concealed past sexual history. We collected fifty-two sex offenders' data and analyzed it. Among the 52 participants, the court ordered 26 sex offenders to take the psychiatric evaluation and the polygraph test. The other half were prisoners at the hospital who were currently undergoing treatment. The participants in the polygraph group disclosed more deviant sexual behaviors and paraphilia interests/behaviors than the comparison group. Thus, the polygraph examination is a powerful tool that can encourage sex offenders to disclose hidden information to help create suitable psychological therapy programs for preventing recidivism in the future.


Assuntos
Detecção de Mentiras/psicologia , Reincidência/prevenção & controle , Delitos Sexuais/psicologia , Adulto , Criminosos/psicologia , Humanos , Masculino , Transtornos Parafílicos/diagnóstico , Transtornos Parafílicos/psicologia , Prisioneiros/psicologia , Comportamento Sexual/psicologia , Revelação da Verdade/ética
14.
Cochrane Database Syst Rev ; 9: CD007668, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32880104

RESUMO

BACKGROUND: Antisocial personality disorder (AsPD) is associated with poor mental health, criminality, substance use and relationship difficulties. This review updates Gibbon 2010 (previous version of the review). OBJECTIVES: To evaluate the potential benefits and adverse effects of psychological interventions for adults with AsPD. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also searched reference lists and contacted study authors to identify studies. SELECTION CRITERIA: Randomised controlled trials of adults, where participants with an AsPD or dissocial personality disorder diagnosis comprised at least 75% of the sample randomly allocated to receive a psychological intervention, treatment-as-usual (TAU), waiting list or no treatment. The primary outcomes were aggression, reconviction, global state/functioning, social functioning and adverse events. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: This review includes 19 studies (eight new to this update), comparing a psychological intervention against TAU (also called 'standard Maintenance'(SM) in some studies). Eight of the 18 psychological interventions reported data on our primary outcomes. Four studies focussed exclusively on participants with AsPD, and 15 on subgroups of participants with AsPD. Data were available from only 10 studies involving 605 participants. Eight studies were conducted in the UK and North America, and one each in Iran, Denmark and the Netherlands. Study duration ranged from 4 to 156 weeks (median = 26 weeks). Most participants (75%) were male; the mean age was 35.5 years. Eleven studies (58%) were funded by research councils. Risk of bias was high for 13% of criteria, unclear for 54% and low for 33%. Cognitive behaviour therapy (CBT) + TAU versus TAU One study (52 participants) found no evidence of a difference between CBT + TAU and TAU for physical aggression (odds ratio (OR) 0.92, 95% CI 0.28 to 3.07; low-certainty evidence) for outpatients at 12 months post-intervention. One study (39 participants) found no evidence of a difference between CBT + TAU and TAU for social functioning (mean difference (MD) -1.60 points, 95% CI -5.21 to 2.01; very low-certainty evidence), measured by the Social Functioning Questionnaire (SFQ; range = 0-24), for outpatients at 12 months post-intervention. Impulsive lifestyle counselling (ILC) + TAU versus TAU One study (118 participants) found no evidence of a difference between ILC + TAU and TAU for trait aggression (assessed with Buss-Perry Aggression Questionnaire-Short Form) for outpatients at nine months (MD 0.07, CI -0.35 to 0.49; very low-certainty evidence). One study (142 participants) found no evidence of a difference between ILC + TAU and TAU alone for the adverse event of death (OR 0.40, 95% CI 0.04 to 4.54; very low-certainty evidence) or incarceration (OR 0.70, 95% CI 0.27 to 1.86; very low-certainty evidence) for outpatients between three and nine months follow-up. Contingency management (CM) + SM versus SM One study (83 participants) found evidence that, compared to SM alone, CM + SM may improve social functioning measured by family/social scores on the Addiction Severity Index (ASI; range = 0 (no problems) to 1 (severe problems); MD -0.08, 95% CI -0.14 to -0.02; low-certainty evidence) for outpatients at six months. 'Driving whilst intoxicated' programme (DWI) + incarceration versus incarceration One study (52 participants) found no evidence of a difference between DWI + incarceration and incarceration alone on reconviction rates (hazard ratio 0.56, CI -0.19 to 1.31; very low-certainty evidence) for prisoner participants at 24 months. Schema therapy (ST) versus TAU One study (30 participants in a secure psychiatric hospital, 87% had AsPD diagnosis) found no evidence of a difference between ST and TAU for the number of participants who were reconvicted (OR 2.81, 95% CI 0.11 to 74.56, P = 0.54) at three years. The same study found that ST may be more likely to improve social functioning (assessed by the mean number of days until patients gain unsupervised leave (MD -137.33, 95% CI -271.31 to -3.35) compared to TAU, and no evidence of a difference between the groups for overall adverse events, classified as the number of people experiencing a global negative outcome over a three-year period (OR 0.42, 95% CI 0.08 to 2.19). The certainty of the evidence for all outcomes was very low. Social problem-solving (SPS) + psychoeducation (PE) versus TAU One study (17 participants) found no evidence of a difference between SPS + PE and TAU for participants' level of social functioning (MD -1.60 points, 95% CI -5.43 to 2.23; very low-certainty evidence) assessed with the SFQ at six months post-intervention. Dialectical behaviour therapy versus TAU One study (skewed data, 14 participants) provided very low-certainty, narrative evidence that DBT may reduce the number of self-harm days for outpatients at two months post-intervention compared to TAU. Psychosocial risk management (PSRM; 'Resettle') versus TAU One study (skewed data, 35 participants) found no evidence of a difference between PSRM and TAU for a number of officially recorded offences at one year after release from prison. It also found no evidence of difference between the PSRM and TAU for the adverse event of death during the study period (OR 0.89, 95% CI 0.05 to 14.83, P = 0.94, 72 participants (90% had AsPD), 1 study, very low-certainty evidence). AUTHORS' CONCLUSIONS: There is very limited evidence available on psychological interventions for adults with AsPD. Few interventions addressed the primary outcomes of this review and, of the eight that did, only three (CM + SM, ST and DBT) showed evidence that the intervention may be more effective than the control condition. No intervention reported compelling evidence of change in antisocial behaviour. Overall, the certainty of the evidence was low or very low, meaning that we have little confidence in the effect estimates reported. The conclusions of this update have not changed from those of the original review, despite the addition of eight new studies. This highlights the ongoing need for further methodologically rigorous studies to yield further data to guide the development and application of psychological interventions for AsPD and may suggest that a new approach is required.


Assuntos
Transtorno da Personalidade Antissocial/terapia , Psicoterapia/métodos , Adulto , Agressão/psicologia , Transtorno da Personalidade Antissocial/mortalidade , Transtornos Relacionados ao Uso de Cocaína/terapia , Terapia Cognitivo-Comportamental/métodos , Dirigir sob a Influência , Feminino , Humanos , Masculino , Prisioneiros/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reincidência/estatística & dados numéricos , Recompensa , Resultado do Tratamento
15.
Artigo em Inglês | MEDLINE | ID: mdl-32872124

RESUMO

This article contributes to the study of inequality in the biological welfare of Chile's adult population during the nitrate era, ca. 1880s-1930s, and in particular focuses on the impact of socioeconomic variables on height, making use of a sample of over 20,000 male inmates of the capital's main jail. It shows that inmates with a university degree were taller than the rest; that those born legitimate were taller in adulthood; that those (Chilean born) whose surnames were Northern European were also taller than the rest, and in particular than those with Mapuche background; and that those able to read and write were also taller than illiterate inmates. Conditional regression analysis, examining both correlates at the mean and correlates across the height distribution, supports these findings. We show that there was more height inequality in the population according to socioeconomic status and human capital than previously thought, while also confirming the importance of socioeconomic influences during childhood on physical growth.


Assuntos
Estatura/etnologia , Prisioneiros , Prisões , Adolescente , Adulto , Criança , Chile , Humanos , Masculino , Classe Social , Fatores Socioeconômicos , Adulto Jovem
16.
Am J Trop Med Hyg ; 103(4): 1466-1472, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32876010

RESUMO

In many low- and middle-income countries, tuberculosis (TB) incidence in prisons is high, exposing incarcerated populations to an elevated risk of TB infection. We conducted a randomized, double-blind, placebo-controlled trial among HIV-negative male inmates of a high TB burden prison to determine whether isoniazid given twice weekly (900 mg) for 12 months prevents TB infection. The primary outcome was QuantiFERON-TB Gold in Plus (QFT) conversion to ≥ 0.35 international units per milliliter (IU/mL) at 6 months; secondary outcomes included alternative QFT thresholds (≥ 0.7, ≥ 2.0, and ≥ 4.0 IU/mL). In total, 467 participants were randomly assigned to intervention (N = 258) or control (N = 209). In an interim analysis of participants who had completed 6 months of follow-up (N = 170), QFT conversion occurred in 20.8% (19/91) and 21.5% (17/79) of participants in intervention and control arms (efficacy: 2.9%, P = 0.91), respectively. The trial was then stopped according to the trial protocol, and the remaining participants prematurely discontinued. In an analysis of secondary outcomes, the intervention arm had significantly lower rates of conversion at a cutoff of ≥ 2.0 IU/mL (efficacy: 82.6%, P < 0.01). In conclusion, 900 mg of isoniazid, administered twice a week, did not effectively prevent QFT conversion at a cutoff point ≥ 0.35 IU/mL in a trial of QFT-negative inmates. Higher QFT cutoffs are associated with sustained conversion and greater protection. Future clinical trials that evaluate protection for latent infection should use the highest cutoff than that recommended by the manufacturer.


Assuntos
Isoniazida , Tuberculose Latente/tratamento farmacológico , Prevenção Primária , Prisioneiros , Tuberculose/prevenção & controle , Adulto , Método Duplo-Cego , Humanos , Incidência , Testes de Liberação de Interferon-gama/métodos , Isoniazida/administração & dosagem , Isoniazida/uso terapêutico , Tuberculose Latente/epidemiologia , Mycobacterium tuberculosis/isolamento & purificação , Prisões/estatística & dados numéricos , Teste Tuberculínico/métodos , Adulto Jovem
17.
Crim Behav Ment Health ; 30(5): 256-267, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32896935

RESUMO

Liaison and Diversion (L&D) has twin objectives: improving mental health outcomes and reducing re-offending. Early diversion from police custody seems promising, but evidence of benefit is required to sustain such programmes. To test the hypothesis that contact with L&D services while in police custody would lead to improved mental health outcomes and a reduction in type and level of offending, we used a pre-post service use design. National Health Service (NHS) records in two counties were searched for evidence that patients had been involved with L&D services while in police custody during the period July 2009-December 2017. We defined January 2009-July 2014 as the pre-intervention period and any time after contact as the post-intervention period. Data from the Police National Computer were gathered for each period for these individuals, to assess their pre-post L&D contact offending histories. NHS Trust data were similarly gathered to assess their pre-post use of mental health legislation. 4,462 individuals were identified who had used L&D services in police custody. There were statistically significant reductions in the amount of offending following contact with the L&D service (whether one or two contacts), regardless of offence type. Statistically significant reductions were also observed in use of the four most commonly used legislative powers for detaining patients in hospital on mental disorder grounds, regardless of offending status (prolific/non-prolific). Our results indicate positive associations between the L&D interventions and change in offending and use of compulsory hospital detention. Whilst our research does not allow a direct causal relationship to be established in either area, the findings go beyond other impact assessments of L&D which have either been with small samples or relied only on qualitative data or expert opinion.


Assuntos
Criminosos/psicologia , Aplicação da Lei , Pessoas Mentalmente Doentes/psicologia , Polícia , Prisioneiros/psicologia , Adulto , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/diagnóstico , Saúde Mental , Serviços de Saúde Mental , Transtornos Psicóticos , Medicina Estatal , Reino Unido
18.
Cien Saude Colet ; 25(9): 3493-3502, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876243

RESUMO

Prisional health is, in its essence, public health. The COVID-19 pandemic poses a great threat to the world and has shown that preventing the disease escalation in prisons integrates the novel corona virus clash in society in general. Up to this moment, the most effective known measure to curb the disease spread is social isolation. Nevertheless, in penal institutions, often overcrowded, social isolation becomes difficult to carry out and, when it happens, it takes the enclosed population to overisolation, with consequences to their mental health. Besides, prisoners suffer with clogged up environment, lack of materials for personal hygiene, poor basic sanitary conditions and difficulties in accessing health services. This paper deals with a narrative review on the pandemic effects in prisons and how government and civil society have organized themselves in order to reduce the disease consequences at those places. The text has been divided into three sections: the first with literature review on the current health theme; the second discusses how different countries have been dealing with the prison situation in the pandemic context, and, the last part focuses on how the Brazilian Penal System has reacted to the new disease.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Prisioneiros/estatística & dados numéricos , Prisões/estatística & dados numéricos , Brasil , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde , Humanos , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Prisioneiros/psicologia , Isolamento Social
19.
PLoS One ; 15(9): e0237439, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931490

RESUMO

Patients who are incarcerated are a vulnerable patient population and may suffer from less access to routine cancer screenings compared to their non-incarcerated counterparts. Therefore, a thorough evaluation of potential differences in cancer diagnosis staging is needed. We sought to examine whether there are differences in cancer stage at initial diagnosis between non-incarcerated and incarcerated patients by pursuing a retrospective chart review from 2010-2017 for all patients who were newly diagnosed with cancer at an urban safety net hospital. Incarceration status was determined by insurance status. Our primary outcome was incarceration status at time of initial cancer diagnosis. Overall, patients who were incarcerated presented at a later cancer stage for all cancer types compared to the non-incarcerated (+.14 T stage, p = .033; +.23 N stage, p < .001). Incarcerated patients were diagnosed at later stages for colorectal (+0.93 T stage, p < .001; +.48 N stage, p < .001), oropharyngeal (+0.37 N stage, p = .003), lung (+0.60 N stage, p = .018), skin (+0.59 N stage, p = 0.014), and screenable cancers (colorectal, prostate, lung) as a whole (+0.23 T stage, p = 0.002; +0.17 N stage, p = 0.008). Incarcerated patients may benefit from more structured screening protocols in order to improve the stage at presentation for certain malignancies.


Assuntos
Detecção Precoce de Câncer , Acesso aos Serviços de Saúde , Cobertura do Seguro , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Prisioneiros , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
20.
J Prim Care Community Health ; 11: 2150132720954687, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865152

RESUMO

BACKGROUND: COVID-19 is a highly infectious disease which usually presents with respiratory symptoms. This virus is disseminated through respiratory droplets, and, therefore, individuals residing in close quarters are at a higher risk for the acquisition of infection. The prison population is at a significantly increased risk for infection. METHODS: Prisoners from the Montford Correctional facility in Lubbock, Texas, hospitalized in the medical intensive care unit at University Medical Center between March 1, 2020 and May 15, 2020 were compared to community-based patients hospitalized in the same medical intensive care unit. Clinical information, laboratory results, radiographic results, management requirements, and outcomes were compared. RESULTS: A total of 15 community-based patients with a mean age of 67.4 ± 15.5 years were compared to 5 prisoners with a mean age of 56.0 ± 9.0 years. All prisoners were men; 10 community-based patients were men. Prisoners presented with fever, dyspnea, and GI symptoms. The mean number of comorbidities in prisoners was 2.4 compared to 1.8 in community-based patients. Prisoners had significantly lower heart rates and respiratory rates at presentation than community-based patients. The mean length of stay in prisoners was 12.6 ± 8.9 days; the mean length of stay in community-based patients was 8.6 ± 6.5. The case fatality rate was 60% in both groups. CONCLUSIONS: Prisoners were younger than community-based patients but required longer lengths of stay and had the same mortality rate. This study provides a basis for comparisons with future studies which could involve new treatment options currently under study.


Assuntos
Infecções por Coronavirus/terapia , Cuidados Críticos/estatística & dados numéricos , Pandemias , Pacientes/estatística & dados numéricos , Pneumonia Viral/terapia , Prisioneiros/estatística & dados numéricos , Centros Médicos Acadêmicos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Texas/epidemiologia , Resultado do Tratamento
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