L’acte et son énigme. Entre l’indicible et l’innommable

Contiguous with social spaces, the prison is invested with a degree of secrecy. However, those who are incarcerated tolerate the space, which imprisons them with difficulty, insofar as this place, which punishes them, does not allow them to approach an act where the significance escapes. The act, which led them to this place, identifies them, more than it interrogates the “acting out of the act”, which is profoundly enigmatic and rarely questioned. The legal procedures fix behaviors by a ruling, which is hardly suitable for clarifying acts, which inhibit the significance. Based on clinical situations, we have attempted to conduct investigations concerning the act, defining the role, which the psychologist, orientated by psychoanalysis, must have in the individual work that he maintains with the prisoners. Far from numbing the significance, the aim is to articulate the statements with the contradictions, which compose them, to let an aborted word appear under appropriate discourse; the one which touches on the unspeakable. Taken literally, the significant point of the act is revealed to be less expressible than it had seemed and allows a glimpse of unsuspected areas.     

当前监狱系统职工脂肪性肝病流行病学分析

目的：了解当前监狱系统职工脂肪性肝病（FLD）流行病学与探讨其专业的防治策略。方法：采用整群抽样的方法,明确对象为广东省某监狱参加年度健康体检并同时完成BP、BU、FBG、TG、TC、LDL-C、HDL-C与UA的职工及其全部体检项目资料,进行FLD流行病学分析。结果：①FLD DR为13.7%;男高于女（P=0.006）,≥45岁者高于〈45岁者（P=0.000）;30～44岁（男高于女,P=0.001）或45～59岁者（性别间无差异）均高于15～29岁者（P=0.037或0.013）,而其他性别间均无差异;②在没有考虑超重和（或）肥胖的成分下,SFLD不多（DR为5.7%）,而CFLD比较常见,尤其是FLD＋血脂异常（性别间与年龄间均无差异）与FLD＋血脂异常＋高尿酸（男高于女,P=0.000;年龄间无差异）,DR、CR分别为4.8%、35.3%与4.6%、33.7%,均高于其他FLD合并多元代谢紊乱（P=0.000）。结论：当前广东省监狱系统职工FLD不容忽视,在制定专业的防治策略时应以中老年男性为主,把30～44岁与45～59岁列为重点人群,对该人群无论男女都应关注;还应干预其合并多元代谢紊乱,特别是FLD＋血脂异常与FLD＋血脂异常＋高尿酸。     

A randomized clinical trial of methadone maintenance for prisoners: Results at 12 months postrelease

This study examined the impact of prison-initiated methadone maintenance at 12 months postrelease. Males with preincarceration heroin dependence (N = 204) were randomly assigned to (a) Counseling Only: counseling in prison, with passive referral to treatment upon release; (b) Counseling + Transfer: counseling in prison with transfer to methadone maintenance treatment upon release; and (c) Counseling + Methadone: counseling and methadone maintenance in prison, continued in the community upon release. The mean number of days in community-based drug abuse treatment were, respectively, Counseling Only, 23.1; Counseling + Transfer, 91.3; and Counseling + Methadone, 166.0 (p < .01); all pairwise comparisons were statistically significant (all ps < .01). Counseling + Methadone participants were also significantly less likely than participants in each of the other two groups to be opioid-positive or cocaine-positive according to urine drug testing. These results support the effectiveness of prison-initiated methadone for males in the United States. Further study is required to confirm the findings for women.     

Bringing to light the health needs of African-American men: the Overtown Men's Health Study

Background

The harsh intersections of racism and sexism in US society have contorted roles for African-American men and damaged their social ties, thereby contributing to excess morbidity and mortality in communities of color. The Overtown Men's Health Study is used here as a case study to examine the health needs of African-American men.

Methods

Men aged 18 years and older who resided in the neighborhood of Overtown within Miami, Florida, USA completed an in-person survey administered at 15 community sites: 3 housing complexes, 3 rooming houses, 3 commercial sites, 2 abandoned buildings, 1 large and 1 small public park, 1 union hall, and 1 community center.

Results

The vast majority of respondents (n = 129) were identified as Black/African-American (95.3%). Just 9.3% of the men surveyed were currently married, yet over half were fathers (59.7%). Nearly two-thirds (62.8%) of the men in Overtown reported drinking alcohol, and almost half (47.3%) reported smoking cigarettes. Only one of three (33.3%) Overtown men reported having a primary care physician or health practitioner, and only one of five (20.2%) had received dental care in the previous 12 months. A remarkable one of four (25.6%) Overtown men reported having been a victim of police violence, and nearly two-thirds (65.9%) reported having been incarcerated.

Conclusions

These findings are a call to action issuing from Overtown to other distressed neighborhoods of color within central cities through the USA. Urgent pursuit of measures for reducing social disparities in health for African-American men is ethically compulsory.     

Modified Therapeutic Community for Homeless Mentally Ill Chemical Abusers: Emerging Subtypes*

This paper is one of a series reporting on a clinical field trial evaluating the efficacy of the modified therapeutic community (TC) approach for the treatment of homeless mentally ill chemical abusers (MICAs). The social and psychological characteristics of the treatment sample were described in an earlier paper; the purpose of the present report was to categorize subtypes of homeless MICA clients to predict with greater accuracy their treatability in modified TCs. An index that consistently correlated with treatment-relevant variables was identified for each of three dimensions; Homelessness (residential instability), Mental Illness (current severity), and Substance Abuse (current substance abuse/dependence diagnosis). These indices yielded distributions that captured the variability in the sample with respect to a number of variables, including drug use, criminality, human immunodeficiency virus (HIV) risk (sexual behavior), psychological status, and motivation. Bivariate and multivariate analyses showed that the indices were not strongly related to demographic variables such as race/ethnicity, age, or gender, but were significantly associated with baseline drug use, criminal activity, HIV risk (sexual behavior), psychological symptoms, and motivation and readiness. These findings indicate that, even among those admitted to residential treatment for substance abuse, homeless MICA clients are not homogeneous; rather, subgroup differences emerge among the indices of homelessness, mental illness, and substance abuse. The efficacy of treatment in modified TCs for these subgroups will be assessed in subsequent papers examining the relationships among the three indices, client retention, and outcomes during and subsequent to residential treatment.     

A Research on Subjective Well-being of Prison Police

Objective An investigation is conducted into the subjective well-being （SWB） of prison police and some related factors. Methods 273 prison police subjects from four provincial prisons finished Social Support Rating Scale and Index of Subjective Well-Being. Results （1） The degree of prison police＇s SWB is lower than that of ordinary people; （2） the degree of the female police＇s SWB working in the men-prisons is higher than that of their male fellowss; （3） the degree of the prison police＇s SWB working over 8 hours per day is lower than that of those working within 8 hours; （4） the degree of social support is closely relative to the SWB of prison police. Conclusion Prison police＇s SWB was worse than common people and especially it is necessary to improve the SWB level of the on-field prison police.     

2012至2015年哈尔滨市某监狱在押人员结核病发病情况分析

目的 分析2012-2015年哈尔滨市某监狱在押人员结核病发病情况和治疗效果,了解监狱内结核病的流行分布趋势,为结核病的防治提供依据.方法 在2012-2015年,对监狱在押服刑人员通过入监体检、普查、巡诊和因症就诊等几种方式,按照结核病诊断标准,根据痰培养和X光胸片确诊结核病,获得结核病患者人群.调查该人群基本情况、患病情况,同时给予化学药物治疗,并判定治疗预后.结果 2012-2015年该监狱内结核病共确诊病例有98例,发病率为1.69％.其中涂阳肺结核占31.6％(31/98),涂阴肺结核占60.2％ (59/98),结核性胸膜炎占8.2％ (8/98).2012-2015年监狱内结核病发病率分别为2.46％、1.83％、1.36％和1.19％,其中入监体检占49.0％ (48/98),普查占16.3％(16/98),因症就诊占34.7％(34/98).2012-2015年监狱内结核病治愈率为85.7％,各年度分别为81.3％(26/32)、85.7％(24/28)、86.9％(20/24)和93.3％ (14/15),呈现治愈率逐渐上升趋势.结论 2012-2015年监狱内结核病发病率呈现逐年下降的趋势;结核病患者的治愈率呈现逐年上升的趋势.现监狱内实行的结核病防治和管理工作取得了良好的疗效.