Effectiveness of a Drug-Free Detention Treatment Program in a Dutch Prison

Several Dutch penitentiaries, which have relatively severe drug-use related problems, experimented with drug-free detention treatment programs (DVA). These programs aim at controlling drug use by offering a therapeutic atmosphere and serve as linkage to detention posttreatment. In a Rotterdam jail (335 cells), ca. 10% were the DVA. Information was gathered from 86 male inmates who volunteered to enter the program, and 42 from other wings. After 1 year the drug-free detention group more actively searched and accepted treatment. No differences were found in drug use, recidivism, or physical, social, and psychological problems.     

A critical examination of the health promoting prison two decades on

Two decades since the WHO Regional Office for Europe outlined and published a report on health promotion in prison, which stimulated further debate on the concept of the ‘health promoting prison’, this paper discusses the extent to which the concept has translated into practice and the extent to which success has been achieved. This paper primarily focuses on why there has been a gap between the strategic philosophy of health promotion in prison and practical implementation, suggesting that factors such as ‘lifestyle drift’ and public and political opinion have played a part. A further argument is made in relation to the overall commitment of European countries and more broadly WHO in their support of settings-based health promotion in this context. It is proposed that there has been a weakening of commitment over time with a worrying ‘negative trajectory’ of support for health promoting prisons. The paper argues that despite these challenges, the opportunities and potential to address the needs of those who are often most vulnerable and excluded is colossal and acting to tackle this should be a greater priority.     

Prevalence of HIV,syphilis, hepatitis B,and hepatitis C among entrants to Maryland correctional facilities

Although high prevalence of hepatitis C virus (HCV) in correctional institutions has been established, data are sparse regarding the comorbidities of hepatitis B virus (HBV), HCV, and human immunodeficiency virus (HIV), all of which may complicate the management of HCV. This study sought to estimate the prevalence and correlates associated with HCV prevalence among entrants into the Maryland Division of Correction and the Baltimore City Detention Center. Participants included all newly incarcerated entrants between January 28 and March 28, 2002. Excess sera with identifiers removed from samples drawn for routine syphilis testing were assayed for antibodies to HIV and HCV and for HBV surface antigen and surface and total core antibodies. Separately, all HIV-positive specimens were tested using the serological testing algorithm for recent HIV seroconversion. Of the 1,081 immates and 2,833 detainees, reactive syphilis serology was noted in 0.6% of the combined population; HIV seroprevalence was 6.6%; HCV prevalence was 29.7%; and 25.2% of detainees and prisoners had antigen or core or surface antibodies to HBV. A multivariate analysis of predictors of HCV positivity indicated that detainees, women, whites, older age groups, those who were HIV seropositive, and individuals with past or present infection with HBV were significantly more likely to be positive for HCV. These data indicate that hepatitis C remains an important public health concern among entrants to jail and prison and is complicated with coinfections that need to be addressed for effective treatment.     

监狱警察睡眠及情绪状况调查

目的:了解监狱警察睡眠和焦虑、抑郁情绪的现状。方法:用匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对广东省监狱管理局的2093名监狱警察进行调查。结果:监狱警察PSQI均分为7．10±3．68,40．71％的监狱警察存在睡眠问题。SAS分为41．64±7．66,焦虑症状发生率为11．94％;SDS分为45．11±8．01,抑郁症状发生率为26．99％。男警PSQI得分高于女警(7．2±3．6／6．7 ±3．9,t=2．1,P<0．05)。35岁以上监狱警察SAS、SDS的标准分及焦虑症状发生率高于≤35岁的警察 (14．0％,11．1％,X2=18．77,P=0．000)。监区警察的PSQI得分高于行政人员(7．3±3．6／6．5±3．7．P< 0．05),行政人员睡眠问题发生率低于后勤人员、监区警察(34．4％、41．5％、42．1％,P<0．05)。PSQI分与SAS总分、SDS总分的相关系数为0．23、0．36(P<0．05)。结论:监狱警察的睡眠质量问题和焦虑、抑郁情绪比较严重,不同工作岗位、年龄及男女监狱警察的睡眠、焦虑、抑郁状况不同。     

Pathological and Sub-clinical Problem Gambling in a New Zealand Prison: A Comparison of the Eight and SOGS Gambling Screens

Prison populations have been identified as having elevated levels of problem gambling prevalence, and screening for problem gambling may provide an opportunity to identify and address a behaviour that may otherwise lead to re-offending. A problem gambling screen for this purpose would need to be brief, simple to score, and be able to be administered, with limited training, by prison assessors. The Eight Screen was developed as a brief tool for Family Doctors to use in a patient population, but has also been used effectively in more generalised populations. In this study 100 inmates received into a medium security prison were screened using the Eight screen and the South Oaks Gambling Screen (SOGS), with those scoring three or more on either screen then being assessed by a specialist clinician using DSM-IV Pathological Gambling Disorder criteria. Twenty-nine inmates were screen positives who also correlated highly with assessed gambling pathology. The Eight Screen appears to be a suitable gambling screen for prison use and has since been adopted as an assessment instrument by the New Zealand Department of Corrections.     

Psychiatrie de liaison en milieu pénitentiaire : organisation, moyens, psychopathologies et réponses thérapeutiques

The rise of the psychiatry practice in prison is recent. It corresponds to the setting places, since the law of January 18, 1994, of interventions by teams of sector psychiatry in the penal establishments, to supplement the action of the SMPR established two or three per region. The practice of psychiatry in prison must take account of a particular private clinic where acting out and psychopathology of deprivation dominates. The model of the consultation-liaison psychiatry such as it was developed in general care is completely appropriate to these working conditions. It allows not only one rewriting necessary of the psychiatric private clinic, but also a taking into account of the specific difficulties to this work environment (monitoring, insulation, risk of cleavage…). Lastly, an adaptation of the therapeutic assumption of responsibility is necessary not only according to pathologies present, but also according to the framework and to the limited duration of the assumptions of responsibility. The role of the maintenance of reception is of primary importance on this level.     

Hepatitis C seroprevalence among newly incarcerated inmates in the Texas correctional system

The seroprevalence of hepatitis C (HCV) infection was examined among a sample of incoming inmates in the Texas Department of Criminal Justice (TDCJ) prison system. Rates were compared across demographic factors and three types of prison facilities: substance abuse felony punishment units (SAFPs), state jails and prisons. The study sample consisted of 3712 incoming inmates incarcerated for any duration, dating from 1 November 1998 to 31 May 1999. Among males, inmates entering SAFPs and state jails had comparable HCV infection rates (29.7 and 27.0%, respectively) to those entering prisons (27.3%). Among females, inmates entering prisons had a higher rate of infection (48.6%) than those entering state jails (35.1%) or SAFPs (38.3%). For both genders, blacks exhibited a lower overall infection rate than whites and Hispanics, and HCV seroprevalence increased in a stepwise fashion with age. All subgroups of TDCJ inmates, including those held in alternative correctional facilities, exhibited HCV infection rates that were comparable with previous reports of inmate populations, but dramatically higher than general community samples. Given that most inmates held in alternative facilities will return to the general community in a short period of time, understanding the HCV infection rates in these subgroups holds particular public health relevance.     

Pox in the docks: varicella outbreak in an Australian prison system

OBJECTIVES: 1. Describe an outbreak of varicella in a prison system. 2. Highlight the risks of disease transmission within the prison environment. 3. Promote infection control guidelines for high-risk sub-groups within the prison system, including the application of quarantine. SETTING: Four prisons, one prison hospital, the prison transport system, one courthouse. MAIN OUTCOME MEASURES: Number of cases of varicella infection; reported varicella immunity status of cases and contacts; immunity status of known HIV antibody positive inmates. RESULTS: Five cases of chickenpox were identified. There were 23 contacts of the Index Case occurring during transport between prison and court and whilst being held in the court holding cells. Two of these contacts developed chickenpox despite having given a prior history of infection. There were over 300 inmates exposed to varicella zoster virus (VZV) during the outbreak, including one HIV antibody positive inmate who had serologically confirmed immunity. This inmate developed shingles following exposure to VZV from one of the cases. CONCLUSIONS: There is an elevated risk of respiratory transmission of infections such as chickenpox in prisons. Clear guidelines should be in place to protect HIV antibody positive people, pregnant women, and others who are at increased risk of complications from such infections. In the case of varicella, all inmates and staff without documented immunity should be screened to determine immunity, and if non-immune, should be offered VZV vaccination. Every effort should be made to prevent HIV antibody positive inmates being exposed to varicella, regardless of their varicella immunity status. If an HIV antibody positive inmate, who is known to be non-immune is exposed to varicella, Varicella Zoster immunoglobulin should be given within 96 h.     

A new approach to prison public health? Challenging and advancing the agenda for prison health

This paper explores recent developments in prison public health, recommending that future prison health policies and practices become more ‘upstream’ in their outlook and approach. It is argued that this will require much firmer acknowledgement of the significance of broad, systemic and structural determinants of prisoner health, particularly if the World Health organization's vision for a ‘healthy prison’ is to be realized. Epidemiological evidence plainly shows that prisoners have experienced—and continue to experience—worse health than the general population, despite the fact that prison settings across the European Union have been targeted for health promotion by the World Health Organization since 1994. In 2005, WHO launched a new 10-year prison public health plan, which it envisages will begin to address key prison health determinants. In the UK, New Labour has identified prison health as a key public health objective within Choosing Health, although health interventions within prisons continue to be predominantly geared towards efficient and effective primary and secondary healthcare, and much less towards public health goals. This paper strives to open up the debate on prison public health, advocating a progressive and more sustainable approach to developing and commissioning health services for prisoners.     

天津市监狱系统推行现代结核病控制技术规范效果分析

目的总结和评价2000年5月至2003年5月期间在天津市监狱系统推行现代结核病控制技术规范的工作情况。方法通过普查和因症就诊的方式发现监狱内在押囚犯中肺结核病例。对确诊病例按照统一的化疗方案免费提供抗结核药品,由监狱系统的医务人员施行直接面视下的督导化疗,在规定时间复查痰涂片和胸部X线大片。天津市结核病控制中心的医务人员定期对各监狱结核病的治疗管理进行督导,在疗程结束时对病例化疗管理效果进行评价。结果3年间共发现涂阳病例86名,其中初治涂阳33例;涂阴681例,囚犯肺结核病患病率逐年大幅下降。初治涂阳病例治愈率93．9％,复治涂阳病例治愈率66％。结论3年间在监狱系统推行并落实现代结核病控制技术规范,有效控制了肺结核病在天津市监狱囚犯中的流行,在全国各地有条件的监狱系统应大力推广。