Prescription Patterns in Jails Before and Since the COVID-19 Pandemic: A Multisite Serial Cross-Sectional Investigation.

In response to the COVID-19 pandemic, jails were advised to reduce facility census, particularly the growing population of those with medical/behavioral health vulnerabilities that increased susceptibility to adverse outcomes. Although jail census decreased across the nation in the initial days to months following pandemic declaration, there are minimal data regarding the health status of those who remained in jail. The current investigation aspired to describe jail census trends before/since the onset of COVID-19 and offer snapshots of temporal changes and context for prevalence estimates of medical/behavioral health conditions in jail detainees from 2019 to 2023. Using a serial cross-sectional design, prescription information for individuals residing in 18 jails across the United States on June 30 of each respective year was extracted and categorized using MediSpan's ontological system to determine prevalence estimates of prescribed agents/products. Although data evidenced an initial 31% census reduction (followed by gradual return to prepandemic rates), prescribing patterns for all major therapeutic drug classes steadily increased, with 10% more individuals prescribed at least one agent in 2023 than 2019. The largest increases were observed for behavioral health agents (e.g., 32.4% of the sample was prescribed psychotropic agents in 2023 compared with 25.7% in 2019). We provide considerations for future investigations.

Assertive community treatment as an alternative to incarceration for American pretrial detainees.

In the United States and elsewhere around the world, people with serious mental illness (SMI) are overrepresented in the criminal justice system. Clinical interventions to divert such individuals out of correctional settings, including Assertive Community Treatment (ACT), have been shown to reduce rates of criminal justice recidivism when modified to allow for the use of court sanctions to encourage treatment adherence. However, these interventions are noted to be underutilized as alternative to incarceration (ATI) programs. This paper summarizes the results of a retrospective cohort study conducted in a New York State forensic psychiatric hospital of 87 pretrial detainees admitted after being found incompetent to stand trial between January 2019 and January 2022. Of these, 49 patients were referred to an ACT team that served as an ATI program. The study outcomes noted that patients referred to this ACT team were 20% less likely to remain in pretrial detention than those that were not. Moreover, patients referred to the ACT program were also 34% more likely to be granted an ATI plea bargain in the community that did not involve serving a prison term. These results suggest that pretrial detainees with SMI are more likely to be granted an ATI program that offers more intensive treatment services such as ACT, due to the capability of such programs to also provide more intensive outreach and community supervision than traditional outpatient mental health service providers.

Prevalence of and Gender Differences in Psychiatric Disorders among Juvenile Detainees in South Korea: A Comparative Study.

Background and Objectives: High rates of psychiatric disorders and comorbidities have been reported in juvenile detainees, which have been associated with repeat offenses. However, research into this topic has been limited to Asian countries. This study aimed to examine the prevalence of psychiatric disorders and sexual differences among juvenile detainees in a detention center in South Korea. Materials and Methods: The participants comprised 54 males and 46 females, with a minimum intelligence score of 80. Psychiatric diagnosis was determined using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). The Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) was used to investigate gender differences. Results: Using the MINI-KID, the most frequent diseases were conduct disorder (CD), alcohol dependence, suicidal tendency, and attention-deficit/hyperactivity disorder (ADHD), with statistically significant differences between men and women. Only alcohol abuse was higher in males, while the rest were higher in females. The items with a statistically significant gender difference in MAYSI-2 were alcohol/drug use, feeling depressed/anxious, somatic complaints, suicidal ideation, and traumatic experiences. All items for which gender difference was statistically significant were higher in the proportion of women. Conclusions: Juvenile detainees exhibit high rates of psychiatric disorders and comorbidities. CDs, alcohol dependence, and ADHD are the most common psychiatric disorders among juvenile detainees in South Korea. Assessment of and intervention in psychiatric disorders may help prevent further offenses. These findings highlight the importance of diagnosing and intervening in psychiatric disorders within juvenile detention systems.

Psychopathology and history of mental healthcare among male detainees transferred to a facility for managing otherwise uncontrollable in-prison violence: An exploratory study.

BACKGROUND: In-prison violence by detainees is a problem worldwide, but despite evidence of a much higher prevalence of a range of psychiatric disorders than in the general population, little is known about psychopathology among violent detainees. AIMS: Our aim was to explore the psychopathology and mental healthcare history of Dutch detainees who were transferred to the highly restrictive facility for uncontrollably violent detainees following severe in-prison violence. METHODS: Anonymised data for all 253 male detainees incarcerated at any time between January 2016 and January 2020 in the specialist national facility for those seriously violent while in prison-'the Violence Facility'-were obtained from the Dutch Ministry of Justice together with similarly recorded data for a matched comparison group of 253 detainees admitted to an in-prison psychiatric facility-'the Psychiatric Facility'. RESULTS: There was no record of any psychiatric assessment for 29% of the Violence Facility men. Almost all of the detainees who had been assessed were classified with at least one disorder. Compared to detainees in the Psychiatric Facility, Violence Facility men were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD), anxiety, behavioural and personality disorders; Psychiatric Facility men were more likely to be diagnosed with psychosis or substance use disorder. Most men in both groups had previously used mental health services. CONCLUSIONS: This first study of detainees in the Dutch in-prison facility for violent detainees raises questions about whether the extent of violence among these men may have masked mental healthcare needs and leads to questions about potential benefits from establishing more systematic mental health assessments for them, and a need for more specialist services.

Competent Witnesses: How Penitentiary Workers Explain the Violence in Italian Prisons during the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic, in the Italian prison of Santa Maria Capua Vetere (SMCV), prison police repressed a riot with extreme violence, bringing the state of prisons and the conditions of prisoners back to the attention of the Italian public opinion. OBJECTIVE: This exploratory study aimed to collect the experiences and the competent opinions of the social and health personnel of Italian prisons regarding the episode of violence that happened in SMCV; the general state of health of the Italian prison system was explored, too, together with the collection of proposals for interventions aimed at the eradication of violence in prison. METHOD: The study employed a qualitative research design. Eighteen social-health workers from 12 Italian prisons were interviewed using in-depth interviews of ~60 min each that were conducted and recorded via Skype video calls. The interview transcripts were analyzed with qualitative reflexive thematic analysis (RTA) to identify the most relevant and recursive themes. RESULTS: Four themes were identified: (1) reactions and thoughts about the events of SMCV; (2) structural problems of Italian prison police; (3) Italian prison system; and (4) reform proposals. CONCLUSIONS: A new and deeper awareness of the suffering of the current Italian penitentiary system emerged, together with courageous reform proposals that can restore dignity and centrality to the re-education of the detainees, preventing further future violence.

Detainees' Perceptions of Procedural Justice: An Examination Throughout the Criminal Justice System.

Procedural justice literature proposes that when individuals perceive their treatment by criminal justice authorities as more procedurally just, they will be more likely to view those authorities as legitimate and, in turn, show more compliant behavior. Knowledge on potential determinants of procedural justice is, therefore, crucial. Research suggests that prior perceptions of procedural justice may influence later judgements of procedural justice. The current study used data from the Prison Project, including information on detainees' perceptions of their treatment by the police, the judge, the prison staff, the probation officer, and the lawyer. The findings show that detainees perceive the treatment by the lawyer as most procedurally just, while they evaluate the treatment by the police as least procedurally just. Further, how detainees experience the procedurally just treatment by the police is associated with how they feel treated by other authorities at a later stage in the criminal justice system.

Mental Health in Prison: Integrating the Perspectives of Prison Staff.

(1) Background: The Italian Constitutional Court's decision n. 99/2019 abolished the distinction between physical and psychological health care in the Italian prison system. However, this and other changes to the penitentiary system present challenges to prison staff, which may vary based on their roles and backgrounds; (2) Purpose: To create a process of dialogue and collaboration that include different points of view, needs, and proposals regarding mental health in prisons, this study collects and integrates the perspectives of 91 prison staff who work in various capacities in eight prisons in northeast Italy. (3) Methods: Each participant was involved in either a focus group or a semi-structured interview, and thematic analysis was used to process the resulting transcripts; (3) Results: Through this process, 10 themes were derived that highlight the difficulties of working with prisoners with psychiatric disorders or psychological distress, including lack of human and economic resources, lack of positive communication between prisoners and society and a sense of professional incompetency; (4) Conclusions: Based on these themes, the need for increased points of view, dialogue, and collaboration between prison professionals and between prison and society is discussed, and the current feasibility of treating psychiatric disorders in prison is considered.

Use of mid-upper arm circumference to screen for thinness among sub-Saharan African male detainees.

OBJECTIVE: BMI is a time-intensive measurement to assess nutritional status. Mid-upper arm circumference (MUAC) has been studied as a proxy for BMI in adults, but there is no consensus on its optimal use. DESIGN: We calculated sensitivity, specificity and area under receiver operating characteristic curve (AUROCC) of MUAC for BMI < 18·5, <17 and <16 kg/m2. We designed a system using two MUAC cut-offs, with a healthy (non-thin) 'green' group, a 'yellow' group requiring BMI measurement and a 'red' group who could proceed directly to treatment for thinness. SETTING: We retrospectively analysed monitoring data collected by the International Committee of the Red Cross in places of detention. PARTICIPANTS: 11 917 male detainees in eight African countries. RESULTS: MUAC had excellent discriminatory ability with AUROCC: 0·87, 0·90 and 0·92 for BMI < 18·5, BMI < 17 and BMI < 16 kg/m2, respectively. An upper cut-off of MUAC 25·5 cm to exclude healthy detainees would result in 64 % fewer detainees requiring BMI screening and had sensitivity 77 % (95 % CI 69·4, 84·7) and specificity 79·6 % (95 % CI 72·6, 86·5) for BMI < 18·5 kg/m2. A lower cut-off of MUAC < 21·0 cm had sensitivity 25·4 % (95 % CI 11·7, 39·1) and specificity 99·0 % (95 % CI 97·9, 100·0) for BMI < 16 kg/m2. An additional 50 kg weight requirement improved specificity to 99·6 % (95 % CI 99·0, 100·0) with similar sensitivity. CONCLUSIONS: A MUAC cut-off of 25·5 cm, above which detainees are classified as healthy and below receive further screening, would result in significant time savings. A cut-off of <21·0 cm and weight <50 kg can identify some detainees with BMI < 16 kg/m2 who require immediate treatment.

Retrospective Post Mortem Study of Custodial Deaths in Uyo, South-South, Nigeria.

INTRODUCTION: The medicolegal auditing of the pattern of death among detainees in police and prison custody is a useful tool in planning for quality care to be given to detainees, who do not have access to stable health care as seen in the free world. AIM: To retrospectively study the peculiarities of custodial deaths (CD), among individuals detained in police and prison custody in Uyo, South-Soth Nigeria and to suggest preventive measures. MATERIALS AND METHODS: This is a review of all the post mortem examinations (PME) that were performed on detainees that died in police or prison custody over 4 years. RESULTS: They were 9 detainees aged between 22-44 years with an average age of 31.1 years. All the detainees were males. Six (66.7%) persons died in police custody, while 2 (22.2%) died in prison custody and 1 (11.1%) person died in police clinic. The shortest duration of detention before death was 1 day (24 hours) and the longest 80 days. Marks of torture were seen in 2 (22.2%) cases. The cause of death was seen in 8 (88.9%) cases. In 1 (11.1%) no anatomic pathologic cause of death was seen. The manner of death was natural in 4 (44.4%), homicide 3 (33.3%), accidental 1 (11.1%) and undetermined 1 (11.1%). The 4 natural causes of death were 2 cases of hypertensive cardiovascular disease, a case of myocardial infarction and a case of alcoholic hepatitis. The cause of death in all the homicidal and accidental cases were massive intracranial bleeding. CONCLUSION: Natural death is the most common manner of death among detainees in Uyo.

INTRODUCTION: L'audit médico-légal des décès parmi les détenus en garde à vue et en détention est un outil utile pour planifier des soins de qualité à prodiguer aux détenus, qui n'ont pas accès à des soins de santé stables comme on le voit dans le monde libre. OBJECTIF: Étudier rétrospectivement les particularités des décès en détention (DC) chez les personnes détenues en garde à vue et en prison à Uyo, dans le sud-sud du Nigeria et proposer des mesures préventives. MATÉRIEL ET MÉTHODES: Il s'agit d'un examen de tous les examens post mortem (EPM) qui ont été effectués sur des détenus décédés en garde à vue ou en prison pendant 4 ans. RÉSULTATS: Il s'agissait de 9 détenus âgés de 22 à 44 ans avec une moyenne d'âge de 31,1 ans. Tous les détenus étaient des hommes. Six (66,7 %) personnes sont décédées en garde à vue, tandis que 2 (22,2 %) sont décédées en garde à vue et 1 (11,1 %) personne est décédée en clinique de police. La durée de détention la plus courte avant le décès était de 1 jour (24 heures) et la plus longue de 80 jours. Des traces de torture ont été observées dans 2 cas (22,2 %). La cause du décès a été retrouvée dans 8 (88,9%) cas. Dans 1 (11,1%) aucune cause anatomique de décès n'a été observée. Le mode de décès était naturel dans 4 (44,4 %), homicide 3 (33,3 %), accidentel 1 (11,1%) et indéterminé 1 (11,1 %). Les 4 causes naturelles de décès étaient 2 cas de maladie cardiovasculaire hypertensive, un cas d'infarctus du myocarde et un cas d'hépatite alcoolique. La cause du décès dans tous les cas homicides et accidentels était une hémorragie intracrânienne massive. CONCLUSION: La mort naturelle est le mode de décès le plus courant parmi les détenus d'Uyo. MOTS-CLÉS: Décès en détention, Examen post mortem, Détenus, Uyo.

The Ninth Circuit Court of Appeals and Jail-Based Competency Evaluation and Restoration.

The U.S. Ninth Circuit is the largest of the federal appeals courts, encompassing the states of Alaska, Washington, and Oregon to the north, Hawaii, Guam, and the Northern Mariana Islands to the west, California and Arizona to the west and southwest, along with the three intermountain states of Idaho, Montana, and Nevada. The landmass within the Ninth Circuit represents great diversity of geography, climate, population density, and cultural and political traditions. This article considers two landmark Ninth Circuit decisions, one from Oregon and the other from Washington, two states that share geography, culture, and political orientation. Informed by these decisions, we consider how the Ninth Circuit might view the jail-based competency evaluation and restoration programs in the state of Arizona. We explore: the due process rights of jail detainees who are awaiting an evaluation of trial competency; and the time necessary for admission to, and the adequacy of, Arizona's jail-based competency restoration programs after a finding of incompetency.

The prevalence of mental illness and unmet needs of police custody detainees.

BACKGROUND: Internationally, there is evidence of high rates of mental disorders amongst police custody detainees but this literature is limited, and there has been little research into the unmet needs of police detainees in the UK, or elsewhere. Such research could support better focussed interventions for improving health and recidivism outcomes. AIM: To examine psychiatric and developmental morbidity amongst police detainees, and ascertain differences in need between morbidity categories. METHOD: We used a cross-sectional study design and interviewed a 40% sample of people entering police custody in one South London police station over a 2-week period. A series of standardised measures was administered to screen for the presence of mental illness, general health and social care needs. RESULTS: A cohort of 134 people was generated, of whom nearly one-third (39, 29%) had current mental illness (major depression and/or psychosis); more had a lifetime diagnosis (54, 40%). Just under a fifth met the threshold for post-traumatic stress disorder (11, 8%). Clinically relevant alcohol or daily cannabis use affected about one quarter of the sample. Twenty-one percent (or 28) screened positive for personality disorder, 11% (or 15) for attention deficit hyperactivity disorder and 4% (6) for intellectual disability. Nearly one-fifth (24, 18%) were at risk for suicide. Those with psychosis, and those deemed at risk for suicide, had the highest levels of unmet need and, indeed, overall need. The most frequent unmet need was for accommodation. CONCLUSION: Our findings not only confirm high rates of mental health problems amongst police detainees but also demonstrate their high risk of suicide and high levels of unmet need, especially as regards accommodation. This underscores the need to provide mental health services in police stations, to help identify and resolve these issues at this early stage in the criminal justice system. Extending accommodation capacity to help some arrestees may help to save lives and interrupt cycling through the criminal justice system.

HIV-Risk Behavior Among Adults with Opioid Use Disorder During 12 Months Following Pre-trial Detention: Results from a Randomized Trial of Methadone Treatment.

This was a three group randomized clinical trial of interim methadone and patient navigation involving 225 pre-trial detainees with opioid use disorder in Baltimore. The HIV Risk Assessment Battery (RAB) was administered at baseline (in jail), and at 6 and 12 months post-release. Generalized linear mixed model analyses indicated the condition × time interaction effect failed to reach significance (ps > .05) for both the drug risk and sex risk subscale scores. Therefore, findings suggest that there were no intervention effects on drug or sex risk behaviors. However, increased use of cocaine at baseline was associated with increases in drug- (b = .04, SE = .02) and sex-risk (b = .01, SE = .003) behaviors. These results suggest that interventions targeting cocaine use among pre-trial detainees may serve as a means of reducing HIV risk associated with drug- and sex-risk behaviors.Clinical Trials Registration: Clinicaltrials.gov NCT02334215.

Knowledge, attitude, and practice of breast cancer and breast self-examination among female detainees in Khartoum, Sudan 2018.

INTRODUCTION: Breast cancer is the common cancer among females and a leading cause of mortality among them globally, its rates are three times higher in developing countries. Breast self-examination (BSE) had an important role in early detection, increasing the survival rate of breast cancer patients, despite these benefits, the rates of practicing BSE are low, especially in developing countries. OBJECTIVE: To assess the levels of awareness about breast cancer, and BSE among the detainees of Dar-Altaebat facility, a female's detention facility in Khartoum, Sudan. METHODS: A cross-sectional study conducted at Dar-Altaebat a female imprisonment facility in Khartoum, Sudan. 354 participants were randomly selected from the total population of the facility. Data was collected using a self-administered structured questionnaire, which was composed of socio-demographic section, knowledge section, attitude section, and breast self-examination section. Data was analyzed using statistical package for social sciences(SPSS) software. RESULTS: 330 participants responded to the questionnaire, their mean age was (31, SD: 11.2) years, 126 (38.2%) of them were illiterate, 196 (59.4%) were married, and the majority of them 177 (76.3%) were housewives. their overall knowledge score revealed that 185(56.2%) of them had poor knowledge about breast cancer. 218 (66.3%) of them had poor knowledge about breast self-examination, however 314 (95.3%) thought that it was important. 315 (95.5%) of the participants had poor practice towards breast self-examination. CONCLUSION: Poor levels of knowledge about breast cancer were reported among the detainees. Additionally, their level of knowledge and practice of breast self-examination was also low, thus more health education campaigns are recommended in such facilities.

A mortalidade entre adolescentes egressos do sistema penal / Mortality among former youth offenders

Resumo O objetivo deste artigo é analisar as causas de internações da FASE do Estado do Rio Grande do Sul e a sua relação com a mortalidade de adolescentes egressos entre os anos de 2002 a 2014. Estudo observacional realizado com o banco de dados de adolescentes privados de liberdade nas unidades da FASE-RS de Porto Alegre, desligados nos anos de 2002 a 2012 (n = 8290). Informações sobre data de desligamento, ato infracional, tempo de internação e variáveis biológicas foram obtidas de banco de dados. Essa amostra foi comparada com o Sistema de Verificação de Óbitos da Secretaria Estadual de Saúde para analisar a mortalidade entre os anos de 2002 e 2014. Os adolescentes foram internados predominantemente por atos infracionais de cunho patrimonial e ligados a entorpecentes, os quais sofreram um aumento de aproximadamente 700% no período. O desfecho óbito associou-se (p < 0,001) às variáveis gênero masculino e número de entradas (≥ 3). Essa amostra apresentou alta taxa de mortalidade sendo a principal causa homicídio. Os achados evidenciam o alto grau de vulnerabilidade psicossocial dos egressos do sistema penal juvenil de internação. Nota-se uma associação entre crimes de baixo poder ofensivo e altas taxas de mortalidade pós-liberdade.

Abstract The objective of this article is to analyze the detention of youth offenders involved in the juvenile justice system in the State of Rio Grande do Sul (FASE-RS), the reason for detention, and mortality among former young offenders. We conducted an observational study with youth offenders discharged from facilities run by FASE-RS in Porto Alegre between 2002 and 2012 (n = 8,290). We collected the following information: date of discharge, offence committed, skin color, gender, and duration of detention. The data was crosschecked with data from the state's Mortality Information System to identify deaths among former young offenders up to December 2014. The predominant offences were crimes against property and drug-related crimes. The large majority of youth detained for drug-related offences were admitted for offences related to drug trafficking. There was a seven-fold increase in drug-related offences over the period. Death was associated (p<0.001) with being male and number of reentries (>3). The sample's mortality rate was high and the main cause of death was homicide. The findings suggest that young offenders face high levels of psychosocial vulnerability. There was an association between minor crimes and high rates of mortality among former young offenders.

Prisoners in a pandemic: We should think about detainees during Covid-19 outbreak.

In Italy, where the Covid-19 emergency developed immediately after China, the spread of the pandemic has highlighted some unsolved problems inherent to the prison system. This theme is already, unfortunately, of distressing topicality. Among these, the complex balance between the security needs and the protection of the prisoner's right to health deserves particular attention. The detainees, in fact, constitute a group particularly vulnerable to the spread of an infectious disease, both because they have an average level of health lower than that of the general population, and because they live forced in cramped, overcrowded, poorly ventilated environments, in which it is not always possible to observe the general hygiene rules. For these reasons, during the ongoing pandemic emergency, it could be even more difficult to concretely protect the right to health of this portion of the population.

Exploring the autistic and police perspectives of the custody process through a participative walkthrough.

BACKGROUND: Research suggests that autistic individuals may be more likely to come into contact with police and have more negative experiences in police custody. However, limited information about the difficulties they experience during the custody process is available. AIMS: This study explores the experiences of autistic individuals and officers during a walkthrough of the custody process to identify specific difficulties in these encounters and what support is needed to overcome these. METHODS AND PROCEDURES: A participative walkthrough method was developed to provide autistic individuals and officers an interactive opportunity to identify areas where further support in the custody process was needed. Two autistic participants and three officers took part in the study. OUTCOMES AND RESULTS: Autistic participants reported negative experiences due to: i) the emotional impact of the physical setting and custody process ii) communication barriers leading to increased anxiety and iii) exposure to sensory demands. Officers highlighted three factors which limit their ability to support autistic individuals effectively: i) the custody context ii) barriers to communication and iii) knowledge and understanding of autism. CONCLUSIONS AND IMPLICATIONS: Adjustments are needed to the custody process and environment to support interactions between autistic individuals and officers and improve the overall wellbeing of autistic individuals.

A structure and process evaluation of a police Watch House Emergency Nurse (WHEN) model of care.

BACKGROUND: Increasing presentations to the Emergency Department (ED) via police (which include detainees, prisoners and community residing persons) and the increase in chronic and mental health illness in detainee and prisoner populations has prompted an increased requirement for healthcare delivery within the custodial environment. This study aimed to describe the Watch House Emergency Nurse (WHEN) role, focusing on structures and processes underpinning the role. METHODS: In this qualitative, descriptive study, semi-structured interviews were undertaken in 2015 with 14 key stakeholders from health, police, and ambulance services. Interviews were analysed using content analysis to inform the findings. FINDINGS: Important structural elements of the WHEN role included an ED triage competent registered nurse, a 2-day integrated training program, and clear guidelines to provide a framework for identifying, prioritising and managing healthcare needs. Important process elements were clear communication between nurses, police, and medical staff, and a clear understanding of roles and responsibilities to facilitate continuity of care and appropriate referral. The underpinning perceived benefit of the WHEN role was 'safety'. This was in terms of personal, professional, and detainee safety. CONCLUSION: The structures and processes underpinning the innovative WHEN role provides a valuable foundation for guiding evaluations of other nursing roles in other early custody settings.

Fathers detained, contact restrained: Experiences of Palestinian children visiting their fathers in Israeli detention.

BACKGROUND: Very little is known about the experiences of children of political prisoners internationally, because of the challenges of researching within politically oppressive contexts. OBJECTIVE: The aim of this secondary analysis was to explore and understand Palestinian children's experiences visiting their fathers in Israeli detention. PARTICIPANTS, SETTING AND METHODS: Qualitative data from sixteen in-depth interviews with thirty-one children were analyzed. Structural and longitudinal coding cycles were employed and focused upon the timeline of the visitation process. RESULTS: Three overarching themes emerged, which included: Children's experiences 'before the visit', 'during the visit', and 'after the visit'. Subthemes related to the distressing and at times traumatic experiences the children suffered throughout the process of preparation for, going through, and the aftermath of the visit. This included reports of experiencing punitive measures at checkpoints and waiting areas and humiliation and maltreatment by the Israeli authorities during the visitation process. These findings are discussed with reference to the United Nations Convention on the Rights of the Child. It was clear that the children's best interests were denied and contact and interaction with their fathers was restrained under the Israeli visitation scheme. Despite the arduous visitation process that children often hated, they loved to see their fathers. CONCLUSIONS: Even though the children's rights were infringed upon, they still endured hardships to maintain whatever contact was possible. International advocacy for the realization of the 'rights of the child' for Palestinian children, as well as other children of political detainees is warranted.

A randomized controlled study of intervention to improve continuity care engagement among HIV-infected persons after release from jails.

Short-term stay, multiple jail admissions and social and financial difficulties are significant obstacles for continuity care engagement (CCE) after release among HIV-infected jail detainees. However, data existing on interventions or strategies to increase post-release CCE among this population are limited. We conducted a randomized controlled study among HIV-infected detainees at Cook County Jail during 2011-2014. The intervention group received telephone contact within 2-4 days of release by a continuity clinic coordinator, who scheduled and informed the ex-detainees of their appointment date within 6 weeks post-release plus standard of care, while the control group received standard of care. The standard of care included comprehensive discharge planning, offering substance abuse treatment and provision of information on how to self-schedule an appointment with the chosen clinics. Of the 166 detainees enrolled, 56 were excluded due to being sent to prison or re-incarcerated within 6 weeks. The final cohort included 55 detainees in each of the groups. The rate of CCE within 6 weeks after release was significantly higher in the intervention group compared to the control group (58% vs. 33%; P = .007). In multivariable logistic regression analysis, being in the control group was the only factor associated with no CCE within 6 weeks (adjusted odds ratio 2.66; 95% confidence interval 1.18-6.00; P = .02). The study findings suggest that the simple telephone contact intervention significantly improved CCE among HIV-infected jail detainees.

Aging Prisoners' Views on Healthcare Services in Swiss Prisons.

OBJECTIVE: Due to the higher morbidity prevalent in the increasing older population, prisons are facing new challenges on a structural, ethical, and financial level. This study's goal was to explore older prisoners' views and experiences regarding the quality of medical services. METHOD: In this qualitative study, 35 semi-structured interviews were conducted with older inmates aged 50 years and above in 12 different prisons in the German-speaking (23 interviews) and the French-speaking parts (12 interviews) of Switzerland. RESULTS: The majority of older prisoners in this sample expressed concerns about quality of treatment throughout incarceration. Topics addressed reached from quality of the entrance to routine examinations, quality of the treatment received, and delays in care and services provided. CONCLUSION: This study's findings suggest that healthcare in prison is often perceived as insufficient and inadequate by older inmates.