Analysis of emergency healthcare demand in a prison

Objective: To analyze the reasons for seeking emergency medical care amongst prison inmates and their relationship to sociodemographic characteristics. Material and method: An observational, descriptive and retrospective study was carried out. We collected the sociodemographic variables of inmates and their healthcare needs at the referral hospital over nine years. Results: A total of 972 hospital visits were included. The most common healthcare needs, in descending order, were multiple trauma, limb problems and dyspnea. Mondays and Wednesdays were found to be the busiest days (P <0.001). The average stay in cases of hospitalization was 6.1 (SD: 4.3) days; patients with nontraumatic healthcare needs required a longer stay. The majority of the inmates native to Africa, Asia and America received emergency healthcare services due to traumatic injuries; by contrast the most common injuries among Europeans were non-traumatic and unrelated to suicide attempts (P <0.001). European inmates were on average 4.2 years older than Africans and 4.7 years older than American inmates (P <0.001). Discussion: The reasons for seeking emergency care are clearly differentiated according to the inmates’ nationality, one notable outcome was the greater longevity of European internees. These results highlight the importance of understanding healthcare demand within the prison system in order to better address considerations such as prevention, organization and the location of healthcare units.

Experiences of incarcerated mothers living with their children in a prison in Lima, Peru, 2020: a qualitative study

Objectives: This study explores the experiences of incarcerated women living with their children in the Women Chorrillos Penitentiary, Lima, Peru, 2020. Material and method: Qualitative, exploratory study with a phenomenological design, through semi-structured interviews with inmates who lived with their minor in the prison. In total there were 13 interviews considering the theoretical saturation of categories. Results: The experiences consisted of mostly negative intrapersonal experiences, related to different individual aspects and the conditions of confinement and prison treatment. Serious deficiencies perceived in the health care of inmates and children stand out, with emphasis on mistreatment and indifference on the part of the staff. Other factors involved in the construction of these experiences were identified. Discussion: The results provide evidence of serious structural and organizational deficiencies that violate the fundamental rights of the population group studied. Government efforts to date are partial and insufficient. Sustainable policies and programs are urgently needed that prioritize quality health care and adequate prison treatment for these people with an emphasis on preventivepromotional actions. There is a need for evidence-based interventions to reduce the harmful effects of childhood incarceration.

Diagnosis and treatment of hepatitis B. What contributions can prisons make?

Hepatitis B is a parenterally and sexually transmitted infection. Vaccination for the disease is highly effective, and its inclusion in Spain as part of a systematic and universal schedule for newborns has led to a significant decrease of incidence in the national population. However, the number of inmates born in other countries - some from endemic areas of HBV infection -, the mechanisms of transmission and lack of vaccination in third world countries mean that its prevalence in the prison population is higher than in the general population. These institutions therefore play an essential role in detecting and managing hepatitis B. In this paper, the situation of hepatitis B in prisons is reviewed and recommendations are proposed to optimize its control.

Analysis of penitentiary, social and legal operators’ perceptions of prison inmates with intellectual disabilities

Objective: To analyze the different perceptions of professionals about the problem of intellectual disability in the prison setting. Material and method: Exploratory-descriptive type. In-depth interviews with legal, social and prison operators of Centro Penitenciario de Zuera (Zaragoza). Results: The narratives of the interviewed subjects point to the aggravating circumstances that a closed social environment can entail for inmates with intellectual disabilities. Communications in the prison administration are written in a technical language that is not understandable for inmates with intellectual deficits. Discusion: There is a need to give more visibility to the case of inmates with intellectual disabilities. Procedures also need to be applied that favour greater cognitive accessibility for this profile of inmates, along with the promotion of awareness raising and training for professionals to enable them to deal with this issue.

Is mass screening enough to control tuberculosis in Ecuador’s prisons?

Objective: To evaluate mass screening campaigns for tuberculosis in prisoners in Ecuador. Material and method: Cross-sectional study of Chronic Cough (CC) detected amongst inmates who entered two prisons in Ecuador between January and December 2016 (n = 12,365). The time distribution of the CCs was analyzed with the uniformity test and its relationship with the diagnosed cases of PTB, the prevalence of PTB was calculated. A logistic regression model was performed to determine the factors modifiers of PTB positivity. Results: 1.332 chronic cougher were recorded, the positivity rate was 17.3% (95% CI, 15.1-19.4), and the prevalence was 1.9% (95% CI, 1.6 - 2.1). There was an absence of uniformity in the detection and diagnosis by epidemiological weeks; there was a positive correlation between CC and PTB cases. The positivity rate was associated with the prison with the highest density (adjusted OR 3.8; 95% CI, 2.5-5.5). Discussion: Massive screening campaigns are not enough to control tuberculosis in Ecuador’s prisons. The incidence found is high. It is necessary to strengthen the diagnostic process to treat all the cases found and thus break the chain of transmission.

The role of prison nursing: an integrative review

Objectives: To review the scientific literature on the role of the nurse in Penitentiary Institutions through the study of care training and ethical implications when offering quality care to the prison population. Material and method: An integrative review was carried out in Medline, SciELO and LILACS databases. The MeSH and DeCS terms used were: nurse’s role, nursing, nurse, nursing education, prison, ethics, ethical issues, job satisfaction, enfermeria, penitenciaria, health professionals, nursing care. The types of studies included in this work are literature reviews, and qualitative, quantitative and mixed studies. The CASPe tool was used to assess the methodological quality of selected literature. The review period was October, November and December 2019. Results: A total of 264 articles were obtained, of which 98 were chosen after applying filters corresponding to each database and after discarding duplicate articles. The title and abstract of these articles were read and the established selection criteria were applied, to obtain 18 studies. Finally, after critical reading, 15 articles were selected for this work. Discussion: The role of the prison nurse is generally unknown. Nursing undergraduate training in this area is limited, exposing a specific training need, which may help these professionals to deal with ethical issues that they may find in their practice, as well as to improve the quality of care for the prison population.

Legal, medical and epidemiological characteristics of persons exempt from criminal liability in the National Prison Institute of Peru, 2014-2019

Objectives: To describe and correlate the epidemiological, clinical and legal characteristics of persons exempt from criminal liability registered in the National Prison Institute of Peru in the period 2014-2019. Material and method: Retrospective, cross-sectional descriptive study with correlational components and secondary sources. The sample consisted of all the persons exempt from criminal liability who formed part of the prison population of Peru during the study period. A validated data collection sheet was used. Data were analyzed through descriptive statistics using SPSS v24 software. For inferential analysis, a simple binary logistic regression was carried out. Results: A total of 179 persons exempt from criminal liability were identified in 36 Peruvian prisons; 94.4% were males, with an average age of 35 years; 6.1% were undocumented. 67.0% had a diagnosis of the schizophrenia spectrum. The main crimes were against freedom (39.1%) and against life, body and health (36.8%). In 74.6% of cases, the duration of involuntary commitment was more than five years; 11.5% remained in prison after the date of release. In 18.4%, involuntary commitment was established by the Peruvian National Prison Institute. Associations between variables such as diagnosis, type and severity of the crime were found. Discussion: Aspects that violate national and international regulations (excessive length of involuntary commitment, in unsuitable locations, unjustified imprisonment, etc.) were identified, affecting the fundamental human rights of persons exempt from criminal liability in prison.

Family and social environment associated with traits of antisocial personality disorder in the prison population of Peru

Introduction: The prison environment in Peru is one of the worst in the continent. In situations such as these, where there is considerable stress, many inmates can develop antisocial disorders, especially if they come from a conflictive family setting. Objectives: To determine the association between family relationships, social environment and features of antisocial personality disorder (ASPD) in the Peruvian prison population in 2016. Material and method: Analytical cross-sectional study based on a sub-analysis of the First National Penitentiary Census of Peru in 2016. The sample is the prison population (≥18 years old) that participated in said census, which was carried out in 66 correctional facilities nationwide and reached a coverage of 98.8%. Results: Of the 77,086 prisoners, 76,152 participated in the analysis. The prevalence of antisocial traits was 96% and half of the population met two criteria for the disorder. Independently associated factors were, being male (RPa: 1.35; 1.30-1.40), born outside the capital (RPa: 0.89; 0.88-0, 91), friends in the neighborhood who committed offences (RPa: 1.01; 1.00-1.02) and not living with a father (RPa: 1.00; 1.00-1.01). Discussion: The prevalence of antisocial personality disorder traits in the Peruvian prison population was 96%. We found greater association with the male sex, in those born in Lima and in those who escaped from their home before the age of 15.