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Purpose: This study aims to assess the nature and scope of dog-based programmes in prisons, assessing critically the potential opportunities, benefits, challenges and risks of developing innovative dog-based programmes for older prisoners in England and Wales. This paper outlines the potential benefits and challenges of developing dog-based programmes for older prisoners and sets out next steps for future research and practice. Design/methodology/approach: This study is based on a scoping review of published research literature on prison dog programmes (PDPs) in the USA, the UK and other countries, with particular reference to older people in prison, followed by semi-structured interviews with six members of an expert advisory group. The literature review and data from the qualitative interviews were analysed thematically. Findings: There is a substantial body of published research literature which supports PDPs as having identifiable positive impacts for people and also dogs, and also published research which highlights the benefits to older people of dog ownership or participation in dog-based activities. However, much of this research is small-scale and qualitative, and it has been argued that there is a lack of a quantitative evidence base. This research concludes that findings from the literature review and the semi-structured interviews support further research and the creation of pilot projects to develop dog-based projects for older people in prison. Research limitations/implications: This study was small-scale, and the findings need to be approached with caution. The literature review searched a small number of databases and filtered out articles published in languages other than English, and the review of the grey literature focused on reports from the UK. The number of experts interviewed was small and there was no direct consultation with older people in prison nor with older people with recent personal lived experience of imprisonment and community resettlement. A more extensive future study would benefit from a more extensive literature review, a larger group of participants and the inclusion of service users, prison managers and government policymakers, subject to the appropriate ethical and security approvals. At the time the research took place, ongoing COVID-19 restrictions on prison research meant that research with current prisoners and prison managers would not have been approved by the HMPPS NRC. Practical implications: This research provides a research-based justification for future dog projects for older prisoners, leading potentially to improved well-being for older people in prison. Originality/value: This study brings together the published research literature on PDPs with the research literature on the needs and experiences of older people in prison for the first time, and identifies potential directions for future research. [ABSTRACT FROM AUTHOR]

Background: Nursing students and nurse preceptors indicate that a comprehensive orientation is vital to successful work-integrated learning placements in Prison Health Services. The aim of this study was to implement and evaluate a Prison Health Service orientation package that included innovative asynchronous online video simulations with branched decision-making and feedback opportunities to stimulate learning and improve students' feelings of preparedness for a placement in this setting. Methods: A cross-sectional pre and post design was used to evaluate the resource. Students were given access to the package and invited to complete a pre-placement survey evaluating the resource and their feelings of preparedness for placement. Following placement, they re-evaluated the resource in terms of how well it prepared them for the placement and how well prepared they felt. Third year Australian undergraduate nursing students from one university who completed a Prison Health Service work-integrated learning placement in 2018, 2021, and 2022 were invited to participate. Placements were unavailable in 2019 and 2020. Independent t-tests were used to determine differences in scale means and level of preparedness between pre- and post-survey responses. Results: Twenty-three of 40 (57.5%) eligible nursing students completed the pre-placement survey and 13 (32.5%) completed the post placement survey. All respondents to the pre-placement survey indicated that they felt satisfactorily, well, or very well prepared after completing the orientation package prior to their clinical placement. Students were significantly more likely to consider themselves well prepared by the package after they had attended placement (p <.001). All students post placement indicated that overall, the simulation resources and the specific simulation scenario about personal boundaries and management of manipulative behaviours was useful for their placement. The majority of students would recommend the orientation package to other students. Suggestions for improvement included streamlining the resource to reduce the time to complete it. Conclusions: Asynchronous online simulation with the capacity for branched decision making and feedback along with a comprehensive online orientation package were perceived as useful to prepare undergraduate students for placement in the Prison Health Service work-integrated learning setting. [ABSTRACT FROM AUTHOR]

Background: Nurses provide healthcare in prisons worldwide. Working within security restraints, in environments not designed for nursing care, custodial health nurses (CHNs) use specialist nursing skills and knowledge to do essential work. Rapid increases in prisoner age, infirmity and ill‐health of prisoners mandate their access to these nurses. Aim: To raise awareness of the CHNs struggle for specialty status within the nursing profession, public health frameworks and prisons. Sources of evidence: Publicly available information is organised and analysed through the author's lens of 20 years working in the Australian prison system as a general nurse and nurse practitioner. Discussion: CHNs efforts towards becoming a specialty within nursing, public health and prisons are ongoing. Overcoming barriers and maximising facilitators to effective CHN practice would be indicators of successful incorporation of nursing models that assist prisoner patients. Prison healthcare contexts are unique regarding prisoner health and funding that impacts the CHNs resourcing, their scope of practice and acceptance of nursing in prison systems and the broader healthcare sectors. Conclusion: Greater visibility of the CHNs will help promote policy reforms regarding nursing services within a changing prisoner demographic. Changes to educational and professional support for CHNs are needed. Policy restrictions on funding for CHN models in Australia fall short of international standards for prison healthcare; however, political and organisational commitment in this area will be necessary to attain community‐equivalent healthcare standards across the custodial setting. Implications for nursing and other policies: Professional structures, competencies and specialty policy frameworks are required to promote CHNs as advocates for prisoners needing care and their professional development. CHNs at the forefront of policy development and review will benefit all stakeholders in custodial health. [ABSTRACT FROM AUTHOR]

Purpose: Among the noninstitutionalized population, health care is increasingly shifting from a paternalistic model toward promoting patients' involvement in decision‐making and in managing their condition. This paradigm shift toward health self‐management is less applicable to individuals in prison whose health management choices are limited. The aim of this study was to explore prisoners' health self‐management needs and the strategies used to maintain health self‐management in a highly restrictive prison environment. Design A qualitative phenomenological study design was selected for this research. Methods: An interpretive phenomenological analysis was chosen to present the narratives of prisoners regarding their health self‐management. Semi‐structured interviews were conducted with 15 male prisoners followed by content analysis. Results: The analysis of the participants' narratives revealed four major themes: (1) "I thrive on the anger so I can turn it into some more sit‐ups:" Initiating sporting activities (2) "Food shouldn't be that white...:" Prisoners' quest for healthier eating (3) "I felt I want more out of life...:" Avoiding an unhealthy lifestyle (4) "I want to be taken care of:" The struggle for better health care. Conclusions: The findings suggest that prisoners can overcome the challenges of maintaining health in prison and become committed to better health management. Prisoners who serve as health resources may help reduce the load on correctional facilities' health care systems and the public. [ABSTRACT FROM AUTHOR]

Purpose: There are very few studies about the oral health status of juvenile inmates. This study aimed to determine past dental attendance, medicament usage, and smoking habits, besides oro-dental status, including caries prevalence and periodontal health status of juvenile inmates in detention centers. Material and Methods: This cross-sectional study was conducted on 232 juvenile male inmates (meanage: 16.65±0.91) in a detention center in Istanbul-Turkey. After taking general demographic information, the subjects were clinically examined according to WHO criteria. In addition, the Plaque Index (PI) and Gingival Index (GI) were recorded at Ramfjord teeth to evaluate periodontal status. All data were statistically analyzed using the IBM Statistical Package for Social Sciences (SPSS) 22.0 programme, Pearson correlation coefficient, Spearman's rho correlation coefficient, chi-square test, Fisher's exact test, Kruskal-Wallis test, and One-way ANOVA test. Results: Average length of stay was 6.54±8.38 months. 44.4% of inmates have never visited a dentist. The mean DMF-T, PI, and GI scores of the subjects were 6.78±4.07, 1.18±0.55, and 1.13±0.47, respectively. In addition, 80.2% of inmates smoked before being taken to the detention center. Conclusion: This study indicated that the oral health of detained inmates was poor. Prison health services should not be isolated but integrated into national and regional health systems. [ABSTRACT FROM AUTHOR]

Social policy has traditionally been implemented in two ways: using targeted or universal approaches. Each of these mechanisms has advantages and disadvantages to the populations to whom the policies are applied and to the system applying the policies. A third approach to social policy implementation has emerged: targeted universalism. Targeted universalism is not simply a combination of targeted and universal approaches. It stands apart as a unique way of conceptualizing and implementing social policy. This viewpoint provides an overview of targeted approaches, universalism, and targeted universalism to social policy development and implementation. It examines the ways targeted universalism could be applied to the U.S. correctional health care system to ensure that people who are incarcerated receive the health care to which they are constitutionally entitled. [ABSTRACT FROM AUTHOR]

Palliative care is increasingly important in the prison setting, but information about the quality and accessibility of this care is extremely limited. Developing and implementing standardised quality indicators will provide transparency, accountability, and a platform for quality improvement at both local and national levels. [ABSTRACT FROM AUTHOR]

This research explores the views of probation specialists working with young offenders about their professional process, professional problems, and the evidence-based practice approach. The qualitative method was used in the research and the phenomenology pattern forms the basis of the research. The data deciphered and conceptualized with descriptive analysis by the organizing and senior researcher. According to data from in-depth interviews, due to the dual structure of the probation system, which includes both execution and rehabilitation, professional staff experience role conflict. Professional problems such as excessive workload, inadequate physical conditions, not separating the job descriptions of probation specialists according to their fields of expertise, job dissatisfaction, and burnout are common. In addition, there are no scientific tools to measure the effectiveness of the intervention programs and monitoring process in the probation system. There is a need for developing the effectiveness of intervention programs in the probation system and an evidence-based intervention system. At the end of the article, some suggestions on effective social work practices in the probation system are presented from the perspective of evidence-based practice. [ABSTRACT FROM AUTHOR]

Covid-19 has had an especially detrimental impact on mental health of people with intersectional marginalized identities. Yet, research evidence on this impact is lacking, with efforts to generate it stymied by pandemic restrictions. To explore how a socially excluded gender minority group—transgender and non-binary (TGNB) prisoners—experienced, and coped with, the pandemic stressors. The data were collected via correspondence with 15 TGNB prisoners in England and Wales in April-October 2020 using an exploratory person-centred qualitative longitudinal approach and examined using reflexive organic thematic analysis. The pandemic and its restrictions to support structures and health care detrimentally impacted TGNB prisoners' mental health and wellbeing. TGNB prisoners experienced added stressors associated with their intersecting incarceration and gender minority positions, including prolonged solitary confinement and reduced access to gender-affirming health care. Environmental resources for problem-focused, emotion-focused, socially supportive and disengagement coping were reduced by the prison pandemic regime, with adaptive coping through positive distraction and engagement with TGNB/LGBTQ community particularly affected. During a pandemic and beyond, greater support and innovative practices are needed to improve the TGNB prisoners' access to gender-affirming care and to TGNB/LGBTQ community, to protect their mental health and wellbeing. [ABSTRACT FROM AUTHOR]

This prospective study aims to report on the prevalence of depression and anxiety levels, in a sample of Greek prisoners with a history of substance and alcohol use. The study comprises 100 male prisoners with a history of substance and/or alcohol use, in the Grevena Correctional Facility, in Northern Greece. BDI AUDIT, DUDIT, CAGE, STAI Y-1 & Y-2 and SCL-90 R were used. Sixty-three percent of study participants stated they had mental health problems. Another 37% stated they were on antidepressants, 16% on anti-anxiety medication, and 7% on antipsychotic medication, while only 34% were not on medication. Linear regression was utilized to identify independent predictors for each of the questionnaires scores, adjusting for age. The prevalence of depression among Greek prisoners with history of substance and alcohol use is much higher than in the general population in Greece and even between other inmate groups. Also anxiety levels of these prisoners were significantly elevated. This is the latest study in Greek prisons and the only one concerning inmates with history of dependence. Therefore, its conclusion of higher than before prevalence of depression and high anxiety level while incarcerated should be considered for diagnosis and therapy strategies in prison. [ABSTRACT FROM AUTHOR]

Background and Aims: Hepatitis C virus (HCV) is highly prevalent within the prison setting. Although HCV testing and treatment are available within prisons, system barriers can impede progress along the HCV care cascade for those who are incarcerated. The PIVOT intervention used a 'one‐stop‐shop' model (i.e. point‐of‐care HCV RNA testing, Fibroscan‐based liver disease assessment and treatment) at a reception prison in New South Wales, Australia. This analysis sought to understand the role of point‐of‐care HCV RNA testing at intake in reducing barriers to the HCV care cascade within the male prison setting. Design and Setting: Qualitative analysis using semi‐structured interviews in a reception prison in Australia. Participants: Twenty‐four men enrolled in the PIVOT study; all participants had undergone HCV point‐of‐care testing in the intervention arm. Measurements: Høj's Integrated Framework informed this analysis. Findings: Participants widely expressed the view that point‐of‐care HCV RNA testing on entry was beneficial for care engagement. Point‐of‐care testing was perceived as timely (compared with standard pathology) and reduced opportunities for adjudication by correctional officers due to fewer clinic visits for testing and results. Adoption of routine opt‐out testing at prison intake was regarded as an important strategy for normalising HCV testing (and likely to increase pathways to treatment uptake) and fostered patient candidacy (i.e. self‐perceived eligibility to access care). Conclusion: Twenty‐four men in prison in New South Wales, Australia, who underwent opt‐out point‐of‐care HCV RNA testing on entry into prison, widely supported the programme as a means of overcoming barriers to HCV testing and treatment in the prison setting, as well as providing public health benefits through early detection of HCV infection among people entering into custody. [ABSTRACT FROM AUTHOR]

Objective: This research aimed to examine the legal and regulatory obligations of authorities and healthcare professionals in the provision of prison emergency health services and to identify problems in the provision of emergency care to prisoners by using case examples from coronial findings. Methods: Review of legal and regulatory obligations and a search of coronial cases for deaths related to the provision of emergency healthcare in prisons in the past 10 years in Victoria, New South Wales and Queensland. Results: The case review identified several themes – issues with prison authority policies and procedures that delay access to timely healthcare or compromise the quality of care, operational and logistical factors, clinical issues and stigmatic issues including prison staff attitudes to prisoners requesting urgent healthcare assistance. Conclusion: Coronial findings and royal commissions have repeatedly identified deficiencies in the emergency healthcare provided to prisoners in Australia. These deficiencies are operational, clinical and stigmatic and not limited to a single prison or jurisdiction. Applying a health quality of care framework focussed on prevention and chronic health management, appropriate assessment and escalation when urgent medical assistance is requested, and a structured audit framework could avoid future preventable deaths in prisons. [ABSTRACT FROM AUTHOR]

In France, women can be incarcerated during pregnancy and can keep their babies with them in prison up to the age of 18 months. The small number of nurseries in France and their unequal geographic distribution as well as the high percentage of foreign prisoners often result in women's isolation from their usual cultural environment. Family members and cultural community play a crucial role in the process of mothering. The aim of this study is to explore through these mothers' narratives how they experience the cultural aspects of this process in the prison environment. We conducted semi-structured interviews to collect the experience of 25 mothers and 5 pregnant women in 13 different prison nurseries in France and used interpretative phenomenological analysis to explore the data. Four different themes emerged: prison: repression of cultural practices, prison: a culture of its own, loss of traditional culture, and cultural hybridization. The specific environmental architecture and operating rules in prison nurseries may induce acute repression regarding cultural ways of mothering. Considering both cultural permeability specific to the peripartum period during which women tend to more easily embrace cultural aspects from their environment, and family distance which restrains cultural transmission, these mothers gather multiple factors of vulnerability for full prisonization, as a form of forced assimilation to prison culture. But a sort of specific hybrid prison culture around motherhood seems to emerge instead, in a process similar to creolization. [ABSTRACT FROM AUTHOR]

As outlined in Estelle v Gamble (1976), the 8th Amendment to the US Constitution requires that states provide adequate care for people who are incarcerated--but what constitutes "acceptable" care under professional guidelines is frequently at odds with the standard of care used by clinicians outside of carceral facilities. Outright denial of standard care runs afoul of the Constitutional prohibition on cruel and unusual punishment. As the evidence base that undergirds standards of care in transgender health has evolved, people who are incarcerated have sued to expand access to mental health and general health care, including hormonal and surgical interventions. Carceral institutions must transition from lay administrative to licensed professional oversight of patient-centered, gender-affirming care. [ABSTRACT FROM AUTHOR]

In congregate living settings when active coronavirus disease 2019 (COVID-19) transmission is present, limiting the scope of dental care to urgent and emergent treatment minimizes exposure risk for patients and staff. Engineering controls to mitigate aerosol production during dental procedures, including enhanced high-volume evacuation, high-efficiency particulate absorbing air filtration, and the use of a dental dam provide additional protection for dental providers and staff. Properly fitted N-95 respirators are of particular importance to limit COVID-19 transmission when SARS-CoV-2 containing aerosols may be present. When patients are known to be COVID-19 positive, the use of powered air-purifying respirators is appropriate. Further protection against the spread of disease among patients and staff may be provided by point-of-care testing for patients prior to dental procedures during outbreaks. [ABSTRACT FROM AUTHOR]

Dyslexia is the most common learning disability and involves difficulty in reading, writing, and spelling in your native language despite at least average intelligence. A disproportionate share of incarcerated individuals have both dyslexia and are African American. Behavior manifestations associated with dyslexia often lead to life choices resulting in incarceration. Dyslexia is rarely considered as playing a role in unemployment, drug misuse, and incarceration. Dyslexia screening upon prison admission permits identification of individuals with dyslexia and allows for specialized reading classes to boost self-esteem and develop a skill set that is desirable in the workforce upon release. Dyslexia should be recognized as a social determinant of health whose early recognition and intervention may engender self-confidence in those affected and encourage them to be positively engaged in society. [ABSTRACT FROM AUTHOR]

Like women who are incarcerated, women sentenced to probation have high levels of physical and mental health morbidities. They rely heavily on hospital emergency departments (EDs) for health care in community settings. We examined the prevalence of nonurgent ED use in a cohort of women with a history of probation system involvement in Alameda County, California. We found that two-thirds of ED visits were nonurgent, even though most women had health insurance. Factors associated with nonurgent ED use included having one or more chronic health conditions, severe substance use, low health literacy, and recent arrest. Among a subgroup of women who also received primary care, dissatisfaction with a recent primary care visit was also associated with nonurgent ED use. The heavy use of the ED for nonurgent care in this study may reflect a need to provide options better attuned to the multiple forms of instability and barriers to wellness faced by women with criminal legal system involvement. [ABSTRACT FROM AUTHOR]

Background: In France, addiction care in prison usually consists of nurses' interventions, medical care and socio-educational programs, but new alternatives have arisen, namely the therapeutic community (TC) model. This pilot study aims to evaluate the effectiveness of this prison-based TC in comparison with classic and socio-educational care offered in French prisons. Methods: To compare these three types of prison-based care, two detention centers' files were screened for use of multiple drugs, willingness to participate and absence of psychiatric comorbidities incompatible with group therapy. A custom questionnaire was built based on the fifth version of the Addiction Severity Index. It investigates medical status, employment and support, primary addiction status, legal status, social/familial status and psychiatric status through various items. Results: Our sample only consisted of male repeat offenders with a mean age of 37.7 ± (9.1) years. Primary addiction status improvement was observed for all care studied but was more important in TC than in classic care. Self-esteem and social/familial status saw significant improvement throughout TC care. Conclusions: The TC model represents an alternative to classic and socio-educational care in French prisons. More studies are needed to assess the extent of the benefits provided on both the medical side and economic side. [ABSTRACT FROM AUTHOR]

Mobile health applications have gained popularity in assisting high-risk, hard-to-reach groups in self-management of health conditions. One such population with high rates of health disparities comprises women under community supervision. In this review, we examine the literature on mHealth applications to address health disparities among women under community supervision. We searched CINAHL, PubMed, and PsycInfo for peer-reviewed research articles conducted in the U.S. After removal of duplicates, review of 231 article titles and abstracts and 36 articles for full-text review yielded five articles for analysis. Extracted data include author, year, design, sample, objectives, conclusions, measures, interventions and analytic approach. Of the five studies that addressed health disparities of individuals under community supervision, one was done with participants on probation, four with participants on medication therapy for substance use disorder, and one with participants in a drug court program. Only one article was specific to women or controlled for ethnicity. No studies were done with those on parole. None done with populations outside the U.S. Few studies focused on health disparities of women under community supervision. mHealth applications that address substance use, reproductive and sexual health, and safety issues specific to women under community supervision are warranted. mhealth apps can assist with alleviating health disparities in hard-to reach populations. Women on community supervision have unique health care needs based on their intersectionality. Conditions such as substance use disorder and violence often go under reported or undertreated. [ABSTRACT FROM AUTHOR]

The Sequential Intercept Model has helped conceptualize interventions for people with serious mental illness in the criminal/legal system. This paper operationalizes the Sequential Intercept Model into a 35-item scorecard of behavioral health and legal practices. Using interviews, survey, and observational methods, the scorecard assesses an exploratory sample of 19 counties over 27 independent data collections. A series of ordinary least squares regression models assessed the predictor scores on four jail outcomes: prevalence of serious mental illness, length of stay, connections to treatment, and recidivism. Increases in pre-booking scores showed significant decreases in jail prevalence of serious mental illness at the p < 0.05 level, and post-booking scores and overall scores showed significant positive associations with connections to treatment at the p < 0.05 level, though these were non-significant after correcting for multiple comparisons. Preliminary findings suggest a combination of practices across the Sequential Intercept Model could have synergistic impacts on key jail diversion outcomes. [ABSTRACT FROM AUTHOR]

Justice-involved populations are at an elevated risk for infectious disease transmission and have been profoundly negatively impacted by the COVID-19 pandemic. Vaccination is being utilized as a primary tool for prevention and protection from serious infection in carceral settings. We examined the barriers and facilitators to vaccine distribution by surveying key stakeholders--sheriffs and corrections officers--in these settings. Most respondents felt prepared for rollout, although they still identified significant barriers to operationalization of vaccine distribution. Barriers ranked highest by stakeholders were vaccine hesitancy and problems related to deficits in communication and planning. There is enormous opportunity to install practices that will address the significant barriers being faced to efficient vaccine distribution and amplify existing facilitators. These could include, for example, the incorporation of in-person community communication models for discussion of the vaccine (and hesitancy) in carceral facilities. [ABSTRACT FROM AUTHOR]

Objectives: This article describes the process used to adapt the only group-based, computer-assisted, HIV/sexually transmitted infections (STI) prevention intervention designed for drug-using Black women in community corrections using an integrated health equity ADAPT-ITT framework with a peer engagement lens. Methods: Key adaptation partners included cisgender, drug-using Black women in community corrections, and Black, female, community reentry providers slated to deliver the adapted intervention. Focus groups and a study pilot were held. Results: The resulting intervention, Empowering African-American Women on the Road to Health (E-WORTH), features HIV/STI-specific Afrocentric themes of risk and resiliency tailored for and by Black women in the criminal legal system. Evaluation of E-WORTH confirms its cultural resonance. Participants had a 54% lowered odds of testing positive for any STI and reported 38% fewer acts of condomless vaginal or anal intercourse at 12-month follow-up. Conclusions: Findings underscore the need to develop an adaptation model that is explicitly health equity in focus. [ABSTRACT FROM AUTHOR]

There are over 150,000 incarcerated females in the United States. Structural inequities, including racism, adversely affect the reproductive health outcomes, autonomy, and access to care that people in custody face. This article reviews the status of reproductive health and health care among incarcerated women and describes ways that community OB/GYNs can address health inequities by providing comprehensive, compassionate care to incarcerated people, especially when they come to community settings for care while they are in custody. To address reproductive health disparities and inequities that adversely affect incarcerated individuals, community providers can implement these recommendations and also engage in advocacy. [ABSTRACT FROM AUTHOR]

The population of incarcerated adults in the United States is aging rapidly. Incarcerated adults experience accelerated aging, the process in which exposure to incarceration speeds up biological aging. The current article highlights unique structural factors and care practices that incarcerated older adults face in correctional and community health systems. These factors and practices are often in direct opposition to age-friendly care. Opportunities exist to expand research, modify existing policies, and change current care practices. Given their expertise in health system processes, gerontological nurses in correctional and community health care systems can play a pivotal role in improving the care of this growing and vulnerable population. [Journal of Gerontological Nursing, 49(3), 7–11.] [ABSTRACT FROM AUTHOR]

Women in the criminal justice system are a diverse yet marginalised group, living with the most dangerous of intersectional oppressions. Women from the Global Majority face a "double disadvantage" (Agenda, 2017). Prison is evidenced as the least effective place for women, yet prison places have increased and gender-informed services are inadequate. These obstructions to healing from trauma have created a spiralling crisis, leading to preventable deaths and the destruction of families. As a white, female art therapist, I argue that an intersectional framework is critical to understanding and supporting this service-user group. I maintain the established perspective generated by Black feminists and marginalised groups, that focusing on the most ostracised and working from the 'ground up', is an effective way of tackling social injustice. A gap in research for art therapy with this service-user group and evidence of epistemological racism within the existing literature presents an opportunity for development and growth within the profession. I discuss the possibilities of using an intersectional framework as intertwined with this service-user group, and with re-establishing ways of knowing within art therapy to ensure anti-oppressive practices. Through a summary of the existing literature developed through research in my final year of training, I will demonstrate how resistance to art therapy occurs at systemic and individual levels and that this cannot be disentangled from the neoliberal status quo. A call to action is proposed for white art therapists to increase their curiosity about their complicity in white supremacy and find ways to develop alternative epistemologies. The criminal justice system (CJS) provides care for people who are confined in institutions, such as prison or secure hospital, because they pose a significant risk to themselves or others. It also includes people who now live in the community but still need continued support when they leave hospital or prison. Most people in the CJS are men, and facilities have therefore been designed around male needs. The needs of women within the CJS have been persistently ignored by UK government, and women from the Global Majority – Black, Asian, Dual-Heritage, Indigenous and 'Ethnic Minority' communities (Campbell-Stephens MBE, 2020) – face particular disadvantages. Race, class and gender oppressions overlap and cause significant harm to the women and their families. Art therapy has been offered within these services for many years; however, there is not much research to support therapy with women in these settings. As an art psychotherapy trainee on placement at a hostel in the community for women leaving secure hospital, I wanted to find out what literature was available to support this work. I searched online databases and found only 24 published articles and book chapters. It was difficult to relate the findings to my community work as the literature was based mostly in high security settings. Most of the authors were white women in professional roles so other people's perspectives were not represented. This meant that what I found was not a fair description and therefore, not very reliable. However, art psychotherapy was shown to offer positive benefits and respond to existing recommendations for this client group. This paper presents an argument for the need for art therapy services for women in forensic services and proposes a call to action for white art therapists to increase their curiosity about their complicity in white supremacy and find ways to develop alternative intersectional, anti-oppressive practices. The paper also highlights the need for more research from art psychotherapists from different backgrounds that is developed in collaboration with service-users. [ABSTRACT FROM AUTHOR]

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There is variation in provision of social care in prisons. Our research aimed to understand variation across adult prisons in England and Wales, including: (1) what social care is provided? (2) who delivers social care? (3) what peer support initiatives are used? (4) what social care indicators are relevant? and (5) are there differences between prison type and social care provision? We analysed Her Majesty's Inspectorate of Prisons (HMIP) reports (published 2017–2020) from 102 prisons. From these reports we extracted and analysed data on social care provision. Elements of social care are not consistently delivered; need assessments (81.4 per cent) and referrals (75.5 per cent) were most frequently reported. Different providers (health care/social care/prison) deliver social care. Forty-one prisons (40.2 per cent) included peer support (formal to informal). We found no notable differences between prison categories and social care delivery, although, within category D prisons, a significantly larger proportion of those with a disability reported receiving support they needed. Inspection reports highlighted that prison social care should mirror community social care, but we could not fully evaluate this due to reporting issues. Social care provision varies; effectiveness of different models is not yet known. We provide recommendations to improve social care reporting within HMIP reports. [ABSTRACT FROM AUTHOR]

In the article "Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics," Sean Valles provides an important reminder of the consequences of mass incarceration in the United States and identifies potential roles for bioethicists in addressing this system. My limited view—that of a physician who conducts court‐ordered investigations and monitoring of health services behind bars—is that the ongoing failure of most academic and professional organizations to be more effective in this much‐ignored area stems from the lack of leaders and staff who have been directly impacted by mass incarceration. As conditions behind bars worsen, and a new war on drugs recoils the spring of mass incarceration, there is a pressing need to train, recruit, and promote people who know the realities of the criminal (and immigration) justice system and its impact on health and well‐being. This step can bring a more powerful engagement of bioethics regarding housing, employment, and health care and policing, as well as the numerous and harmful elements of jails, prisons, and detention settings. I provide examples of partners I learn from in this arena, as well as some discrete and technical areas for possible investigation. [ABSTRACT FROM AUTHOR]

George F Winter explores existing issues in the provision of midwifery care for women in prison, in relation to the United Nations' declaration regarding standards of care for prisoners [ABSTRACT FROM AUTHOR]

Background: Lifestyle factors place those who experience incarceration at increased risk of morbidity and mortality from a range of preventable diseases, including cancer. Methods: Two nurses were employed for a period of 6 months to facilitate bowel and breast cancer screening of prisoners across four correctional centres in Queensland. We identify factors impacting on cancer screening in prisons and document the outcomes for those screened. Results: Both screening programs produced a positivity rate of ~17% in those screened, with 23 individuals returning a positive faecal occult blood test and five women requiring further investigations following breast screening. At 3 months postscreening, all of the positive cases had been referred for further investigations. It is likely that the screening programs were instrumental in preventing morbidity (and mortality) in the subgroup with positive test results. Conclusions: Cancer screening within the prison environment presents a number of challenges. Intervention at the individual and systems level is required to ensure prisoners can access a standard of care equal to that provided in the community. Cancer screening programs in correctional centres are poorly established and tend to be provided on an ad hoc basis. We show that co-ordinated cancer screening programs in prisons enabled early detection of bowel and breast cancer that may have gone undiagnosed. Intervention at the individual and systems level is required to ensure prisoners can access health care equal to that provided in the community. [ABSTRACT FROM AUTHOR]

Background: This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII) designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. Methods: A mixed-method cluster randomized design was used to randomize 21 sites to early- or delayed-start within 9 research centers. Parent study protocol was reviewed to develop fidelity constructs (i.e., responsiveness, dose, quality, adherence). Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percent goals achieved). Correlations, analyses of covariance, regressions and moderation analyses were performed. Qualitative interviews assessed facilitators/barriers to implementation. Results: Fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness (i.e., engagement in the OPII) related to poorer outcome. Conclusions: It is important to consider contextual factors (e.g., leadership) that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance. [ABSTRACT FROM AUTHOR]

Background The Centers for Disease Control and Prevention recommends serial rapid antigen assay collection within congregate facilities. Although modeling and observational studies from communities and long-term care facilities have shown serial collection provides adequate sensitivity and specificity, the accuracy within correctional facilities remains unknown. Methods Using Connecticut Department of Correction data from 21 November 2020 to 15 June 2021, we estimated the accuracy of a rapid assay, BinaxNOW (Abbott), under 3 collection strategies: single test collection and serial collection of 2 and 3 tests separated by 1–4 days. The sensitivity and specificity of the first (including single), second, and third serially collected BinaxNOW tests were estimated relative to RT-PCRs collected ≤1 day of the BinaxNOW test. The accuracy metrics of the testing strategies were then estimated as the sum (sensitivity) and product (specificity) of tests in each strategy. Results Of the 13 112 residents who contributed ≥1 BinaxNOW test during the study period, 3825 contributed ≥1 RT-PCR paired BinaxNOW test. In relation to RT-PCR, the 3-rapid-antigen-test strategy had a sensitivity of 95.9% (95% CI: 93.6–97.5%) and specificity of 98.3% (95% CI: 96.7–99.1%). The sensitivities of the 2- and 1-rapid-antigen-test strategies were 88.8% and 66.8%, and the specificities were 98.5% and 99.4%, respectively. The sensitivity was higher among symptomatic residents and when RT-PCRs were collected before BinaxNOW tests. Conclusions We found serial antigen test collection resulted in high diagnostic accuracy. These findings support serial collection for outbreak investigation, screening, and when rapid detection is required (such as intakes or transfers). [ABSTRACT FROM AUTHOR]

Students with forensic/correctional interests seek out related doctoral internship sites, though often without clear, updated information on what these sites desire of applicants. To clarify student experiences and qualities most valued by these internships. We identified internship sites reporting "forensic/correctional experience" via a public internship directory (N = 164). We gathered site information from directory pages and sent an online survey to the sites' internship directors. Internship directors (n = 57) preferred students with primarily generalist (rather than forensic) training. Applicant characteristics (e.g., flexibility and professionalism) were most impactful, followed by intervention and assessment experiences (especially cognitive-behavioral therapy and intelligence and personality testing). Cultural competency was deemed more important and research experience less important than in previous studies of general internships. Conclusion: Results are largely consistent with previous surveys, though some observed changes in training directors' expectations appear to reflect changes in the field at large. Students with forensic/correctional interests should primarily seek generalist experiences with supplementary forensic training. Training should focus on fostering flexibility, openness, professionalism, and cultural competency as well as cognitive-behavioral intervention, intelligence testing, and personality assessment. [ABSTRACT FROM AUTHOR]

Background: Jails in Massachusetts are among the first nationwide to provide correctional populations with medications to treat opioid use disorder (MOUD). The COVID-19 pandemic caused jails to pivot and adapt MOUD programming. We aimed to identify adaptations and barriers to MOUD access that COVID-19 exacerbated or created, and document new elements that staff wish to sustain as COVID-19 recedes. Methods: We conducted semi-structured in-depth interviews and focus groups in 2020–2021 with 29 jail staff who implement MOUD programming in two Massachusetts jails. We conducted qualitative data analysis in Atlas.ti 8 using an inductive approach. Results: Participants shared that access to MOUD among correctional populations is understood by jail staff to be an essential health service. Thus, to facilitate continued access to MOUD, both during incarceration and also at community reentry, jail staff quickly implemented changes in MOUD regulations and dosing protocols and established telehealth capacity. Despite these program adaptations, participants identified how COVID-19 increased health and social needs among correctional populations, reduced availability of community-based healthcare and recovery-supportive services, and introduced new factors that could undermine recovery. Innovations that participants wished to sustain as COVID-19 receded included telehealth capacity, smaller-sized therapeutic groups, and application of a public health approach to treat opioid use disorder among correctional populations. Conclusions: During disruptive events, jails can adapt MOUD programming to ensure access for people living in jail and upon release. Findings identify factors for understanding the outcomes of jail-based MOUD programming during COVID-19 and highlight opportunities to improve service delivery after COVID-19. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the implementation of the first Professional Master's Course in Nursing in the state of Rondônia, Brazil, contemplated in Notice 28/2019 of the Technical Cooperation Agreement CAPES/Cofen 30/2016. Methods: This is a study from a historical perspective, which used institutional documents and legal provisions related to the subject. The collection of information was carried out from September 2020 to September 2021. Results: Implementation of the first Professional Master's course, away from headquarters, by the Postgraduate Program in Health Care Practices at the Federal University of Paraná in the State of Rondônia. Ten professionals were selected to form the first professional master's class, who develop research projects in different professional nursing practice scenarios: Tertiary Care (66.7%), Primary Care (22.2%), and Federal Prison System (11.1%). Results of the research conducted will develop a technical/technological product, according to the requirements of a Postgraduate Program in the Professional Master's Degree modality. Conclusion: Offering a professional master's degree in the state of Rondônia has provided the qualification of nurses, preparing them for decision-making based on scientific evidence. This proposal promotes professional valorization and the improvement of health practices in the Amazon region. [ABSTRACT FROM AUTHOR]

Women incarcerated in local jails have pregnancy and sexual health needs, yet little information is available about what services are provided and how jail administrators prioritize this care. Our objective was to document jails' provision of pregnancy and sexual health services in four states in the Midwest. We invited all jail administrators (N = 347) in Kansas, Missouri, Iowa, and Nebraska to participate in a web-based survey conducted from November 2017 to October 2018. We asked administrators which pregnancy and sexual health services they offered and to rate the importance of offering services. Results were analyzed using descriptive statistics and logistic regression. The survey response rate was 55% (192/347). Jails most often provided pregnancy testing (n = 116 [60%]) and distribution of prenatal vitamins (n = 85 [44%]). Sexually transmitted infection treatment was offered at 23% of jails (n = 45). Larger, accredited jails located in urban areas and with high numbers of clinical providers on staff were more likely to provide sexual health services. Jails with privately contracted health care were more likely to provide pregnancy services compared with other entities providing medical care. The most prioritized sexual health service was sexually transmitted infection testing, with 39% of administrators believing it was important. Only 6% of administrators responded that contraception was important. Local jails in the Midwest do not meet the basic reproductive and sexual health needs of women. Provision of these services is not a priority for jail administrators. Appropriate partnerships could engage administrators and increase the availability of services to meet the needs of women in jail. [ABSTRACT FROM AUTHOR]

This study investigated the perceived health status and satisfaction with prison healthcare services of detained male individuals in Italy. A cross-sectional study was performed between March and June 2021. Of 800 male detained individuals who were invited to participate in the study, 632 returned the self-administered questionnaire, resulting in a response rate of 79%. Overall, 72.8% of participants reported that they were moderately or completely satisfied with their health status, and 27.2% stated that they were not at all satisfied. Moreover, 66.2% of participants reported that they had at least one health problem or disease, compared with 34% at the time of incarceration, with 35% reporting multiple health problems/diseases. In total, 10.1% of participants requested healthcare when a health problem occurred, and 12.4% were always satisfied with the healthcare that they received. Significant determinants of dissatisfaction with health status were older age, reported health problems/diseases, suicide attempts, emotional problems and no working activity in prison. Significant determinants of dissatisfaction with healthcare services were younger age, health problems at incarceration, suicide attempts and multiple experiences of incarceration. This study shows that detained male individuals have multiple and frequently unmet health needs. Some of the reported health problems or diseases were present at the time of incarceration, but these often worsened and/or increased during detention. This study highlights the need to promote evidence-based intervention to strengthen the role of healthcare services provided in prisons. [ABSTRACT FROM AUTHOR]

Objectives: The number of incarcerated women in the United States has risen exponentially. Many are of childbearing age with 3-4% being pregnant at intake. Despite the need for comprehensive pregnancy-related health care in prisons and jails, there is no oversight that requires adherence to the established standards. The objective of this study was to assess prison and jail pregnancy policies and practices with an emphasis on restraint use and compliance with anti-shackling legislation. Methods: We conducted a survey of 22 state prisons and six jails, including the five largest jails, from 2016–2017 regarding pregnancy policies and practices including restraint use, prenatal care, delivery and birth, and other pregnancy accommodations. We compared reported restraint policies to state legislation at the time of the survey. Results: Data indicate that pregnancy policies and services in prisons and jails vary and compliance inconsistencies with anti-shackling legislation exist. A third of the prisons and half of the jails did not have accredited health care services. All study facilities provided prenatal vitamins and most provided supplemental snacks. Most facilities stationed an officer inside the hospital room during labor and delivery, but nearly one-third of facilities did not require a female-identifying officer. Conclusions for practice: Limited oversight and standardization of carceral health care and accommodations for pregnant people lead to variability in prisons and jails. Prisons and jails should adopt and implement standards of care guidelines to ensure the safety and well-being of pregnant people who have unique healthcare needs. Incarcerated pregnant people should be viewed as expectant parents in need of comprehensive health care, rather than as criminals who forfeited their right to a safe, respectful, and humane childbirth. [ABSTRACT FROM AUTHOR]

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Purpose: There is clear evidence that prison can be detrimental to mental health and that wider society has tended to assume "out of sight, out of mind" for prisoners in mental distress. The lack of access to effective mental health care in prisons along with increasingly lower numbers of prison officers, or Operational Officers (OOs), has created a negative culture that requires the development of specialist services. With this comes a need to conduct evaluations, and investigations, into the roles of OOs and mental health-care staff. This study aims to report on a commissioned evaluation around the introduction and development of an HMP Mental Health Unit, named the integrated support unit (ISU), in the North of England. This study's section of the wider evaluation focuses on the early team building, working practice and development of mental health registered nurses, other care staff and OOs within the ISU. Design/methodology/approach: Three focus groups incorporating two professional groups took place on the ISU. The first of six Mental Health Workers (MHW) including Registered Mental Health Nurses and support workers; the second of two sets of two ISU dedicated OOs. The areas addressed within each of the groups concerned why staff wanted to work in the ISU, as well as how they would measure its potential success, and the necessary skills competencies and training they thought were required to prepare them to work in the area. Findings: Overall, the participants expressed an interest or enthusiasm for their work having actively chosen to work in the ISU. There was a strong sense of a wish for the unit to succeed; in fact, success was a motivating drive for all. Both OOs and MHW emphasised the importance of teamworking, autonomy and freedom as well as information sharing. Analysis also revealed many areas of practice that were challenging. The findings are optimistic for the development of such special units as evaluated here. The drivers for different professions along with their measures of success in the field are discussed in detail. The relationship, expectations, hopes and needs of both MHW and prison officers working in a multidisciplinary unit provide useful information to support both policy and practice in the field. The authors make recommendations around training regimes and how they can effectively coordinate the different symbiotic professional roles. The ISU is a new initiative in offender management within prisons and is reviewed as a model of mental health practice in prison settings. Practical implications: The value in recruiting to the ISU dedicated OOs, with committed interests in mental health. A continued emphasis on the ongoing development of team working, focussing on issues of risk, trust and treatment. The development (by nurses) of a formal/mandatory period of training for new OO's prior to taking up a role on the ISU. For mental health nurses to embrace team leadership/educator roles in the areas of mental health awareness, team building and conflict resolution. To capture and formulate and develop the specific range of mental health interventions offered within the ISU. Originality/value: The presented research explores and evaluates the introduction of a new mental health wing (ISU) for 11 patients in a Northern UK prison. It does this through the consideration of group discussions with both MHW and OOs on this wing. This work is part of a larger study. [ABSTRACT FROM AUTHOR]

An overwhelming number of justice-involved individuals arrive in correctional settings with many complex physical and mental health conditions. Consequently, health care interventions are needed to stabilize and prevent further deterioration of these conditions. This opinion article discusses the significance of nursing care in correctional settings. The goal is to raise awareness and convince readers that this is an important issue to address. The article presents evidence from practice, court cases, and published research that supports the arguments and facts, with focus on the overarching correctional goals of public safety and rehabilitation, and the role of nurses in the achievement of those goals. Corrections and health care administrators must engage in meaningful and compromising ways to attain the correctional goals for the benefit of justice-involved individuals and the community at large. [ABSTRACT FROM AUTHOR]

The U.S. Department of Justice indicates that 83% of individuals released from state prisons in 2005 were arrested at least once during a 9-year follow-up period. With only 17% of released individuals not rearrested, it could be argued that correctional facilities fail to provide the necessary resources that individuals need for proper rehabilitation and reintegration. Thus, there is a need for alternative jail and prison programming. This article reviews the leading program, cognitive behavioral therapy, and advocates for the integration and use of mindfulness-based interventions (MBIs) in carceral settings. Specifically, this article reviews the literature on MBIs and their significance in corrections. [ABSTRACT FROM AUTHOR]

The health of incarcerated populations is intertwined with the health of security staff, but the social mechanisms, and especially the specific interventions, that might mitigate these health harms are underexplored. We examine one possible mechanism of interrelated health harms: whether and how jail security staff are willing and able to care for mentally ill detainees. We hypothesize that the attitudes of security staff towards care affect the well-being of everyone in a jail setting—staff, as well as detainees. Analyzing 539 anonymous respondent surveys administered to a stratified cluster sample of security staff working in a large U.S. county jail system, we (1) describe the prevalence of a perceived duty to care and availability of caring resources among security staff and (2) analyze whether variations in a duty to care and caring resources predict outcomes associated with staff and detainee well-being. Across five maximum likelihood models estimated, both perceived duty to care and availability of caring resources are significantly associated with collaborative relationships with medical staff, increased perceptions of personal safety, decreased frequency of hostile encounters, and better self-reported health outcomes. Our models explain 20 percent of the variation in self-reported health outcomes (R2 =.20), a meaningful effect of care on security personnel's well-being. Our findings suggest security staff have an often-overlooked duty to care akin to that experienced by healthcare staff. Among healthcare staff, dual loyalty trainings have successfully amplified caring duties relative to security duties; similar trainings for security staff might better leverage their caring duties to improve both staff and detainee well-being. • Security staff, like medical staff, experience "dual loyalty" conflicts in jails. • Jail security staff with access to more caring resources are healthier and safer. • Health and safety of jail security staff is closely related to that of detainees. • More access to caring resources can improve overall staff and detainee well-being. [ABSTRACT FROM AUTHOR]

49 Background: Cancer is the leading cause of death in US prisons. Incarcerated patients with cancer have 92% higher 5-year mortality than the general population with cancer, but little is known about how to improve cancer screening, diagnosis and treatment in this high-risk population. Methods: We conducted interviews with state prison medical directors and primary care clinicians, and medical, radiation and gynecologic oncologists who coordinate or provide cancer care for individuals incarcerated in prison. Participants were recruited via 1) email invitation to participants at a correctional health conference, 2) purposeful sampling using targeted emails to clinicians in prison systems selected for diversity in size, geography and correctional health model (e.g., contracted care), and 3) snowball sampling of individuals from research and participant networks. Participants were interviewed about 1) logistics of cancer care delivery from screening and treatment through end-of-life care, 2) barriers and facilitators to cancer care delivery, and 3) evidence-based strategies to facilitate cancer care in prisons, including best practices. Interview transcripts were analyzed using mixed inductive/deductive thematic content analysis to identify emerging themes. Results: 34 participants from 16 prison systems were interviewed (10 medical directors, 6 PCPs, 14 oncologists, 4 other). Participants reported prison clinicians coordinate most cancer care (e.g., screening, diagnosis and symptom management), while cancer treatment largely occurs in community or academic facilities outside of prison. Common barriers identified included underscreening / delays in diagnosis, complex logistical coordination, poor communication (between patients and oncologists, and prison clinicians and oncologists), inadequate symptom management, dehumanizing practices, loss-to-follow-up after release and that patients often come from marginalized populations. Common facilitators were better access to insurance, cancer screening, and general medical and cancer care than incarcerated patients might receive before/after incarceration. Participants identified multiple ways to improve cancer screening (creating enforceable standards, increasing continuing medical education, implementing electronic medical record reminders, reducing logistical barriers), cancer treatment (implementing navigators within prisons and cancer centers, prioritizing care with oncologist input, keeping care in prisons, decarceration), and transitions to the community (Medicaid activation prior to release, community partnerships to facilitate care transitions). Conclusions: Incarceration imposes multiple barriers to cancer care delivery, but clinicians identified numerous tools to improve cancer care in prison. Future studies should test and optimize these strategies to improve cancer outcomes for incarcerated patients. [ABSTRACT FROM AUTHOR]

Prison needle exchange programs (PNEPs) are a critical component for harm reduction in prisons. Little is known about the PNEP access barriers for people who are incarcerated, but the low uptake in the Canadian program highlights these constraints. We aimed to identify the barriers and potential solutions for increasing PNEP coverage in the nine Canadian federal prisons where they operate. Eighteen focus groups were conducted in nine prisons using nominal group technique (NGT) with two stakeholders: peer advocates and people who use or identified as potential users of the PNEP. NGT uses a round-robin technique followed by generating a list of barriers to PNEP enrolment within their prison. Participants then allocated votes to rank the highest priority barriers, followed by an identical process to generate solutions to address the top three barriers. Interview transcripts describing participant narratives during this process were de-identified and coded to generated themes. Barriers and solutions receiving >10 % of votes within respective participant groups, alongside associated narratives, are discussed more fully. Fear of repercussions due to drug use, lack of confidentiality, and fear of being targeted and sanctioned by correctional authorities were perceived by both stakeholder groups as the top barriers inhibiting PNEP enrolment. Stigma (peer advocates) and the application process for the program (PNEP users) were also ranked as a priority. Proposed solutions included education and external oversight of PNEP (i.e., not via correctional officers) by both groups. Peer advocates regarded improving participant confidentiality and a supervised/safe injection site as potential enablers for program participation, while PNEP users identified wrap-around services as likely to improve access. Barriers to increasing PNEP coverage in Canadian federal prisons proposed by participants highlight the importance of trust and perceived repercussions surrounding program participation. These barriers and proposed solutions highlight a need for changes in implementation to PNEP delivery if the potential health benefits of PNEPs are to be realised. [ABSTRACT FROM AUTHOR]