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Background: The World Health Organization (WHO) has indicated that the absence of prison health poses a threat to public health, making it important to safeguard access to quality healthcare for incarcerated populations. Although several studies have explored the quality of care in prisons, there is a dearth of empirical evidence on the perspectives of incarcerated individuals. This study investigated incarcerated individuals' perspectives and opinions on the general healthcare services in Ghanaian prisons. Methods: Utilizing a qualitative approach, focus group discussions were conducted with 51 incarcerated individuals in five prisons sited in the Northern, Middle and Southern zones of Ghana. Thematic analysis following the tradition of Braun and Clarke was conducted. Four of the six constructs of the WHO Health Systems Framework – service delivery, health workforce, access to essential medicines, and leadership and guidance – were applied deductively to organise the data into themes and subthemes. Results: Four themes were generated from the analysis: "Health service delivery", "Health workforce in prisons", "Access to essential medicines" and "Leadership; regulating healthcare services". Participants rated health services in prisons as below average compared to those available to the general population. The use of nurses as prescribers in prison infirmaries, though consistent with Ghana Health Service policy, seems to negatively influence prisoners' perceptions of the quality of the health workforce in prisons. Lack of basic equipment and essential medications at the infirmary for common endemic conditions such as malaria coupled with the bureaucratic processes required to access care outside of the prison also negatively affected incarcerated individuals' perceptions of the quality of health care. Conclusions: Incarcerated individuals perceived that the quality of health services provided in prisons was inferior to that provided in the general population. Addressing challenges associated with the unavailability of essential drugs and equipment, improving the number of health staff, and addressing bottlenecks in accessing urgent care will enhance the experiences of incarcerated populations on the quality of care given. [ABSTRACT FROM AUTHOR]

There is a need for updated survey literature collected from correctional mental health professionals working within prison settings. Up to date research can add to the literature addressing the best practices for mental health treatment of the transgender incarcerated population in order to provide health care professionals and correctional staff with more effective, efficient, and widely understood intervention practices to facilitate the well‐being and safety of this population. Guided by three research aims, 50 mental health professionals from 21 states throughout the United States were surveyed in this quantitative survey regarding their work with the transgender incarcerated population. Results are discussed in terms of implications for the type of care and coordination of care provided by correctional mental health professionals. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusions Impact Reporting Method Patient or Public Contribution to the Development of this Study To explore nursing students' lived experience of a clinical placement within healthcare in a prison, to gain an insight into the support provided prior to and during this unique clinical placement.An inductive phenomenological study.Participants included 14 nursing students from three undergraduate nursing programmes in England, Adult (n = 4), Learning Disability (n = 3) and Mental Health (n = 7). Following a clinical placement in a prison, each participant completed a semistructured audio‐recorded interview on MS Teams between October and December 2021. Audio recordings were transcribed verbatim and thematic analysis was completed.Two overarching themes were identified, ‘shock’ due to the (a) reality of prison; (b) overwhelming emotional impact and (c) frequency and severity of self‐harm and ‘surprise’ due to (a) the need to work with prison officers; (b) recognizing and addressing preconceptions of people in prison and (c) the development of clinical knowledge, skills and becoming a nurse.The need remains for a comprehensive strategy of preparation and orientation for nursing students before commencing a clinical placement in prison, which includes the development of knowledge and clinical skills to support the complex health and social care needs of people in prison.Our research identified the support provided to nursing students prior to clinical placement in prison varies considerably. The development of a preparation and orientation programme has the potential to reduce pre‐placement anxiety, emotional burden and support nursing students in addressing their preconceptions of people in prison. This approach is essential to support future nursing students to embrace the unique opportunity of a clinical placement within a prison, enhance their clinical knowledge and skills, and develop as a nurse.Our paper adheres to the consolidated criteria for reporting qualitative research (COREQ).None. [ABSTRACT FROM AUTHOR]

The aims of this research were to explore custodial prison staff and male prisoners' perceptions toward self-harm, prison system responses and environmental impacts on self-harm. Four staff focus groups (thematic analysis) and 12 semi-structured interviews with male prisoners (interpretative phenomenological analysis) took place in three prisons in England. Prison staff attributed manipulative intention to self-harm; self-harming prisoners felt misunderstood. The prison environment and formal response processes were barriers for care access and provision. Recommendations include staff training in understanding and management of self-harm, supported by a care-focused culture, and fostering safety, security, empowerment and value for both prisoners and staff. [ABSTRACT FROM AUTHOR]

Background: Nurses working in detention centers play a pivotal role in inmate healthcare. Yet, they often face areas of tension due to conflicting jail policies and nursing principles, which affects their work and their response to the challenging environment. Objectives: This qualitative study explores nurses' experiences in providing healthcare to inmates, focusing on areas of tension within this context. Method: We conducted a Reflective Lifeworld Research study using semi-structured interviews to explore the phenomenon. Results: Four elements emerged as areas of tension: 1) reconciling meaningful care with the harsh environment; 2) navigating between constraints and opportunities; 3) maintaining trust while avoiding manipulation; and 4) balancing alliances with controversies between nurses and other professionals. Conclusions: This study provides an in-depth understanding of nurses' complex roles in detention centers, highlighting their adept handling of areas of tension in a demanding work environment. Nurses successfully manage workplace challenges by remaining consistently aware of the harsh surroundings without compromising their relationships with inmates or the quality of care provided. [ABSTRACT FROM AUTHOR]

Criminal justice staff work in a challenging setting and yet are often expected to promote positive change in justice-involved individuals. This study examined the 1) types of supportive interactions criminal justice staff engage in with justice-involved individuals, 2) association between staff’s professional quality of life (i.e. burnout, secondary traumatic stress, compassion satisfaction) and their endorsement of supportive interactions, and 3) the moderating impact of stigmatizing attitudes. Criminal justice staff across the U.S. (n = 152) completed demographic questionnaires, the Professional Quality of Life-V, Attitudes Toward Prisoners scale, and endorsed types of supportive interactions they engaged in with justice-involved individuals in the past year. Bivariate correlations, Poisson regressions, and moderation analyses were conducted. Staff with traditional helping roles (e.g. psychologists), higher degrees obtained, and more compassion satisfaction (i.e. one’s gratification from their job) engaged in more types of supportive interactions. Staff with more stigma toward justice-involved individuals engaged in fewer types of supportive interactions. Staff’s stigma, as a moderator, strengthened the association between compassion satisfaction and the types of supportive interactions staff endorsed. Criminal justice agencies should continue training to improve working relationships between staff and clients, increase compassion satisfaction, and reduce stigma to potentially impact justice-involved individuals’ behavior during and after incarceration. [ABSTRACT FROM AUTHOR]

Background: More than 50,000 older male veterans incarcerated in prisons are expected to return to their communities and utilize the Veterans Health Administration (VHA) and community healthcare systems. To support the continuity of healthcare and overall successful community reentry of older incarcerated veterans, an understanding of their health profiles and treatment utilization while in correctional care is needed. Objective: To assess the health status of older male veterans incarcerated in state prisons and explore demographic, military, and VHA-related factors associated with medical conditions, disabilities, behavioral conditions, and medical and behavioral treatment utilization. Design/Participants: Cross-sectional observational study of 880 male veterans aged 50 + incarcerated in state prisons using data from the 2016 Bureau of Justice Statistics Survey of Prison Inmates. Main Measures: Veteran status, self-report health status, and treatment utilization since prison admission. Prevalence rates for conditions and treatment utilization were calculated. Logistic regression models were used to examine the association of characteristics with conditions and treatment utilization. Key Results: Among the 880 older male veterans in state prisons, the majority reported having a current medical condition (79.3%) or disability (61.6%), almost half had history of a mental health condition (44.5%), and more than a quarter (29%) had a substance use disorder. Compared to White veterans, Black veterans were less likely to report a disability or mental health condition. Few demographic, military, and VA-related characteristics were associated with medical or behavioral conditions or treatment utilization. Conclusion: Our results suggest that the VHA and community healthcare systems need to be prepared to address medical and disability conditions among the majority of older male veterans who will be leaving prison and returning to their communities. Integrated medical and behavioral healthcare delivery models may be especially important for these veterans as many did not receive behavioral health treatment while in prison. [ABSTRACT FROM AUTHOR]

Background: Little is known about the health and well-being of U.S. correctional nurses. To protect correctional nurses, a better understanding of organizational characteristics, job stress, and well-being must be undertaken. Method: A cross-sectional design was used in the form of an online survey. Correctional nurses were conveniently recruited using national listservs and snowball sampling. Variables were measured with the Health & Safety Executive Management Standards Indicator Tool, Nurse Wellbeing Index, and the Perceived Stress Scale. Data were analyzed using descriptive statistics and analyses of variance. Findings: Two hundred seventy participants (142 registered nurses, 83 licensed practical nurses/licensed vocational nurses, and 42 advanced practice nurses) completed the survey. Job stress scored moderate (M = 16.26, SD = 7.14), and well-being levels were just below the risk for adverse events (M = 1.8, SD = 3.06). Lower scores were noted for managerial support (M = 3.13, SD = 0.35) and job demands (M = 3.56, SD = 0.92), but slightly better for job control (M = 3.57, SD = 0.77), peer support (M = 3.85, SD = 0.64), and workplace relationships (M = 3.73, SD = 0.95). Conclusions: Significant differences between organizational characteristics, job stress, and well-being were found across nursing licensure, workplace environments, biological sex, and employment through state or private agencies. Registered nurses working in U.S. prisons experienced the highest job stress and worse well-being. Application to Practice: This work is an essential next step in promoting healthy workspaces, urging the need for further research establishing the impact of organizational characteristics and job stress on nurse well-being. [ABSTRACT FROM AUTHOR]

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study sought to establish the feasibility of a two-component intervention embedded within a jail setting that would detect detainees with early psychosis and connect them to coordinated specialty care (CSC) in the community upon release. The two components of the intervention were a targeted educational campaign for correction officers and a specialized early engagement support service to facilitate jail discharge planning. Jail detainees with early psychosis were referred to the project and assessed for positive and negative symptoms, substance use, and duration of untreated psychosis (DUP). During a 24-month period, 25 individuals were referred, of whom eight were eligible and interviewed. The sociodemographic and clinical characteristics of the jail detainees were similar to those of individuals in hospital settings. The median DUP was 36 weeks. One of the eight detainees with early psychosis was successfully referred to CSC; for the other detainees, social or criminal legal factors precluded referral. A targeted educational campaign for correction officers and a specialized early engagement support service can be implemented in a jail setting, and referrals can be facilitated. Success of the campaign may depend on having dedicated liaisons within the jail setting (e.g., among correctional health staff) as well as liaisons in local CSC programs and leadership. Changes in the law and policy environments (e.g., criminal legal system reform) and changes in organizational practices and processes for corrections, correctional health, and local CSC programs (such as those made during the COVID-19 pandemic) require ongoing collaborations. [ABSTRACT FROM AUTHOR]

Background: Security prisoners in Israel are those imprisoned due to offenses involving harming state security or from nationalistic motivations. On the one hand, they are accused of a serious criminal offense that harmed state security, while on the other hand they have a right to healthcare like any human being. According to the Theory of Planned Behavior, an attitude is one of three components that predict a behavior intention. The study aims to evaluate the attitudes of nurses, paramedics, and medics toward security prisoners, and to identify factors that could be related to their attitudes. Methods: A cross-sectional study, conducted using a convenience sample. Attitudes toward security prisoners were measured using the Attitudes Towards Prisoners (ATP) questionnaire. The study included 281 participants. The results show that the nationality of staff members (Jewish, Muslim, or Christian) did not influence their attitudes toward security prisoners (p > 0.05). Results: Staff members who had treated a security prisoner showed a more positive attitude compared with those who had never treated a security prisoner (p < 0.05). The study also found that the youngest group of participants (20–30 years) had a lower average attitude compared with older age groups (p < 0.05). This may be due to the younger participants' closer age to the experience of military service. Conclusions: This study showed that there is no connection between staff members' nationality and their attitudes toward security prisoners. This indicates that the staff treat patients in accordance with the equality value. By characterizing variables related to the staff's attitudes we can propose appropriate training programs for the studied staff and the introduction of this topic into the various curricula in Israel, thus improving the quality of staff care. [ABSTRACT FROM AUTHOR]

Background: Mental health problems are highly prevalent in prison populations. Incarcerated persons generally come from disadvantaged backgrounds and are living under extraordinary conditions while in prison. Their healthcare needs are complex compared to the general population. Studies have found that incarcerated individuals are reluctant to seek help and that they experience challenges in accessing mental healthcare services. To some extent, seeking treatment depends on the degree of fit between potential users and health services, and actual use might be a better indication of accessibility than the fact that services are available. This study aimed to explore individual and systemic facilitators and barriers to accessing mental healthcare in a prison context. Methods: An analytical approach drawing on elements of constructivist Grounded theory was the methodological basis of this study. Fifteen male participants were recruited from three prisons in Northern Norway. Data was collected through in-depth interviews on topics such as help-seeking experiences, perceived access to services and availability of health information. Results: We found that distrust in the system, challenges with the referral routines, worries about negative consequences, and perceived limited access to mental healthcare were barriers to help-seeking among incarcerated individuals. How prison officers, and healthcare personnel respond to incarcerated persons reporting mental distress could also be critical for their future willingness to seek help. Providing information about mental health and available services, initiating outreaching mental health services, and integrating mental health interventions into treatment programs are examples of efforts that might reduce barriers to accessing services. Conclusions: Facilitating access to mental health services is crucial to accommodate the mental health needs of those incarcerated. This study provides insights into the complex interplay of individual, social and systemic factors that may contribute to the utilization of mental health care among incarcerated persons. We suggest that correctional and healthcare systems review their practices to facilitate access to healthcare for people in prison. [ABSTRACT FROM AUTHOR]

Background: Evidence has shown that the risk of transmission of SARS-CoV-2 is much higher in prisons than in the community. The release of the COVID-19 vaccine and the recommendation by WHO to include prisons among priority settings have led to the inclusion of prisons in national COVID-19 vaccination strategies. Evidence on prison health and healthcare services provision is limited and often focuses on a single country or institution due to the multiple challenges of conducting research in prison settings. The present study was done in the framework of the EU-founded project RISE-Vac. It aimed to analyse the best practices and challenges applied in implementing COVID-19 universal vaccination services during the pandemic to support future expansion of routine life course vaccination services for people living in prison (PLP). Methods: Two online cross-sectional surveys were designed and piloted: survey1 on prison characteristics and (non-COVID-19) immunisation practices; survey2 on the implementation and coverage of COVID-19 vaccination with open-ended questions for thematic analysis. Each RISE-Vac project partner distributed the questionnaire to one or two prisons in their country. Answers were collected from eight European prisons' directors or medical directors between November 2021-May 2022. Results: According to our findings, the implementation modalities of COVID-19 vaccination services in the surveyed prisons were effective in improving PLP vaccination coverage. Strategies for optimal management of the vaccination campaign included: periodic time slot for PLP vaccination; new staff recruitment and task shifting; distribution of informational material both to PLP and prison staff. Key challenges included continuity of care after release, immunisation information system, and vaccine hesitancy. Conclusions: To the best of our knowledge, this is the first study describing the implementation of COVID-19 vaccination services in European prisons, suggesting that the expansion of vaccination provision in prison is possible. There is no unique solution that will fit every country but commonalities likely to be important in the design and implementation of future vaccination campaigns targeting PLP emerged. Increased availability of vaccination services in prison is not only possible, but feasible and highly desirable, and can contribute to the reduction of health inequalities. [ABSTRACT FROM AUTHOR]

Background: While the broader medical community grapples with the widely accepted notion that it takes an average of 17 years for research evidence to be incorporated into clinical practice, the implementation of evidence-based interventions in carceral settings (i.e., jails and prisons) faces longer delays, exacerbating health disparities. Main body: The "prison implementation penalty" describes the significant delay in and limited adoption of evidence-based healthcare practices in carceral settings. We explore the complex challenges of implementing evidence-based interventions in jails and prisons, environments where healthcare often plays a secondary role under security and discipline. We use specific frameworks to highlight the unique barriers within these settings and propose potential implementation strategies. These challenges have broad implications for health equity due to the disproportionate impact on the marginalized groups affected by mass incarceration. Implementation science has potential to mitigate these disparities. Conclusion: Bridging the gap between healthcare evidence and practice in carceral settings offers a public health opportunity. Implementation science offers a unique role in improving healthcare standards and reducing health inequities in this environment. [ABSTRACT FROM AUTHOR]

The "Orange Jumpsuit" stigma reflects many complex issues found at the intersection of criminal justice and healthcare.1 It represents the widespread prejudice and discrimination faced by incarcerated peoples, particularly regarding their access to adequate healthcare.2 In prisons, healthcare is often perceived as a secondary concern to societies, overshadowed by the punitive aspects of imprisonment.3 This stigma can lead to significant health disparities as a consequence of poor quality care, as seen by the increased onset of mental and physical illnesses. This is particularly seen in the case of Alzheimer's disease and cardiovascular disease within incarcerated populations. The Orange Jumpsuit stigma has serious impacts in medical and societal contexts. Adequate prison healthcare is not just a matter of human rights, but is instrumental to the successful reintegration of incarcerated peoples into society.4 By ensuring that standard medical care, mental health support, and rehabilitation services are received, prisons can facilitate smoother transitions for incarcerated people post-release, thereby reducing recidivism and enhancing community safety. This article aims to explore the health disparities fostered by the Orange Jumpsuit stigma and examine the ongoing efforts to mitigate these challenges. It seeks to provide an understanding of the current state of prison healthcare, the obstacles incarcerated peoples encounter when accessing healthcare, and the initiatives being undertaken to bridge these gaps, addressing the overarching stigma associated with incarceration. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period. Methods: The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010–2019), Denmark (2011–2018), and Sweden (2010–2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year. Results: The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased. Conclusions: While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people. [ABSTRACT FROM AUTHOR]

Sexual violence within prisons is a complex issue. The Prison Rape Elimination Act identifies standards to guide the provision of care to meet the medical and forensic needs of individuals who experience sexual assault (SA) while incarcerated. The standards include access to care by a Sexual Assault Nurse Examiner (SANE) whenever possible. Telehealth is one solution to ensure expert SANE access. This brief report addresses the pre-examination concerns/worries and immediate post-examination perceptions and experiences of six individuals who experienced SA while incarcerated. Findings show resolution of pre-examination worries, high satisfaction with care, high telehealth acceptability rates, and universal endorsement that examinations should occur outside of correctional facilities. Although not generalizable, this report provides preliminary insight into care in an understudied population with unique health care needs. [ABSTRACT FROM AUTHOR]

With the introduction of direct‐acting antivirals, elimination of hepatitis C virus (HCV) infection is becoming possible. People who inject drugs (PWID) represent a population with a high risk for HCV infection, which has been reported as high as 90% in Taiwanese PWID. To reach the goal of HCV elimination, PWID is a key population deserving special attention. Barriers in HCV care cascade still exist in PWID, and interventions to promote access to HCV diagnosis, link‐to‐care, treatment, and prevention for PWID are warranted. Although HCV micro‐elimination can be achieved in some prisons and opioid substitution therapy (OST) centers by a multidisciplinary team and integrated care in Taiwan, there are still several unmet needs for HCV elimination in PWID. Continuous efforts, such as the participation of OST specialists and the continuum of care for HCV among PWID, are needed to achieve HCV elimination in Taiwan. In addition, the combination of harm reduction services, treatment as prevention and regular posttreatment HCV surveillance is critical to substantially reduce HCV transmission and prevalence in PWID. [ABSTRACT FROM AUTHOR]

Background: High rates of health inequalities and chronic non-communicable diseases exist amongst the prison population. This places people in and/or released from prison at heightened risk of multimorbidity, premature mortality, and reduced quality of life. Ensuring appropriate healthcare for people in prison to improve their health outcomes is an important aspect of social justice. This review examines the global literature on healthcare interventions to detect, monitor and manage chronic non-communicable diseases amongst the prison population and people recently released from prison. Methods: Systematic searches of EMBASE, MEDLINE, CINAHL, Web of Science, Scopus, and the Cochrane Library were conducted and supplemented by citation searching and review of the grey literature. The literature searches attempted to identify all articles describing any healthcare intervention for adults in prison, or released from prison in the past 1 year, to detect, monitor, or manage any chronic non-communicable illness. 19,061 articles were identified, of which 1058 articles were screened by abstract and 203 articles were reviewed by full text. Results: Sixty-five studies were included in the review, involving 18,311 participants from multiple countries. Most studies were quasi-experimental and/or low to moderate in quality. Numerous healthcare interventions were described in the literature including chronic disease screening, telemedicine, health education, integrated care systems, implementing specialist equipment and staff roles to manage chronic diseases in prisons, and providing enhanced primary care contact and/or support from community health workers for people recently released from prison. These interventions were associated with improvement in various measures of clinical and cost effectiveness, although comparison between different care models was not possible due to high levels of clinical heterogeneity. Conclusions: It is currently unclear which interventions are most effective at monitoring and managing chronic non-communicable diseases in prison. More research is needed to determine the most effective interventions for improving chronic disease management in prisons and how these should be implemented to ensure optimal success. Future research should examine interventions for addressing multimorbidity within prisons, since most studies tested interventions for a singular non-communicable disease. [ABSTRACT FROM AUTHOR]

Background: Optimal adherence is crucial for ensuring both therapeutic and preventative benefits of antiretroviral therapy (ART). Sub-optimal adherence is common in prisoners and little information is available about its predisposing circumstances in resource-limited settings. We explored lived experiences of inmates living with HIV (ILWH) and experiential accounts of service providers in South Ethiopia to identify barriers to and facilitators of HIV care use in the prison context. Methods: We conducted qualitative in-depth interviewing with eleven ILWH and eleven service providers. Audio recorded interview data were transcribed verbatim in Amharic language, translated into English and coded based on emerging concepts. We employed a descriptive phenomenological approach to abstract meaning attributed to the prisoners' lived experiences in relation to HIV care use and service providers' experiential account regarding care provision as presented to our consciousness. Findings: Several concepts emerged as barriers to HIV care use amongst ILWH in South Ethiopia including: limited access to standard care, insufficient health staff support, uncooperative security system, loss of patient privacy, a lack of status disclosure due to social stigma, and food supply insufficiency. In addition to a unique opportunity offered by an imprisonment for some ILWH to refrain from health damaging behaviours, the presence of social support in the prison system facilitated care use. Conclusions: This study identified important structural and social contexts that can both hinder and enhance HIV care use amongst ILWH in South Ethiopia. Given the disproportionate burden of HIV in prisoners and the potential of transmission to others during and after incarceration, development of contextually-responsive strategies is required to address the barriers and to also strengthen the enablers. [ABSTRACT FROM AUTHOR]

Background: The number of older people in prison is growing. As a result, there will also be more prisoners suffering from dementia. The support and management of this population is likely to present multiple challenges to the prison system. Objectives: To examine the published literature on the care and supervision of people living in prison with dementia and on transitioning into the community; to identify good practice and recommendations that might inform the development of prison dementia care pathways. Methods: A scoping review methodology was adopted with reporting guided by the PRISMA extension for scoping reviews checklist and explanation. Results: Sixty-seven papers were included. Most of these were from high income countries, with the majority from the United Kingdom (n = 34), followed by the United States (n = 15), and Australia (n = 12). One further paper was from India. Discussion: The literature indicated that there were difficulties across the prison system for people with dementia along the pathway from reception to release and resettlement. These touched upon all aspects of prison life and its environment, including health and social care. A lack of resources and national and regional policies were identified as important barriers, although a number of solutions were also identified in the literature, including the development of locally tailored policies and increased collaboration with the voluntary sector. Conclusion: To our knowledge, this is the most comprehensive and inclusive review of the literature on dementia care pathways in prison to date. It has identified a number of important areas of concern and opportunities for future research across the prison system, and its operations. This will hopefully lead to the identification or adaptation of interventions to be implemented and evaluated, and facilitate the development of dementia care pathways in prisons. [ABSTRACT FROM AUTHOR]

Introduction: This study discusses the experiences of nurses in Spanish prisons during the HIV/AIDS pandemic, emphasizing administrative changes and adaptive measures, such as the creation of the Subdirectorate General of Penitentiary Health. Objective: We describe the experiences of nurses in Spanish penitentiary centers in the face of the HIV/AIDS. Materials and methods: The interpretative and phenomenological approach explored experiences between 1981 and 2023 through focus groups and convenience sampling. Participants were recruited through telephone calls and telematic meetings using Microsoft Teams. Four key themes were identified: the stigmatization of inmates, changes in nursing, the importance of training and resources, and equal treatment between genders. Results: The nursing vision focused on gathering information, providing comprehensive patient support, and sharing personal experiences. Discussion: This research provides a historical perspective on the adaptation of prison nursing to the pandemic, highlighting coping processes and suggesting future lines of research on the experiences of inmates, prison guards, and surveillance officers. Conclusions: We highlight the low media visibility of the pandemic in prisons, underlining the importance of understanding and valuing the nursing experience in prison settings during health crises. [ABSTRACT FROM AUTHOR]

The effect of medium secure care on reoffending is unknown; adequate control groups cannot be identified and exposure to reconviction may be confounded by onward placement and by legal restrictions. Retrospective analysis of convictions for an England and Wales National Cohort of adults discharged from 35 medium secure services during 1997/8. Data were retrieved from the Offenders Index and from each service. Reconviction risk for 711 cases was estimated using Offending Groups Reconviction Scale-2 (OGRS-2). Reconviction (any standard list offense) served as the sole outcome during a uniform six-year follow up. Reconviction outcomes were highest following transfer to prison, reduced by further secure care whilst restriction orders were effective in reducing convictions only in those at high risk. Substantial reductions in reconvictions were observed across the full range of criminogenic risk after control of the above confounding. OGRS-2 proved a useful assay for estimating the effects of secure services on reconvictions. Analysis of more contemporary samples using the current methods and more recent versions of OGRS is warranted. [ABSTRACT FROM AUTHOR]

This article discusses the use of shackles and restraints on palliative prisoner patients in hospital settings. It examines international standards and guidelines that emphasize the need for humane treatment and the limited use of restraints. The article highlights cases in Australia and the United Kingdom where prisoners were restrained for extended periods, despite their deteriorating health and minimal security risk. The practice of shackling dying prisoner patients is criticized for impeding the provision of palliative care and causing distress to patients and their families. The article calls for a review and overhaul of this practice to ensure that prisoners are granted the right to a dignified death. [Extracted from the article]

US correctional facilities operate under a binary interpretation of gender, which can yield inherent risks and conflicts for incarcerated transgender people. We conducted a scoping literature review on challenges unique to transgender individuals within US correctional settings. Online databases were searched to identify papers that addressed the challenges of incarcerated transgender adults age 18 + within US correctional institutions. A concurrent analysis of legal literature was reviewed with key policy recommendations extracted. A total of 33 papers (21 scientific studies and 12 legal analyses) met criteria for inclusion. Of the 21 scientific studies, the majority of papers (n = 14) focused on transgender women and most (n = 13) utilized qualitative methods. Emerging themes revealed challenges in key domains of violence, health, healthcare access, housing, and a pervasive culture of transphobia. Legal analyses supported policy changes such as implementing case-by-case housing classification systems, providing all forms of gender-affirming care, and safeguarding gender expression. Transgender persons face distinct obstacles while incarcerated in US correctional facilities and are in need of expanded protections. Working in tandem with efforts to decarcerate and reduce criminal legal involvement, widespread institutional policy change, such as redefining housing assignment policies, ensuring gender-affirming healthcare, and expanding transgender-specific competency trainings for correctional staff, is necessary. [ABSTRACT FROM AUTHOR]

"I Refuse for the Devil to Take My Soul: Inside Cook County Jail" is a book that provides insight into the experiences of incarcerated individuals at Cook County Jail in Chicago. The jail has a significant population of mentally ill inmates and has faced criticism for inadequate healthcare and safety concerns. The book features interviews and portraits of inmates and staff, aiming to give a voice to those impacted by the criminal justice system and promote a deeper understanding of their experiences. It explores the intersection of mental illness and the criminal justice system, highlighting the overrepresentation of individuals with mental illness in American incarceration. The text also discusses the challenges faced by incarcerated individuals with mental illness, including longer periods of incarceration, abuse, and higher rates of recidivism. It emphasizes the need for policy changes to reduce incarceration levels and improve mental health care in jails and prisons. The article also discusses the importance of qualitative data and visual representations, such as photographs, in understanding the experiences of incarcerated individuals. It compares the book "I Refuse" to other works that have documented incarceration and emphasizes the social significance of jails and prisons beyond their role in disease transmission. [Extracted from the article]

Background: Improving access to high-quality healthcare for individuals in correctional settings is critical to advancing health equity in the United States. Compared to the general population, criminal-legal involved individuals experience higher rates of chronic health conditions and poorer health outcomes. Implementation science frameworks and strategies offer useful tools to integrate health interventions into criminal-legal settings and to improve care. A review of implementation science in criminal-legal settings to date is necessary to advance future applications. This systematic review summarizes research that has harnessed implementation science to promote the uptake of effective health interventions in adult criminal-legal settings. Methods: A systematic review of seven databases (Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Social Work Abstracts, ProQuest Criminal Justice Database, ProQuest Sociological Abstracts, MEDLINE/PubMed) was conducted. Eligible studies used an implementation science framework to assess implementation outcomes, determinants, and/or implementation strategies in adult criminal-legal settings. Qualitative synthesis was used to extract and summarize settings, study designs, sample characteristics, methods, and application of implementation science methods. Implementation strategies were further analyzed using the Pragmatic Implementation Reporting Tool. Results: Twenty-four studies met inclusion criteria. Studies implemented interventions to address infectious diseases (n=9), substance use (n=6), mental health (n=5), co-occurring substance use and mental health (n=2), or other health conditions (n=2). Studies varied in their operationalization and description of guiding implementation frameworks/taxonomies. Sixteen studies reported implementation determinants and 12 studies measured implementation outcomes, with acceptability (n=5), feasibility (n=3), and reach (n=2) commonly assessed. Six studies tested implementation strategies. Systematic review results were used to generate recommendations for improving implementation success in criminal-legal contexts. Conclusions: The focus on implementation determinants in correctional health studies reflects the need to tailor implementation efforts to complex organizational and inter-agency contexts. Future studies should investigate policy factors that influence implementation success, design, and test implementation strategies tailored to determinants, and investigate a wider array of implementation outcomes relevant to criminal-legal settings, health interventions relevant to adult and juvenile populations, and health equity outcomes. Trial registration: A study protocol (CRD42020114111) was registered with Prospero. [ABSTRACT FROM AUTHOR]

In 2021, Cameroon held approximately 26,300 inmates in 84 prisons. The Ministry of Justice manages health services in prisons. Conclusive data concerning health care in prisons are lacking. Herein, we present the results of an assessment of health care provision and delivery in 10 central prisons. We adopted mixed methods, including document review, observations, interviews with the Ministry of Justice and prison facility officials, and inmate focus group discussions (FGDs). The 6 building blocks of the World Health Organization's health system framework guided the data collection. Moreover, we collected data on imprisonment conditions. Ministerial authorisation and verbal informed consent were obtained for all activities. There were a total of 17,126 inmates, with the prison populations ranging from 353 inmates to 4,576 inmates. The majority of prisons were characterised by huge overcrowding (mean 301%). The 10 central prisons operated infirmaries with insufficient space and equipment. Compared with the civilian health sector, the numeric ratio of paramedical personnel/inmates was favourable (1:3.4 vs. 1:0.5 p. 1,000 pop, respectively). Recent admissions were screened for the coronavirus disease 2019, tuberculosis (TB), and human immunodeficiency virus (HIV). Moreover, the inmates were diagnosed for current pathologies and lesions. For the treatment of chronic diseases and medical emergencies, the prison health services bridged service gaps on a case-by-case basis through informal arrangements with the civilian health sector. The service quality control was limited to those performed by the TB and HIV/acquired immune deficiency syndrome control programmes. Health data was collected and transmitted with a multitude of data collection tools, without standardisation and systematic verification. The primarily reported problems comprised the scarcity of resources and the absence of an effective oversight of resource management and service quality performance entailing governance problems. Participants in FDGs esteemed the quality of treatment as poor unless paid for in cash, and denounced severe difficulties for access to care outside the prisons when required. For meeting the standard minimum rules for the treatment of inmates, prison health care in Cameroon should fill the crucial gaps involving imprisonment conditions, access to health services, and accountability. Regarding chronic underfunding, intensifying collaboration with the civil health sector may partially address the problem. [ABSTRACT FROM AUTHOR]

Aim: To provide a snapshot of the extent to which nursing and the prison context features in non‐specialist/generic nursing journals. Design: Focused mapping review and synthesis. Methods: Relevant articles were examined for the extent to which they featured nursing and the prison context. A descriptive and contextual analysis of the data was carried out to provide a topography and synthesis of the key trends identified. Data Sources: Articles meeting criteria for nursing and the prison context in relevant non‐specialized, generic nursing journals (n = 7) from January 2018 to December 2022. Results: Four thousand, nine hundred and twelve (n = 4912) articles were published during the review period of which (n = 14) met inclusion criteria. The key trends identified are presented under three headings: taking an advocacy approach for better health and well‐being, examining self‐determination and autonomy in prison populations and nursing in the prison context. Conclusion: Nursing and the prison context features in non‐specialized and generic nursing journals but sparsely and infrequently. There is a need for greater visibility of nursing and the prison context in nursing journals to help reduce stigma and marginalization of those working and those detained in prison. Implication for the Profession and/or Patient Care: Nurses working in prison environments often manage extremely complex care needs. It is necessary to feature all nursing care environments in nursing journals so as to increase visibility and to act as a source of education for all. Impact (What Problem Did the Study Address? Main Findings? Where/Whom Will the Research Have Impact on): The findings of this review will have impact on all nurses engaged in practice and research as it highlights the extent to which nursing in a prison context is featured in non‐specialized nursing journals and also speaks to the challenges faced by those working and detained in prison. Patient or Public Contribution: No patient or public contribution. This was a review of existing literature. [ABSTRACT FROM AUTHOR]

Background: People being held in prison are particularly vulnerable to Covid-19 infection, as places of detention are high-risk environments for spread of infection. Due to this risk, many prisons across the globe introduced measures to reduce the risk of Covid-19 transmission. The pandemic changed almost all aspects of prison life, including prison healthcare provision. We undertook a scoping review to understand what is known about the impact of the Covid-19 pandemic on the receipt and delivery of prison healthcare. This scoping review is part of a wider mixed-methods study focusing more specifically on the impact that Covid-19 had on prison healthcare delivery in England. Methods: We conducted an international scoping review of peer-reviewed articles published between December 2019 and January 2022, across six electronic databases. We also conducted a hand search of key journals and the reference lists of included articles. Results: Twelve articles met our inclusion criteria. The articles focused primarily on prisons in high-income countries and mostly explored the impact that the pandemic had on the provision of drug treatment services. Some aspects of drug treatment services were more impacted than others, with those delivered by external providers and preparations for release particularly hindered. Whilst prison mental health services were purportedly available, there were changes regarding how these were delivered, with group therapies suspended and most consultations taking place using telehealth. The articles reported both digital and non-digital adaptations or innovations to prison healthcare services to ensure continued delivery. Collaboration between different agencies, such as the prison itself, healthcare providers, and non-governmental organisations, was key to facilitating ongoing provision of healthcare to people in prison. Conclusions: Covid-19 impacted on prison healthcare internationally, but different treatment services were affected in disparate ways, both within and between countries. The published literature concentrates on the impact on drug treatment services. Prison healthcare providers rapidly adapted their processes to attempt to maintain service provision. [ABSTRACT FROM AUTHOR]

Background: Pharmacotherapy is essential for the delivery of an equivalent standard of care in prison. Prescribing can be challenging due to the complex health needs of prisoners and the risk of misuse of prescription drugs. This study examines prescribing trends for drugs with potential for misuse (opioids, benzodiazepines, Z-drugs, and gabapentinoids) in Irish prisons and whether trends vary by gender and history of opioid use disorder (OUD). Methods: A repeated cross-sectional study between 2012 and 2020 using electronic prescribing records from the Irish Prison Services, covering all prisons in the Republic of Ireland was carried out. Prescribing rates per 1,000 prison population were calculated. Negative binomial (presenting adjusted rate ratios (ARR) per year and 95% confidence intervals) and joinpoint regressions were used to estimate time trends adjusting for gender, and for gender specific analyses of prescribing trends over time by history of OUD. Results: A total of 10,371 individuals were prescribed opioid agonist treatment (OAT), opioids, benzodiazepines, Z-drugs or gabapentinoids during study period. History of OUD was higher in women, with a median rate of 597 per 1,000 female prisoners, compared to 161 per 1,000 male prisoners. Prescribing time trends, adjusted for gender, showed prescribing rates decreased over time for prescription opioids (ARR 0.82, 95% CI 0.80–0.85), benzodiazepines (ARR 0.99, 95% CI 0.98–0.999), Z-drugs (ARR 0.90, 95% CI 0.88–0.92), but increased for gabapentinoids (ARR 1.07, 95% CI 1.05–1.08). However, prescribing rates declined for each drug class between 2019 and 2020. Women were significantly more likely to be prescribed benzodiazepines, Z-drugs and gabapentinoids relative to men. Gender-specific analyses found that men with OUD, relative to men without, were more likely to be prescribed benzodiazepines (ARR 1.49, 95% CI 1.41–1.58), Z-drugs (ARR 10.09, 95% CI 9.0-11.31), gabapentinoids (ARR 2.81, 95% CI 2.66–2.97). For women, history of OUD was associated with reduced gabapentinoid prescribing (ARR 0.33, 95% CI 0.28–0.39). Conclusions: While the observed reductions in prescription opioid, benzodiazepine and Z-drug prescribing is consistent with guidance for safe prescribing in prisons, the increase in gabapentinoid (primarily pregabalin) prescribing and the high level of prescribing to women is concerning. Our findings suggest targeted interventions may be needed to address prescribing in women, and men with a history of OUD. [ABSTRACT FROM AUTHOR]

Purpose: The US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women's health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated. Design/methodology/approach: After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis. Findings: The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: "feeling stigmatized and insignificant," "care as punishment," "delay in care," "exceptions to the rule," "fragmentation of care" and "obstetric trauma and resilience." Originality/value: Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group. [ABSTRACT FROM AUTHOR]

BACKGROUND: Delivering in-person health care to the more than 1.2 million incarcerated adults can be expensive, logistically challenging, fragmented, and pose security risks. The purpose of this study was to evaluate the implementation of a specialty care telemedicine program in statewide prisons in North Carolina during the COVID-19 pandemic. METHODS: We evaluated the first 6 months of implementation of a new telemedicine program to deliver specialty care to adults incarcerated in 55 North Carolina prison facilities. We measured patient and practitioner perceptions and the impact on the cost of care. RESULTS: A total of 3232 telemedicine visits were completed across 55 prisons within the first 6 months of the program. Most patients reported that the ability to use telemedicine contributed to their overall personal well-being and safety. Many practitioners found that working with the on-site nursing staff to conduct physical exams and to make collective decisions were key drivers to the success of telemedicine. A direct relationship was found between the telemedicine experience and patients' preference for future visits such that as satisfaction increased, the desire to use telemedicine increased. Telemedicine reduced total costs of care by $416,020 (net: -$95,480) within the first 6 months, and $1,195,377 estimated in the first 12 months postimplementation (95% confidence interval: $1,100,166-$1,290,587). CONCLUSIONS: Implementing specialty care telemedicine in prison facilities enhanced patient and practitioner experiences and reduced costs within the prison system. The implementation of telemedicine in prison systems can increase access to care and reduce public safety risks by eliminating unnecessary off-site medical center visits. [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]

Women are experiencing growing rates of incarceration at twice the pace of that for men. Additionally, one-third will be older than 55 years of age by the end of the decade. Women who are incarcerated experience a higher prevalence of gynecologic malignancies and present with higher stage disease, which may be contributing to the greater mortality from cancer than the age-adjusted US population. Limited access to guideline-recommended screening and prevention and resource limitations across correctional facilities may result in gynecologic cancer disparities. Reasons for delayed gynecologic cancer care in prisons remain underexplored. Therefore, we sought to identify contributors to delayed gynecologic cancer care among women experiencing incarceration. Women at a single tertiary center in the Southeastern U.S. who were incarcerated and were diagnosed with a gynecologic cancer during 2014–2021 were identified in the electronic medical record. Note text was extracted and contributors to delay were identified and categorized using the RADaR method. Descriptive statistics were used to assess quantitative data. 14 patients were identified with a total of 14,879 text excerpts. Data reduction was performed to identify excerpts that were relevant to the central research question resulting in 175 relevant note excerpts. Delays prior to the tertiary care visit included patient and institutional contributors. Delays during transition from the tertiary center to prison included discharge planning and loss to follow-up during/after incarceration. Transportation, authorization, and restraints were concrete contributors. Abstract contributors included communication, and the patient's emotional experience. We identify myriad contributors to delayed or fractured gynecologic cancer care in women experiencing incarceration. The impact of these issues warrants further study and intervention to improve care. • During incarceration, patient and institutional factors delayed the initial gynecologic oncology visit • Discharge planning and loss to follow-up during and after incarceration introduced delays in the hospital-prison transition • Transportation, authorization, and the use of restraints were concrete delays • Abstract delays included communication and the patient's emotional experience [ABSTRACT FROM AUTHOR]

Aim: This research aims to examine the legal and ethical issues surrounding Australia prisoners as potential kidney transplant recipients. Methods: Examination of relevant statutory and common law including human rights law, state and territory corrections legislation and negligence law. Ethical principles considered, particularly in regards to practical and logistical considerations including adequate delivery of transplantation medical care and implications on the broader organ donation program. Approaches in the United States of America and United Kingdom are compared with the Australian approach. Results: Prisoners are more likely than non‐incarcerated individuals to have chronic medical conditions. For most people with kidney failure, kidney transplantation improves both quality of life and life expectancy compared with dialysis therapy. Prisoners have a right to access reasonable medical care under state‐based corrections legislation, which is underpinned by human rights law and ethical principles, primarily beneficence, transparency and justice. The right of prisoners to receive reasonable medical care likely extends to ensuring prisoners with kidney failure are considered for kidney transplantation and waitlisted if medically appropriate. Social factors and logistical factors can be relevant when considering eligibility for transplantation as they can relate to a person's ability to comply with medical therapy. Additionally, organ allocation decisions can be emotive, and a decision to offer a kidney transplant to a prisoner may generate significant negative publicity. Conclusion: Prisoners with kidney failure should be considered for kidney transplantation. Logistical barriers, such as guard availability, should be addressed by state departments responsible for prisoner health. Summary at a Glance: Prisoners in Australia have a right to be treated with dignity and receive reasonable medical care. Given the benefits of kidney transplantation over dialysis therapy, the right to receive reasonable medical care likely extends to ensuring prisoners with kidney failure are considered for kidney transplantation and waitlisted if medically appropriate. [ABSTRACT FROM AUTHOR]

Prisons are key venues for scaling-up hepatitis C virus (HCV) testing and treatment. Complex clinical pathways and frequent movements of people in prison remain barriers to HCV care. This study evaluated the impact of a 'one-stop-shop' point-of-care HCV RNA testing intervention on treatment uptake compared with standard of care among people recently incarcerated in Australia. PIVOT was a prospective, non-concurrent, controlled study comparing HCV treatment uptake during 'standard of care' (n = 239; November 2019–May 2020) and a 'one-stop-shop' intervention (n = 301; June 2020–April 2021) in one reception prison in Australia. The primary endpoint was uptake of direct-acting antiviral treatment at 12 weeks from enrolment. Secondary outcomes included the time taken from enrolment to each stage in the care cascade. A total of 540 male participants were enrolled. Median age (29 vs. 28 years) and history of injecting drug use (48% vs. 42%) were similar between standard of care and intervention phases. Among people diagnosed with current HCV infection (n = 18/63 in the standard of care phase vs. n = 30/298 in the intervention phase), the proportion initiating direct-acting antiviral treatment within 12 weeks from enrolment in the intervention phase was higher (93% [95% CI 0.78–0.99] vs. 22% [95% CI 0.64–0.48]; p <0.001), and the median time to treatment initiation was shorter (6 days [IQR 5–7] vs. 99 days [IQR 57–127]; p <0.001) compared to standard of care. The 'one-stop-shop' intervention enhanced treatment uptake and reduced time to treatment initiation among people recently incarcerated in Australia, thereby overcoming key barriers to treatment scale-up in the prison sector. This study provides important insights for policymakers regarding optimal HCV testing and treatment pathways for people newly incarcerated in prisons. The findings will improve health outcomes in people in prison with chronic HCV infection by increasing testing and treatment, thereby reducing infections, liver-related morbidity/mortality, and comorbidities. The findings will change clinical practice, clinical guidelines, and international guidance, and will inform future research and national and regional strategies, in particular regarding point-of-care testing, which is being rapidly scaled-up in various settings globally. The economic impact will likely include health budget savings resulting from reduced negative health outcomes relating to HCV, and health system efficiencies resulting from the introduction of simplified models of care. This study is registered at Clinicaltrials.gov (NCT04809246). [Display omitted] • The proportion tested for HCV was higher in the intervention (99%) compared with the control phase (26%). • The proportion treated for HCV was higher in the intervention (93%) compared with the control phase (22%). • Median time from diagnosis to treatment initiation was shorter in the intervention than in the control phase (6 vs. 25 days). • Combining all key HCV assessments into a single visit improved efficiencies and enhanced testing and treatment uptake. [ABSTRACT FROM AUTHOR]

This article reports the results of aligning the new Essentials: Core Competencies for Professional Nursing Education (American Association of Colleges of Nursing, 2021) with the continuing education needs of nurses who work in justice settings and with justice-involved populations. Much progress in considering the development of the "future" nurse is generated by and intended for academic institutions. Although the readiness of health care agencies (employers) is being discussed, continued professional development of currently employed nurses to help them transition smoothly to work with this "future" nurse has received less attention. To that end, during its latest review, the Nurse Advisory Council to the National Commission on Correctional Health Care aligned its educational plan for correctional nurses with the Essentials document. [J Contin Educ Nurs. 2023;54(9):399–404.] [ABSTRACT FROM AUTHOR]

Background: Achieving World Health Organization (WHO) targets for viral hepatitis elimination will require simplification and decentralisation of care, supported through task-shifting and training of non-specialist frontline healthcare workers. To inform development of national health worker trainings in viral hepatitis, we review and summarise available online and workshop trainings for management of hepatitis B virus (HBV) and hepatitis C virus (HCV). Methods: We performed a systematic search of PubMed, Embase, Web of Science, conference abstracts, and grey literature using Google to identify online and in-person workshop trainings for health workers focused on HBV and/or HCV. Additional trainings were identified through a WHO regional network. We included online trainings written in English and in-person workshops developed for low-and-middle-income countries (LMICs). Available curricula are summarised together with key operational features (e.g. training length, year developed/updated, developing institution) and programmatic features (e.g. content, mechanism for self-assessment, use of clinical case studies). Results: A total of 30 trainings met our inclusion criteria (10 online trainings; 20 in-person workshops). 50% covered both HBV and HCV, 13% HBV alone and 37% HCV alone. Among online trainings, only 2 (20%) were specifically developed or adapted for LMICs; 70% covered all aspects of hepatitis care, including prevention, assessment, and treatment; 9 (90%) included guidance on when to refer to specialists, and 6 (60%) included modules on management in specific populations (e.g., people who inject drugs [PWID], prisoners, and children). Online trainings used different formats including text-based modules, narrated slide-sets, and interactive web-based modules. Most workshops (95%) were targeted towards non-specialty providers, and 50% were an integral part of a national strategy for viral hepatitis elimination. Workshop length ranged from several hours to multiple sessions over the course of months, and many were part of a blended educational model, which included other opportunities for ongoing learning (e.g., telementorship). Conclusion: This compendium of online and in-person workshop trainings for HBV and HCV is a useful resource for national hepatitis programmes developing training curricula for non-specialists. Additional online training curricula are needed for use in LMICs, and additional materials are needed to address management challenges in key populations, such as PWID. [ABSTRACT FROM AUTHOR]

Background: Health literacy is an important factor for enabling people to manage their health and live long fulfilling lives. People in prison are frequently from marginalised communities, often out of reach of conventional community based health organisations, and have poorer health outcomes. It is essential to understanding the health literacy profiles of people in prison, and its contribution to the well-established health inequities and outcomes of this population. This study aimed to use a multi-dimensional health literacy measurement tool to describe the strengths and challenges of adults incarcerated in NSW prisons. Methods: A cross-sectional survey was conducted for people in prison across 14 publicly operated metropolitan prisons. Data were collected from 471 participants using the Health Literacy Questionnaire (HLQ). Participant characteristics and health conditions were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between participant characteristic groups. Results: Participants' median age was 38.0 (range 19 – 91) years. Males comprised 81% of the sample, 21% identified as Aboriginal and/or Torres Strait Islander, and 53% reported a health problem. People in prison had lower scores for all nine HLQ scales when compared to the general Australian population. Small to medium ES were seen for mean differences between most demographic groups. Compared to males, females had lower scores for several of the HLQ scales including 'having sufficient information to manage health' (ES 0.30 [95% Confidence Interval (CI) 0.07, 0.53]), 'ability to actively engage with health care professionals' (ES 0.30 [95% CI 0.06, 0.53]), 'navigating the healthcare system' (ES 0.30 [95% CI 0.06, 0.53]), and, 'ability to find good health information' (ES 0.33 [95% CI 0.10, 0.57]). Differing health literacy scale scores with small to medium ES were found when comparing participants by legal status. Mainly small ES were seen when comparing other participant characteristic groups. Conclusions: This study provides insights into the health literacy strengths and challenges for people in NSW prisons. These findings highlight the important role health literacy could have in addressing health disparities in this vulnerable population and can inform prison health services. [ABSTRACT FROM AUTHOR]

Background: Supported accommodation intends to address challenges arising following release from prison; however, impact of services, and of specific service components, is unclear. We describe key characteristics of supported accommodation, including program components and outcomes/impact; and distil best-evidence components. Methods: We conducted a systematic review, searching relevant databases in November 2022. Data were synthesised via effect direction plots according to the Synthesis Without Meta-analysis guidelines. We assessed study quality using the McGill Mixed Methods Appraisal Tool, and certainty in evidence using the GRADE framework. Results: Twenty-eight studies were included; predominantly cross-sectional. Program components which address life skills, vocational training, AOD use, and mental health appear to positively impact criminal justice outcomes. Criminal justice outcomes were the most commonly reported, and while we identified a reduction in parole revocations and reincarceration, outcomes were otherwise mixed. Variable design, often lacking rigour, and inconsistent outcome reporting limited assessment of these outcomes, and subsequently certainty in findings was low. Conclusion: Post-release supported accommodation may reduce parole revocations and reincarceration. Despite limitations in the literature, the findings presented herein represent current best evidence. Future studies should clearly define program components and measure their impact; use analyses which reflect the high risk of adverse outcomes, such as time-to-event analyses; and consider outcomes which reflect the range of challenges faced by people leaving prison. Registration: PROSPERO registration CRD42020189821. [ABSTRACT FROM AUTHOR]

Background: Women prisoners' health is one of the major challenges among public health issues since the increasing incarceration rate has a direct impact on prisoners' health status. Female prisoners often face many health issues in which most important are reproductive health problems. The prison services regarding reproductive health needs of female inmates vary in every jail. Unfortunately, in many prisons, health care services for women are still not adequate. Objectives: The objectives of the study are to determine the frequency of reproductive health problems of female inmates and to assess the health care services offered to female inmates of Women Jail Multan. Method: It was cross-sectional descriptive study in which 118 female inmates of reproductive age group were included. Data was collected through questionnaire which was entered in to computer using SPSS 20.0. Frequencies and percentages were calculated and data was presented in tables. Means, Standard Deviations and Correlation were calculated. ANOVA was applied to test significance and Chi-square test was applied. Level of significance was kept at p = 0.05. Results: Among 118 female inmates, 33.9% were 31-40 years old, 87.3% were married and 78.0% were illiterate. The length of incarceration of 42.4% female inmates was upto 12 months. 35.0% had 1-2 children and 16.5% were living in jail with their children. Majority (92.4%) had gynecological problem and 82.2% had medical problems while 11.0% had experienced sexual violence by jail staff. Only 2 females were pregnant. 100.0% female inmates had availability of lady doctor or LHV for antenatal check-up.100.0% female inmates were provided proper diet and food supplements and the quality of food was satisfactory. Conclusion: Study revealed that health care services for reproductive problems including obstetric and gynecological issues was satisfactory however prevalence of gynecological issues was high. Sexual violence of female inmates faced by jail staff during imprisonment was noticed for which strict legislative measures should be taken. [ABSTRACT FROM AUTHOR]

Recently incarcerated people with opioid use disorder are at high risk of overdose and adverse outcomes as a result of biopsychosocial risk factors. Peer support models aiming to improve these outcomes have expanded in recent years. This qualitative study aimed to document participants' experiences with peer health navigation before and after prison release, examine participants' perspectives on the role of peer health navigators, and understand participants' views on service improvements. The authors conducted in-depth, semistructured interviews with 39 recipients of peer health navigation at release, 30 of whom also completed a follow-up interview 3 months later. Interviews were analyzed via cross-case analysis. Interviewees differently valued the various types of support they received. Participants appreciated working with someone with shared lived experience with whom they could establish a trusting relationship. Nevertheless, structural and policy barriers meant that certain key needs—such as housing and employment—could not always be met. Peer health navigators can connect participants to evidence-based treatment and help them address their psychosocial needs and develop skills to support long-term wellness. Further research is needed to assess the impact of peer health navigation on participant outcomes, such as overdose reduction, treatment engagement, and sustained recovery. [ABSTRACT FROM AUTHOR]

The Federal Bureau of Prisons clinical skills training development (CSTD) team accomplished the planning, creation, and execution of a first-ever national clinical skills assessment program (CSAP) for nurses and advanced practice providers (APPs). Clinical skills assessment is a part of nurse and APP credentialing and privileging and must be completed for new hires along with continued biennial recredentialing accreditation standards. A training resource manual, discipline-specific skills checklist, pre-/postprogram written examination, and standard operating procedures were created. The CSTD team used commercially available manikins, food items, and easily obtainable office supplies for simulated experiential skills assessments. The CSAP provided a consistent, reproducible, and scalable approach for the orientation, assessment, and, if indicated, remediation for correctional nurses and APPs. [ABSTRACT FROM AUTHOR]

Introduction: This study reports on an assessment of mental health needs among Scotland's prison population which aimed to describe the scale and nature of need as well as identify opportunities to improve upon the services available. The project was commissioned by the Scottish Government to ensure that future changes to the services available to support the mental health and wellbeing of people in prison would be evidence-based and person-centered. Methods: A standardized approach to health needs assessments was employed. The study was comprised of four phases. In phase I a rapid literature review was undertaken to gather evidence on the prevalence of mental health needs experienced by people in prison in the UK. In Phase II a multi-method and multi- informant national mapping exercise involving providers to all Scottish prisons was undertaken to describe the mental health services available, and any gaps in these services, for people in and leaving prison. In Phase III prevalence estimates of severalmental health needs were derived for Scotland's current prison population, modeled froma national survey dataset of Scotland's community population using logistic regression. Finally in Phase IV, professional stakeholders and individuals with lived experience were interviewed to understand their experiences and insights on challenges to supporting the mental health and wellbeing of people in prison, and ideas on how these challenges could be overcome. Results: Evidence across the four phases of this needs assessment converged indicating that existing provision to support the mental health of people in prison in Scotland was considered inadequate to meet these needs. Barriers to effective partnership working for justice, health, social work and third sector providers appear to have led to inadequate and fragmented care, leaving prisoners without the support they need during and immediately following imprisonment. Conclusions: Joint and coordinated action from justice, health and social care, and third sector providers is needed to overcome enduring and structural challenges to supporting themental health of people in prison. Eighteen evidence- based recommendations were proposed to the Scottish Government relating to the high-level and operational-level changes required to adequately meet the prison population's mental health needs. [ABSTRACT FROM AUTHOR]

The article discusses a descriptive qualitative study on nurses' perceptions of job satisfaction, competency development need and nursing service priorities for correctional nurses in Indonesia. The study assessed priority competencies and priorities for nursing practice and outlines actions needed in developing competence and career paths for correctional nurses. The top most needed nursing services are consultation, collaboration with health workers and emergency services.