Penitentiary Setting Research Articles

Regimes for the execution of sentences and rights and obligations of sentenced persons

Correcting deviant behavior has been a problem for society since ancient times. In order to find out what is the most appropriate way to proceed with the retouching of deviant behavior, we must know about the cause of the criminal urge, look for the psychological springs that impel an individual to resort to committing violations of the criminal law. A determining factor is also played by the significant discrepancy between social categories through the unequal distribution of income, which also influences the quality of living standards, living and purchasing power. In this respect, it was desired to join the OECD, being perceived as a means of activating national reforms that have as main objective the improvement of the material situation of citizens. The Organization for Economic Co-operation and Development is an international body that aims to ensure sustainable economic growth and social stability of 35 developed countries that accept the principles of democracy and free market economy. With Romania's accession to the European Union, it was also desired to get closer to the other European states in order to borrow the methods and measures applied that contribute to maintaining a state of general stability. However, integration did not occur with accession, as demonstrated by repeated refusals and barriers to acceptance into various European and international organizations, the most famous case being the desire to enter the Schengen area, a wish rejected, even if the accession criteria are met. Due to such a vast history with reference to the penitentiary setting, but also due to the worldly character attributed to the execution of custodial measures in recent years, we will go through together the evolution of the penitentiary regime and of the rights and obligations of convicted persons, so that in the end we will see if all these measures to correct those who conduct themselves deviate from the rules admitted by society lead to the expected result.

Old Age Psychiatry and Prison

Old age population is growing steadily during last decades (WHO 2017). Old population suffer from more morbidity including mental disorders (De Lorito,2018). This fact also applies for prison population (Yortons 2006) and in the lasts years has been an increasing interest for this topicThe aging of the world population is reflected in the penitentiary setting, with a progressive increase of elderly inmates. These prisoners present complex clinical processes with multiple comorbidities, requiring a specialized approach. In the 2020, the old age population in prison (considered over 60 years old) is around 5% in Catalonia (377 inmates,), same proportion (5%) in Spain.If we consider the cut-off point 50 y.o. (as other research) the proportion is 12% Our aims are to describe sociodemographical and clinical characteristics of old age inmates (over 50 y. o.) who required to be admitted to psychiatric unit in Catalan prisons between 2016 and 2020. The asample of this study will be around 150 inmates admitted in our unit. Elderly inmates present a high prevalence of substance abuse (especially alcohol), affective symptoms (depression) and cognitive deterioration. Likewise, is observed a significant presence of personality disorders, anxiety, post-traumatic disorders, psychotic disorders, and physical comorbidities. Prisoners over 50 have a different profile from the rest of the prison population. They suffer more physical and mental illnesses, so they require specific health and social approach. It would be advisable to adapt clinical care by optimizing resources, developing prison psychogeriatrics and establishing specific evaluation and treatment methodDisclosureNo significant relationships.

Not Only COVID-19: Prevalence and Management of Latent Mycobacterium Tuberculosis Infection in Three Penitentiary Facilities in Southern Italy.

Latent Mycobacterium tuberculosis infection (LTBI) and active tuberculosis in prisoners are higher than the general population and are two public health concerns, especially in low- and middle-income countries. We conducted a cross-sectional study to determine the prevalence and the factors associated with LTBI among the inmate population detained in three Southern Italian penitentiaries. Tuberculin intradermal reaction skin test was performed on the inmates who agreed to participate in the study. In case of positivity, the QuantiFERON-TB test was performed. In those positive to QuantiFERON, chest X-ray films were performed, and treatment initiated. A total of 381 inmates accepted to participate. The prevalence of LTBI was 4.2%. In the analysis, LTBI was associated with no self-reported contact with active tuberculosis patients within the prisons, and 10% of subjects admitted the use of inhaled drugs. No HIV coinfections were found. No cases of active symptomatic tuberculosis were identified during the study period. Our results confirm that incarceration increases the risk of tuberculous infection. Non-EU nationality and a history of drug addiction appear to be major risk factors for tuberculosis infection in the penitentiary setting. Reinforcing tuberculosis control is essential to prevent its transmission in prisons.

COVID-19 outbreak investigation and response in a penitentiary setting: the experience of a prison in Italy, February to April 2020.

Prisons are high-risk settings for COVID-19 and present specific challenges for prevention and control. We describe a COVID-19 outbreak in a large prison in Milan between 20 February and 30 April 2020. We performed a retrospective analysis of routine data collected during the COVID-19 emergency in prison. We analysed the spatial distribution of cases and calculated global and specific attack rates (AR). We assessed prevention and control measures. By 30 April 2020, 57 confirmed COVID-19 cases and 66 clinically probable cases were recorded among a population of 1,480. Global AR was 8.3%. The index case was a custodial officer. Two clusters were detected among custodial staff and healthcare workers. On 31 March, a confirmed case was identified among detained individuals. COVID-19 spread by physical proximity or among subgroups with cultural affinity, resulting in a cluster of 22 confirmed cases. Following index case identification, specific measures were taken including creation of a multidisciplinary task-force, increasing diagnostic capacity, contact tracing and dedicated isolation areas. Expanded use of personal protective equipment, environmental disinfection and health promotion activities were also implemented. Outbreaks of COVID-19 in prison require heightened attention and stringent comprehensive measures.

Telemedicine efficiently improves access to hepatitis C management to achieve HCV elimination in the penitentiary setting

IntroductionLinkage to care for hepatitis C includes a new tool: teleconsultation. Micro-elimination in prison is a recommendation and is feasible. An economic evaluation of telemedicine for hepatitis C virus (HCV) treatment in prisons has not yet been performed. This study aimed to provide a cost-minimization analysis comparing two strategies of HCV treatment in a prison: telemedicine clinical practice (TCP) and the usual clinical practice (UCP). MethodsAn observational cost-minimization study was carried out on a cohort of inmates who received anti-HCV treatment in El Dueso prison (May 2016–November 2017). A decision tree was constructed, incorporating different clinical profiles according to the severity of the disease, the results of diagnostic tests, and treatment outcomes as well as the costs of each profile. Satisfaction with telemedicine was evaluated through an 11-question questionnaire with a 5-point Likert scale. ResultsSeventy-five inmates were treated and underwent TCP with a follow-up of one year. The average cost per patient with the TCP strategy was €1,172 (€1,151 direct costs). Had UCP been carried out, the cost would have been €1,687 (€1,630 direct). Telemedicine consultation practice produced savings of €516 (30.6%) per patient, with total savings of €38,677. The transfer costs from prison to hospital represented the most important saving item, accounting for 99.3% of the TCP-related savings. The questionnaire revealed high levels of satisfaction with TCP, with a median score of 5 in each question. Sustained virological response rates were 94.7% after the first treatment and 100% after retreatment of the four relapses. ConclusionTelemedicine consultation practice is a more efficient strategy than UCP, mainly due to the reduction of transfer costs while preserving effectiveness and user satisfaction.

Personal Background Surveys of Inmates: Legal and Psychological Aspects

The article discusses the legal and psychological aspects of personal background surveys of inmates serving a prison sentence. In the legal context, the statutory objectives of psychological diagnosis of prisoners were discussed, i.a. as a basis for individualisation of a custodial sanction, prevention of harmful influence of demoralised convicts and ensuring prisoners’ personal safety. As regards the psychological aspect, arguments were put forward in favour of in-prison diagnosis as a variety of psychological diagnosis, mainly due to the fact that it offers a description of characteristic ways of behaviour of a convicted person as well as explaining the mechanisms of their emergence, maintenance and possible changes in the functioning of the diagnosed person. In the analysis of the legal and psychological aspects of diagnosis in the penitentiary setting, the specific nature of three types of personal background tests was presented: 1) psychological rehabilitation diagnosis, 2) psychological therapeutic diagnosis, 3) psychological diagnosis of recidivism. Finally, attention was paid to factors that should be considered in the development of psychological diagnosis of inmates, for example, the testing of positive and dynamic personality aspects of convicted persons and standardisation of research, including the development of modern diagnostic tools.

Ajuste psicológico y habilidades para la resolución de problemas en condenados por homicidio o tentativa de homicidio

ResumenCon el objetivo de conocer el ajuste psicológico (sinto­matología y diagnóstico clínico) y las destrezas para la resolución de problemas (afrontamiento) en una pobla­ción de homicidas, se ha llevado a cabo un estudio en el que se contrastaron ambos factores entre una muestra de condenados por homicidio o tentativa de homicidio, con la población normativa. Participaron en el estudio 27 hombres internos en el Centro Penitenciario de Oporto (Portugal), con una edad promedio de 38.63 años. Para la medida del ajuste psicológico se acudió al SCL-90-R, mientras que el afrontamiento fue evaluado mediante el CRI-A. Los resultados revelaron que los reclusos mos­traban una probabilidad superior de ser clasificados como casos clínicos en las dimensiones clínicas del SCL-90-R, a excepción de Hostilidad, así como puntuaciones significativamente más elevadas en las dimensiones clí­nicas a excepción de Hostilidad y Ansiedad Fóbica, y en los tres índices globales (i.e., GSI, PST, PSDI). Además, la muestra de condenados se caracterizaba por acudir a estrategias de afrontamiento evitativas, que son recono­cidas como formas desadaptativas o improductivas. Asi­mismo, del estudio de las características delictivas se ve­rificó que la mayoría de los acusados guardaban algún tipo de relación previa con la víctima, y que la muestra homicida se caracterizaba por versatilidad delictiva y tendencia a la reincidencia. Se discuten las implicaciones de estos resultados para la práctica profesional en el contexto penitenciario. AbstractWith the aim of knowing about psychological adjustment (clinical symptomatology and diagnosis) and problem-solving skills (coping) in a homicide prison inmate pop­ulation, a study to contrast sentenced murderers or at­tempted murderers with the normative population was conducted. Participated in the research, 27 male prison inmates at the Prison of Oporto (Portugal) with an age average of 38.63. Psychological adjustment and coping strategies were measured with the SCL-90-R checklist and the CRI-A questionnaire, respectively. The results exhibited that prison inmates showed a higher probability of being classified as clinical cases in most of the SCL-90-R dimensions (except in Hostility), as well as signifi­cantly higher scores in almost all of them (with the ex­ception of Hostility and Phobic Anxiety), an in the global indexes (i.e., GSI, PST, PSDI). Furthermore, prison in­mates were characterized by using avoidance coping strategies, which are considered such as maladaptive or unproductive. Likewise, the results from the crimino­logical characteristics of the inmates have revealed that homicides had a previous relationship with the victim, criminal versatility and a recidivism trend. Implications of the results for professional practice in penitentiary setting are discussed.

Erratum to: Management of HCV infection in the penitentiary setting in the direct-acting antivirals era: practical recommendations from an expert panel.

The prevalence of HCV infection is higher among prisoners than in the general population. The introduction of HCV direct-acting antivirals (DAA) holds the potential to improve clinical outcomes also in inmates. However, treatment of hepatitis C in inmates has to face several clinical and logistical issues which are peculiar of prison environment. Recommendations on the management of HCV infection specific for the penitentiary setting in the DAA era remain scant. The Italian Society for Penitentiary Medicine and Healthcare has, therefore, issued these recommendations, to provide clinicians with a guide for the comprehensive management of HCV infection in the restriction setting, taking into account its peculiar characteristics. Dedicated diagnostic and treatment procedures should be established in each prison. In particular, the use of DAAs appears crucial to provide patients with an effective therapeutic option, able to overcome the limitations of IFN-based regimens with a short period of treatment. DAA treatment should be initiated as soon as possible in all eligible subjects with the aim to cure the patient, as well as to limit the transmission of HCV infection both inside the penitentiary system and to the free community, once the inmates ends his/her release. Importantly, efforts should be made to open a discussion with regulatory bodies, to define specific regulations aimed to guarantee wide access to effective therapies of all eligible patients, to optimize the management of and the adherence to the HCV treatment, and to ensure the therapeutic continuity after discharge from prison.

Management of HCV infection in the penitentiary setting in the direct-acting antivirals era: practical recommendations from an expert panel.

The prevalence of HCV infection is higher among prisoners than in the general population. The introduction of HCV direct-acting antivirals (DAA) holds the potential to improve clinical outcomes also in inmates. However, treatment of hepatitis C in inmates has to face several clinical and logistical issues which are peculiar of prison environment. Recommendations on the management of HCV infection specific for the penitentiary setting in the DAA era remain scant. The Italian Society for Penitentiary Medicine and Healthcare has, therefore, issued these recommendations, to provide clinicians with a guide for the comprehensive management of HCV infection in the restriction setting, taking into account its peculiar characteristics. Dedicated diagnostic and treatment procedures should be established in each prison. In particular, the use of DAAs appears crucial to provide patients with an effective therapeutic option, able to overcome the limitations of IFN-based regimens with a short period of treatment. DAA treatment should be initiated as soon as possible in all eligible subjects with the aim to cure the patient, as well as to limit the transmission of HCV infection both inside the penitentiary system and to the free community, once the inmates ends his/her release. Importantly, efforts should be made to open a discussion with regulatory bodies, to define specific regulations aimed to guarantee wide access to effective therapies of all eligible patients, to optimize the management of and the adherence to the HCV treatment, and to ensure the therapeutic continuity after discharge from prison.

Screening for pulmonary tuberculosis in a Tanzanian prison and computer-aided interpretation of chest X-rays.

Tanzania is a high-burden country for tuberculosis (TB), and prisoners are a high-risk group that should be screened actively, as recommended by the World Health Organization. Screening algorithms, starting with chest X-rays (CXRs), can detect asymptomatic cases, but depend on experienced readers, who are scarce in the penitentiary setting. Recent studies with patients seeking health care for TB-related symptoms showed good diagnostic performance of the computer software CAD4TB. To assess the potential of computer-assisted screening using CAD4TB in a predominantly asymptomatic prison population. Cross-sectional study. CAD4TB and seven health care professionals reading CXRs in local tuberculosis wards evaluated a set of 511 CXRs from the Ukonga prison in Dar es Salaam. Performance was compared using a radiological reference. Two readers performed significantly better than CAD4TB, three were comparable, and two performed significantly worse (area under the curve 0.75 in receiver operating characteristics analysis). On a superset of 1321 CXRs, CAD4TB successfully interpreted >99%, with a predictably short time to detection, while 160 (12.2%) reports were delayed by over 24 h with conventional CXR reading. CAD4TB reliably evaluates CXRs from a mostly asymptomatic prison population, with a diagnostic performance inferior to that of expert readers but comparable to local readers.

Multicenter study on the discontinuation and efficacy of chronic hepatitis C treatment in the Spanish penitentiary population (EPIBAND study).

Imprisonment entails a golden opportunity for chronic hepatitis C treatment, as treatment adherence can easily be achieved in this setting. The objective of this study was to determine the proportion and causes of discontinuation of chronic hepatitis C therapy among the Spanish penitentiary population. This is an observational, prospective multicenter study performed in 26 Spanish penitentiaries between October 2007 and December 2009. Patients with chronic hepatitis C who were undergoing treatment with pegylated interferon plus ribavirin in accordance with clinical practice were included. The primary variable in the study was the proportion of discontinuation of treatment for chronic hepatitis C. A total of 431 patients were included in this analysis (92.3% male; mean age, 37.9±6.3 years; 66.4% with high viral load; genotype 1, 51.0%; genotype 3, 35.7%; genotype 4, 11.8%; genotype 2, 1.4%; coinfected with HIV, 24.4%). The proportion of treatment discontinuation for chronic hepatitis C was 22.5% (n=97; 95% confidence interval: 18.65-26.75). Therapy discontinuation was more frequent during the first trimester of treatment (n=45; 46.4%), and release from prison was the most frequent cause for treatment discontinuation (n=35; 36.1% of discontinuations). Among 407 patients included in the efficacy analysis, sustained viral response was achieved in 52.1% (95% confidence interval: 47.12-57.02). Treatment discontinuation for chronic hepatitis C in the penitentiary setting is low. However, further efforts should be made to improve the coordination between penitentiary institutions and external centers to ensure treatment after the inmates are released or transferred to other prisons.

Teaching Geology in a Penitentiary Setting

Compared to other sciences, materials necessary for beginning geology laboratories lend themselves well to the special problems associated with education in the penitentiary setting. The limited available time for weekly lectures is met by translating portions of the introductory material into a programmed-text style. Many of the solutions may be applicable to similar problems with educational programs run in remote areas such as military bases.

Predicting Dangerous behavior in a Penitentiary Using the Megargee Typology

This study investigates the efficacy of the Megargee typology system for classifying inmates in a penitentiary setting and for predicting institutional adjustment during incarceration. A random sample of 520 inmates from a penitentiary population of 1074 are classified into the typology groups according to procedures developed by Megargee, et al. (1977). A variety of demographic and criminal history variables are analyzed to determine subject characteristics for each of the ten typology groups. Institutional adjustment is assessed by data on inmate behavior routinely collected and recorded on each inmate by prison staff. Analysis of the data shows that: (1) the Megargee typology could classify inmates into ten groups not proportionately different than those in a medium-security institution, (2) the groups did not differ significantly from one another on age, race, or offense type, and (3) contrary to predictions by Megargee et al. for a medium-security prison, the typology groupings are not effective in predicting which inmates would be antisocial or aggressive in a penitentiary setting.

Predicting Inmate Penitentiary Adjustment

This study examines the relative efficacy of four classification systems in predicting inmate institutional adjustment in a penitentiary setting. The four systems are: (1) demographic variables, (2) Megargee Typologies, (3) Security Designation, and (4) Custody Classification. Data on 337 male inmates' adjustment as measured by four criterion variables of (a) number of disciplinary reports received, (b) days spent in disciplinary segregation, (c) days of statutory good time forfeited. and (d) work performance ratings were obtained and analyzed in relation to the four classification systems. Results of a canonical correlation procedure indicate that Custody Classification was the single best predictor of overall inmate adjustment with the demographic variable of age a distant second best. Using a stepwise multiple regression, each of the four measures of inmate adjustment was examined separately. Results reveal Custody Classification and inclusion in three of the ten Megargee Typologies to be the most effective single predictors. Recommendation for establishing a classificatory formula based on these variables is made with emphasis placed on the benefits of such a system.

Compensations in a Total Institution: The Forms and Functions of Contraband

An assessment is made of the deprivations experienced by in voluntary clients of total institutions, particularly prisons. Com pensations made by inmates in response to their restricted circum stances often involve stealing, fabricating, or smuggling in contra band (illicit commodities). Some observations are then made on the reactions by prison correctional officers to prisoners' compensa tions, and a final section is devoted to the forms of contraband in a penitentiary setting.