Prison Context Research Articles

Assessing progress towards viral hepatitis B and C elimination in prisons in the European region

Abstract Background In 2016 the WHO launched the global health sector strategy for the elimination of viral hepatitis, alongside a dedicated monitoring&evaluation (M&E) framework to assess progress at national, regional and global levels. Despite being a priority setting for viral hepatitis elimination in Europe, prisons are rarely integrated into national monitoring efforts. Besides, prisons are particular contexts with a high viral hepatitis prevalence, where it is possible to utilize adequate micro-elimination strategies. Objectives We aimed to assess available metrics of viral hepatitis burden and coverage of prevention and control interventions in prison settings in Europe using routine sources of data. Methods We adapted the WHO M&E framework for viral hepatitis elimination to the prison context. The resulting M&E framework has 49 indicators of which 10 are defined as core. Data were sourced from available European prison surveillance systems at European level, namely: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and WHO Health in Prisons European Database (HIPED). Results In total 38 countries in the European region provided data to either data sources for 2020. For WHO-HIPED, among core indicators, 3 out of 10 could be calculated for HCV, and covered prevalence, HCV treatment availability and treatment outcome. Concerning HBV, 3 core indicators out of 10 could be calculated and covered prevalence, screening availability and treatment coverage in prison. With EMCDDA surveillance system we could calculate 4 HCV core indicators and 6 HBV core indicators. Lessons Availability of health data from prison settings is scarce, hampering the current capacity to monitor the progress in the viral hepatitis elimination within prisons contexts strategies and its relative contribution to global health goals achievement. A coordinated and standardised M&E framework tailored to this specific setting is needed to foster data collection and systematic monitoring. Key messages • Micro-elimination strategies in prison context contribute to the global health goals achievement. • A coordinated and standardized M&V framework, adapted to the prison context, is needed to foster data collection and monitoring of the viral hepatitis elimination strategy.

Clima socioemocional en el centro penitenciario de A Lama (Pontevedra, España)

This study examines the socioemotional climate in A Lama prison (Pontevedra, Spain). The study involved 153 participants, male (82.9 %), with an average age of 42.33 (SD = 11.40) years. Correlation analyses showed significant relationships between various affective processes, such as hope, solidarity, trust, and hatred, as well as associations between fear and the feeling of loneliness. Mediation analysis confirmed that educational opportunities for inmatesnot only increase joy but also reduce anger, contributing to a positive socioemotional climate. These results highlight the complexity of socioemotional experiences in the prison context, emphasizing the importance of simultaneously considering multiple emotional processes to gain a deeper understanding of the penitentiary socioemotional climate.

Idle Time in Prison: The Emotional, Social, and Practical Impacts of Incapacitation

The existing research on the prevalence and impact of boredom in prison is extensive. The passing of time and its unique meaning in a prison context has been documented. Missing from the research is an analysis of the ways in which “warehouse” prisons do not prioritize meaningful activity, even when there is agreement between correctional staff and incarcerated individuals about the negative impacts of idle time in prison. Based upon research in a Vermont men’s prison, we use data involving incarcerated individuals and correctional staff, including focus groups and interviews, surveys, and qualitative feedback on the meaning of the survey results. Synthesizing these various data forms, this article focuses on the relationship between incarcerated persons’ perceptions of how they are able to spend their time in the facility, how prepared they feel for release, lack of opportunities to earn money, and the impacts on their wellbeing. “Warehousing,” as it is known in prison terms, contributes to the sense of hopelessness that incarcerated people feel, and acknowledgment by staff that the prison function is incapacitation. As this project is aimed at improving prison climate, addressing idle time in prison emerged as a high priority.

Differences in Health Status between People with and without Disabilities in Ecuadorian Prisons

People with disabilities experience significant health inequalities and inequities compared to people without disabilities. However, there is little evidence on the frequency of health conditions and their association with disability in the prison context. The aim of this study was to compare the proportions and associations between various health conditions and different disability indicators. A secondary analysis of existing data from the Ecuador Prison Census 2022 was conducted. The variable of interest was based on three disability indicators from the six-item Washington Group Short Set on Functioning. A cross-tabulation was carried out to estimate the proportion of prisoners with different disability indicators by gender. These proportions were also calculated for different health conditions. Moreover, we analyzed the association between each of the three disability indicators and the different health conditions using multivariable logistic regression. A total of 30,612 incarcerated persons were included in the analysis, revealing that 8% had disabilities. According to gender, a higher proportion of women had disabilities (10.7% vs. 8.5%), some difficulty functioning (33.8% vs. 28.0%), and multiple disabilities (2.4% vs. 2.0%) compared to men. Furthermore, people with disabilities had a higher proportion of health conditions compared to those without a disability. Strong and very strong evidence of associations were found between different disability indicators and several health conditions, while a lower odds of drug use was observed in people with disabilities and multiple disabilities compared to their counterparts, and no evidence of association was found with Human Immunodeficiency Virus (HIV) infection. Our results reflect the health inequalities and inequities experienced by prisoners with disabilities. This highlights the need to implement targeted policies within prisons and to include prisoners with disabilities in the country’s agenda.

Language education for migrant/refugee inmates inside two prisons in Greece: a nexus analysis research

ABSTRACT The article discusses the challenges and methodological choices undertaken within a research project on language education in two prison schools in Greece with migrant multilingual student inmates, aged 18–22 years old. The 2.5 years of research adopted Nexus Analysis as a methodology and an interpretive framework. Throughout prolonged engagement of the research with the field, data were generated via inclusive, collaborative and reflexive research practices and research interventions for and with inmate participants. Through recontextualization of research practices and pedagogies, the research is considered as a form of resistance to the monolingual and monocultural discourses which dominate in the superdiverse prison context.

The priorities for a prisoner are food, being able to talk to their family, and taking a shower: the experiences of prisoners placed in emergency isolation due to COVID-19 in a Catalan prison

PurposeThis study aims to learn about the experiences of inmates who experienced long periods of isolation due to a COVID-19 outbreak in the Brians 1 penitentiary centre. This approach is relevant, as it sought to understand the experiences from the perspective of the prisoners during periods of isolation. The aim was to gain in-depth knowledge, based on the idiosyncrasies of this population, of their emotions and coping strategies in the prison context. This information that may be useful to prison institutions and prison primary healthcare teams to guide the organisation in future health emergencies involving the isolation of prisoners.Design/methodology/approachA qualitative interpretative phenomenological study was conducted. Face-to-face semi-structured interviews were conducted with a sample of 30 people who had undergone a period of isolation due to a COVID-19 outbreak in one or two of the last two outbreaks at the Brians 1 (Barcelona) prison in 2022, in the days following periods of social isolation. The interviews were transcribed and analysed using the content analysis approach, and were coded using the NVivo 12 qualitative software. The credibility and validity of the data analysed were increased through triangulation at different levels. In this study, data was collected from a heterogeneous sample of prisoners, capturing different views among the prison population.FindingsThis research gave us the opportunity to collect prisoners’ accounts of isolation due to COVID-19, in which it became clear that it conditioned the management of time and space in daily prison life. The restrictions amplified negative emotions such as anxiety, stress and restlessness and led to disruptions in communication with the outside world, daily prison activities and judicial processes. Despite these changes, the prisoners understood the imperatives of isolation and the need to adapt to the new situation for a limited period of time. Faced with the detrimental effect on their well-being, the prisoners employed coping strategies focused on emotional management, social supports and occupational engagement.Research limitations/implicationsThis study is subject to several limitations related to the characteristics of the sample. No women participated in the study as the modules studied were exclusively for men. People with impaired cognitive abilities, were not included. With regard to the method, it is understood that conducting the interviews in the days after the isolation may have influenced the content and enthusiasm of the participants. Despite these limitations, we are confident that the data triangulation may have given us reliable insight that will further our knowledge of prisoners’ experiences in this type of situation.Originality/valueThe issue of the negative impact of restrictive measures in the prison environment has rarely been studied from the perspective of prisoners. To the best of the authors’ knowledge, this study is the first to provide qualitative data on the experiences of prisoners during periods of social isolation due to COVID-19 outbreaks in prisons in Catalonia (Spain). The narratives allowed the authors to determine what impact the restrictions had on the emotional well-being and daily life of the prison population, information that can help prison institutions and healthcare teams understand how prisoners experienced this type of situation. The authors were also able to carry out an in-depth study of the coping strategies used by the prisoners to deal with negative emotions during the COVID-19 outbreaks, which may serve to guide the organisation of material and human resources in future emergencies or regimented situations involving social isolation.

Exploring Accessibility and Sustainability of Prison Education Through the Supervision of Students in Distance E-Learning

The purpose of the study was to explore the accessibility and sustainability of prison education through the supervision of students in distance e-learning. The method involved qualitative interviews with 12 prison students in a Namibian prison who were registered and actively studying via distance e-learning. Participants were selected based on their engagement with distance education programs, ensuring relevance to the study's focus. A professional transcriber meticulously transcribed the interview data verbatim. Using an interpretive paradigm, the author analyzed the transcriptions to derive meaningful insights into the experiences and challenges faced by incarcerated students. This approach allowed for a nuanced understanding of how supervisory support in distance e-learning impacts the accessibility and sustainability of educational opportunities for prison students. The findings underscore the importance of effective supervision in overcoming barriers to education within the prison context, highlighting critical factors that contribute to successful learning outcomes.

Prison and Love: The Role of Affection and Rehabilitative Actions in Reducing Recidivism and Beyond

Abstract: This study investigates the protective role of emotional relationships and rehabilitative actions in reducing recidivism within the prison context. Data were collected from three Italian prisons as part of the European project “Calypsos”. This study examines the role of love across its various expressions and components in the social reintegration of inmates, exploring how family ties, educational programs, and employment opportunities contribute to their well-being and socio-affective regeneration. Descriptive analyses and multiple linear regression were used to assess the impact of these factors on recidivism. The results indicate that stable family relationships, positive interactions with teachers, and meaningful work experiences significantly reduce the likelihood of reoffending. The findings highlight the necessity of policies supporting the maintenance of emotional bonds and the provision of educational and vocational training within prisons. This study concludes that integrating these elements into rehabilitation strategies can improve inmate outcomes, reduce recidivism, and enhance social cohesion. Finally, the article identifies love as a performative right as a future research direction.

Physical Activity and Associated Factors among Brazilian Adult Inmates: A Cross-Sectional Study.

Previous studies on health in prison facilities have determined that imprisonment has adverse effects on both physical and emotional well-being. Therefore, the introduction of public health measures is encouraged. This study aimed to (a) evaluate the levels of physical activity and the health condition of a sample of Brazilian prisoners and (b) determine the predictors of low physical activity. An observational and cross-sectional study was developed following the STROBE checklist. Data collection took place between June and November 2019 in a maximum-security Brazilian prison institution. This study's final sample included 220 people selected through convenience sampling, of which 115 (53.2%) were aged 18 to 29 years, followed by 79 (36.6%) aged 30 to 44 years and 22 (10.2%) aged 45 to 59 years old. Overall, 64.3% of participants failed to meet the World Health Organization (WHO) recommendation for physical activity [at least 150-300 min of moderate-intensity or 75 min of vigorous-intensity aerobic physical activity per week]. The majority reported unhealthy food consumption (116; 53.7%). Regarding body mass index (BMI), 50.2% of individuals were classified as eutrophic, 38.1% were overweight and 11.6% were obese. Older age (AOR: 0.95; CI95%: 0.92-0.99; p = 0.01) and sitting time (AOR: 0.74; CI95%: 0.65-0.85; p < 0.01) were associated with low adherence to physical activity. Our results highlight the importance of practicing physical activity within the prison context and the need for institutional programs that promote regular physical activity.

Forgiveness and rehabilitation of Portuguese incarcerated individuals: what do they think about forgiveness?

Literature reveals that forgiveness can bring advantages to those who experience it, increasing quality of life. This study explores the relevance of forgiveness in a prison context and aims to understand how incarcerated individuals perceive forgiveness, focusing on their rehabilitation processes. The sample comprised N = 11 participants (males) who were serving a prison sentence in the Porto Prison Establishment. Qualitative data were collected through a sociodemographic questionnaire and a semi-structured interview and analyzed based on thematic analysis. The findings offer further evidence on the importance of all types of rehabilitation programs and, specifically the ones focused on forgiveness. These findings show that forgiveness can be a facilitator for behavioral changes in incarcerated individuals and highlights the importance of psychological interventions during rehabilitation. We discuss the implications of these results, suggesting the need to increase knowledge with future studies about forgiveness and rehabilitation processes with this public.

Transforming &lt;i&gt;Romeo and Juliet&lt;/i&gt; in a Juvenile Detention Centre in Italy: A decolonising approach to Prison Shakespeare

This article examines an Italian Prison Shakespeare initiative based at the Cesare Beccaria juvenile detention centre in Milan and facilitated by the University of Milan and the theatre company Puntozero in 2022. In particular, it focuses on the young inmates’ reappropriation and recontextualisation of Romeo and Juliet, arguing that the structure of the 2022 workshops and final play allows for the empowerment of the participants, decentring the problematic authority of Shakespeare. Through the exploration of a case study that exemplifies a decolonising approach to Shakespeare in the marginal(ised) context of prison, my discussion ultimately invites reflection on the alleged ‘transformative’ aims and impact of Prison Shakespeare.

Psychometric properties of the long and short forms of the AQ aggression questionnaire in a sample of Spanish inmates.

The Buss-Perry Aggression Questionnaire (AQ; Buss & Perry, 1992) is a broad measurement tool used with the general public in Spain. There is some debate regarding the interpretation of AQ scores and the usefulness of a shorter version. The aim is to study and compare the psychometric properties of the long and short version of the AQ and check the reliability of the short version in a sample of male prisoners. The sample was composed of 236 incarcerated males (mean age of 40.4 years of age) from Ocaña 1 prison center who volunteered to participate in the study. The sample was selected by using the tiered random sampling technique based on the internal inmate number. A random list of possible substitutes was also included in the event of refusal to be interviewed, with replacement being discontinued in the event of two consecutive refusals. This study is a descriptive cross-sectional design. The short version of the scale demonstrated better adjustment than the long version, as indicated by the larger CFI and smaller WRMR values. The number of prison sentences was positively associated with physical aggression, verbal aggression, anger, and hostility. The coefficients were slightly higher for the short version of the scale than the long one. The short version of the AQ is a valid instrument for measuring aggressiveness in prison contexts in relation to the long version, and correlates with subscales of aggression more strongly than the long one.

Medical students' perceptions of cervical cancer screening in women deprived of their liberty

Objective: To report on the experience of medical students in carrying out preventive examinations on women deprived of their liberty. Methodology: This is a descriptive study based on the experience of five students in the teaching-service-community integration IV course. Results: Active listening was essential in enabling us to understand the realities and complaints of these women. The activity made it possible to observe that incarcerated women often have a history of sexually transmitted diseases and low socioeconomic and educational levels. It also highlighted the barriers encountered in implementing preventive health measures in the prison context. Conclusion: The experience made it possible to observe the reality of the social vulnerability of women deprived of their liberty. It also provided us with personal growth and better adherence to the teaching-learning process, in order to implement effective health promotion and prevention actions in post-academic practice.

Mortality in women with a history of incarceration in Norway: a 20-year national cohort study.

Women carry a substantial burden of psychiatric, somatic and lifestyle-related morbidity in the prison context. By describing causes of death and estimating the risk and burden of mortality compared with the general population, this study investigates how mortality operates in this highly marginalized and under-researched population. In this registry-based study of all women incarcerated in Norwegian prisons from 2000 to 2019 (N = 11 313), we calculated crude mortality rates, years of lost life and, by using mortality in age-matched women from the general population as a reference, age-standardized mortality ratios and years of lost life rates. Over a mean follow-up time of 10.7 years, at a median age of 50years, 9% of the population had died (n = 1005). Most deaths (80%) were premature deaths from an avoidable cause. Drug-induced causes and deaths from major non-communicable diseases (NCDs) were most frequent (both 32%). Compared with women in the general population, women with a history of incarceration were more likely to die from any cause. Trends in annual age-standardized years of lost life rates suggest that the mortality burden associated with major NCDs has gradually replaced drug-induced causes. Women with a history of incarceration die at a greater rate than their peers and largely from avoidable causes. The profile of causes contributing to the substantial burden of mortality placed on this population has changed over time and has important implications for future efforts to reduce morbidity and the risk of premature death following release from prison.

Imprisonment for South Ethiopian people living with HIV presents a double health burden: lived experiences of prisoners.

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. 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. 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. 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.

The need for speed? Exploring the risks and benefits of pharmacological treatment for adult ADHD in prisons

Attention deficit/hyperactivity disorder (ADHD) is overrepresented in prison populations globally. Although pharmacological treatment has generally been demonstrated to be an effective tool for managing ADHD symptoms in the general population, it remains controversial in the prison context. This is primarily due to concerns about the diversion and abuse of medication. To evaluate the impact of pharmacological ADHD treatment for adults who are or have been in prison, a narrative literature review was completed and seven international studies were identified. Further research into the use of stimulant medication in prisons, particularly within the Australian context, is recommended.

Board game on sexually transmitted infections for imprisoned women

IntroductionThe board games is an educational technology that represents an appealing, active and playful pedagogical strategy and may be capable of motivating imprisoned women to learn about Sexually Transmitted Infections.MethodsA methodological study to develop and evaluate a board game, following these stages: 1. Integrative literature review to identify educational technologies on Sexually Transmitted Infections used by imprisoned women; 2. Development of the board game; and 3. Content validation performed by 23 evaluators and semantic evaluation carried out with 10 imprisoned women who were enrolled in a school located within a female prison unit in the city of Recife, state of Pernambuco, Brazil.ResultsThe board game consisted of the following: 01 board; 01 instructions manual; 05 pawns; 52 cards; and 01 dice. A global Content Validity Index of 0.966 was reached in the content validation process performed by health and education professionals. In the validation of the board game content regarding appearance, performed by designers/developers, most of the items obtained a Content Validity Coefficient below 0.85, which resulted in the need for adjustments and a new validation round with these professionals, in which Content Validity Coefficient = 0.917 was obtained. In the semantic evaluation, all the women stated that they improved their knowledge, increased their motivation to attend the class and would like to play the board game again.ConclusionsThe “Previna” board game has been validated and can be considered an important pedagogical tool in the construction of knowledge in relation to the prevention, treatment and control of Sexually Transmitted Infections in the female prison context. The quality of this educational technology is directly related to its development based on an appropriate theoretical and methodological framework, in addition to satisfactory feedback from the target audience.Trial registrationNot applicable.

Emotional Processing and Psychopathy Among Women: A Systematic Review

ABSTRACT Psychopathy in women has gained the attention of the scientific community, but research on the emotional processing in individuals with psychopathic traits and its role in criminal behavior is still scarce. The present systematic review aims to aggregate existing literature that analyze emotional processing in women with psychopathy traits. The search terms, conducted in six databases, identified 13 relevant studies, meeting the following criteria: women, 18 years or older, prison or community contexts, and written in English, Spanish, or Portuguese. Studies pointed to a compromise in the understanding, management, and categorization of emotions, especially those with negative valence, and the presence of alexithymia in women with higher scores of psychopathic traits. Some studies revealed that women with psychopathy had reduced limbic activation, cortical deficits in emotional processing, and an absence of aversive startle response when exposed to aversive stimuli. Significant relationships between psychopathic traits, heart rate, and skin conductance response were documented. Additionally, the interpersonal-affective facet of psychopathy was linked to emotion management difficulties, while the antisocial-impulsive dimension seems linked to alexithymia and deficits in the processing of negatively valenced emotions. These findings carry practical implications for interventions with psychopathic women.

Suicide, suicide attempts and self-harm in Moroccan prisons

PurposeHigh rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts.Design/methodology/approachThe authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution.FindingsOver a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations.Research limitations/implicationsTo make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent.Practical implicationsThis study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored.Originality/valueTo the best of the authors’ knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.

Pendekatan Sa'id Nursi Terhadap Penghuni Penjara Denizli di Turkiye Berpandunkan al-Quran dan Sunnah

Sa'id Nursi is renowned globally for his contributions to the Muslim community, particularly in Turkiye, where he is esteemed by many. This qualitative study seeks to examine Sa'id Nursi's role in disseminating the message of da’wah and fostering Islamic awareness among the inmates at Denizli Prison, Turkiye. This holds significance as addressing criminal behavior and preventing recidivism should encompass more than punitive measures alone. The focus should also extend to rehabilitation, especially within an Islamic context, as an effective rehabilitation program can deter individuals from relapsing into criminal activities. Employing an inductive approach, this article delves into Sa'id Nursi's biography and his contributions, using a descriptive method to analyse and elaborate on the prominent aspects of his approach. Primary sources, notably Rasa'il al-Nur (Epistles of Light) penned during his incarceration, including the Fruits Epistle and the Rasa'il al-Nur website, along with secondary sources such as journals from library archives, form the basis of this study. It is instrumental in spotlighting his post-incarceration contributions through an Islamic lens within the prison context. Research affirms Nursi's commitment to imparting an Islamic message that resonates within Muslim life at Denizli Prison, Turkiye. The findings underscore Nursi's contributions through an Islamic approach that emphasizes recognition of Allah SWT and the strengthening of faith in the hereafter. He achieves this by drawing on Quranic verses and Hadiths, employing the approach of bi-l-hikmah (wisdom), and engaging inmates' conscience through reflective practices such as tafakkur (contemplation). Nursi frequently utilizes majaz (metaphor) or dharb al-amthal (analogy) and al-muqaranah (comparison) to elucidate truths or facts in his teachings.