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Introduction: The high rate of incarceration, now exceeding 11.5 million people worldwide, has raised concerns about the conditions within penal institutions, such as the consequences of incarceration on the person. This retrospective study aims to investigate the issue of death in custody, exploring the relationship between incarceration, health vulnerabilities, and death from the forensic pathologist's point of view. Methods: We analyzed, from a forensic, clinical and toxicological perspective, 86 cases of deaths in detention facilities in North-Western Italy from 1999 to 2022. Results: The analysis has shown that suicide, mainly committed by hanging, plastic bag suffocation and butane intoxication, represents the leading type of violent death (52%), followed by accidental deaths (16%). On the other hand, cardiovascular diseases are the leading cause of natural deaths (42%), followed by infectious diseases (especially HIV-related). Discussion: The present study identifies the most frequent and critical situations and risk factors related to death in custody and the profile of the inmate who is at a higher risk of death, allowing to highlight the issues to be addressed from a public health point of view. On the whole, it calls for comprehensive reforms, aligned with international human rights standards, addressing mental and physical care gaps, improving correctional officers' education, and training, and focusing on rehabilitation with well-being and dignity.

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BACKGROUND: Recent literature suggests that ADHD is a risk factor for the development of antisocial behavior that is more severe and persistent than in community and other psychiatric populations. The combination of stimulant medication and psychotherapy (particularly cognitive behavioral therapy, CBT) is considered an evidence-based intervention for adults with ADHD. In contrast, few studies have evaluated the efficacy of medication in adult prisoners with ADHD, and the literature on the efficacy of psychotherapy is virtually nonexistent. Therefore, this article presents the protocol of a trial that will assess the efficacy of a formulation-based CBT program for inmates with ADHD. METHODS: The study has a multicenter randomized controlled trial design. After screening and recruitment, participants will be randomly assigned to the CBT intervention, a general offender treatment program, or a waitlist. Pre- and post-treatment self-report and clinician-report assessments, as well as 6- and 12-month follow-up assessments will be conducted. These will include both clinical (e.g., ADHD symptoms, depression and anxiety symptoms, self-esteem, alcohol/drug abuse, treatment adherence, quality of life) and criminological (e.g., recidivism and risk of recidivism) measures. Linear mixed models will be used to assess differences between groups. DISCUSSION: This study may be the first to evaluate the efficacy of a psychotherapy intervention in adult inmates with ADHD. It is expected that addressing the specific needs of ADHD would not only result in the previously reported clinical improvements (e.g., reduction in ADHD and comorbidity symptoms), but also reduce the risk and rate of recidivism compared to the general intervention or no intervention. However, the design may be limited by the difficulties inherent in the prison setting and in following up the sample after release. TRIAL REGISTRATION: ClinicalTrials.gov NCT06080373. Registered on October 12, 2023.

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Introduction: Studies on inmates' Health Care Service (HCS) utilization are scarce globally, infrequent in Ethiopia while findings about the factors associated with HCS utilization are inconsistent. The present study, therefore, examined inmates' HCS utilization and associated socio-demographic and imprisonment related factors in Northwestern Ethiopia. Methods: The study employed institution-based cross sectional research design and data was collected using questionnaire from 422 inmates in three prisons. The questionnaire collected data about prisoners' demographic characters, imprisonment related information and HCS utilization. Descriptive statistical techniques as well as bi-variate and multiple logistic regressions were used to analyse the data. Results and discussions: The study found that 72.5%, 66.1% and 13.3% of the inmates, respectively, used medical services, guidance and counseling services, and psychiatric services. Inmates with primary education, with secondary education, and who know the availability of the services were more likely to use medical services. Inmates with accused status were less likely to use medical services than inmates with convict status. Divorced marital status and knowledge of the service availability were associated with high guidance and counseling service use. An increase in the length of stay in the prison was associated with a decrease in psychiatry service use while knowledge of service availability was associated with higher odds of psychiatry service use. There are high medical care service utilization while low mental health care service utilization among inmates in Northwestern Ethiopia. Results of the study implied that there is a critical need for immediate health care service promotion and education measures. Besides, there are also needs for large scale, longitudinal and potentially cross-cultural studies to better understand additional factors that influence inmates' HCS utilization.

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PURPOSE: The purpose of this study is to describe the oral health status of inmates. The secondary aims were to compare recidivists with first-time offenders and also study the impact of psychoactive drugs on the oral health status. DESIGN/METHODOLOGY/APPROACH: This retrospective study included 120 male inmates from a French prison. Data from the medical and the dental questionnaires and examinations were collected and analyzed. FINDINGS: The results showed that overall, the inmates had a poor oral health despite their young age. This population was at high risk regarding caries and periodontal diseases due to sedentary behaviors, improper diet, drug, alcohol and tobacco consumption. In total, 93% of inmates had at least one decayed untreated tooth and 95% had periodontal disease. The use of psychoactive drugs seemed strongly related to oral health status degradation. However, the comparison between recidivists and first-time offenders showed few differences. PRACTICAL IMPLICATIONS: The need for periodontal and dental care is considerable in this population and increased in this environment where risk factors such as addictive behaviors and poor eating habits are common. The impact of psychoactive drugs on oral health should also be taken into consideration. SOCIAL IMPLICATIONS: Unfortunately, even though strategies for the prevention and management of oral health in prisons have been put in place for some years, the results still seem insufficient. ORIGINALITY/VALUE: There are still few studies that analyze the impact of this medication on oral health in prisons.

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Introduction: The behavioral addiction model posits that repetitive suicidal behaviors can serve as maladaptive strategies for managing stress and negative emotional states, akin to substance addiction. Both behaviors involve negative emotions, offer temporary psychological relief, and persist, indicating shared neurobiological mechanisms. This study explored psychometric differences among major repeaters, occasional attempters, and non-suicidal prisoners. Methods: A multi-centre cross-sectional survey of 363 inmates across four prisons assessed depression, cognitive-emotional regulation, impulsivity, perceived stress, lifetime non-suicidal self-injury and suicide attempts. Results: Mild depression, moderate suicidal ideation, and moderate impulsivity were common, with nearly half of the participants having attempted suicide at least once. Hierarchical multiple regression analyses revealed that repeated suicidal behavior in the past increases susceptibility to future suicidal thoughts, with suicide attempts serving as a maladaptive emotion regulation strategy among repeated attempters. Discussion: The results reveal differences in emotional dysregulation, impulsivity, and stress coping strategies among the studied groups, reinforcing the idea of suicidality as a form of behavioral addiction. The addiction approach helps explain the sensitivity to later suicidal thoughts in former attempters and self-harmers, offering valuable insights for tailored interventions within correctional settings.

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The objective of this study was to analyze the epidemiological links of the human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV-HCV coinfections to less studied types of transmission in certain populations. We performed an observational, prospective study on 903 patients aged between 15-87 years who took part in the Open Test Project. They were divided in two subgroups: general population vs. individuals from prisons who were questioned about multiple risk factors. A chi-square independence test was used to establish correlations between risk factors and results of screening tests. Logistic regression was used to calculate the probability of a reactive screening test based on each independent risk factor and age. HIV was very strongly associated with unprotected sexual intercourse with HIV-positive partners (the strongest association), unprotected sexual intercourse with sex workers, newly diagnosed sexually transmitted diseases (STDs), intravenous drug users (IDUs) and sharing injecting materials. In the case of HCV reactive tests, very strong associations have been established with IDUs (the strongest association), unprotected sex with IDUs and sharing injecting materials. Our study indicates the need for implementing targeted public health programs, tailored to the local epidemiology that can ultimately lead to micro-elimination of hepatitis and HIV infections in this area.

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PURPOSE: Oral health is an integral part of general health. Different population groups have been assessed for oral health status in India, but still, many have been neglected; one such group is the prisoners. The prison population is a unique and challenging one with many health problems, including poor oral health, which may be due to lack of knowledge about good oral health practices. This study aims to assess effectiveness of oral health education on oral health knowledge, attitude and practices and oral hygiene status among the male prison inmates of central jail in Kolkata, India. DESIGN/METHODOLOGY/APPROACH: An interventional study was done among 240 male convicts. The data was elicited using a structured proforma; oral health status was assessed by recording OHI-S index, and the severity of gingivitis was assessed by recording the gingival index. Oral health education was delivered by using audio-visual aid. Oral health knowledge, attitude, practices and oral hygiene and gingival status were reassessed among the inmates before and after dental education at the end of three and six months. FINDINGS: A significant change in oral health knowledge, attitude and practices was seen, which in turn resulted in an appreciable decrease in the mean gingival index score (1.73 ± 0.382 to 1.20 ± 0.321) and OHI-S (3.31 ± 0.815 to 2.57 ± 0.551) in all the inmates after oral health education program over the period of time. ORIGINALITY/VALUE: The oral health education with reinforcement proved to be an effective tool to instil good oral hygiene practices in the inmates.

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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.

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The article presents a systematic literature review on the use and the psychiatric implications of over-the-counter drugs (OTC), prescription-only-medications (POM), and new psychoactive substances (NPS) within custodial settings. The searches wer carried out on 2 November 2022 on PubMed, Scopus, and Web of Science in line with PRISMA guidelines. A total of 538 records were identified, of which 37 met the inclusion criteria. Findings showed the most prevalent NPS and OTC and POM classes reported in prisons were synthetic cannabinoids receptor agonists (SCRAs) and opioids, respectively. NPS markets were shown to be in constant evolution following the pace of legislations aimed to reduce their spread. The use of such substances heavily impacts the conditions and rehabilitation of persons in custody, with consequent physical and mental health risks. It is important to raise awareness of the use and misuse of such substances in prisons (i) from an early warning perspective for law enforcement and policy makers (ii) to prompt doctors to cautiously prescribe substances that may be misused (iii) to improve and increase access to treatment provided (iv) to add such substances to routine toxicological screening procedures (v) to improve harm reduction programmes.

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BACKGROUND: Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry). METHOD: The data were obtained through an interview where the individuals completed a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and a Participant Satisfaction Questionnaire to assess their satisfaction with services offered via telepsychiatry. Additionally, calculations of time spent waiting for a face-to-face psychiatric evaluation and time spent in handcuffs and in confined spaces were made before and after the introduction of telepsychiatry. RESULTS: Statistically significant improvements (all p-values < 0.001) were noted in waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behavior of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry led to the elimination of time spent in handcuffs and in confined spaces (transport vehicles). CONCLUSION: According to the results of this study, telepsychiatry is an acceptable method of service delivery in correctional facilities and was associated with a reduction of coercive practices.

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Telepsychiatry is an effective tool to support and provide mental health services to prison inmates. In Greece, telepsychiatry was formally applied in two correctional facilities in 2018. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation. The sample consisted of 100 male inmates with a multicultural background and prior experience with both methods of services provision. The data were obtained through a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and another Participant Satisfaction Questionnaire to assess satisfaction with telepsychiatric services. The results have shown a higher level of satisfaction with telepsychiatry compared to face-to-face care. Statistically significant improvements (all p-values <0.001) were noted in: waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behaviour of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry has proved to be an acceptable way of approaching and supporting inmates in Greece, with most of the participants expressing high acceptance, satisfaction, and preference rates. Implications for additional research and further development of telepsychiatry are discussed.

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AIMS: Given the high prevalence of oral health problems among prisoners, the goal of this systematic review is to provide a better knowledge of the scope of this problem. METHODS: Electronic searches of PubMed/MEDLINE, Embase, Scopus, and Google Scholar were performed. Studies that investigated inmates aged 18 or older with oral health problems were eligible. Variables reported in four or less studies were described narratively. Conversely, for variables reported in more than four studies, a meta-analysis was performed using random effect model. Furthermore, meta-regression and sensitivity analysis is also performed to evaluate moderator effect on outcome. Doi and LFT index is applied to assess publication bias. RESULTS: Out of 494 results, 12 studies were included. The pooled prevalence of caries among prisoners is 78.42% (59.48%-92.58%). On meta-regression, the prevalence of caries appears to be lower in studies with a higher male percentage; however, non-significant (p = .079) due to small sample size. Community periodontal index (CPI) scores revealed periodontal disease, with scores of 3 and 4. Moreover, a significant need for oral hygiene instruction, prosthesis, extraction, and tooth ache, periodontal disease, oral mucosal lesions, leucoplakia, attrition, abrasion, bruxism, and smoking behaviors were also reported. CONCLUSION: Poor oral health status in the incarcerated population highlights the urgent need for comprehensive oral health intervention in prisons.

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Background and Aims: The environment within prisons, such as overcrowding, lack of access to portable water, poor sanitation, and hygiene predisposes inmates to infections, including intestinal parasitic infections (IPIs). This study therefore determined the prevalence and associated factors of IPIs among prison inmates in Southern Ghana. Methods: A cross-sectional study using the stratified sampling technique was employed. The study recruited 461 prison inmates across three notable prisons, with 50 inmates from Ho Central, 357 inmates from Nsawam Medium Security, and 54 inmates from Sekondi Central Prisons all in Southern Ghana. A structured closed-ended questionnaire was administered to collect data on sociodemographics, lifestyle/behavioral characteristics, and signs and symptoms of IPIs. In addition, stool samples were collected and analyzed for the presence of various stages of intestinal parasites (trophozoites, cysts, ova, and larva) using formol-ether concentration, and the modified Ziehl-Neelsen techniques. Results: The prevalence of IPIs among inmates of the three selected prisons was 38.2% (95% confidence interval [CI]: 33.72%-42.79%). The prevalence of IPIs among inmates of the three prisons, the Ho Central, Nsawam Medium Security, and Sekondi Central were 46% (95% CI: 31.82%-60.68%), 37.5% (95% CI: 32.49%-42.79%), and 35.2% (95% CI: 22.68%-49.38%), respectively. After adjusting for confounders, the following factors; handwashing after defecation (adjusted odds ratio [AOR]: 0.05 [0.00-0.67]; p = 0.024), trimmed fingernails (AOR: 0.32 [0.13-0.76]; p = 0.011), itchy skin (AOR [95% CI]: 5.99 [3.43-10.43]; p < 0.001), anal itching (AOR [95% CI]: 0.35 [0.19-0.62]; p < 0.001), nausea (AOR [95% CI]: 5.57 [3.22-9.65]; p < 0.001), and worm expulsion (AOR [95% CI]: 3.80 [1.42-10.18]; p = 0.008) were found to be associated with intestinal parasitic infections. Conclusion: The study revealed that the prevalence of intestinal parasitic infections among prisons in Southern Ghana is high and is therefore an important public health concern. The Public Health Department of Ghana Health Service should therefore embark on health promotion and deworming exercise in all prisons in Ghana.

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Despite the importance of sleep to overall health and well-being, there is a high prevalence of undiagnosed sleep disorders and adverse sleep health, particularly among vulnerable populations. Such vulnerable populations include people experiencing homelessness (PEH), refugees, and incarcerated individuals. In this narrative review, we provide an overview of the literature on sleep health and disorders among key and vulnerable populations (e.g., PEH, refugees, and incarcerated individuals). The limited research among these populations indicated a high prevalence of sleep disorders, mainly insomnia, short sleep duration, and fatigue. Substance abuse and PTSD were commonly found among PEH and refugee populations, respectively, which were was related to poor sleep. Similar across the included vulnerable populations, the individuals reside in environments/facilities with inopportune light exposure, noise disruption, inadequate bedding, and forced sleep schedules. Studies also found a high prevalence of psychosocial stress and reports of threats to safety, which were associated with poor sleep health outcomes. Additionally, several studies reported environmental barriers to adherence to sleep disorder treatment. This paper highlighted the conditions in which these vulnerable populations reside, which may inform interventions within these various facilities (homeless shelters, refugee camps, prisons/jails). The improvement of these facilities with a sleep equity focus may in turn improve quality of life and daily functioning.

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Background: Modern penitentiary systems attach great importance, at least in the area of formal and codified arrangements, to providing inmates with access to health care and rehabilitation. The aim of our study was to analyze the Web of Science (WoS) and SCOPUS medical databases in order to search for and evaluate the available literature discussing the oral status and dental treatment needs of adult male prisoners. Methods: The following terms were used: prisoners or inmates; oral health, oral status; periodontal status, periodontal disease; oral hygiene; caries; mucosa; and saliva. The studies were screened based on their title and abstract according to the PICO (population, intervention, control, and outcome) criteria. The research protocol was prepared on the basis of the 2020 PRISMA guidelines and was not registered. The available literature discussing the oral status and dental treatment needs of adult imprisoned patients was analyzed. The inclusion criteria were as follows: articles published in English between 1 January 2012 and 2022; articles discussing the oral cavity status of adult inmates over 18 years old (hard tissues, periodontal status, saliva, mucosa condition, or oral hygiene); articles with a full text available; and articles that were assessed as satisfactory according to the Newcastle-Ottawa Scale. Results: A total of 934 articles were identified, out of which 9 were included in the systematic review. Two articles discussed the oral condition of prisoners in Europe (Russia and Finland), four examined prisoners in Asia (three in India and one in Saudi Arabia), two examined prisoners in Africa (Nigeria), and one examined prisoners in the Americas (Brazil). Conclusions: The oral status of prisoners has been widely discussed in the available literature. Among inmates, a higher frequency of both caries and periodontal disease along with poorer oral hygiene were observed. It can be concluded that inmates should have access to specialized treatment from periodontists and endodontists.

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PURPOSE: The COVID-19 pandemic broke out at the end of 2019, and throughout 2020 there were intensive international efforts to find a vaccine for the disease, which had already led to the deaths of some five million people. In December 2020, several pharmaceutical companies announced that they had succeeded in producing an effective vaccine, and after approval by the various regulatory bodies, countries started to vaccinate their citizens. With the start of the global campaign to vaccinate the world's population against COVID-19, debates over the prioritization of different sections of the population began around the world, but the prison population has generally been absent from these discussions. APPROACH AND FINDINGS: This article presents the approach of Jewish ethics regarding this issue, that is, that there is a religious and a moral obligation to heal the other and to take care of his or her medical well-being and that this holds true even for a prisoner who has committed a serious crime. Hence, prisoners should be vaccinated according to the same priorities that govern the administration of the vaccine among the general public. ORIGINALITY: The originality of the article is in a comprehensive and comparative reference between general ethics and Jewish ethics on a subject that has not yet received the proper attention.

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BACKGROUND: Mounting evidence has shown that incarceration can affect the health and well-being of individuals and increase the risk of noncommunicable diseases (NCDs). Diet quality is known to be one of the main determinants of risk of NCDs, and dietary changes are the first approach used in primary care to reduce the incidence of NCDs. OBJECTIVE: This scoping review aimed to summarize the evidence for (1) the diet quality of inmates, and (2) the effect of nutritional intervention in prison systems. In addition, we aimed to describe limitations in the current literature and to suggest potential future research areas. METHOD: A systematic search was performed in 2 databases (PubMed and Web of Science) using predefined search terms and covering the period May 2023 to June 2023. Additionally, reference lists from the retrieved studies were hand-searched to identify any additional relevant publications. The identified literature was screened based on defined search strategies, criteria, and research questions defined using the PICo (population or problem, interest, and context) framework. The review was conducted referring to the PRISMA-ScR and the PICo framework. RESULTS: A total of 19 studies out of 63 initially identified records were included in this review (11 cross-sectional evaluations and 9 intervention-based studies). In almost all studies, assessment of the diet quality of menus showed the menus to be nutritionally adequate, except for having a higher-than-recommended intake of total energy, saturated fatty acids, sodium, cholesterol, and sugar. In addition, some studies reported a lower-than-recommended intake of fiber, magnesium, potassium, vitamins D, E, and A, and omega-3 fatty acids. Nutritional interventions were mainly planned in the form of workshops, seminars, and written material to deliver information on healthy dietary choices. Although no significant changes in inmates' dietary choices were observed in any of the studies, a high participation rate was detected. CONCLUSION: Inmates might require additional prevention intervention to reduce their susceptibility to cardiometabolic diseases by virtue of their isolation from community facilities. Interventions should be tailored to the characteristics of prison settings and inmates to increase adherence to nutritional recommendations.

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Objective. Evaluate the pattern of contact with the healthcare system, including prison health facilities, and HIV testing. Method. This was a quantitative case-control study of HIV infected and uninfected incarcerated people serving time in 2019 in the Federal District, matched by age. Results. There was no difference in the pattern of contact with the healthcare system or the pattern of testing between HIV-infected and uninfected incarcerated people. Most of the infected patients were diagnosed in the prison environment and had early infections, demonstrating the effectiveness of screening in this scenario. Conclusion: The pattern of contact with the healthcare system among the individuals in this study probably reflects that of young men in general, i.e., less contact with primary care outpatient services and trauma as the main reason for contact in emergency departments. 

Objetivo. Evaluar el patrón de contacto con el sistema sanitario, incluidos los centros sanitarios penitenciarios, y las pruebas del VIH. Método. Estudio cuantitativo de casos y controles de personas infectadas y no infectadas por el VIH que cumplían condena en 2019 en el Distrito Federal, emparejadas por edad. Resultados. No hubo diferencias en el patrón de contacto con el sistema de salud ni en el patrón de realización de pruebas entre personas encarceladas infectadas y no infectadas por VIH. La mayoría de los pacientes infectados fueron diagnosticados en el medio penitenciario y presentaron infecciones precoces, lo que demuestra la eficacia del cribado en este escenario. Conclusiones. El patrón de contacto con el sistema sanitario entre los individuos de este estudio probablemente refleja el de los hombres jóvenes en general, es decir, menor contacto con los servicios ambulatorios de atención primaria y traumatismos como principal motivo de contacto en los servicios de urgencias. 

Objetivo. O estudo avaliou o padrão de contato com o sistema de saúde e de testagem para HIV, incluindo as unidades de saúde prisionais.  Métodos. Trata-se de estudo quantitativo de caso-controle em detentos que cumpriam pena em 2019 no Distrito Federal, pareados por idade. Resultados. Não houve diferença no padrão de contato com o sistema de saúde e padrão de oferta de testagem entre detentos infectados ou não com HIV. A maior parte dos infectados teve o diagnóstico realizado no ambiente prisional e de maneira precoce, evidenciando efetividade do rastreamento nesse cenário. Conclusão. O padrão de contato com o sistema de saúde dos indivíduos neste estudo reflete provavelmente o de homens jovens como um todo: pouco contato com serviços ambulatoriais de atenção primária e trauma como principal motivo de contato, em prontos-socorros.  

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Background: Childhood adversities and adult trauma are common among female inmates. Associations have been documented with childhood adversities and mental illness, personality disorders, human immunodeficiency virus (HIV) and violent offending. However, no such study had been conducted in South Africa (SA), despite the high prevalence of HIV and trauma in SA. Aim: To measure the prevalence of childhood adversities and adult trauma; and to determine if there is a relationship between childhood adversities, mental illness, personality disorders, HIV and violent offending among female inmates. Setting: The study was conducted at the largest correctional centre in Durban, KwaZulu-Natal, South Africa. Methods: This cross-sectional, descriptive study randomly recruited 126 female inmates. The World Health Organization's Adverse Childhood Experiences- International Questionnaire (WHO ACE-IQ) was used to measure childhood adversities; the Structured Clinical Interview for the Diagnostics and Statistical Manual-5 Research Version (SCID 5-RV) was used to diagnose mental illness; and a structured questionnaire was used to measure adult trauma. Human immunodeficiency virus data was confirmed from prison medical records. Results: Elevated rates of individual childhood adversities and adult trauma were found. Associations were found between cumulative childhood adversities and post-traumatic stress disorder (PTSD), alcohol use disorder, substance use disorder, borderline personality disorder, and HIV. Conclusion: Female inmates are a highly traumatised population. Prison mental health services should provide trauma-informed and trauma-focussed care to improve inmates' mental health outcomes and decrease recidivism. Contribution: This study contributes to the emerging literature on adverse childhood experiences (ACEs) and their associations among incarcerated female populations, in a low- and middle-income, South African setting.

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The worldwide incarceration rate per 100,000 people varies from 30 in India, 580 in Europe, to 750 in United States. The health of prisoners is of great concern. Research in many countries has shown poor oral health conditions among prisoners, particularly reflected in the high number of lost and untreated decayed teeth. The aim of our study was to evaluate the quality and range in dental procedures conducted on male prisoners, based on a retrospective analysis of medical history gathered at the Academic Center of Dentistry and Specialistic Medicine of Medical University of Silesia in Bytom for the period 2018-2021, and its correlation with the results obtained from the analysis of the Web of Science (WoS) and SCOPUS medical databases. Our research was carried out on the examined group, 86 men (mean age 31 years old), and a control group, 106 men (mean age 32 years old). The retrospective analysis of the medical history was performed. Results of our own research showed the values for decayed and missing teeth were significantly higher in the examined group while the values for the filled teeth component were significantly higher in the control group. The chance for the occurrence of the radices was 2.5 times higher in the examined group than in the control. The examined group was characterized by 3.6 times higher chance of no root canal treatment than the control group. The number of the endodontically treated teeth was significantly higher in the control group. The examined group was characterized by 4.2 higher probability for periapical lesion occurrence in teeth that were not endodontically treated. The number of teeth qualified for the endodontic treatment was significantly higher in the examined group, while the number of teeth qualified for the reendow treatment was significantly higher in the control group. The probability for the occurrence of both vertical and horizontal atrophy in the alveolar process was twice and three times higher in the examined than in the control group. In conclusion, the oral status of inmates is worse when compared to those who live in freedom, which is why there is a need to prepare a scheme to improve the condition of the stomatognathic system in prisoners.