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INTRODUCTION: Skin diseases pose a significant health challenge globally, especially within prison settings where overcrowding and inadequate sanitation create a breeding ground for infections. Prisons, as part of society, exist in a dynamic equilibrium, serving as potential sources of infections that can spread beyond their confines. Despite facing similar challenges, there is a dearth of research focusing on skin diseases among inmates in Nepal. This study aims to assess patterns of skin diseases among prisoners. METHODS: This was a descriptive cross-sectional study at the central prison, Kathmandu from December 2023 to March 2024. All patients with skin disease visiting the consultant Dermatologist and giving consent were included in this study. Ethical approval was obtained from the Nepal Health Research Council. Data were entered in Microsoft Excel 2010 and analysis was done by the Statistical Package for the Social Sciences software. Data were presented in the form of frequency and percentage. RESULTS: A total of 253 patients visited the consultant Dermatologist for skin conditions. Out of which, eczema was 67 (26.50%), fungal infections 57 (22.50%), and bacterial infections 51 (20.10%). The mean age of the respondents was 34.21±12 years. CONCLUSIONS: The fungal and bacterial infections were common among the prisoners.

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BACKGROUND: While correctional systems often function separately from academic and community-based organizations, there is opportunity for mutually beneficial collaborative partnerships to strengthen services and relationships. Community-academic partnerships (CAPs) are a well-established model in implementation science and in scientific literature. Applying best practices for CAPs to a partnership that includes community, academic, and correctional partners could contribute to a stronger partnership with more capacity to improve population health of people who experience incarceration. OBJECTIVES: To describe our work to identify CAP best practices, and to discuss considerations and approaches for applying these best practices in an emerging community- academic-corrections partnership. METHODS: From the scientific literature, we identified best practices for CAPs across nine domains: bringing the community into the project; building new relationships while addressing the past; establishing mutually beneficial vision, goals, and purpose; roles and expectations of partners; communication; administration; leadership; project implementation and evaluation; and building community capacity and awareness. In this paper we describe considerations from the perspective of the academic partner regarding these nine best practice domains in the development of a community-academic-corrections partnership. CONCLUSIONS: While established CAP best practices have relevance, there are specific considerations for partnerships with correctional authorities that require attention. Informed by best practices, planning and preparation for partnership can help mitigate challenges, support effectiveness, and strengthen relationships.

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INTRODUCTION: The mobility of the prison population creates a need for information transmitted in transfers between centers that can guarantee optimal care continuity. OBJECTIVE: To assess the quality of transmission of health information when inmates are transferred between prisons in Spain. MATERIAL AND METHOD: Observational, descriptive and cross-sectional study, consisting of a review of medical records of inmates who passed through Madrid III Prison in a three-month period. All measured variables were qualitative, and were expressed in absolute and relative frequencies. RESULTS: 1,168 inmates passed through Madrid III Prison in this period. Only 21 came from prisons in Catalonia, the Basque Country or Navarre, where their medical records are different from those in the rest of Spain, and only 57.14% provided some type of health information. Of the remaining inmates, 70.79% provided some type of information: 63.90% of the total had prescriptions for medication and 5% were prescribed with methadone. Of those taking medication, 89.10% were prescribed it in electronic prescriptions, which were correct in 98% of the cases. For methadone, only 75.44% had electronic prescriptions, which were correct in all cases. The date of the last dose administered was only indicated in 72.40% of the treatments. DISCUSSION: Only 34.70% of the records presented optimal quality in terms of the information transmitted, and in 2.50% of the cases the information received was deficient. The use of computerized tools facilitates the transmission of information, reduces the workload and improves patient safety.

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Vaccination has traditionally been one of the primary prevention activities to which most effort has been devoted in Spanish penitentiary institutions. Once again, the type 2 coronavirus pandemic causing severe acute respiratory syndrome (SARS-CoV-2) pandemic has highlighted the importance of vaccination in the control of immunopreventable diseases. After overcoming the health emergency caused by the coronavirus disease 2019 (COVID-19), we face the challenge of recovering the vaccination coverage we had before the pandemic, in addition to increasing the coverage of other vaccines with lesser implantation in our environment. Among the improvement strategies to be implemented would be the optimization of the transmission of health information between penitentiary centers dependent on different administrations. It would also be desirable to be able to access the vaccine information systems of the different autonomous communities, both to know the vaccination status of patients and to report the doses administered during the period of internment, as well as to improve the vaccine statistics available in prison.

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BACKGROUND: Incarceration is a social determinant of cardiovascular health but is rarely addressed in clinical settings or public health prevention efforts. People who have been incarcerated are more likely to develop cardiovascular disease (CVD) at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. This study aims to identify incarceration-specific factors that are associated with uncontrolled CVD risk factors to identify potential targets for prevention. METHODS AND RESULTS: Using data from JUSTICE (Justice-Involved Individuals Cardiovascular Disease Epidemiology), a prospective cohort study of individuals released from incarceration with CVD risk factors, we examine the unique association between incarceration-specific factors and CVD risk factor control. Participants (N=471), with a mean age of 45.0±10.8 (SD) years, were disproportionately from racially minoritized groups (79%), and poor (91%). Over half (54%) had at least 1 uncontrolled CVD risk factor at baseline. People released from jail, compared with prison, had lower Life's Essential 8 scores for blood pressure and smoking. Release from jail, as compared with prison, was associated with an increased odds of having an uncontrolled CVD risk factor, even after adjusting for age, race and ethnicity, gender, perceived stress, and life adversity score (adjusted odds ratio 1.62 [95% CI, 1.02-2.57]). DISCUSSION: Release from jail is associated with poor CVD risk factor control and requires tailored intervention, which is informative as states design and implement the Centers of Medicare & Medicaid Services Reentry 1115 waiver, which allows Medicaid to cover services before release from correctional facilities.

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BACKGROUND: Scholarship on how fentanyl affects the complexities of correctional settings is limited in Canada, as scholars have focused on the prevalence of opioid use and overdose in prisons, as well as community treatment and access following release. Fentanyl constitutes a continuing challenge both in prisons and broader society. RESULTS: The current qualitative, interview-based empirical study examines how fentanyl is interpreted by correctional officers (COs, n = 99) across federal prisons in Canada, some of whom have worked in institutions with a high presence of fentanyl, while others have less exposure to the drug. We found that while many COs had responded to an overdose during their first or second year on the job, most COs who had did not perceive the event to be psychologically traumatic nor were concerned about the presence and availability fentanyl in their work environment, or they were indifferent. Yet this finding competes with the 41.4% of officers who did express concern about the presence of fentanyl - suggesting both a "normalization" of fentanyl as a workplace hazard as well as an underpinning social concern. CONCLUSIONS: We discuss the implications of these complicated findings in relation to reducing workplace stressors and countering misinformation that, in addition to other potential occupational factors, may be responsible for the concerns of COs tied to the presence of fentanyl.

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OBJECTIVES: The main aim of this article was to analyze the emotional levels of anxiety amongst health professionals employed in prisons during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic. MATERIAL AND METHOD: This descriptive, cross-sectional study was conducted by means of a validated anxiety questionnaire answered by 100 clinical nurses and nursing assistants residing in Spain and working in prisons. Alongside the demographic information, the test included 14 items related to anxiety levels. The questionnaire turned out to be highly reliable after carrying out an analysis with a Cronbach´s alpha of 0.935, demonstrating high reliability. RESULTS: Over one third of health participants presented severe anxiety levels, with a greater impact on women than on men. The situation in centers for the elderly appears to be more tense and complex than in prisons, although the latter are far more overcrowded. However, both institutions show common factors, such as the vulnerability of their populations and a possible explosive outbreak, which would exceed the resources available in such institutions. DISCUSSION: The significant levels of anxiety that nursing professionals showed in the study make it necessary to implement measures to avoid more serious future consequences in the medium and long term.

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PURPOSE: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. Considering the restricted and enclosed nature of prisons and closed environments and the prolonged and close contact between individuals, COVID-19 is more likely to have a higher incidence in these settings. This study aims to assess the prevalence of COVID-19 among prisoners. DESIGN/METHODOLOGY/APPROACH: Papers published in English from 2019 to July 7, 2023, were identified using relevant keywords such as prevalence, COVID-19 and prisoner in the following databases: PubMed/MEDLINE, Scopus and Google Scholar. For the meta-analysis of the prevalence, Cochrane's Q statistics were calculated. A random effect model was used due to the heterogeneity in COVID-19 prevalence across included studies in the meta-analysis. All analyses were performed in STATA-13. FINDINGS: The pooled data presented a COVID-19 prevalence of 20% [95%CI: 0.13, 0.26] and 24% [95%CI: 0.07, 0.41], respectively, in studies that used PCR and antibody tests. Furthermore, two study designs, cross-sectional and cohort, were used. The results of the meta-analysis showed studies with cross-sectional and cohort designs reported 20% [95%CI: 0.11, 0.29] and 25% [95%CI: 0.13, 0.38], respectively. ORIGINALITY/VALUE: Through more meticulous planning, it is feasible to reduce the number of individuals in prison cells, thereby preventing the further spread of COVID-19.

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This article aims to assess the importance of caring for oral health among prisoners, as an often-overlooked aspect of general health well-being in prisons. The incidence of oral disease among prisoners compared to the general population is much higher due to many factors such as limited access to dental care, unhealthy lifestyles and overcrowded cells. The research review confirms the need to increase access to dental care and promote hygiene awareness among inmates. Differences between genders and the impact of the length of the sentence on oral health are also pointed out.

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OBJECTIVES: To review the homogeneity of pharmacological prescription and control measures applied in cases of scabies in prisons in Catalonia. MATERIAL AND METHOD: Observational, multicenter, and retrospective study. Cases of scabies from March 01, 2021 and March 01, 2022 were analyzed according to the International Alliance for the Control of Scabies (IACS) 2020 criteria: a) confirmed cases; b) clinically probable cases; and c) suspected cases.Epidemiological, clinical, therapeutic and regimental control variables were collected. We checked whether the interventions were homogeneous in each site. The mean and standard deviation were used as continuous variables and percentages and confidence interval (95%) for discrete variables. The Chi-square test was used to determine statistical association. RESULTS: 269 cases were detected (21.2% confirmed, 50.2% clinically probable and 28.6% suspected). 61.3% were treated with permethrin, 18.6% with ivermectin and 20.1% with both. 27.1% of the cases were withdrawn.There were no significant in-site differences in the study of contacts, isolation and treatment of clothing and belongings, but there were significant differences in the prescription of drugs (P <0.001), duration of treatment (P <0.001) and disinfection of the cell (P <0.001). DISCUSSION: The number of detected cases is estimated to be high, and the majority (71.4%) confirmed or clinically probable. Control measures are homogeneous, except for cell disinfection, which was conventional in 59.1%. Pharmacological treatment and its duration varied between prisons. It would be advisable to establish a protocol to standardize control measures applied to new cases in the centers of Catalonia and subsequently evaluate their efficacy.

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OBJECTIVES: Therapeutic education is one of the pillars of the approach to diabetes. The aim of this study is to evaluate the effectiveness of group therapeutic patient education in 15 people diagnosed with diabetes, with poor metabolic control, inmates of the Madrid III-Valdemoro Penitentiary Center (Madrid), whose population is exclusively male. MATERIAL AND METHOD: Quasi-experimental study based on 4 training sessions aimed at a group of 15 people with diabetes and poor metabolic control. The intervention was carried out by 4 health professionals from the center. An evaluation of knowledge before and after the training and an assessment of the analytical and anthropometric parameters 5 months after the training were carried out. An anonymous self-evaluation questionnaire was also completed by the participants. RESULTS: After the intervention, a statistically significant reduction in weight, abdominal perimeter, glycosylated hemoglobin and diastolic blood pressure was obtained. The remaining parameters decreased non-significantly. The level of diabetes knowledge also improved significantly. DISCUSSION: The group intervention had a high potency in relation to the introduction of short-term changes in the group of patients with poor metabolic control.

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

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

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BACKGROUND: Prisons often serve as high-risk environments for drug use, and incarcerated people are at a high risk for substance use-related mental and physical harms. This study aimed to determine the prevalence of non-injection drug use inside the prison and its related factors among incarcerated people in Iran. METHODS: We utilized data from three national bio-behavioral surveillance surveys conducted among incarcerated people in Iran in 2009, 2013, and 2017. Eligibility criteria were being ≥ 18 years old, providing informed consent, and being incarcerated for over a week. Overall, 17,228 participants across all surveys were recruited through a multi-stage random sampling approach. Each participant underwent a face-to-face interview and HIV test. The primary objective of the study was to assess self-reported non-injection drug use within the prison environment within the last month. A multivariable logistic regression model was built to determine associated covariates with drug use inside prison and an adjusted odds ratio (aOR) with 95% confidence intervals (CI) were reported. RESULT: The prevalence of non-injection drug use inside the prison was 24.1% (95% CI 23.5, 24.7) with a significant decreasing trend (39.7% in 2009, 17.8% in 2013, 14.0% in 2017; p-value < 0.001). Overall, 44.0% of those who used drugs were also receiving opioid agonist therapy (OAT) and we noted that in 2017, 75.1% of those on OAT used stimulants. In the multivariable logistic regression model, the year of interview (2013: aOR = 1.43 and 2009: aOR = 5.60), younger age (19-29: aOR = 1.14 and 30-40: aOR = 1.37), male sex (aOR = 3.35), < high school education (aOR = 1.31), having a history of previous incarceration (aOR = 1.26), and having a history of lifetime HIV testing (aOR = 1.76) were significantly and positively associated with recent non-injection drug use inside the prison. CONCLUSIONS: Approximately one in four incarcerated people in Iran reported drug use within the last month inside prisons. While a declining trend in non-injection drug use was noted, substantial gaps persist in harm reduction programs within Iranian prisons. In particular, there is a pressing need for improvements in drug treatment programs, focusing on the integration of initiatives specifically designed for people who use stimulants.

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