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Journal of Correctional Health Care
Article Abstracts
Volume 10, Issue 1 — Spring 2003
·
The Association of Infectious Disease Diagnoses With
Incarceration-related Factors Among
Prison Inmates
Jacques Baillargeon, PhD; Patrick Bradshaw, MS
Prison inmates present with higher rates of infectious
disease than the general population. Decisions on how to manage
and treat infectious diseases in the prison setting are often
contingent upon factors such as the length of the inmate’s
prison sentence, the type of facility in which the inmate is
housed, and factors associated with the inmate’s compliance
with prescribed treatment regimens. Little information is
available regarding how infectious disease rates vary according
to these factors. The study population consisted of 336,668
Texas Department of Criminal Justice inmates who were
incarcerated for any duration between January 1, 1999, and
December 31, 2001. Information on medical conditions,
incarceration factors, and sociodemographic factors was obtained
from an institutionwide medical information system. The findings
indicate that the prevalence of five major infectious diseases
varied substantially according to type of criminal offense,
prison facility type, and comorbid psychiatric disorder. Inmates
who were incarcerated for violent offenses, were incarcerated in
a prison facility, and exhibited at least one major psychiatric
disorder all exhibited elevated rates of disease. It will be
important for future studies to assess the driving forces behind
these disease patterns. This information may ultimately help
correctional administrators and clinicians more efficiently
deliver clinical care to inmates with infectious diseases.
·
A Concept Analysis of Professional Autonomy: A
Correctional Nursing Perspective
Sue Smith, BSN, RN, CCHP
As professional autonomy has emerged as an important
factor to the discipline of nursing, so it has emerged as an
important factor to correctional nursing. This paper analyzes
the concept of professional autonomy as it relates to
correctional nursing and proposes areas of future study. A
literature review and a concept analysis reveal that
characteristics of professional autonomy include authority,
independent practice, patient advocacy, and accountability.
Three case studies are presented and areas of future study are
proposed.
·
Individual Educational Sessions and Inmate Follow-up
for Latent Tuberculosis Infection
Treatment After Jail Release—A Pilot Study
Mark R.
Johnston, MD, MPH; Virginia Cronin, MS, RN, NP; Margaret Wells,
MS, RN, NP;
Sanju Johri, PhD
The
objective of this study was to determine whether individual
educational sessions improve tuberculosis clinic follow-up rates
after inmate-patients’ release into the community compared to
usual care. Study subjects were inmates of a county correctional
facility receiving treatment for latent tuberculosis infection (LTBI).
Inmates beginning LTBI treatment were randomly assigned to
receive either a standardized educational session or usual care.
Follow-up rates at the tuberculosis clinic after jail release
were determined. Of 58 subjects enrolled, 17 were released to
the community while on LTBI treatment. Of these, 1 of 8 subjects
who were offered an educational session and 1 of 9 who were not
offered the session came to the tuberculosis clinic within four
weeks of jail release. The difference was not statistically
significant. Possible reasons for the high dropout rate are
discussed, as are suggestions for a definitive study.
·
Mental Health Services in Kentucky Jails: A Self Report
by Jailers
Daniel W.
Phillips, III, PhD; Carrie G. Mercke, MSSW
This work examines jail mental health services in
Kentucky, a rural state with relatively small jails. While
mental health services in prisons and large jails have been
studied extensively, little is known about smaller jails. Each
of the 85 Kentucky jail administrators was mailed a survey
regarding mental health services at their jail. Jail
administrators self-reported their information; no attempt was
made to verify their data and therefore it may not reflect
actual practices. The response rate was 70.6%. Jail
administrators relied on a variety of techniques to determine if
an inmate was mentally ill. Jail staff members were most likely
to administer medication, while community mental health center (CMHC)
staff provided assessments, counseling/therapy, and psychiatric
visits. Jail administrators were most likely to pay for
services. Jail administrators preferred that the CMHC staff
treat inmates, but that the the inmate/family and state mental
health authority pay for the services.
·
An Evaluation of Cholesterol Management Within a State
Correctional System
Judith E.
LaForest, RPh, MS; Thomas W. Algozzine, PharmD, BCPS
The objectives of this evaluation were to analyze the
efficacy of cholesterol lowering therapy as outlined by the
National Cholesterol Education Program (NCEP) guidelines and to
determine the cost-effectiveness of treating hyperlipidemia in
the incarcerated patient. A retrospective chart review was
conducted of 100 randomly selected charts (using a random
numbers table) identified through the pharmacy claims data.
Criteria for inclusion were that patients had received at least
60 days of therapy and had a baseline LDL-C prior to drug
initiation. Seventy-nine patients met these criteria. Overall,
71% (56) of patients achieved NCEP 2 goal LDL-C. Forty-five
percent of patients with coronary heart disease (CHD) achieved a
goal LDL-C of less than 100 mg/dL. Ninety-five percent of
patients were compliant with their therapy (at least five
refills in six months). It was hypothesized that over five years
the system will prevent one CHD patient from having a coronary
procedure and two fatal coronary events in the population
reviewed. The results of this review reinforce the importance of
effectively managing hyperlipidemia in a state correctional
system.
·
The High Cost of Health Care Within the Juvenile
Justice System
Debra
H. Tennyson, PhD
Correctional facilities experience increasing costs and
demands while resources remain limited. This paper provides a
matrix to identify and compare categorized health care costs.
Methods: A 525-bed, primarily male, long-term juvenile
correctional system’s costs were categorized as either general
health or mental health, and further divided as fixed,
intermediate, or variable costs, depending on several factors.
Results: Mental health costs were three times higher than
general medical costs. Approximately 11% of the health costs are
labeled variable and hard to predict, with prescription costs at
3.3% of the health care budget. Conclusions: This baseline pilot
project suggests that previous studies have underestimated
incarcerated juveniles’ health care costs.
·
Weight Lifting in Prisons: A Survey and Recommendations
John
Amtmann, EdD; Don Berryman, MS; Robert Fisher
Proper strength training regimens have many well-known
benefits. However, given that improper strength training
programs can be injurious, should correctional health officials
support policy that requires proper strength training
techniques? Twenty-five randomly picked prisons in the western
United States were surveyed and asked these questions: (a) Are
there weights or formal resistance training equipment within the
facility? (b) If yes, does the institution have any formal
policies established regarding use of that equipment?
Twenty-three of the institutions had strength training
equipment; only 2 had policies regarding equipment use. Survey
results clearly show that most correctional facilities have no
policy regarding practice of safe and effective strength
training techniques and therefore may fail to achieve the
desired results. It is recommended that qualified supervision be
present inside all correctional strength training facilities.
The qualified personnel in charge should be certified by
nationally recognized organizations and should enforce safe
lifting policy, including (a) limitations of one repetition
maximum lifts allowed—at least six repetitions should be
performed for each exercise for most inmates, (b) emphasis on
slow and controlled lifting movements only, and (c) emphasis on
proper warm-up and cooldown procedures.
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