Search Results (55)

The communities that develop in prison are often small, insular, and central to the experience of incarceration. In these carceral communities, the deaths of individuals—especially those integral to these groups—can echo heavily within a housing unit, and even an entire institution, resulting in a collective experience of grief. While grief is experienced universally, it manifests in unique ways in the carceral context. The shared sorrow, loss, and sadness characterizing the experiences of those left behind are central to this form of mourning, and among imprisoned communities, grief is experienced uniquely. This paper draws on semi-structured interviews with 58 men imprisoned during the COVID-19 pandemic in an institution where over a dozen men died in a relatively short time. Their experiences suggest that, while grieving in prison is often complicated and may be repressed by both the individual and the carceral institution, bereavement may take a different form when experienced collectively and broadly within the carceral context. We develop the concept of mass carceral grief to explain this phenomenon. While unique in many ways, the lessons on carceral grief from this public health crisis can inform our broader understanding of how loss impacts those incarcerated. Full article

Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for more than 12 years. However, like many prisons during the COVID-19 pandemic, the prison ceased all in-person programming between March 2020 and July 2021. In response, the SHARE treatment team pivoted to a hybrid telehealth delivery model (i.e., group participants gathering in a facility group room and therapists joining via video, displayed on a computer screen within the group room). Given the lack of evidence for hybrid telehealth in carceral settings, and specifically for group therapy for sexual trauma, the current study compared ratings on internalizing symptoms (Brief Symptom Inventory-18 or BSI-18), posttraumatic stress symptoms (Posttraumatic Checklist-5 or PCL-5), and group cohesion ratings (Inclusion of Self in Other scale, or IOS) for participants who received SHARE in person (n = 21) or through hybrid telehealth (n = 19). The results demonstrated that participants of in-person and hybrid telehealth SHARE groups reported similar significant reductions in BSI-18 (15.21 in person vs. 16.00 in hybrid telehealth) and PCL-5 (30.78 in person vs. 26.40 in hybrid telehealth) scores pre- to post-treatment and comparable IOS ratings (5.06 in person vs. 5.31 in hybrid telehealth). The findings suggest hybrid telehealth is an effective and feasible treatment modality for meeting the need for trauma-focused therapy in prisons. Future studies examining the effectiveness and implementation of trauma-focused hybrid telehealth groups in prisons are warranted. Full article

Background: The SARS-CoV-2 pandemic led to an enormous global health, social and economic crisis. The pandemic caused considerable upheaval and considerable difficulties due to an unforeseen and devastating health condition. Materials and Methods: We discuss the numerous challenges encountered in the fields of forensic medicine and public health during the COVID-19 pandemic. Particularly during the first wave of the pandemic, forensic pathologists faced significant difficulties due to the lack of safe autopsy protocols and insufficient personal protective equipment. Mainly in Europe, they had to manage a substantial number of potential cases of medical liability related to COVID-19. The widespread outbreak of the virus in residential care homes and prisons posed another significant challenge. Furthermore, forensic pathologists had to address the issue of complications arising from vaccination campaigns. Conclusions: This article underscores the need for continued efforts in scientific research and healthcare preparedness to effectively manage such complex crises. Forensic pathologists must be equipped with the necessary resources and training to address unpredictable, complex situations with far-reaching social implications. Full article

Background/Objectives: This study investigated the experiences of inpatient family caregivers who experienced restrictions in meeting their family members owing to the changed visitation guidelines of long-term care hospitals during the early stages of the coronavirus disease 2019 (COVID-19). We aimed to deepen our understanding of the nature of these caregivers’ experiences. Methods: The participants were family caregivers of patients in long-term care hospitals during the early stages of the COVID-19 pandemic. We collected data from nine inpatient caregivers from April to July 2021. Individual interviews and data were analyzed using Colaizzi’s phenomenological method. Results: Participants’ experiences were classified into the following three themes: (1) a prison-like long-term care hospital bound by strict COVID-19 prevention rules; (2) growing affection for unreachable parents; and (3) adaptation to a new, safer daily life. Participants had difficulty communicating with their families living under quarantine conditions during COVID-19 due to non-face-to-face situations. However, amid the long-term COVID-19 situation, participants overcame these challenges through efforts to facilitate communication. Conclusions: The results of this study can be used as basic data to support the smooth communication between patients and caregivers in long-term care hospitals in the event of an infectious disease outbreak in the future, to alleviate emotional stress, and to minimize the weakening of families. Full article

This study examines the epidemiological and genomic characteristics, along with the transmission dynamics, of SARS-CoV-2 within prison units I and II in Campo Grande, Mato Grosso do Sul, Brazil. Conducted between May and October 2022, it reveals how the virus spreads in the confined settings of prisons, emphasizing the roles of overcrowded cells, frequent transfers, and limited healthcare access. The research involved 1927 participants (83.93% of the total prison population) and utilized nasopharyngeal swabs and RT-qPCR testing for detection. Contact tracing monitored exposure within cells. Out of 2108 samples, 66 positive cases were identified (3.13%), mostly asymptomatic (77.27%), with the majority aged 21–29 and varying vaccination statuses. Next-generation sequencing generated 28 whole genome sequences, identifying the Omicron variant (subtypes BA.2 and BA.5) with 99% average coverage. Additionally, the study seeks to determine the relationship between immunization levels and the incidence of SARS-CoV-2 cases within this enclosed population. The findings underscore the necessity of comprehensive control strategies in prisons, including rigorous screening, isolation protocols, vaccination, epidemiological monitoring, and genomic surveillance to mitigate disease transmission and protect both the incarcerated population and the broader community. Full article

Much of the American response to the COVID-19 pandemic was characterized by a divergence between general public opinion and public health policy. With little attention paid to individuals incarcerated during this time, there is limited direct evidence regarding how incarcerated people perceived efforts to mediate the harms of COVID-19. Prisons operate as a microcosm of society in many ways but they also face unique public health challenges. This study examines vaccine hesitancy—and acceptance—among a sample of individuals incarcerated within adult prisons in Pennsylvania. Using administrative records as well as rich attitudinal data from a survey of the incarcerated population, this study identifies a variety of social and historical factors that are—and are not—associated with an incarcerated person’s willingness to receive the COVID-19 vaccine. Our findings highlight vaccination challenges unique to the carceral context and offer policy recommendations to improve trust in credible health messengers and health service provision for this often overlooked but vulnerable population. Full article

Prison populations are unlikely to have access to prompt, effective medical care as the general population. Therefore, vaccination and effective surveillance systems have been recommended to mitigate coronavirus disease 2019 (COVID-19) transmission in prison settings. This pilot study aimed to assess the application of wastewater-based epidemiology (WBE) in a prison to act as an early warning tool for COVID-19 transmission. In this study, weekly wastewater samples (n = 21) were collected for 21 weeks from a prison facility in New Orleans, LA, USA, and analyzed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the results were compared with the number of confirmed cases during the same period. SARS-CoV-2 was concentrated using two methods and quantified via RT-qPCR using CDC N1 and N2 assays. Overall, SARS-CoV-2 was detected in eight samples (38%). An equal number of samples tested positive for SARS-CoV-2 using the two concentrating methods, indicating the effectiveness of both methods for building-scale WBE. Despite limited clinical testing in the studied prison facility, instances of SARS-CoV-2 detection in wastewater prior to the diagnosis of COVID-19 depict the potential use of wastewater surveillance in detecting the presence of early and averting outbreaks in asymptomatic COVID-19 patients. Full article

During the COVID-19 crisis, organizations had to demonstrate organizational resilience (OR) to continue to carry out their missions. We conducted qualitative research to identify the factors that contributed to the OR of police and penitentiary institutions in French-speaking Switzerland, in terms of their operations and management. The modes of action and crisis responses of these emergency services, regularly confronted with crises and particularly impacted during the pandemic, are worthy of attention. To this end, we synthesized the OR factors that are frequently identified in both theoretical and empirical review articles and identified four theoretical conceptualizations: (a) resilience engineering, (b) ecological resilience (these two are the most widely used), (c) a third way situating resilience at an intermediate stage in a metamodel representing the evolution of organizations from a fragile to antifragile state, and (d) a conceptualization focusing on the temporal dimension of OR. Based on the results of 25 semi-structured interviews with executives from cantonal police forces and prisons, we present what we consider to be the key levers in a three-phase resilience process (upstream, during, and after the shock): anticipatory and proactive organizational culture, information management and communication, liminal leadership practices, social and environmental practices, agility-enhancing governance practices, and learning capabilities. Our results largely confirm that these parameters significantly contributed to the OR of the institutions in question. They also enable us to propose winning configurations of factors that can increase the potential for OR. Full article

(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before and after the onset of COVID-19. (2) Methods: At prison reception, inmates underwent clinical interviews and were assessed using the Blaauw Scale and Suicide Assessment Scale. Psychological distress, measured by the Symptom Checklist-90-R, was compared between inmates admitted before and after COVID-19. Regression analyses were run to examine psychosocial vulnerabilities associated with suicidal intent in newly incarcerated individuals at risk of suicide. (3) Results: Among the 2098 newly admitted inmates (93.7% male) aged 18 to 87 years (M = 39.93; SD = 12.04), 1347 met the criteria for suicide risk, and 98 exhibited high suicidal intent. Inmates who entered prison after the onset of COVID-19 were older and had fewer social relationships. They had a higher prevalence of recidivism and substance abuse, along with elevated levels of psychological distress. An increase in perceived loss of control, anergia, obsessive-compulsive symptoms, phobic anxiety, and paranoid ideation emerged as the factors most strongly associated with high suicidal intent. (4) Conclusions: These findings support the value of psychosocial screening in promptly identifying inmates at risk of suicide, enabling the implementation of targeted, multi-professional interventions. Future research should replicate these results, with a focus on longitudinal studies that monitor the same inmates throughout their incarceration period. Full article

The COVID-19 vaccination of prisoners and prison staff represents a public health intervention to reduce the impact of the pandemic in conglomerate settings. In Spanish prisons, the road map of the Ministry of Health was followed to protect the population at risk. We conducted a cross-sectional study to assess the acceptance of COVID-19 vaccination by prisoners and prison staff in a prison in Alicante, Spain. We analyzed data obtained through a standardized, self-administered, and anonymous questionnaire; 1016 prisoners and 288 prison staff responded to the survey. The majority of inmates and staff reported no history of symptomatic COVID-19, 90.15% and 91.66%, respectively. Respondents reported that 88.72% agreed to be vaccinated and 89.64% would recommend the vaccine to others. Approximately 89% believe that the benefit of getting vaccinated against COVID-19 is greater than the risk, and 70.55% reported that vaccination should be mandatory for inmates and staff to participate in some activities. The acceptance of COVID-19 vaccination among prisoners and prison staff is high in a Provincial Prison in Spain. Elevated acceptance of COVID-19 vaccination in prisons is a major factor in public health intervention and vaccine equity. Full article

The COVID-19 pandemic had several repercussions on prison staff, but the currently available evidence has mainly ignored these effects. This qualitative study aimed to understand the impact of COVID-19 on the prison system through the narratives of health and security professionals, using the methodological framework of the constructivist grounded theory proposed by Charmaz. The sample included 10 healthcare workers and 10 security professionals. Data collection took place between October and November 2022 through individual in-depth interviews. The data were analyzed using the MaxQDA software. Three categories of interrelated data emerged: (1) “Confrontation and disruption” caused by the COVID-19 pandemic in the prison system; (2) “Between disinfodemic and solicitude” referring to the tension between information management and the practice of care centered on the needs of inmates; and, finally, (3) “Reorganization and mitigation strategies during the fight against COVID-19”. Continuous education and the development of specific skills are essential to enable professionals to face the challenges and complex demands that arise in prison contexts. The daily routines professionals had previously taken for granted were disrupted by COVID-19. Thus, investing in adequate training and emotional support programs is crucial to promote the resilience and well-being of these professionals, ensuring an efficient and quality response to critical events. Full article

Worldwide, the COVID-19 pandemic represented a health emergency for prisons. This study sought to understand the meanings and experiences through the narratives of prisoners and family members affected by the COVID-19 pandemic in the context of a maximum-security state penitentiary complex in southern Brazil. For this purpose, a qualitative study was developed based on the methodological framework of constructivist grounded theory. Data were collected between February and August 2022 through individual in-depth interviews and field notes. The sample consisted of 41 participants: 28 male prisoners, and 13 family members. Guided by the Charmaz method of grounded theory analysis, the study afforded the core category “Feeling trapped in prison during the COVID-19 pandemic” with three interrelated phases: “Triggering”, “Escalating”, and “Readjustment”. The “Triggering” phase refers to COVID-19-related elements or events that triggered certain reactions, processes, or changes in prison. During the “Escalating” phase, participants became overwhelmed by the suffering caused by incarceration and the pandemic crisis. The “Readjustment” phase involved adapting, reorienting, or reformulating previous approaches or strategies for dealing with a specific situation. Prisons faced complex challenges during the pandemic and were forced to prioritize protecting public health. However, the measures adopted must be carefully evaluated, ensuring their needs and that they are based on scientific evidence. The punitive approach can undermine inmate trust in prison authorities, making it difficult to report symptoms and adhere to preventive measures. Full article

Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated people, patients with psychiatric disorders, and migrants. A narrative review of literature was performed using key electronic databases (Scopus, Pubmed—MEDLINE) and search engines (Google Scholar). Peer-reviewed publications, grey literature on HCV, and recent models proposed for micro-elimination in underserved populations were included. An insight into the COVID-19 pandemic and its influence on HCV micro-elimination pathways will be also provided. Regarding prison settings, a progressive reduction in HCV epidemiology among incarcerated people in the last years was found (one-third of the level it had been before). People suffering from psychiatric disorders have a high anti-HCV prevalence, but there is a lack of data on active infections. A bidirectional relationship between HCV and psychiatric disorders was found. Migrants showed a very inconsistent assessment of HCV. Furthermore, available studies recorded data from populations with high heterogeneity of anti-HCV prevalence, Therefore, the reported results need caution in their evaluation. Full article

This study explores COVID-19 vaccine acceptance among prison security staff and the extent to which they trust varied sources of information about the vaccines. Cross-sectional survey data were obtained from a state-wide sample of corrections officers (COs, hereafter; n = 1208) in February 2021. Group differences, disaggregated by demographic characteristics, were examined using F-tests and t-tests. Despite the comparatively limited risk of contracting the virus, non-security staff reported they would accept a COVID-19 vaccine at no cost (74%), compared to their more vulnerable CO counterparts (49%). We observed vaccine refusal correlations between COs’ reported gender, age, and length of time working as a CO, but none with their self-reported race. Vaccine refusal was more prevalent among womxn officers, younger officers, and those who had spent less time working as prison security staff. Our findings also suggest that the only trusted source of information about vaccines were family members and only for officers who would refuse the vaccine; the quality of trust placed in those sources, however, was not substantially positive and did not vary greatly across CO racial groups. By highlighting characteristics of the observed gaps in COVID-19 vaccine acceptance between COs and their non-security staff coworkers, as well as between corrections officers of varied demographic backgrounds, these findings can inform the development of responsive and accepted occupational health policies for communities both inside and intrinsically linked to prisons. Full article

Little is known about occupational SARS-CoV-2 exposures and COVID-19 outcomes. We established a Doctor’s First Reports of Occupational Injury or Illness (DFR)-based surveillance system to study cases of work-related COVID-19 exposures and disease. The surveillance data included demographics, occupation, industry, exposure, and illness, details including hospitalization and lost work. We classified workers into ‘healthcare’, non-healthcare ‘public-facing’, or ‘other’ worker groups, and rural–urban commuting areas (RUCAs). We describe worker exposures and outcomes overall by worker group and RUCA. We analyzed 2848 COVID-19 DFRs representing workers in 22 detailed occupation groups and 19 industry groups. Most DFRs were for workers in metropolitan RUCAs (89%) and those in healthcare (42%) and public-facing (24%) worker groups. While DFRs were from 382 unique worksites, 52% were from four hospitals and one prison. Among 1063 DFRs with a suspected exposure, 73% suspected exposure to a patient or client. Few DFRs indicated hospitalization (3.9%); however, the proportion hospitalized was higher among nonmetropolitan (7.4%) and public-facing (6.7%) workers. While 56% of DFRs indicated some lost work time, the proportion was highest among public-facing (80%) workers. Healthcare and prison workers were the majority of reported occupational COVID-19 exposures and illnesses. The risk of COVID-19 hospitalization and lost work may be highest among nonmetropolitan and public-facing workers. Full article