An acute intestinal obstruction caused by a torsion of the descending colon with incarceration and strangulation of the apex of the cecum was diagnosed in a mature Holstein cow. The clinical signs manifested were acute anorexia, depression, signs of abdominal pain, and absence of feces. Rectal examination revealed a sharp decrease in luminal size of the descending colon and taut bands at that level. The final diagnosis was obtained by exploratory celiotomy. Although surgical correction was attempted, the cow died of acute fecal peritonitis 18 hours postoperatively.
Anterior abdominal wall hernias are uncommon, and herniation of a gravid uterus into these hernias is even rarer. Although reducible initially, the herniation of pregnant uterus may be complicated by incarceration and subsequent strangulation within the hernial sac, late in the course of pregnancy. There is no consensus over the management of this rare condition. Each case should be individualized. If uncomplicated, a conservative approach until term followed by delivery and herniorrhaphy is a good option. Here, 2 cases of herniation of gravid uterus into the anterior abdominal wall are described along with a brief review of literature pertaining to its presentation, complications, and management.
OBJECTIVE: The authors examine the possible adverse consequences of incarceration on drug offenders, their families, and their communities. OBSERVATIONS: State and federal policies on drug felons may affect eight elements of personal and community well-being: children and families, access to health benefits, access to housing benefits, access to assistance for higher education, immigration status, employment, eligibility to vote, and drug use or recidivism. CONCLUSIONS: Minorities have a high chance of felony conviction and an increasing lack of access to resources, suggesting that patterns of drug conviction and health disparities may be mutually reinforcing. Large numbers of people sent to prison for drug offenses are now completing their terms and reentering communities. Their reentry will disproportionately affect minority communities. Without resources (education, job opportunities, insurance, health care, housing, and the right to vote) drug abusers face a higher risk of recidivism and increase the burden on their communities.
Blowout fractures of the orbit, a frequent complication of midfacial trauma, result from an increased intraorbital pressure which “blows out” the weakest area—the floor. Intraorbital fat and muscles herniated into the maxillary sinus, muscles incarcerated in the fracture, and the displaced orbital contents produce diplopia. After incarceration, elevation of the affected eye is impossible.
Past research has demonstrated that individuals with psychopathic characteristics are under-responsive to aversive stimuli, however, much of this work has failed to include non-incarcerated samples, or to examine gender differences in this relationship. Additionally, few studies have examined the role of specific personality characteristics, as they relate to both psychopathic behavior and emotional responsiveness. The current study assessed emotional modulation of the startle response in a community sample of 108 men and women (99 with usable startle data) during perception of emotion-laden photographs. Consistent with previous work, men reporting high levels of psychopathy failed to show the typical increase in the startle response when exposed to aversive photographs, but only when responses were elicited relatively early in picture viewing (i.e., 2.0 s as compared to 4.5 s post-photograph onset). Additionally, both genders showed a significant effect of harm avoidance and anxiety on modulation of the startle response, such that individuals reporting low levels of each trait failed to show significant responses to aversive photographs. These results suggest that while deficits in emotional processing extend to non-incarcerated samples...
This paper deals with the problems faced by offenders in a category of short-term, bit-term and long-term incarceration. Each group has characteristics which mitigate against unassisted rehabilitation. In a country burdened by unemployment of skilled and well-educated people, the criminal releasee is at a great disadvantage and often finds the freedom of prison more comfortable than the captivity of society. The bleak and forlorn futures of offenders vary in intensity. Certain recommendations are made in this paper which could prevent future criminal involvement.
From a health care point-of-view, the most needy adolescents in the United States are those who become incarcerated in the juvenile justice system. These youngsters have poor health care before incarceration is not much better. Their health problems range from the results of trauma to the consequences of sexual activity to severe psychological problems. Their health needs include: (1) prevention of health problems which contribute to behaviors for which youths are incarcerated; (2) comprehensive assessment and care; (3) continuity of care after discharge from the institutions; (4) comprehensive health education and health promotion; (5) professional, competent health care providers; (6) educated, sympathetic administrators and supervisory personnel; and (7) adequate financing of health services. Concerned health providers must become advocates for these adolescents and for their health care in correctional and political settings.
A majority of inmates in the state of Connecticut Department of Corrections use opioids or are opioid dependent before incarceration. None of the state’s prisons offer opioid substitution therapy other than for detoxification or maintenance therapy for women during pregnancy. On release to the community, most prisoners relapse to drug use and this has been associated with higher recidivism rates, and less adherence to antiretroviral medications for HIV-infected persons. Nationally and internationally, methadone (METH) and buprenorphine (BUP) have been found to decrease relapse to drug use, decrease recidivism rates, improve adherence to antiretroviral medications, decrease HIV-risk taking behaviors, and improve mortality. However, the general knowledge about opioid substitution therapy among correctional facility staff has been reported as substandard. This pilot study compiled results of answers to anonymous surveys from 27 individuals who work directly with inmates in a patient-care capacity for the Connecticut Department of Corrections (CT DOC) and CT DOC case-management referral program (Project TLC) in the year 2006. The surveys included questions regarding current attitudes and knowledge about opioid substitution therapy for prisoners. A minority of respondents refer released prisoners with a history of opioid dependency to METH or BUP treatment. The majority of correctional workers and case-management referral workers did not have knowledge about BUP or METH’s ability to improve health and decrease HIV risk taking behaviors. This study found that more education of individuals treating and caring for HIV-infected opioid dependent prisoners is needed.
This paper examines the relationship between illegal drug economy involvement, gun-related victimization, and recent gun carrying among young men and women incarcerated in a state prison in the United States. Interviews were conducted with 18- to 25-year old incarcerated men (n = 135) and women (n = 69) between July 1999 and October 2000. Forty-five percent of men and 16% of women reported carrying a gun in the year prior to incarceration. Respondents who sold crack cocaine or other drugs were more likely to have carried guns than those not selling drugs. However, hard drug use was not associated with gun carrying among men. All ten women who carried guns had used hard drugs. Sixty-seven percent of men and 28% of women had been shot at. Respondents who sold crack cocaine were at elevated risk of being shot at. Among men, selling crack (OR = 10.2, 95% CI = 2.5, 42.1) and ever being shot at (OR = 4.6, 95% CI = 1.7, 12.2), were associated with carrying guns. These findings provide further evidence of a link between crack selling (but not necessarily drug using) and gun carrying.
In response to growing numbers of drug offenders cycling in and out of the criminal justice system without treatment for underlying drug problems, the judicial system has increasingly adopted drug courts as a strategy to divert these offenders from incarceration to supervised drug treatment. Our aim was to determine if drug court treatment effectiveness could be improved using contingency management, in the form of twice-weekly vouchers, to reinforce abstinence and positive behaviors for 163 clients over 26 weeks. We found no significant differences in outcomes among the study groups, although the Treatment Plan Group that received reinforcement for positive behaviors showed a trend toward poorer performance. We suspect that the influence of the judge within the courtroom had a stronger impact on drug court clients’ attitudes, drug use behaviors and other outcomes than the relatively low-value vouchers awarded as part of the treatment protocol.
Aggression, antisocial and delinquent behavior frequently result in the incarceration of a large number of young people, but these problems pale in comparison to the mental health challenges faced by many of these youth. Recent studies show a high prevalence of mental disorders among adolescents within the justice system. These findings have led researchers, clinicians and policy-makers to re-evaluate the assessment and treatment options that are available for youth within correctional facilities. This article provides a concise review of the most recent research related to mental health disorders among incarcerated juveniles within Canada and the United States. Rates of some of the most common mental health disorders among juveniles, including depression, anxiety, attention deficit hyperactivity and substance use are summarized. Throughout the review, issues related to co-morbidity and gender differences are highlighted. The implications of mental health disorders for juvenile justice policy and practice are discussed.
Although dramatically heightened rates of violence have been observed among injection drug users (IDU), little is known about the gender differences associated with violence among this population. Employing a risk environment framework, we performed an analysis of the factors associated with experiencing violence among participants enrolled in a prospective cohort study of IDU during the years 1996-2005 using generalized estimating equations (GEE). Among 1114 individuals, 291 (66%) of females and 470 (70%) of males reported experiencing violence during the study period. In multivariate analyses, mental illness, frequent alcohol use, frequent crack use, homelessness, Downtown Eastside residency, and requiring help injecting were positively associated with experiencing violence for both sexes (all p < 0.05). For females, binge drug use (AOR = 1.30) and drug dealing (AOR = 1.42) were positively associated with violence, while younger age (AOR = 1.02), frequent heroin injection (AOR = 1.24), and incarceration (AOR = 1.50) were significant for males. Women were more likely to be attacked by acquaintances, partners, and sex trade clients, while men were more likely to experience violence from strangers and the police. These findings indicate that susceptibility to violence among IDU is structured by environmental factors such as homelessness and drug-related factors such as frequent alcohol use and involvement in drug economies. Furthermore...
Anterior pelvic ring disruptions are often associated with injuries to the genitourinary structures with the potential for considerable resultant morbidity. Herniation of the bladder into the symphyseal region after injury with subsequent entrapment upon reduction of the symphyseal diastasis has seldom been reported in the literature. We report such a case involving bladder herniation and subsequent entrapment after attempted closed reduction with anterior pelvic external fixation immediately treated with open reduction and internal fixation along with a review of the literature.
To explore why some Proposition 36 offenders do not enter drug treatment, we analyzed self-reported and administrative data to compare the characteristics, perceptions, and re-arrest rates of 124 untreated and 1,335 treated offenders assessed by thirty sites in five California counties. Offenders were comparable in many domains at assessment, however untreated offenders were younger, not employed, more criminally severe, and less motivated for treatment. To avoid incarceration was the primary reason for choosing Proposition 36, but fewer untreated offenders felt treatment-ready (12.9% vs. 35.7%) and more accepted the Proposition 36 program only upon recommendation by others (37.9% vs. 11.7%). Reasons for not entering treatment included re-arrest (31.6%), no desire for treatment (23.9%), and assignment to a program that was too far away (11.1%). Both groups had fewer total arrests after assessment, but recidivism was higher among untreated offenders. Understanding untreated Proposition 36 offenders can aid efforts to improve treatment entry rates and related outcomes.