Search results

Prison populations in Western countries are characterised by a high hepatitis C prevalence. This reflects a high rate of imprisonment for drug related offences. Prison entrants who are HCV‐negative face a significant risk of acquiring hepatitis C. Effective prevention strategies and successful treatment of a significant percentage of hepatitis C‐positive inmates could reduce the risk of transmission in the prison context significantly. Several reports of treating hepatitis C in prisoners in major facilities have been published. We report our experience of establishing a liver clinic service in two regional prisons in New South Wales, Australia. Liver biopsy requirements to access treatment in Australia meant that only 46 of 196 reviewed patients were able to commence treatment in our 5‐year experience. Treatment completion rate was 61% and end of treatment viral response was 57%. The removal of liver biopsy requirements in Australia in April 2006 has freed up access to treatment and our results encourage further effort to optimise the process of assessment and treatment in this high‐risk population.

Schema therapy has gone through various adaptations, including the identification of various schema modes. The purpose of this paper is to suggest that there may be a further dissociative mode, the “frozen child” mode, which is active for some patients, particularly those that have experienced extreme childhood trauma.

The paper is participant observer case study which is based on the personal reflections of a forensic patient who completed a treatment programme which includes schema therapy.

The proposed mode, “frozen child”, is supported by theoretical indicators in the literature. It is proposed that patients develop this mode as a protective strategy and that unless recognised and worked with, can prevent successful completion of therapy.

Based on a single case study, this concept is presented as a hypothesis that requires validation as the use of the case study makes generalisation difficult.

It is suggested that if validated, this may be one of the blocks therapists have previously encountered that has led to the view that people with severe personality disorder are “untreatable”. Suggestions are made as to how patients with this mode, if validated, can be treated with recommendations as to the most appropriate processes to potentiate such therapy.

The suggestion of this potential “new schema mode” is based on service user initiative, arising from a collaborative enterprise between service user and clinician, as recommended in recent government policies.

Studies have found innate vulnerabilities which potentially may increase the risk of an individual with autism spectrum disorders (ASD) finding themselves involved with the criminal justice system as a result of being charged with a sexual offence. The purpose of this paper is to evaluate the literature which has explored sexual offending in individuals with ASD.

A systematic PRISMA review (PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted using internet-based bibliographic databases (PsycINFO, MEDLINE, Psychology and Behavioural Sciences Collection and PsycARTICLES) in order to access studies which investigated to any degree the association between ASD and sexual offending.

Only a small number of case reports (n=7) on sexual offending in individuals with ASD and a small number of prevalence studies (n=7) were identified.

Research is urgently required to identify the specific requirements and needs of sexual offenders with ASD in order to inform an appropriate treatment strategy for successful outcomes.

Relatively few studies and reviews have investigated the area of ASD and sexual offending specifically.

I was recently asked to see a woman suffering from compulsive eating, a problem of sufficient severity to warrant admission to a mental hospital. Frequently the clinical psychologist learns a great deal about normal behaviour by studying the abnormal and Mrs. M's irresistible compulsion to eat was no exception. In brief, her eating tended to be triggered, or at least strongly influenced, by food and mood cues rather than hunger pangs and eating plans. She could not sit in a room with a bar of chocolate for any length of time without devouring it whole, and she could only rarely eat one Black Magic without consuming the whole box. In common with the obsessive‐compulsive, the alcoholic, smoker and compulsive gambler, she found that in certain moods and when exposed to certain cues she had little or no control over her behaviour and was compelled to relinquish her long‐term goals in favour of short‐term gratification. The severity of Mrs. M's compulsive urges demonstrated, in exaggerated form, the loss of control phenomenon which is experienced by every struggling slimmer and is a regrettable feature of the human predicament.

Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co‐epidemic of HIV, tuberculosis has already started to make a comeback in wealthier countries. The WHO’s solution to this global tuberculosis epidemic is the DOTS strategy, the implementation of which presents many problems. The two issues most common to the majority of locations are delay in presentation for treatment and non‐completion of treatment. This review looks at the reasons for these problems in the less developed world, and addresses some solutions. The main reasons for delayed presentation are: a lack of understanding about TB; the stigma associated with the disease; the inaccessibility of treatment; and a preference for private practitioners. The main reasons for non‐completion of treatment are: the stigma of the disease; a lack of information; dissatisfaction with the treatment and its delivery; and inaccessibility of treatment. Successful implementations of the DOTS strategy need to address all these issues. There is little evidence that DOT enhances treatment completion unless combined with other strategies. Community‐based, patient‐orientated DOTS appears to be an appropriate way of addressing many of these issues. The involvement of volunteers in community‐based strategies is common, but needs more research in order for this strategy to realise its full potential.

The authors use laboratory experiments to test two self-assessment tax mechanisms for facilitating land assembly. One mechanism is incentive compatible with a complex tax function, while the other uses a flat tax rate to mitigate implementation concerns. Sellers publicly declare a price for their land. Overstating its true value is penalized by using the declared price to assess a property tax; understating its value is penalized by allowing developers to buy the property at the declared price. The authors find that both mechanisms increase the rate of land assembly and gains from trade relative to a control in which sellers’ price declarations have no effect on their taxes. However, these effects are statistically insignificant or transitory. The assembly rates in our self-assessment treatments are markedly higher than those of prior experimental studies in which the buyer faces bargaining frictions, such as costly delay or capital constraints.

Since the early 1990s, various countries have introduced HIV prevention programmes in prisons. Such programmes include education on HIV/AIDS, HCV and on drug use for prisoners and for staff, voluntary testing and counselling, the distribution of condoms, bleach, and needles and syringes, and substitution therapy for injecting drug users. Other forms of drug‐dependence treatment, as well as drug demand reduction and drug supply reduction measures may also be relevant to managing HIV/AIDS and HCV in prisons, and may facilitate HIV prevention measures ‐ or have unintended negative consequences for such measures. Prison systems in a growing number of countries are implementing such programmes. However, many of them are small in scale and restricted to a few prisons. Provision of care and treatment for people living with HIV or AIDS has become a priority worldwide, and it is considered to be a basic human right. This includes the provision of antiretroviral therapy (ARV) in the context of comprehensive HIV/AIDS care. Providing access to ARV for those in need in the context of correctional facilities is a challenge, but it is necessary and feasible. Studies have documented that, when provided with care and access to medications, prisoners respond well to ARV. Part 3 of the select annotated bibliography on HIV/AIDS and HCV in prisons contains selected “essential” articles and reports that provide information about (1) substitution treatment and other forms of drug‐dependence treatment; (2) other drug demand and drug supply reduction measures; and (3) care, treatment, and support for prisoners living with HIVor AIDS and/or HCV. Each section also contains a brief review of the evidence, based on recent work undertaken by the World Health Organization (WHO).