Planning primary health-care services for South Australian young offenders: A preliminary study

Physical Health, Medical Care Access, and Medical Insurance Coverage of Youth Returning Home After Incarceration: A Systematic Review

Youth reentry following incarceration is a subject of active health care policy innovation and debate. We systematically searched PubMed, CINAHL, Cochrane Library, and Google Scholar for research articles on physical health status or medical care access related to youth reentry (i.e., children and adolescents under 18 years of age). A total of 2,187 articles were identified in the search. After applying exclusion criteria, 10 articles remained. Those included covered general physical health (four articles), medical insurance coverage (five), noninsurance barriers to care and care utilization (five), and reentry youths' prioritization of needs (four). Despite vulnerable health status, the literature on youths' physical health status and medical care access during reentry is sparse, signifying a disconnect in research priorities. The findings suggest that intervention trials on youth reentry and health are needed and that that policy makers should be concerned with Medicaid policy reform.

The pivotal role of primary care in meeting the health needs of people recently released from prison

OBJECTIVE

Australia's prison population is growing at a rate well in excess of population growth. Indigenous Australians are over-represented by a factor of 13. Prisoners are a profoundly marginalised group characterised by complex health and social needs. Despite improvements in health during incarceration, poor health outcomes after release are common, and the net effect of incarceration is usually health depleting. Given the need for effective care coordination, primary care plays a pivotal role in meeting the health needs of this population. In this paper we review what is known about patterns of primary care utilisation in ex-prisoners, identify evidence-based strategies for increasing access to primary care in ex-prisoners, and consider how such contact may shape subsequent health service outcomes.

CONCLUSIONS

Primary care is a necessary but not sufficient condition for effective post-release support. Positive outcomes may depend more on the quality than the quantity of care received. Given massive over-representation of Indigenous people in Australia's prisons, and compelling evidence of preventable morbidity and mortality after release from prison, effective models of care for this population are an important component of closing the gap in Indigenous life expectancy.

HIV/AIDS in Lebanese prisons: challenges and proposed actions

PURPOSE

The purpose of this paper is to discuss the extent of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) crisis in Lebanese prisons, propose functional reforms for Roumieh prisons (the country's largest male top-security prison), and outline the main challenges to HIV/AIDS prevention, intervention, and treatment.

DESIGN/METHODOLOGY/APPROACH

All recommendations were based on previous successful stories, international prison standards as well as cultural considerations.

FINDINGS

This paper argues that prevention and interventions starts within the prison community including inmates, guards, and other prison and provision of appropriate health care, education, and prison infrastructure.

SOCIAL IMPLICATIONS

These strategies are not only important in limiting prevention and transmission of HIV/AIDS, but also contribute in optimizing quality of life within the prison system.

ORIGINALITY/VALUE

This paper is the first of its kind to discuss the prison situation in Lebanese prisons in terms of public health promotion and reforms.

How is Primary Health Care conceptualised in nursing in Australia? A review of the literature

Australia, in common with many other countries, is expanding the role of Primary Health Care (PHC) to manage the growing burden of chronic disease and prevent hospitalisation. Australia's First National Primary Health Care Strategy released in 2010 places general practice at the centre of care delivery, reflecting a constitutional division of labour in which the Commonwealth government's primary means of affecting care delivery in this sector is through rebates for services delivered from the universal healthcare system Medicare. A review of Australian nursing literature was undertaken for 2006-2011. This review explores three issues in relation to these changes: How PHC is conceptualised within Australian nursing literature; who is viewed as providing PHC; and barriers and enablers to the provision of comprehensive PHC. A review of the literature suggests that the terms 'PHC' and 'primary care' are used interchangeably and that PHC is now commonly associated with services provided by practice nurses. Four structural factors are identified for a shift away from comprehensive PHC, namely fiscal barriers, educational preparation for primary care practice, poor role definition and interprofessional relationships. The paper concludes that while moves towards increasing capacity in general practice have enhanced nursing roles, current policy and the nature of private business funding alongside some medical opposition limit opportunities for Australian nurses working in general practice.

Reintegrating young offenders into the community through discharge planning: a review of interventions and needs of youth in secure care

The health status of young offenders is often poorer than similar aged non-offenders. Addressing young offender needs is a key priority for their rehabilitation and reintegration into the community. The objectives were to identify programs and interventions that assist detained youth through focussed discharge planning by a systematic review of the literature. In addition, this review examined the identified health needs of young offenders in secure care. Our systematic review searched electronic databases using the keyword terms youth, secure care, health assessment and primary health care. Keyword browser terms were also entered as search strings, and only literature from 1997 onwards was retained. Twenty-two pieces of published literature were retained, and these documented the needs and service utilisation of young offenders. Mental health problems and trauma exposure were commonly identified in the literature, as was general physical health deficits and social and familial problems. Retrieved articles also made recommendations for health assessments and discharge planning, and some provided discharge planning models. Young offenders have diverse needs that can be ascertained from quality assessment measures. Effective discharge planning is important to attend to ongoing health issues and aid rehabilitation and reintegration into the community. By administering a comprehensive multidimensional screening measure upon admission to secure care, individualised care plans can be formulated with discharge planning measures. Recommendations for further study include the development and implementation of a needs assessment tool in youth secure-care facilities that complements the existing assessments and helps reintegrate young offenders to primary health care and community services.