The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

INTRODUCTION

More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.

OBJECTIVES

To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison.

METHODS

We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology.

RESULTS

The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up.

CONCLUSIONS

The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population.

KEY WORDS

Mortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.

The longitudinal course of prisoners’ mental health problems during and after imprisonment

Mental health problems are common in prison populations. Correctional institutions offer an important opportunity to improve prisoners’ health, which also benefit the wider public health agenda. At present, little is known about the longitudinal course of prisoners’ mental health problems during and after imprisonment. The aims of this presentation are: (a) to examine the longitudinal development of mental health problems in prison and after release; and (b) to identify individual and institutional factors associated with prisoners’ mental health problems.

Data are used from the Prison Project, a nationwide and longitudinal study examining 1.904 male prisoners in the Netherlands. Participants were surveyed at various intervals during detention, and 6 and 24 months after their release. Data include detailed longitudinal information on prisoners’ self-reported mental health problems, healthcare use, prison experiences (e.g. sentence length, victimisation, receiving visits, and exercise), and background characteristics (e.g. sociodemographic characteristics, financial situation, social support, and personality traits).

Prisoners reported more mental health problems in and after prison than men in the general population. Initial results demonstrate that prisoners who entered detention with pre-existing mental health problems and problematic alcohol and drug use, showed mental health improvements during detention.

The high levels of prisoners’ mental problems highlight the importance of addressing mental issues in prison and ensuring the continuity of care to support prisoners with their transition into the community.

[Mental health symptoms among prisoners: psychometric properties of the Brief Symptom Inventory (BSI)]

Mental health problems are common in prison populations. Imprisonment may provide important opportunities to improve prisoners' mental health. To do so, it is important to systematically identify prisoners with mental health problems as soon as possible.<br/> AIM: To examine the psychometric properties of the Brief Symptom Inventory (BSI) among male prisoners.<br/> METHOD: A total of 1,624 male prisoners filled out the BSI. The following psychometric properties of the BSI scales were examined: distribution, internal consistency, inter-item correlations, and the factor structure. To examine the (criterion) validity, the BSI scores of different groups were compared.<br/> RESULTS: Cronbach's α's of the BSI scales ranged from 0.97 to 0.76. In general, the observed factor structure resembled the intended nine BSI scales. Prisoners reported significantly higher scores on the BSI than men from the general population, but had lower scores than male psychiatric patients. Prisoners who had been treated for mental disorders prior to their detention, scored significantly higher than prisoners who had not.<br/> CONCLUSION: The BSI showed reliable scales among prisoners and is well able to distinguish between different groups. KEY WORDS Brief Symptom Inventory, prisoners, psychiatry, psychometric properties.

Mental health symptoms during imprisonment: a longitudinal study

OBJECTIVE

Mental health problems are common in prison populations. Less is known about how mental health problems develop during imprisonment. The objective was to examine the longitudinal course of mental health symptoms during imprisonment and individual factors associated with the development of these symptoms.

METHOD

In a prospective cohort study, 1.664 Dutch male prisoners were questioned 3 weeks after their arrival in detention. Those still in custody were questioned again after 3, 9, and 18 months. Multilevel analyses were conducted to identify predictors of the course of mental health symptoms.

RESULTS

Prisoners reported continued elevated symptom levels compared to the general population. Inmates who entered detention with pre-existing mental health problems and problematic alcohol/drugs use showed mental health improvements during detention.

CONCLUSION

The high levels of prisoners' mental health problems highlight the importance of addressing mental health issues in prison. Imprisonment does not have an overall negative effect on mental health.

The effect of dietary protein and fermentable carbohydrates levels on growth performance and intestinal characteristics in newly weaned piglets1

Reducing the CP content and increasing the fermentable carbohydrates (FC) content of the diet may counteract the negative effects of protein fermentation in newly weaned piglets fed high-CP diets. To study the synergistic effects of CP and FC on gut health and its consequences for growth performance, 272 newly weaned piglets (26 d of age, 8.7 kg of BW) were allotted to 1 of 4 dietary treatments in a 2 x 2 factorial arrangement, with low and high CP and low and high FC content as the factors. Eight piglets from each dietary treatment were killed on d 7 postweaning. Feces and digesta from ileum and colon were collected to determine nutrient digestibility, fermentation products, and microbial counts. In addition, jejunum tissues samples were collected for intestinal morphology and enzyme activity determination. During the entire 4-wk period, interactions between the dietary CP and FC contents were found for ADFI (P = 0.022), ADG (P = 0.001), and G:F (P = 0.033). The high-FC content reduced ADFI, ADG, and G:F in the low-CP diet, whereas the FC content did not affect growth performance in the high-CP diet. Lowering the CP content of the low-FC diet improved ADFI and ADG, whereas lowering the CP content of the high-FC diet did not influence growth performance. The low-CP diets resulted in a lower concentration of ammonia in the small intestine (P = 0.003), indicating reduced protein fermentation. In the small intestine, the high FC content increased the number of lactobacilli (P = 0.047), tended to decrease the number of coliforms (P = 0.063), tended to increase the lactic acid content (P = 0.080), and reduced the concentration of ammonia (P = 0.049). In the colon, the high-FC diets increased the concentration of total VFA (P = 0.009), acetic acid (P = 0.003), and butyric acid (P = 0.018), and tended to decrease the ammonia concentration (P = 0.076). Intestinal morphology and activity of brush border enzymes were not affected by the diet, although maltase activity tended to decrease with increasing dietary FC (P = 0.061). We concluded that an increase in the dietary FC content, and to a lesser extent a decrease in the CP content, reduced ammonia concentrations and altered the microflora and fermentation patterns in the gastrointestinal tract of weaned piglets. However, these effects were not necessarily reflected by an increased growth performance of the piglets.

Psychological, musculoskeletal, and respiratory problems and sickness absence before and after involvement in a disaster: a longitudinal study among rescue workers

BACKGROUND

On 13 May 2000 a firework depot situated in a residential area in the Netherlands exploded. Many rescue workers were involved in the aftermath of this explosion.

AIMS

To examine the longitudinal course of psychological, musculoskeletal, and respiratory problems and sickness absence among rescue workers involved.

METHODS

The study population was composed of 1036 rescue workers. Data on health and sickness absence both before and after the disaster were collected from the electronic database of the rescue workers' occupational physicians. Health problems were coded according to an adapted version of the ICD-10.

RESULTS

After the disaster a long term increase was found in psychological, musculoskeletal, and respiratory problems. Compared to six months before the disaster, the average length of sickness absence in the first half year after the disaster increased from 6.6 to 11.6 days, and decreased slowly in the following six month periods.

CONCLUSIONS

Rescue workers involved in a disaster may experience subsequent impairment in occupational functioning.

Differential modulation of enterocyte-like Caco-2 cells after exposure to short-chain fatty acids

The response of intestinal epithelial cells to short-chain fatty acids, which are increasingly used as food additives, was investigated. Human small intestinal epithelial cell model Caco-2 cells were exposed to formate, propionate and butyrate to assess their effect on cellular growth, metabolism, differentiation and protection against bacteria. The Caco-2 cells were entirely grown in the different short-chain fatty acids and respective growth patterns were determined. Differentiated cells were exposed to 0-20 mM short-chain fatty acids for 48 h and changes in DNA, RNA, (glyco)protein syntheses, sucrase isomaltase activity, transepithelial electrical resistance and protection against Salmonella enteritidis were measured. The short-chain fatty acids, altered linearly and differentially the growth pattern ranging from stimulation by formate to inhibition by butyrate. Formate inhibited cellular metabolism. Low concentrations of up to 5 mM propionate and 2 mM butyrate stimulated metabolism, while higher doses were inhibitory. Formate had no effect on sucrase isomaltase enzyme activity and transepithelial electrical resistance, whereas propionate and butyrate increased these markers of differentiation. Infection with S. enteritidis did not benefit from the short-chain fatty acid-induced transepithelial electrical resistance. It is concluded that formate, propionate and butyrate selectively and differentially modulate growth characteristics, cellular metabolism, sucrase isomaltase activity and transepithelial electrical resistance in a concentration- and carbon atom-related fashion. The short-chain fatty acid-induced transepithelial electrical resistance does not confer protection against S. enteritidis.

Prediction of energy balance in high yielding dairy cows with test-day information

This study used a previously developed model to predict herd mean energy balance of the first 12 wk of lactation from test-day information. The predictions were compared with calculated energy balance based on feed analysis and to changes in body weight. Seven independent feeding trials including 43 diets (519 lactations, 254 cows; 1987 to 1996) were used. Conventional diets were discriminated from nonconventional diets by significant differences between mean calculated energy balance of subtrial diets versus control diets. The total difference between group means of predicted minus calculated energy balance was positive throughout the observed lactation period. It was lowest (5 to 9 MJ of net energy for lactation) during negative energy balance of the conventional diets in wk 2 to 7 when 18 to 50% of the total difference was due to random variation. Because of this difference, both predicted and calculated energy balances were compared to body weight change as a reference for true energy balance. Body weight change was adjusted for rumen fill. While calculated energy balance tended to be negative at times when cows gained weight, predicted energy balance was positive. Cows fed nonconventional diets gained weight, while calculated energy balance was extremely negative, whereas predicted energy balance based on test-day information was positive. We concluded that the prediction difference was relatively small when standard rations were used, and that nonconventional rations biased predicted energy balance to a lesser extent than calculated energy balance. Estimating energy balance based on test-day information appears feasible.

A survey of the relationship between bile staining and oesophagogastric lesions in slaughter pigs

In 280 slaughter pigs, the oesophageal region of the stomach was examined to test the hypothesis that there is a (causal) relationship between the intensity of bile staining of oesophagogastric tissue due to bile regurgitation and the severity of oesophagogastric lesions. When the stomachs were opened, almost all stomachs contained bile and 99.6% of stomachs showed bile staining of the pars oesophagea. A total of 14.3% of the stomachs showed distinct erosions and/or ulceration. A considerable proportion of the stomachs (58.5%) had hyperkeratosis as the only lesion. Only two animals showed a completely intact epithelium. There was no evidence for an increased proportion of oesophagogastric lesions with an increased intensity of bile staining. No dark yellow to green staining was observed; a just detectable to an obvious yellow was seen. This is an indication for bile regurgitation of recent origin. Therefore, there is no evidence for the hypothesis that the regurgitation of bile into the stomach is positively linked to the occurrence of oesophagogastric lesions in fattening pigs. It is suggested that various factors associated with slaughter, such as fasting and slaughter procedure, are primarily responsible for the presence of bile and the staining of the pars oesophagea in the stomachs.

[Changes in stomach mucosa in swine: a literature review]

Oesophagogastric lesions are a worldwide problem in swine. After extensive research in the 1960s, with primarily indications for a relationship with nutrition, no new reports were published for a long time. Recently, oesophagogastric lesions in swine have come to the centre of attention again, because there are indications for an increase in the prevalence of oesophagogastric lesions, and in particular ulcers, in swine. Therefore recent advances in the field are reviewed. The pathogenesis, prevalence, risk factors and economic consequences of oesophagogastric lesions are discussed.