/pdf/about-the-national-institute-for-health-and-care-excellence-4zmiguft2a.pdf

About the National Institute for Health and Care Excellence - NICE.

High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN-HFS) is the preferred surgical treatment for advanced Parkinson's disease. In the 15 years since its introduction into clinical practice, many studies have reported on its benefits, drawbacks, and insufficiencies. Despite limited evidence-based data, STN-HFS has been shown to be surgically safe, and improvements in dopaminergic drug-sensitive symptoms and reductions in subsequent drug dose and dyskinesias are well documented. However, the procedure is associated with adverse effects, mainly neurocognitive, and with side-effects created by spread of stimulation to surrounding structures, depending on the precise location of electrodes. Quality of life improves substantially, inducing sudden global changes in patients' lives, often requiring societal readaptation. STN-HFS is a powerful method that is currently unchallenged in the management of Parkinson's disease, but its long-term effects must be thoroughly assessed. Further improvements, through basic research and methodological innovations, should make it applicable to earlier stages of the disease and increase its availability to patients in developing countries.

https://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(08)70291-6.pdf

Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease

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/pdf/the-growth-of-incarceration-in-the-united-states-exploring-212x90j52g.pdf

The growth of incarceration in the United States: exploring causes and consequences

Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)60858-1.pdf

The health of prisoners

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(06)69002-8.pdf

Suicide in recently released prisoners: a population-based cohort study

Background Assessment of the health of men aged 60 and over in English and Welsh prisons. Methods 203 men were interviewed from 15 prisons, comprising one-fifth of all sentenced men in this age group in England and Wales. Assessment included semi-structured interviews covering chronic and acute health problems, and recording of major illnesses from the medical notes and prison reception health screen. Results 85% of the elderly prisoners had one or more major illnesses reported in their medical records, and 83% reported at least one chronic illness on interview. The most common illnesses were psychiatric, cardiovascular, musculoskeletal and respiratory. Conclusion The rates of illness in elderly prisoners are higher than those reported in other studies of younger prisoners and surveys of the general population of a similar age. The increasing number of elderly people in prison poses specific health challenges for prison health-care services.

/pdf/health-of-elderly-male-prisoners-worse-than-the-general-20j073q76x.pdf

Health of elderly male prisoners: worse than the general population, worse than younger prisoners

BACKGROUND: Recently released prisoners are at markedly higher risk of suicide than the general population. The aim of this study was to identify key risk factors for suicide by offenders released from prisons in England and Wales. METHOD: All suicides committed by offenders within 12 months of their release from prison in England and Wales, between 2000 and 2002, were identified. One control matched on gender and date of release from prison was recruited for each case. Univariate and multivariate logistic regression modelling identified key independent risk factors for suicide. RESULTS: Of 256 920 released prisoners, 384 suicides occurred within a year of release. Factors significantly associated with post-release suicide were increasing age over 25 years, released from a local prison, a history of alcohol misuse or self-harm, a psychiatric diagnosis, and requiring Community Mental Health Services (CMHS) follow-up after release from prison. Non-white ethnicity and a history of previous imprisonment were protective factors. CONCLUSIONS: There is a need to improve the continuity of care for people who are released from prison and for community health, offender and social care agencies to coordinate care for these vulnerable individuals.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0033291709991048

Suicide in recently released prisoners: a case-control study

. Background: Worldwide, prisoners are at high risk of suicide. Research on near-lethal suicide attempts can provide important insights into risk and protective factors, and inform suicide ...

Prevention of Suicidal Behavior in Prisons

To examine risk factors for suicide among prisoners in a national population. The Ministry of Justice identified all suicides occurring in prisons in England and Wales between 2005 and 2008. Two hundred and twenty suicides were matched to 220 living controls on age, gender, date of reception into prison and establishment type. Relative risks for clinical, custodial, service–response and socio-demographic characteristics were estimated using conditional logistic regression models. Having a history of violence and several indicators of past or current psychiatric illness were strong predictors at univariate level. Prisoners who died by suicide were over nine times more likely than controls to have been identified and managed as being at-risk of self-harm/suicide during the prison term. Multivariate analysis identified five mutually independent predictors: previous psychiatric service contact, history of self-harm, single cell occupation, remand status, and non-white ethnicity. Suicide risk is elevated among certain types of prisoners, and targeted suicide prevention strategies should be developed for the monitoring, care and support of the high-risk groups that we identified. Further research is needed to determine the causal mechanisms that explain why some prisoners have a higher suicide risk than their peers.

Mary Piper

Papers

Suicide in recently released prisoners: a population-based cohort study

Health of elderly male prisoners: worse than the general population, worse than younger prisoners

Suicide in recently released prisoners: a case-control study

Prevention of Suicidal Behavior in Prisons

A national case-control study of risk factors among prisoners in England and Wales.