“Prison life can make you go crazy”: Insights into the situation for people with a mental illness in the Malawi prison system

Little is known with regard to due process and forensic assessment capacities in Africa, where over one million are deprived of their liberty on any given day. A rapid situation assessment explored multi-stakeholder perspectives regarding the situation of people with a mental illness in the Malawi prison system. In-depth interviews were conducted with 10 regional professional stakeholders, 18 former prisoners, and five prison staff from two maximum-security prisons. Reflexive thematic analysis yielded five themes; Occurrence of mental illness among people living in prison; Prison environment exacerbating harm and levels of mental illness; Security responses to the presence of psychiatric disorders; Availability and coverage of specialist psychiatric and psychological care; and Diversion, other non-custodial measures and continuity of care on release. Narratives highlight the substantial causal impact of the prison environment in amplifying existing and new mental illness, vulnerability and exploitation of people with a mental disorder. Malawi prisons are hampered by lack of specialist forensic capacity nationally; centralized mental health surveillance system; and insufficient skilled staff to conduct evidence-based screening and care. Security operations implement the use of pharmacological and physical restraint measures at times. Faith-based organizations play an important role in providing psychological and spiritual support. Release and reintegration require family involvement. A cross departmental intersectoral partnership response spanning government ministries, key civil society organisations, the Malawi Prison Inspectorate and Malawi Human Rights Commission is warranted. Recommendations include alleviation of prison congestion, prison staff capacity building and investment in forensic mental health services with adequate geographic coverage

Cardiac damage after treatment of childhood cancer: A long-term follow-up

<p>Abstract</p> <p>Background</p> <p>With improved childhood cancer cure rate, long term sequelae are becoming an important factor of quality of life. Signs of cardiovascular disease are frequently found in long term survivors of cancer. Cardiac damage may be related to irradiation and chemotherapy.</p> <p>We have evaluated simultaneous influence of a series of independent variables on the late cardiac damage in childhood cancer survivors in Slovenia and identified groups at the highest risk.</p> <p>Methods</p> <p>211 long-term survivors of different childhood cancers, at least five years after treatment were included in the study. The evaluation included history, physical examination, electrocardiograpy, exercise testing and echocardiograpy. For analysis of risk factors, beside univariate analysis, multivariate classification tree analysis statistical method was used.</p> <p>Results and Conclusion</p> <p>Patients treated latest, from 1989–98 are at highest risk for any injury to the heart (73%). Among those treated earlier are at the highest risk those with Hodgkin's disease treated with irradiation above 30 Gy and those treated for sarcoma. Among specific forms of injury, patients treated with radiation to the heart area are at highest risk of injury to the valves. Patients treated with large doses of anthracyclines or concomitantly with anthracyclines and alkylating agents are at highest risk of systolic function defect and enlarged heart chambers. Those treated with anthracyclines are at highest risk of diastolic function defect. The time period of the patient's treatment is emerged as an important risk factor for injury of the heart.</p

Parental Socioeconomic Background and Child Behaviour

Although childhood obesity has long been in focus, little is known about the sensitivity of behavioural choices to measure parental resource constraints. The aim of this study is to examine the heterogeneous effects of children’s (or their parents’) choices of lifestyle subject to information and resource constraints, respectively. We address this issue using a unique longitudinal data set of almost 1,500 schoolchildren attending state schools between 2008 and 2010 in the Danish Municipality of Aalborg. One empirical strategy is to control for a rich set of child and parental characteristics; another is to use child fixed effect to control for fixed unobserved child characteristics. By including the interaction between child behaviour and parental socioeconomic background, a more complete but more complex picture arises. Our findings challenge the predominant assumption that behaviour and weight is a choice made by children, or their parents.Although childhood obesity has long been in focus, little is known about the sensitivity of behavioural choices to measure parental resource constraints. The aim of this study is to examine the heterogeneous effects of children’s (or their parents’) choices of lifestyle subject to information and resource constraints, respectively. We address this issue using a unique longitudinal data set of almost 1,500 schoolchildren attending state schools between 2008 and 2010 in the Danish Municipality of Aalborg. One empirical strategy is to control for a rich set of child and parental characteristics; another is to use child fixed effect to control for fixed unobserved child characteristics. By including the interaction between child behaviour and parental socioeconomic background, a more complete but more complex picture arises. Our findings challenge the predominant assumption that behaviour and weight is a choice made by children, or their parents.» Look Inside Although childhood obesity has long been in focus, little is known about the sensitivity of behavioural choices to measure parental resource constraints. The aim of this study is to examine the heterogeneous effects of children’s (or their parents’) choices of lifestyle subject to information and resource constraints, respectively. We address this issue using a unique longitudinal data set of almost 1500 schoolchildren attending state schools between 2008 and 2010 in the Danish Municipality of Aalborg. One empirical strategy is to control for a rich set of child and parental characteristics; another is to use child fixed effect to control for fixed unobserved child characteristics. By including the interaction between child behaviour and parental socioeconomic background, a more complete but more complex picture arises. Our findings challenge the predominant assumption that behaviour and weight is a choice made by children, or their parents. <br/