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ObjectivesPeople with mental illnesses are overrepresented in the U.S. prison population. It is well established that incarceration for this population poses physical and mental health risks including greater likelihood of victimization and suicide compared to the general prison population. Yet, research is less clear about how staff and services shape these prison experiences. The aim of this study was to examine how people with mental illnesses experience incarceration through interactions with correctional officers and treatment staff and their use of physical and mental health care services.MethodsThis project utilized a non-experimental design and qualitative research approach to address the research aims. Adults with mental illnesses who were formerly incarcerated were recruited from three different sites in the Midwest and East Coast. Participants completed an in-depth interview and brief survey on health histories. Data were analyzed using descriptive statistics and the framework method for qualitative analysis.ResultsParticipants (n = 43) identified challenges to utilizing health and mental health care including perceived access and quality of mental health, medical, or substance use treatments obtained during prison as well as participant's willingness to engage in services. Access to health care was marked by cumbersome procedures required for service use requests and inadequate staffing. Participants reported mixed experiences with medical and mental health staff ranging from experiencing kindness to feeling staff did not believe them. Participants perceived most correctional officers as exhibiting professionalism while some enacted stigma and created additional stressors.ConclusionInteractions with correctional staff and health care services have the potential to buffer the stressors and risks inherent in prisons for people with mental illnesses. Perceptions from participants suggest both individual- and systems-level opportunities for intervention to better support people with mental illnesses in prison.

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Doxorubicin is an anthracycline class chemotherapeutic agent that is used alone or in conjunction with other medications to treat different types of cancer. Doxorubicin works by slowing or stopping the growth of cancer cells due to its toxic effects mediated through redox cycling that produces oxidative stress. One of the side effects of doxorubicin treatment, that restricts its use and efficacy is a form of cardiomyopathy, termed doxorubicin‐induced cardiomyopathy (DiC). DiC typically has morphological and functional abnormalities of dilated cardiomyopathy with all four cardiac chambers being dilated. This dilation occurs as a result of a reduction in ventricular ejection fraction and contractile function, resulting in diastolic and systolic dysfunction. Eventually, congestive heart failure can result, which carries a 50% mortality rate. Currently, there is no treatment or prevention for DiC. The goal of this proposal is to test the hypothesis that cardiomyopathy induced by doxorubicin is caused by insufficient blood flow to the heart, leading to the cardiomyopathy. Accordingly, we proposed that the coronary specific dilator, chromonar, will prevent and treat DiC. Previously, we have shown that chromonar has a beneficial effect on the treatment of dilated cardiomyopathy caused by coronary microvascular insufficiency, i.e., inadequate blood flow to the heart. We, also observed that chromonar has a beneficial effect for treating heart failure with non‐obstructive coronary artery disease. Thus, if our speculation that DiC is caused by insufficient blood flow to the heart is correct, then chromonar will be an effective treatment for this condition. Our goal is to determine if the improvement of myocardial blood flow will prevent and treat doxorubicin‐induced cardiomyopathy.MethodsC57Bl6 mice (Male N=10) were treated with doxorubicin (5mg/kg/) once a week for 6 weeks period. After doxorubicin treatment, chromonar treatment started (3mg/kg/day) for 4 weeks. Cardiac function was measured by using a high‐frequency ultrasound system (Vevo 2100).Results and ConclusionSix weeks after doxorubicin treatment, all mice developed heart failure. Ejection fraction was below 40% (figure). Chromonar treatment significantly improved cardiac function (EF increased from 39±5%to 62±4%). In untreated mice, cardiac function continued to deteriorate, even after cessation of doxorubicin treatment. Based on these findings, we propose that a cause of doxorubicin‐induced cardiomyopathy is inadequate myocardial blood flow. Pharmacological coronary vasodilation with chromonar increases myocardial blood flow, which can stop and reverse the functional decline associated with doxorubicin‐treatment, as well as improve cardiac function. Taken together, our results indicate that doxorubicin‐induced cardiotoxicity, which leads to cardiomyopathy may be related to inadequate myocardial perfusion. Correction of the insufficient perfusion produced by doxorubicin reverses the functional decline of the heart.Support or Funding InformationR01 HL135024;RO1HL132240; AHA 10POST4360030This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.