Mapping The Offender Health Pathway: Challenges and Opportunities for Support Through Community Nursing

A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the degree of Doctor of PhilosophyThe current context of offender health in England and Wales indicates that offenders re-enter their communities with limited pre-release preparation for the continuity of access to healthcare and an increased risk of release with a health condition and very little support to cope in the community. This study was aimed at mapping the ex-offender health pathway towards identifying ‘touch points’ in the community for the delivery of a nurse led intervention. The study was a qualitative case study underpinned by ‘The Silences Framework’ which enabled it to gain theoretically by situating power with offenders, thus, aiding their ‘Silences’ to be heard, explored and brought to light. Participants meeting the study inclusion criteria were quantitatively ranked on the basis of poor health with those scoring the lowest and confirming their ranking through a confirmation of a health condition selected as cases and interviewed over the course of six months. These interview narratives were confirmed by interviewing individuals in the professional networks of offenders. The study identified the site of post-release supervision as the ‘touch point’ where a nurse led intervention could be delivered. With regards to the delivery of the health intervention, the study indicated that the nurse led intervention be provided as an advisory and signposting service structured on a drop-in and appointment basis. Furthermore, the study indicated that pre-release, offenders were not prepared in prison for the continuity in access to healthcare in the community on release. On-release, offenders’ on-release preparation did not enquire as a matter of procedure on whether offenders were registered with a GP or had the agency to register self with a GP practice in the community. Post release, the study uncovered a disparity between services which address the physical health needs of offenders and those which address their mental and substance misuse health needs.Burdett Trust for Nursin

Exploring Diversity Management in Transnational Corporations Through the Lens of Migration and Expatriation

In this study, we aim to develop an understanding of the similarity between migration and expatriation,identify both as elements in diversity, and draw attention to the additional layer of ethnic diversity created by the high number of top management expatriates in some Nigerian subsidiaries of transnational corporations.Using the qualitative research design, we thematically analysed data from semi structured interviews with six indigenous managers in four transnational corporations. We found a significant number of expatriate managers in two subsidiaries and a lack of diversity management framework to address the new layer of diversity as reflected in the unequal treatment of indigenous managers. We conclude that migration and expatriation are similar and could be better managed through effective diversity management framework

Honour, Dishonour and Homicides in Britain, Namibia and Turkey : Historical and Contemporary Perspectives

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An exploration of the impact of SARS-CoV-2 (COVID-19) restrictions on marginalised groups in the UK

YesBackground: To contain the spread of COVID-19 within the UK over the past year, there have been a series of local and national lockdowns. These restrictions are likely to have impacted upon the health and well-being of marginalised groups who rely on now closed social and community support services to stay healthy. An understanding of the experiences of marginalised people is important; therefore, this study aimed to explore the impact of the COVID-19 restrictions on the health and well-being of marginalised groups in the UK. Methods: In summer 2020, a rapid telephone survey was conducted by trained, trusted volunteers with 76 participants who were from marginalised groups. As part of this survey, 64 participants consented to describe their experience of lockdown. These case studies were thematically analysed to identify patterns of meaning. Results: Findings indicate that lockdown led to the deterioration of health of participants, impacted adversely on their socio-economic positions and affected access to food and essential supplies. In addition, government public health messaging was considered confusing and inadequate. Conclusions: This study highlights the need for pathways into services which support marginalised groups to remain accessible during periods of restrictions and essential supplies and food to be mapped and protected for marginalised individuals within our local communities.NHS England; Improvemen

Challenges and opportunities for ex-offender support through community nursing

This study was a qualitative case study underpinned by “The Silences Framework” aimed at mapping the ex-offender health pathway towards identifying “touch points” in the community for the delivery of a nurse-led intervention. Participants meeting the study inclusion criteria were quantitatively ranked based on poor health. Participants scoring the lowest and endorsing their ranking through a confirmation of a health condition were selected as cases and interviewed over 6 months. Individuals in the professional networks of offenders contextualized emergent themes. The study indicated that pre-release, offenders were not prepared in prison for the continuity in access to healthcare in the community. On release, reintegration preparation did not routinely enquire whether offenders were still registered with a general practitioner or had the agency to register self in the community. Participants identified the site of post-release supervision as the “touch point” where a nurse-led intervention could be delivere

Tackling barriers to COVID-19 vaccine uptake in London: a mixed-methods evaluation

BACKGROUND: In response to the COVID-19 pandemic, the first vaccine was administered in December 2020 in England. However, vaccination uptake has historically been lower in London than in other English regions. METHODS: Mixed-methods: This comprised an analysis of cumulative percentage uptake across London between 8 December 2020 and 6 June 2021 by vaccine priority cohorts and ethnicity. We also undertook thematic analyses of uptake barriers, interventions to tackle these and key learning from a qualitative survey of 27 London local authority representatives, vaccine plans from London's five Integrated Care Systems and interviews with 38 London system representatives. RESULTS: Vaccine uptake was lower in Black ethnic (57-65% uptake) compared with the White British group (90% uptake). Trust was a critical issue, including mistrust in the vaccine itself and in authorities administering or promoting it. The balance between putative costs and benefits of vaccination created uptake barriers for zero-hour and shift workers. Intensive, targeted and 'hyper-local' initiatives, which sustained community relationships and were not constrained by administrative boundaries, helped tackle these barriers. CONCLUSIONS: The success of the national vaccination programme depended on conceding local autonomy, investing in responsive and long-term partnerships to engender trust through in-depth understanding of communities' beliefs

Tackling barriers to COVID-19 vaccine uptake in London: a mixed-methods evaluation.

BACKGROUND: In response to the COVID-19 pandemic, the first vaccine was administered in December 2020 in England. However, vaccination uptake has historically been lower in London than in other English regions. METHODS: Mixed-methods: This comprised an analysis of cumulative percentage uptake across London between 8 December 2020 and 6 June 2021 by vaccine priority cohorts and ethnicity. We also undertook thematic analyses of uptake barriers, interventions to tackle these and key learning from a qualitative survey of 27 London local authority representatives, vaccine plans from London's five Integrated Care Systems and interviews with 38 London system representatives. RESULTS: Vaccine uptake was lower in Black ethnic (57-65% uptake) compared with the White British group (90% uptake). Trust was a critical issue, including mistrust in the vaccine itself and in authorities administering or promoting it. The balance between putative costs and benefits of vaccination created uptake barriers for zero-hour and shift workers. Intensive, targeted and 'hyper-local' initiatives, which sustained community relationships and were not constrained by administrative boundaries, helped tackle these barriers. CONCLUSIONS: The success of the national vaccination programme depended on conceding local autonomy, investing in responsive and long-term partnerships to engender trust through in-depth understanding of communities' beliefs

Recognising diversity and improving migrant health using the Silences Framework

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The Silences Framework: a tool for exploring marginalised perspectives

NoThe Silences Framework as a tool for exploring marginalised perspectives The Silences Framework was devised for use as a vehicle for exposing additional viewpoints in studies revolving around sensitive subjects and marginalised perspectives. Cyril’s presentation conveys the use of The Silences Framework in the provision of a nurse-led intervention for custodial community based ex-offenders. ‘Screaming Silences’ as exposed were located in the subjective experiences of ex-offenders known as the ‘listener’ and the social and personal context in which their experiences occurred. Crucially, The Silences Framework as used sought to acknowledge and redress the balance of power relating to ‘what and whose’ experience count in a research study. Epistemologically, the generation of knowledge using the framework necessitated an anti-essentialist perspective which was interpretive in nature. Thus, the intent was to arrive at what constitutes as truth from the lived experiences of the individuals researched. It is hoped that this presentation will facilitate understanding by unravelling the process of using The Silences Framework to underpin applied research and concurrently contribute to the wider use of the framework in research with other marginalised groups

Public Health Application of The Silences Framework

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