‘Going into the unknown’: experiences of male patients in secure settings during environmental transition

Little is known about the experiences of male patients in secure mental health and intellectual disability units during environmental transition. We interviewed patients before (n = 9) and after (n = 8) a side-to-side security transition from medium-secure wards in an older building to new wards in a purpose-built building. We inquired about transitional experiences in general and about this transition specifically. We examined interview transcripts and field notes using thematic analysis, and collated routine outcome data to gauge whether transition had obvious positive or negative effects. Qualitative analysis indicated three major themes (information, transition, and behaviour) and five overlapping subthemes (positive information sharing and consultation, concerns and anxieties about lack of information, life change and opportunity, home and sense of belonging, and potential conflict). Outcome data indicated little obvious change between first and second interviews. Expressed concerns of patients about transition were largely about tangible and practical issues, including changes to rules, including smoking and prohibited items. The results highlight the need for the development of supportive patient-inclusion strategies, consistent and transparent communication processes, and a published timeframe during the planning and implementation phases of all types of transitional moves, including the side-to-side transfer of residents between accommodation buildings

The lived experience of working with female patients in a high secure hospital

Women’s secure hospitals are often considered to be stressful and demanding places to work, with these environments characterised as challenging and violent. The staff experience of working in this environment is however not well represented in the literature. This study is the first to examine the ‘lived experience’ of seven nurses working in the National High Secure Healthcare Service for Women. Interview transcripts were analysed with the use of Interpretative Phenomenological Analysis, and the findings presented within four superordinate themes ‘horror’, ‘balancing acts’, ‘emotional hard labour’, and ‘the ward as a community’. These themes all depict the challenges that participants experience in their work, the ways in which they cope with these challenges and how they make sense of these experiences. A meta-theme of ‘making sense by understanding why’ is also presented, which represents the importance for participants to attempt to make sense of the tensions and challenges by formulating a fuller meaning. The findings suggest the importance of workforce development, in terms of allowing sufficient protected time for reflection and formulation (for example within the format of group supervision or reflective practice), and for staff support mechanisms (e.g. clinical supervision, counselling, debriefs) to be inbuilt into the ethos of a service, so as to provide proactive support for staff ‘on the frontline’

Mental health care and resistance to fascism

Mental health nurses have a critical stake in resisting the right-wing ideology of British fascism. Particularly concerning is the contemporary effort of the British National Party (BNP) to gain credibility and electoral support by the strategic re-packaging of a racist and divisive political manifesto. Evidence that some public sector workers are affiliated with the BNP has relevance for nursing at a series of levels, not least the incompatibility of party membership with a requirement of the Professional Code to avoid discrimination. Progressive advances, though, need to account for deep rooted institutionalized racism in the discourse and practice of healthcare services. The anomalous treatment of black people within mental health services, alongside racial abuse experienced by ethnic minority staff, is discussed in relation to the concept of race as a powerful social category and construction. The murder of the mentally ill and learning disabled in Nazi Germany, as an adjunct of racial genocide, is presented as an extreme example where professional ethics was undermined by dominant political ideology. Finally, the complicity of medical and nursing staff in the state sanctioned, bureaucratic, killing that characterized the Holocaust is revisited in the context of ethical repositioning for contemporary practice and praxis

Ecological implications of pedogenesis and geochemistry of ultramafic soils in Kinabalu Park (Malaysia)

In Sabah, Malaysia, ultramafic rock outcrops are widespread (totalling 3500 km2, one of the main outcrops in the tropical zone), and predominantly of the peridotite type. However, strongly serpentinised peridotite is also locally common, particularly along fault lines in the Mt. Kinabalu area. This study aimed to determine the extent of chemical variation in ultramafic soils in relation to the degree of serpentinisation and the weathering intensity, and consequent potential ecological implications linked to resulting soil chemical fertility. It was hypothesized that young soils and soils derived from bedrock with a significant degree of serpentinisation strongly differ from typical Geric Ferralsols and result in soil chemistries with more adverse properties to plant life (e.g. low availability of the essential nutrients N, P, K and Ca and high concentrations of potentially phytotoxic Mg and Ni). Ultramafic soil diversity linked to the age of the soil or the degree of serpentinisation would thus be a main factor of plant diversity and distribution. The diverse topography of Kinabalu Park (ultramafic soils present between 400 and 2950 m asl) has given rise to high pedodiversity with the broad overall ultramafic soil types being: (i) deep laterite soils (Geric Ferralsols); (ii) moderately deep montane soils (Dystric Cambisols) with mor humus; (iii) shallow skeletal soils at high altitude (Eutric Cambisols Hypermagnesic); and (iv) bare serpentinite soils (Hypereutric Leptosols Hypermagnesic) at low altitude (200–700 m asl). Leptosols on serpentinite and Eutric Cambisols have the most extreme chemical properties in the whole Kinabalu Park area both with very high Mg:Ca molar quotients, with either high available Ni (Cambisols) or high pH (Leptosols). These soils host specific and adapted vegetation (high level of endemism) that tolerates geochemical peculiarities, including Ni hyperaccumulators. Geric Ferralsols present far less chemical constraints than Hypermagnesian Cambisols soils to the vegetation and host a tall and very diverse rainforest, not so different than that on non-ultramafic soils. It therefore appears that altitude, soil age and degree of bedrock serpentinisation are the main determining factors of soil properties: the qualifier “ultramafic” alone is not sufficient to define soil geochemical and ecological conditions in the Kinabalu Park area, probably more than in any other ultramafic region in the world

Evaluation of self-help therapy groups for women with compulsive eating problems

Reprint of Jul 1986 edSIGLEAvailable from British Library Document Supply Centre- DSC:7761.8662(HEA-RR--13) / BLDSC - British Library Document Supply CentreGBUnited Kingdo