A healthy prison strategy for HMP Bristol

This report summarises progress in establishing a Healthy Prison strategy for HMP Bristol. It follows a period of consultancy with the prison commissioned by NHS Bristol, and carried out as follow-up to a 2007-8 Health Needs Assessment (HNA) conducted at the prison. The aims of this work were to: [1] assess and build commitment within the prison for a ‘healthy prison’ strategy; [2] produce a realistic and feasible plan for developing the strategy; [3] create a strategy group to lead and drive the project; and [4] form and publish key performance standards for the prison. A period of consultation preceded publication of this report, which involved interviews and meetings with a range of Prison Service and NHS stakeholders and close scrutiny of relevant reports and publications. It should be noted that work on this strategy is ongoing and now forms part of the core business of HMP Bristol

Challenges for prison governors and staff in implementing the Healthy Prisons Agenda in English prisons

© 2018 The Royal Society for Public Health Objectives: In the two decades that have passed since the World Health Organisation established the Healthy Prisons Agenda, there has been no research conducted to investigate barriers and challenges prison managerial and operational staff encounter in implementing the Agenda in the English prison context. This article debates sectoral, institutional and occupational challenges perceived to hinder effective implementation of the Agenda, based on a qualitative study involving prison governors and operational staff. Study design: Qualitative study taking a grounded theory approach. Methods: Semistructured interviews were conducted with 30 participants comprising prison governors, prison officers and external stakeholders with key strategic and operational roles across the prison estate. The interviews were analysed and coded into themes using constant comparative method. Results: The research identified a range of managerial and operational factors that impeded recognition, acceptance and successful implementation of the Healthy Prisons Agenda. These were found to be associated with scarcity of resources, low prioritisation, perceived low importance, and pressures at operational, managerial and strategic levels to adhere to standard operating procedures. Security, control and discipline tended to supersede other imperatives considered of secondary importance to the effective running of prisons. Conclusions: Sustainability of the Healthy Prisons Agenda can only be assured by raising its significance and importance across prison hierarchies and within policies and practices through which operational and strategic objectives are realised. This means achieving wholesale commitment by prisons—among staff at all levels—towards public health goals that are fundamental to a successful and effective criminal justice system

Expert views of peer-based interventions for prisoner health.

Purpose: Formalised support services for prisoners that rely on peer methods of delivery show promising health and social outcomes but there is also conjecture that negative effects, both at an individual and organisational level, can occur. Design/methodology/approach: Individuals with recognised professional expertise from various sectors (including ex-prisoners) were invited to contribute to an expert symposium to share their perceptions of the positive and negative effects of peer interventions in prison. Discussions and debate were audio recorded with the consent of all delegates and verbatim transcripts were analysed using Framework Analysis. Findings: According to the participants, peer interventions in the prison setting created both positive and negative impacts. It was clear from the evidence gathered that peer interventions in prisons can impact positively on health outcomes, but these effects were perceived to be more well-defined for peer deliverers. The notion that peer deliverers can be subjected to ‘burnout’ suggests that supervisory processes for peer workers need to be considered carefully in order to avoid the intervention from being counter-productive. Organizationally, one of the salient issues was the adverse effects that peer interventions cause to the security of the prison. Originality/value: To our knowledge, this is the first time an expert symposium has been conducted to specifically examine peer interventions in prison and to consider the effects, both positive and negative, of such schemes

Using laws to further public health causes: the healthy prisons agenda

© The Author(s) 2019. In this commentary, we propose using laws in implementing the Healthy Prisons Agenda. We evaluate the efficacy of laws in tackling health inequalities in prisons, provide recommendations on how states can uphold their international commitments that safeguard prisoners’ right to healthcare, and frame prisons as health-promoting settings. We also assess the challenges that can thwart this proposal, such as the non-binding nature of international obligations, global prison overcrowding and the dependency on prison governors and staff for implementation of the Agenda. The commentary concludes by recommending further evaluation of our proposal and testing its potential generalisability to other health-promotion agendas

Music in time: An evaluation of a participatory creative music programme for older prisoners

This evaluation was developed as a research collaboration between the University of the West of England (UWE), Bristol and a Community Interest Company, Superact, which is affiliated with the south west regional branch of an arts charity, Live Music Now! The funding for the project was awarded by the former Department for Innovation, Universities and Skills (the Transformation Fund) to support the development of a creative music educational programme for older prisoners. Superact CIC and Live Music Now! have extensive experience of delivering music education programmes for prisoners. UWE was invited to provide research expertise in terms of developing and conducting the evaluation. The evaluation took a formative, qualitative approach to enable the creative music programme provided by Superact CIC to be evaluated from the points of view of prisoners across a range of establishments in the south west of England. This report describes the aims and objectives of the evaluation, provides an overview of the context, describes the methodology and fieldwork processes and reports on the findings. It is hoped that the information in the report can help inform future developments of creative arts programmes in this field

Protein induced by vitamin K absence or antagonist-II (PIVKA-II) specifically increased in Italian hepatocellular carcinoma patients

OBJECTIVE: As a marker for Hepatocellular Carcinoma (HCC), Protein Induced by Vitamin K Absence II (PIVKA-II) seems to be superior to alpha fetoprotein (AFP). To better characterize the role of PIVKA-II, both AFP and PIVKA-II have been measured in Italian patients with diagnosis of HCC compared with patients affected by non-oncological liver pathologies. MATERIALS AND METHODS: Sixty serum samples from patients with HCC, 60 samples from patients with benign liver disease and 60 samples obtained from healthy blood donors were included in the study. PIVKA-II and AFP were measured by LUMIPULSE(®) G1200 (Fujirebio-Europe, Belgium). We considered as PIVKA-II cutoff 70 mAU/ml (mean +3SD) of the values observed in healthy subjects. RESULTS: The evaluation of PIVKA-II showed a positivity of 70% in patients with HCC and 5% in patients with benign diseases (p < 0.0001) whereas high levels of AFP were observed in 55% of HCC patients and in 47% of patients with benign diseases. The combined Receiver Operating Characteristic (ROC) analysis of the two analytes revealed a higher sensitivity (75%) compared to those observed for the individual biomarkers. In conclusion, we demonstrate that as a marker for HCC, PIVKA-II is more specific for HCC and less prone to elevation during chronic liver diseases. CONCLUSIONS: The combination of the two biomarkers, evaluated by the ROC analysis, improved the specificity compared to a single marker. These data suggest that the combined analysis of the two markers could be a useful tool in clinical practice

Drug education as diversion: A mixed methods evaluation of the Avon & Somerset drug education programme

This evaluation was undertaken on behalf of the Office of the Avon and Somerset Police and Crime Commissioner to evaluate Avon and Somerset Constabulary’s Drug Education Programme (DEP). The DEP is an education programme that has operated in South West England since 2016, initially in Bristol before it was extended across the Avon and Somerset Force area in 2019. The programme provides people caught in possession of illegal drugs with an alternative to criminal prosecution or conviction. It is a preventive education programme to which people caught in possession of illegal drugs are referred. Its overarching aim is to reduce drug-related offences in the Avon and Somerset Police Force area, to reduce the burden on the criminal justice system and to build improved relations between local communities and the Police. The aim of the DEP is to educate participants about the health, social and legal effects of drugs and to encourage attitude and behaviour change towards desisting from further drug misuse or drug-related offending. This report presents an evaluation of the DEP using mixed research methods and provides recommendations for its future development. The evaluation was undertaken between October 2020 and November 2021