Alan Farrier

People in prison tend to come from marginalised, economically, and socially disadvantaged sections of society, exhibiting disproportionately high incidences of ill-health. Growing food in prison can provide an intervention that supports both health improvement and positive resettlement opportunities via education, learning, and skills development. This chapter explores these opportunities through the therapeutic horticulture programme, Greener on the Outside for Prisons (GOOP), in England. It proposes the transition of existing GOOP therapeutic horticulture projects into commercial cooperative businesses in order to further reinforce the health and rehabilitative benefits of prison-grown food and to take GOOP to a new level of intervention through the prison gate. This would enable GOOP to deliver additional employment and resettlement benefits as well as its existing health and rehabilitation benefits. Integrating this transition into local food-based Community Wealth Building strategies in the communities to which GOOP participants will return on release would offer a truly whole system of prison-grown food for both individual and wider public health and wealth-building benefit.

This article focuses on an evaluation of a conservation and nature-based pilot project (BOOM) conduced in a UK local prison as part of the Greener on the Outside for Prisons therapeutic horticultural program. BOOM developed a tree and plant growing nursery where prisoners approaching the end of their sentences helped to restore endangered fauna and flora. They also engaged in tree-planting sessions within the prison grounds. Over 100 prisoners participated overall, with approximately a fifth of these going on to take part in an accredited course and engage in creative, arts-based activities related to nature as part of the project. Researchers carried out a series of focus groups with prisoners and staff who had taken part in prison-based BOOM activities during 2022–2023. In addition to BOOM staff, 18 prisoners were interviewed in four narrative-based focus groups, which gave participants a forum to discuss their experience of the project. A thematic analysis of this data has drawn out key themes in relation to health and well-being benefits of the project for an aging prison group and opportunities and challenges that arise from partnership working in this context. These health and well-being themes incorporate trust, connecting with nature, raising environmental consciousness, the value of creativity, and thinking beyond the gate. These findings have implications for future prison-based prisons project involving older prisoners, who are the fastest growing group in the prison population, and whose particular health and well-being needs are not currently entirely understood or met within the UK prison system.

Purpose: Greener on the Outside for Prisons (GOOP) is a therapeutic horticulture programme targeting the high levels of complex health and social care needs in prisons in England. The COVID-19 pandemic and resulting lockdowns led to unprecedented disruption in prisons in England. This paper examines the experiences of prisoners both during and post-lockdowns in four prisons, to understand the effects of participation in GOOP on health and wellbeing after the disruption of restrictions, and identify implications for developing this programme further.Design/methodology/approach: The paper is based on original qualitative data gathered from in-depth narrative-based interviews and focus groups with prisoners and staff in four English prisons. Audio data was transcribed and subject to a thematic analysis, drawing from a realist-informed lens.Findings: Thematic analysis revealed five key themes: reimagining the GOOP context; increasing empathy between participants; building sense of coherence; reconnecting with nature and a joined-up connection with provider services. The main arguments centre on horticulture in prisons remaining under-utilised as a means of promoting good health and wellbeing, although there is enthusiasm from staff to provide green spaces for the most vulnerable prisoners and develop a range of mechanisms to connect people in prison with nature.Originality/value: This paper focuses on new knowledge arising from an unprecedented situation in English prisons, from key stakeholders on the frontline of garden activities. Accounts demonstrate the extent of the health and wellbeing benefits of participation in such activities in this challenging environment, which has implications for practice for prisons more widely.

The impacts of COVID-19 on cities across the United Kingdom were significant and diverse, whilst ongoing climate-related, sustainability and social challenges were highlighted and sometimes amplified. Lessons from organisational and citizen experiences and their responses have the potential to improve local sustainability and resilience to global events; hence, they must be examined. We report findings from a project conducted in Preston (UK) exploring how COVID-19 recovery might accelerate organisation-led and citizen-led action for the wellbeing of people, places and the planet. The project used a settings approach to public health and combined qualitative research with conceptual development; the former involved online interviews and group dialogues with members of several local anchor institutions, whilst the latter examined synergy between community wealth building, Doughnut Economics and place-based climate action. We explore two themes—anchor institutions’ strategic priorities and plans; ‘building back better’, and its future sustainability implications. These revealed four cross-cutting aspects: wellbeing, tackling societal inequalities, collaborative working, and COVID-19 as a catalyst for transformative change. Informed by ‘Doughnut-Shaped Community Wealth Building’, organisations are encouraged to embed commitment to equitable and inclusive climate action; consolidate the co-operative approach developed during the pandemic at strategic, operational and grassroots levels; take a nuanced approach to future work policies and practices; work across anchor institutions to advocate collectively for supportive national-level policy to build a sustainable, wellbeing economy.

Despite global attention, physical and verbal abuse remains prevalent in maternity and newborn healthcare. We aimed to establish theoretical principles for interventions to reduce such abuse. We undertook a mixed methods systematic review of health and social care literature (MEDLINE, SocINDEX, Global Index Medicus, CINAHL, Cochrane Library, Sept 29th 2020 and March 22^nd2022: no date or language restrictions). Papers that included theory were analysed narratively. Those with suitable outcome measures were meta-analysed. We used convergence results synthesis to integrate findings. In September 2020, 193 papers were retained (17,628 hits). 154 provided theoretical explanations; 38 were controlled studies. The update generated 39 studies (2695 hits), plus five from reference lists (12 controlled studies). A wide range of explicit and implicit theories were proposed. Eleven non-maternity controlled studies could be meta-analysed, but only for physical restraint, showing little intervention effect. Most interventions were multi-component. Synthesis suggests that a combination of systems level and behavioural change models might be effective. The maternity intervention studies could all be mapped to this approach. Two particular adverse contexts emerged; social normalisation of violence across the socio-ecological system, especially for ‘othered’ groups; and the belief that mistreatment is necessary to minimise clinical harm. The ethos and therefore the expression of mistreatment at each level of the system is moderated by the individuals who enact the system, through what they feel they can control, what is socially normal, and what benefits them in that context. Interventions to reduce verbal and physical abuse in maternity care should be locally tailored, and informed by theories encompassing all socio-ecological levels, and the psychological and emotional responses of individuals working within them. Attention should be paid to social normalisation of violence against ‘othered’ groups, and to the belief that intrapartum maternal mistreatment can optimise safe outcomes.

Zusammenfassung: Dieses Projekt stellt die Frage, wie die COVID-19-Pandemie Prozesse der sozialen Inklusion und Exklusion von wohnungslosen Jugendlichen beeinflusst. Anhand von drei internationalen Fallstudien soll das Verständnis dafür verbessert werden, wie Pandemien die Risiken und die zugänglichen wohlfahrtsstaatlichen Ressourcen für junge Menschen mit Wohnungslosigkeitserfahrung prägen. Das Wissen, das in dieser vergleichenden Studie entwickelt wird, kann dazu beitragen, die Art und Weise zu verbessern, wie Organisationen der Wohnungslosenhilfe auf neue, veränderte oder verstärkte Probleme und Bedürfnisse von jungen wohnungslosen Menschen reagieren.

Introduction: The number of peri-prosthetic fractures (PPF) is increasing, yet there still lacks a clear evidence-based strategy to best manage these injuries. There is a growing interest to collect a substantial body of information about PPFs in order to aid understanding of this population, current treatments and clinical outcomes. COMPOSE is a national multi-centre, retrospective service evaluation examining the incidence, management, outcomes and patient characteristics of those presenting to secondary care hospitals in the UK with a PPF. Methods: Data will be collected via REDCap for all PPFs which presented to the orthopaedic departments between 1st January 2018 to 31st December 2018 from the participating hospitals. The evaluation will aim to collect pre-operative data (baseline demographics, fracture characteristics, surgical characteristics) and post-operative outcome data (length of stay, discharge, post-operative complications, re-admissions, re-operations, mortality). Results: Currently, 24 hospital sites have registered with a total of 388 cases recorded. We continue to seek further interested sites to join. COMPOSE will generate a unique and robust dataset of PPFs and current practices. All data and outcomes will be reported descriptively. The outcome measures will be analysed using regression modelling with adjustment for baseline variables. Between group comparisons will be reported using confidence intervals and p-values. Conclusion: Following analysis, the aim is to make supported recommendations regarding management, to help plan clinical services for this patient population and to assist with identification of potential risk factors for PPFs and the subsequent outcomes. The dataset will also aid development of testable hypotheses for future research.