Probation as a Setting for Building Well-Being Through Integrated Service Provision: Evaluating an Offender Health Trainer Service.

Probation as a setting for building well-being through integrated service provision: evaluating an Offender Health Trainer service.

Perspect Public Health. 2013 May 13;
Dooris M, McArt D, Hurley MA, Baybutt M

Introduction:The NHS Health Trainer Programme was launched in England and Wales in 2005 with the aim of tackling health inequalities. While initially focusing on geographical communities, the initiative has extended its reach to particular population groups, such as offenders and their families, who experience high levels of physical and mental health needs and wider social exclusion. This paper reports on the evaluation of the Offender Health Trainer service delivered in probation settings in Bury, Rochdale and Oldham (Greater Manchester). This service has sought to improve the health of offenders, improve their access to mainstream services, and help reduce health inequalities – as well as facilitate rehabilitation and improve job prospects for ex-offenders through employment as health trainers.Aims:This evaluative research study aimed to explore the delivery of the Offender Health Trainer service and examine its impact on service users. The study design and limited time frame meant that the research was focused on the journeys of service users rather than on long-term outcomes.Methods:The evaluation used a mixed-methods approach, comprising two key elements: the interrogation and analysis of routinely collected quantitative data extracted from the National Health Trainer Data Collection Recording System (DCRS); and in-depth qualitative research using interviews and focus groups with clients and health trainers.Results:The evaluation points to the overall success of the service in meeting its aims and impacting positively on the lives of offenders. It reveals promising trends in behaviour change and self-perceived health and well-being, articulating a rich narrative detailing how the service has helped probation clients tackle multiple interwoven problems and build hope and self-belief. Of particular importance was the health trainers’ experience of the criminal justice system, which resonated with and inspired clients, developing trust and motivation to change.Conclusions:While the research inevitably had limitations, this study suggests that the health trainer model can be effectively implemented within the probation setting, making a valuable contribution to the improvement of offenders’ health and well-being by working in ways that acknowledge the connections between personal lifestyle and wider determinants of health. Within the context of forthcoming probation reforms, it will be increasingly important to develop services that highlight these links and to invest in appropriate evaluation that can generate further learning about ‘what works and why’. HubMed – rehab


Biomechanical parameters of the BP-enriched bone cement.

Eur J Orthop Surg Traumatol. 2013 May 14;
Matuszewski L, Olchowik G, Mazurkiewicz T, Kowalczyk B, Zdrojewska A, Matuszewska A, Ciszewski A, Gospodarek M, Morawik I

Bisphosphonates (BPs) are well-known substances with very efficient antiresorptive properties. Their beneficial actions are useful not only in achieving better bone mineral density but also in improving bone microarchitecture, strength and, consequently, its quality. Surgical cement, being a polymer composite, is required to be highly biocompatible and biotolerant. The goal of the presented study was to assess whether the enrichment of cement with pamidronate has changed its biomechanical properties. We compared the biomechanical parameters of clean bone¬†cement and BP-enriched bone cement, which were both used formerly in our rat models. Biomechanical properties of BP-enriched bone cement are defined by two basic terms: stress and strain, which are caused by the influence of external force. In the investigatory process of the bone’s biomechanical parameters, the compressive test and the three-point flexural tests were used. During the three-point flexural investigation, the sample was supported at both ends and loaded in the middle, resulting in a flexure. After a specific range of flexure, the sample was fractured. In obtained results, there were no significant differences in the values of the stress determined at the point of maximal load and the energy stored in the samples for proportional stress-strain limit (elastic region). There were also no significant differences in the density of the samples. The study shows that the enrichment of bisphosphonates causes yielding of the bone cement material. In the presented data, we conclude that use of pamidronate implanted in bone cement did not have a detrimental effect on its biomechanical properties. Therefore, the obtained results encouraged us to perform further in vivo experiments which assess the biomechanical properties of bones implanted with BP-enriched bone cement. HubMed – rehab


A multicenter survey of Hispanic caregiver preferences for patient decision control in the United States and Latin America.

Palliat Med. 2013 May 13;
Yennurajalingam S, Noguera A, Parsons HA, Torres-Vigil I, Duarte ER, Palma A, Bunge S, Palmer JL, Delgado-Guay MO, Bruera E

Background:Understanding family caregivers’ decisional role preferences is important for communication, quality of care, and patient and family satisfaction. The family caregiver has an important role in a patient’s decisional role preferences. There are limited studies on family caregivers’ preferences of the patient’s decision control at the end of life among Hispanics.Aims:To identify Hispanic caregivers’ preferences of the decision control of patients with advanced cancer and to compare the preferences of caregivers in Hispanic Latin American and Hispanic American caregivers.Design:We surveyed patients and their family caregivers referred to outpatient palliative care clinics in the United States, Chile, Argentina, and Guatemala. Caregiver preferences of patient’s decision control were evaluated using the Control Preference Scale. Caregivers’ and patients’ sociodemographic variables, patient performance status, and Hispanic American patient acculturation level were also collected.Participants:A total of 387 caregivers were surveyed: 100 (26%) in Chile, 99 (26%) in Argentina, 97 (25%) in Guatemala, and 91 (24%) in the United States. The median age was 56 years, and 59% were female.Results:Caregiver preference of patient’s decision control was passive, shared, and active for 10 (11%), 45 (52%), and 32 (37%) Hispanic American caregivers and 54 (19%), 178 (62%), and 55 (19%) Hispanic Latin American caregivers (p = 0.0023), respectively. Caregiver acculturation level did not affect the preferences of the Hispanic American sample (p = 0.60).Conclusions:Most Hispanic family caregivers preferred the patient to make shared decisions. Hispanic Latin American caregivers more frequently preferred patients to assume a passive decisional role. Acculturation did not influence the preferences of Hispanic American caregivers. HubMed – rehab