Cyril Eshareturi

Policy Responses to Honor-Based Violence: A Cultural or National Problem?

The UK government has consistently sidelined honor-based violence from mainstream political discourse and has chosen to present the issue as a problem that is embedded in the culture of minority communities. This inevitably leads to a sense of heightened cultural sensitivity and the pressure to be viewed as culturally competent. It is argued that for honor-based violence to be managed effectively, it must first be dissociated from culture and from mainstream domestic violence discourse and recognized as a national problem that requires serious and specific policy intervention. Although it is acknowledged that all policy responses to complex social problems should reflect multicultural sensitivity, we argue in this critical review that this should not become an excuse for nonintervention.

Silence of a scream: application of the Silences Framework to provision of nurse-led interventions for ex-offenders:

The Silences Framework and its underpinning concept of ‘Screaming Silences’ was originally presented with the invitation for further peer review and utilisation in other contexts in order to test its usefulness and enable critique by a wider audience. This paper reports the use of the framework in a study researching nurse-led interventions for released ex-offenders. Screaming Silences were situated in how an issue, as experienced by ex-offenders, screams out to them in relation to their health and its impact on their reality while remaining silent in the consciousness of society and the application of practice. In addressing these Screaming Silences, we associated the Silences Framework within marginal discourses as they are less prioritised by policy and frequently positioned as far removed from what society considers as normal. Screaming Silences were situated in the subjective experiences of ex-offenders known as the ‘listener’ and the social and personal context in which these experiences occurred. We affirmed that the framework is ideally suited for researching issues which are under-researched, silent from policy discourse and excluded from practice, as it is oriented towards exploring individual experiences by valuing individual interpretations of events.

The case for nurses as central providers of health and social care services for ex-offenders: a discussion paper

AIMSnA discussion on the case for nurse-led community delivery of health and social care interventions to ex-offenders.nnnBACKGROUNDnEx-offenders re-enter their communities with limited pre-release preparation for the continuity of access to health care once outside prison. Once released, these individuals become hard to reach, do not consider health a priority and consequently use services to address their health and social care needs in a crisis-led way. Nevertheless, how nurses can best support these health-excluded group of individuals in the community remains vague and requires discussion.nnnDESIGNnDiscussion paper.nnnDATA SOURCESnSeveral databases were searched for papers published in English from 1990-2012 using the Population, Intervention and Outcome framework to help structure search.nnnDISCUSSIONnIt is argued that current dominant discourses around equity of care are contradicted in the provision of health and social care services to ex-offenders in the community. Effective engagement with community interventions may be achieved if ex-offenders maintain contact with frontline providers who can support both their structural and health needs.nnnIMPLICATION FOR NURSINGnNurses are uniquely positioned to initiate and sustain contact with ex-offenders, intervening at points of greatest need in the community to address the socially significant health and social care issues that plague them.nnnCONCLUSIONnThe use of nurses in the provision of health and social care interventions to ex-offenders is a strategy, which could increase equity in access to health care, reduce reoffending and improve both the health and life chances of these individuals.

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 delivered.

Embedding learning from adverse incidents: a UK case study

Purpose This paper reports on a regionally based UK study uncovering what has worked well in learning from adverse incidents in hospitals. The purpose of this paper is to review the incident investigation methodology used in identifying strengths or weaknesses and explore the use of a database as a tool to embed learning. Design/methodology/approach Documentary examination was conducted of all adverse incidents reported between 1 June 2011 and 30 June 2012 by three UK National Health Service hospitals. One root cause analysis report per adverse incident for each individual hospital was sent to an advisory group for a review. Using terms of reference supplied, the advisory group feedback was analysed using an inductive thematic approach. The emergent themes led to the generation of questions which informed seven in-depth semi-structured interviews. Findings Time and work pressures were identified as barriers to using adverse incident investigations as tools for quality enhancement. Methodologically, a weakness in approach was that no criteria influenced the techniques which were used in investigating adverse incidents. Regarding the sharing of learning, the use of a database as a tool to embed learning across the region was not supported. Practical implications Softer intelligence from adverse incident investigations could be usefully shared between hospitals through a regional forum. Originality/value The use of a database as a tool to facilitate the sharing of learning from adverse incidents across the health economy is not supported.