Prisoners Helping Prisoners Change: A Study of Inmate Field Ministers Within Texas Prisons.

Research on incarcerated offenders trained to help prisoners change is rare because programs that equip inmates with practical capacities for helping others rehabilitate in prison hardly exist. An exception is the Field Ministry program in Texas, which enlists inmates who have graduated from a prison-based seminary to work as "Field Ministers" and serve other inmates in various capacities. We hypothesize that inmate exposure to Field Ministers is inversely related to antisocial factors and positively to prosocial ones. We applied manifest-variable structural equation modeling to analyze data from a survey of a random sample of male inmates at three maximum-security prisons where the Field Ministry program operated. We found that inmates exposed more frequently to the Field Ministry and for a longer time period tended to report lower levels of criminological risk factors and aggressiveness and higher levels of virtues and predictors of human agency as well as religiosity and spirituality.

A model for sustainable laser tattoo removal services for adult probationers.

PURPOSE: The purpose of this paper is to describe a sustainable free laser tattoo removal clinic for economically disadvantaged adult probationers. DESIGN/METHODOLOGY/APPROACH: This paper describes the partnerships, methods and challenges/lessons learned from the implementation of a free monthly laser tattoo removal program for adult probationers within a medical school setting in California. FINDINGS: Possible patients are identified via a collaboration with the county's Probation Department. Founded in 2016, this monthly program has provided tattoo removal services to >37 adult patient probationers, many of whom receive follow-up treatments. Clients seek to remove about four blue/black ink tattoos. Since its inception, 23 dermatology residents have volunteered in the program. Challenges to patients' ongoing participation primarily pertain to scheduling issues; strategies for overcoming barriers to participation are provided. No safety concerns have emerged. SOCIAL IMPLICATIONS: Programs such as this public-private partnership may benefit probationers by eliminating financial barriers associated with tattoo removal. This model supports the training of cohorts of dermatologists seeking community service opportunities related to laser medicine. Others seeking to implement a similar program may also consider expanding treatment days/times to facilitate access for working probationers, providing enrollment options for other health and social services (e.g. public insurance, food stamp programs) and hosting a mobile onsite clinic to address clients' physical and mental health needs. ORIGINALITY/VALUE: This paper describes a unique collaboration between law enforcement and a medical school and it may assist other jurisdictions in establishing free tattoo removal programs for the benefit of probationers. The methods described overcome challenges regarding the implementation of this specialized clinical service.

Producing food in English and Welsh prisons.

Most prison food research focuses on aspects of consumption rather than production yet farming, horticulture and gardening have been integral to the prison system in England and Wales for more than 170 years. This paper explores the interplay between penological, therapeutic and food priorities over the last fifty years through an examination of historical prison policies and contemporary case studies associated with the Greener on the Outside for Prisons (GOOP) programme. Findings are discussed in relation to how joined-up policy and practice can impact positively on whole population health and wellbeing within and beyond the prison setting.

Trends in addiction treatment in Irish prisons using national surveillance data, 2009-2014.

PURPOSE: Many studies show that incarcerated populations have higher rates of problem drug use than the general population. The purpose of this paper is to analyse trends in addiction treatment demand in prisons in Ireland from 2009 to 2014 using available national surveillance data in order to identify any implications for practice and policy. DESIGN/METHODOLOGY/APPROACH: National surveillance data on treatment episodes for problem drug and alcohol use from 2009 to 2014, collected annually by the National Drug Treatment Reporting System (NDTRS), were analysed. FINDINGS: In total, 6 per cent of all treatment episodes recorded by the NDTRS between 2009 and 2014 were from prison services. The number of prison service treatment episodes increased from 964 in 2009 to 1,063 in 2014. Opiates were the main reason for treatment, followed by alcohol, cocaine and cannabis. The majority (94-98 per cent) of treatment episodes involved males (median age of 29 years) and low educational attainment, with 79.5-85.1 per cent leaving school before completion of second level. The percentage of treatment episodes with a history of ever injecting drugs increased from 20.9 per cent in 2009 to 31.0 per cent in 2014. PRACTICAL IMPLICATIONS: This study can help policy development and service planning in addiction treatment in prison as it provides an insight into the potential needs of incarcerated populations. It also provides a baseline from which to measure any changes in provision of treatment in prison over time. ORIGINALITY/VALUE: This is the first study to analyse treatment episodes in prison using routine surveillance data in Ireland. Analysis of these data can provide useful information, not currently available elsewhere.

Growing health in UK prison settings.

Globally, prisoners tend to come from marginalized and socially disadvantaged sections of the society and exhibit a high incidence of ill health, linked to social exclusion and multiple complex needs. Prisons therefore offer an important opportunity to tackle inequality and injustice, through promoting health, reducing reoffending and facilitating community reintegration.This paper reports on and critically discusses findings from an evaluative research study, which aimed to identify and explore impacts of prisoners' participation in an innovative social and therapeutic horticultural programme, 'Greener on the Outside for Prisons' (GOOP), delivered in prisons in North West England. Focus groups with 16 prisoners and semi-structured interviews with six prison staff were conducted at five sites. Presented under three overarching themes (health and well-being; skills development, employability, and work preparedness; and relationships), findings suggest that engagement with and participation in GOOP were important in improving positive mental well-being, increasing physical activity and knowledge about healthier eating; developing skills and work readiness; and building relationships and catalysing and strengthening prosocial behaviours, important for good citizenship and effective resettlement. The paper concludes that - in the context of the current UK prison reform agenda and concern about the high incidence of violence, substance misuse, self-harm and suicide - prison-based horticulture can offer multiple benefits and make a significant contribution to the creation of safe, secure, supportive and health-enhancing environments. Furthermore, it contends that by joining up health and justice agendas, programmes such as GOOP have the potential to serve as powerful catalysts for wider systemic change, thereby helping tackle inequalities and social exclusion within societies across the globe.

Prisoner rehabilitation through animal-assisted activities in Argentina: the Huellas de Esperanza Prison Dog Programme. / Resocialización de personas privadas de libertad a través de actividades con animales en Argentina: el programa «Huellas de Esperanza¼.

One of the most traumatic events that a person can ever experience in their lifetime is being detained. The prison dog programmes are the most successful prison rehabilitation programmes in the United States of America and consist of detainees training service dogs for other people to assist with different types of disability. It is a typical win-win system: inmates win as they connect with their deepest feelings of affection and solidarity while acquiring a concrete skill for their future release; people with disabilities win because they receive a dog to support their day-to-day activities; the dogs win (especially adopted street dogs) because their lot in life is improved; institutions win because they are enabled to meet their objective more fully; and society wins because they gain a concrete tool to aid the social rehabilitation of detainees. This article describes the operation and achievements of Huellas de Esperanza (Traces of Hope), the Argentine prison dog programme, which has been implemented by the Federal Penitentiary Service since 2010 using State resources. A total of 85 inmates have participated in the programme, which has delivered more than a dozen assistance dogs to people with disabilities and many more dogs to elderly people to provide them with affection and companionship. The article also describes the programme methodology and the way it has decreased prison unrest and led to a low reoffending rate among programme participants.

La privation de liberté est l'une des situations les plus traumatisantes qu'un être humain puisse connaître au cours de son existence. De tous les programmes de réhabilitation appliqués dans les prisons aux États-Unis d'Amérique, Prison Dog Programme est celui qui donne les meilleurs résultats ; il consiste à confier aux détenus la tâche de dresser des chiens en vue d'en faire des chiens aidants qui rendront des services à d'autres personnes atteintes de divers types de handicap. Il s'agit d'un système typiquement « gagnant-gagnant ¼ : le détenu est gagnant, car il renoue avec des sentiments positifs d'affection et de solidarité, tout en recevant un outil concret pour sa vie future une fois libéré ; la personne handicapée est gagnante, car elle reçoit un chien qui l'aidera à vivre au quotidien ; le chien est gagnant, surtout s'il était un chien errant avant d'être adopté, car il accède à une vie meilleure ; enfin, les institutions sont gagnantes car leurs objectifs sont mieux remplis, de même que la société, qui grâce à cet outil concret facilite, la réinsertion sociale des personnes privées de liberté. Les auteurs décrivent le fonctionnement et les réussites de la version argentine de ce programme, intitulée « Traces d'espérance ¼ (Huellas de Esperanza). Le programme a été mis en place par le système pénitentiaire fédéral en 2010 et doté de véritables ressources étatiques; au total, 86 détenus en ont bénéficié et plus d'une douzaine de chiens aidants ont été remis à des personnes handicapées, en plus du grand nombre de chiens dressés et remis à des centres de gériatrie pour apporter un réconfort aux pensionnaires. Les auteurs expliquent la méthodologie suivie, ainsi que la réduction des conflits en milieu carcéral et le faible taux de récidives parmi les ex-détenus ayant participé au programme.

Una de las situaciones más traumáticas que puede atravesar un ser humano a lo largo de su existencia es la privación de su libertad. Los Prison Dog Programmes son los sistemas de rehabilitación carcelaria más exitosos de EE.UU., y consisten en el adiestramiento de perros por parte de personas privadas de la libertad, que los preparan como perros de servicio para apoyo de distintos tipos de discapacidad en otras personas. El sistema es un típico win-win-win: gana el interno conectándose con sus mejores sentimientos de afecto y solidaridad al tiempo que recibe una herramienta concreta para su futuro en libertad; gana la persona con discapacidad que recibe un perro como apoyo para su desempeño cotidiano; gana el perro, sobre todo si se trata de perros vagabundos adoptados que obtienen un destino mejor; ganan las instituciones, que cumplen mejor su objetivo, y gana la sociedad, que facilita, con una herramienta concreta, la reinserción social de las personas privadas de libertad. El presente trabajo describe la operatoria y logros de Huellas de Esperanza, la versión argentina de este Programa, que se desarrolla en el Servicio Penitenciario Federal desde 2010 con recursos estatales genuinos; por este programa han pasado más de 85 internos y ha permitido entregar más de una docena de perros de asistencia a personas con discapacidad y muchos perros a geriátricos para compañía afectiva. Se describe también la metodología y la disminución de la conflictividad intracarcelaria, así como la escasa reiteración de sus participantes.

Pet Therapy in Correctional Institutions: A Perspective From Relational-Cultural Theory.

In this article the authors apply Relational-Cultural Theory to pet therapy in correctional institutions. An important premise is that when pet therapy is used in prisons a symbiotic relationship develops between pets and prison inmates which, at the same time, improve their relationships with people themselves. Relational-Cultural Theory posits that relationships with individuals are not just a means to an end. Rather, good relationships promote growth and healthy development; they also cultivate reciprocal empathy. Hence, a major reason of suffering for most people is their experience of isolation; healing can occur in growth-fostering relationships.

[Chronicity and primary care: the role of prison health]. / Cronicidad y atención primaria: rol de la sanidad penitenciaria.

The Prison Primary Health Care Teams in Catalonia have been integrated into the Catalan Health Institute. This integration shall facilitate¹ training and updating, while eliminating the existing differences between the health services belonging to prison institutions and those of the Catalan Health Service. It shall enable team work and coordination between Primary Health Care Teams in the community and the PHCTs in prisons within the same geographical area by sharing ongoing training, multi-sector work teams and territory-based relations, thereby facilitating continuance in care and complete and integrated treatment of chronicity. The existing information systems in Primary Health Care and the shared clinical history in Catalonia are key factors for this follow up process. Support tools for clinical decision making shall also be shared, which shall contribute towards an increase in quality and clinical safety. These tools include electronic clinical practice guides, therapeutic guides, prescription alert systems, etc. This shall be an opportunity for Prison Health Care Teams to engage in teaching and research, which in turn shall have an indirect effect on improvements in health care quality and the training of professionals in this sector. The critical factor for success is the fact that a unique chronicity health care model shall be shared, where measures for health promotion prevention can be taken, along with multi-sector monitoring of pathologies and with health care information shared between professionals and levels throughout the patient's life, both in and out of the prison environment.

Taking a PAWS to Reflect on How the Work of a Therapy Dog Supports a Trauma-Informed Approach to Prisoner Health.

Canada's Correctional Investigator has found that mental health disorders, alone or in combination with alcohol and drug abuse, challenge public health and safety. Trauma is a key contributor among Canada's inmate population. Therapy dogs can assist in supporting individuals with mental health, addiction, and trauma concerns. This case report presents the work of a St. John Ambulance therapy dog in a trauma-informed approach to prisoner health. The Substance Abuse and Mental Health Services Administration articulates six evidence-based trauma principles for service providers; safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues. These principles are used as a lens to examine what the therapy dog appears to offer instinctively and effortlessly in its interactions with prisoners. Illustrative examples are provided.Video Abstract available for additional insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JFN/A16).

Drug and alcohol use and treatment for Australian Indigenous and non-Indigenous prisoners: demand reduction strategies.

PURPOSE: The purpose of this paper is to compare the use of drugs and alcohol by Indigenous and non-Indigenous prisoners and examine relevant treatment in Australian prisons. DESIGN/METHODOLOGY/APPROACH: Prison authorities were surveyed about alcohol and drug use by prisoners prior to and during imprisonment and drug and alcohol treatment programs in prison. The literature was review for information on alcohol and drug use and treatment in Australian prisons. FINDINGS: In 2009, over 80 percent of Indigenous and non-Indigenous inmates smoked. Prior to imprisonment, many Indigenous and non-Indigenous inmates drank alcohol at risky levels (65 vs 47 percent) and used illicit drugs (over 70 percent for both groups). Reports of using heroin (15 vs 21 percent), ATS (21 vs 33 percent), cannabis (59 vs 50 percent) and injecting (61 vs 53 percent) were similarly high for both groups. Prison-based programs included detoxification, Opioid Substitution Treatment, counselling and drug free units, but access was limited especially among Indigenous prisoners. RESEARCH LIMITATIONS/IMPLICATIONS: Drug and alcohol use was a significant issue in Australian prisons. Prisoners were over five times more likely than the general population to have a substance use disorder. Imprisonment provides an important opportunity for rehabilitation for offenders. This opportunity is especially relevant to Indigenous prisoners who were more likely to use health services when in prison than in the community and given their vast over representations in prison populations. PRACTICAL IMPLICATIONS: Given the effectiveness of treatment in reducing re-offending rates, it is important to expand drug treatment and especially culturally appropriate treatment programs for Indigenous inmates. ORIGINALITY/VALUE: Very little is known about Indigenous specific drug and alcohol programs in Australian prisons.

Cronicidad y atención primaria: rol de la sanidad penitenciaria / Chronicity and primary care: the role of prison health

En Cataluña los Equipos de Atención Primaria Penitenciaria (EAPP) se han integrado en el Institut Català de la Salut (ICS). Esta integración facilitará la formación y actualización de los mismos, desaparecerán las diferencias existentes a nivel laboral entre servicios asistenciales pertenecientes a instituciones penitenciarias y los pertenecientes al Servei Català de la Salut. Permitirá el trabajo en equipo y la coordinación entre los EAP comunitarios y los (EAPP) de un mismo territorio compartiendo formación continuada, grupos de trabajo transversales y relación de base territorial, facilitando la continuidad asistencial y el abordaje integral e integrado de la cronicidad. Los sistemas de información existentes en Atención Primaria (AP) y la Historia clínica compartida de Cataluña son claves en este seguimiento. También se compartirán herramientas de soporte a la toma de decisiones clínicas, que contribuyen al aumento de calidad y seguridad clínica. Entre otras están las guías de práctica clínica electrónicas, guías terapéuticas, sistemas de alerta en prescripción, etc. Para los EAPP supondrá una oportunidad para introducirse en la docencia e investigación, que indirectamente repercutirá en la mejora de la calidad asistencial y de la formación de profesionales en este ámbito. La clave del éxito radicará en compartir un modelo único de atención a la cronicidad, donde se realicen actuaciones en promoción y prevención de la salud , seguimiento transversal de patologías y con la información asistencial compartida entre profesionales y niveles que a lo largo de la vida atiendan a la persona , este o no en el medio penitenciario (AU)

The Prison Primary Health Care Teams in Catalonia have been integrated into the Catalan Health Institute. This integration shall facilitate training and updating, while eliminating the existing differences between the health services belonging to prison institutions and those of the Catalan Health Service. It shall enable team work and coordination between Primary Health Care Teams in the community and the PHCTs in prisons within the same geographical area by sharing ongoing training, multi-sector work teams and territory-based relations, thereby facilitating continuance in care and complete and integrated treatment of chronicity. The existing information systems in Primary Health Care and the shared clinical history in Catalonia are key factors for this follow up process. Support tools for clinical decision making shall also be shared, which shall contribute towards an increase in quality and clinical safety. These tools include electronic clinical practice guides, therapeutic guides, prescription alert systems, etc. This shall be an opportunity for Prison Health Care Teams to engage in teaching and research, which in turn shall have an indirect effect on improvements in health care quality and the training of professionals in this sector. The critical factor for success is the fact that a unique chronicity health care model shall be shared, where measures for health promotion prevention can be taken, along with multi-sector monitoring of pathologies and with health care information shared between professionals and levels throughout the patient’s life, both in and out of the prison environment (AU)

The need to improve health care in prisons.

OBJECTIVE: To analyze physical structure, working conditions of health professionals and outline of the procedures established in prisons. METHODS: We analyzed 34 provisional detention centers and 69 male and six female prison units in the state of Sao Paulo, Southeastern Brazil, in 2009. A self-applied instrument was developed to collect quantitative data on the characteristics of health care structure, equipment and personnel in prisons. Analysis of variance (ANOVA) or equivalent non-parametric tests and Chi-square or Fisher's tests were used to compare categorical and continuous variables, respectively, between the groups. RESULTS: The main problems were delays in the results of laboratory tests and imaging. With respect to the teams, it was observed that a large majority were in conditions close to those proposed by the Bipartite Commission 2013 but without improvement being reflected in the indicators. With respect to the process, more than 60.0% of prisons located in small towns do not have the structural conditions to ensure secondary or tertiary health care for the continuity of treatment. CONCLUSIONS: This profile of prisons in the country can be used for planning and monitoring future actions for the continuous improvement of healthcare processes.

Necessidade de aprimoramento do atendimento à saúde no sistema carcerário / The need to improve health care in prisons

OBJETIVO Analisar a estrutura física, as condições de trabalho dos profissionais da saúde e o delineamento de processos estabelecidos em unidades prisionais. MÉTODOS Foram analisados 34 centros de detenção provisória e 69 unidades prisionais masculinas e seis femininas do Estado de São Paulo, Brasil, em 2009. Foi desenvolvido instrumento autoaplicativo para coleta de dados quantitativos sobre as características de estrutura, equipamento e pessoal para atendimento à saúde nas unidades prisionais. A análise de variância (ANOVA) ou equivalente não paramétrico e os testes de Qui-quadrado ou Fisher foram utilizados para comparação de variáveis contínuas ou categóricas, respectivamente, entre os grupos estudados. RESULTADOS Os principais problemas foram o retardo nos resultados de exames laboratoriais e de imagem. Quanto às equipes, grande maioria apresentou condições próximas da proposta pela Comissão InterGestores Bipartite 2013, mas sem que isso se refletisse em melhoria dos indicadores. Com relação ao processo, observou-se que mais de 60,0% das unidades prisionais estão localizadas em cidades pequenas, sem condições estruturais de saúde para garantir o atendimento secundário ou terciário para continuidade do processo de tratamento. CONCLUSÕES O perfil apresentado das unidades prisionais do País poderá ser utilizado para planejamento e acompanhamento de ações futuras para melhoria contínua das condições estruturais de saúde. .

OBJECTIVE To analyze physical structure, working conditions of health professionals and outline of the procedures established in prisons. METHODS We analyzed 34 provisional detention centers and 69 male and six female prison units in the state of Sao Paulo, Southeastern Brazil, in 2009. A self-applied instrument was developed to collect quantitative data on the characteristics of health care structure, equipment and personnel in prisons. Analysis of variance (ANOVA) or equivalent non-parametric tests and Chi-square or Fisher’s tests were used to compare categorical and continuous variables, respectively, between the groups. RESULTS The main problems were delays in the results of laboratory tests and imaging. With respect to the teams, it was observed that a large majority were in conditions close to those proposed by the Bipartite Commission 2013 but without improvement being reflected in the indicators. With respect to the process, more than 60.0% of prisons located in small towns do not have the structural conditions to ensure secondary or tertiary health care for the continuity of treatment. CONCLUSIONS This profile of prisons in the country can be used for planning and monitoring future actions for the continuous improvement of healthcare processes. .

¿El estado nutricional tras las rejas?, estudio descriptivo del estado nutricional de un grupo de mujeres privadas de libertad en una unidad penal de la Ciudad de Santa Fe (Argentina) / Nutritional status behind bars?, descriptive study of the nutritional status of a group of women deprived of liberty in a detention criminal unit in The City of Santa Fe (Argentina)

Objetivo: Evaluar el estado nutricional y describir la alimentación proporcionada y el nivel de actividad física e identificar las percepciones vinculadas a ellas, en mujeres privadas de libertad en un penal de la ciudad de Santa Fe. Métodos: Se realizó un estudio transversal en 30 mujeres de 20 a 59 años. Se determinó el nivel de actividad física, la ingesta alimentaria y se realizaron mediciones antropométricas y exámenes de laboratorio. Las percepciones se relevaron con preguntas abiertas. Se aplicaron estadísticas descriptivas y se realizó un Análisis de Cluster jerárquico. Resultados: Más del 60% de las mujeres presentan sobrepeso y obesidad y el 40% son sedentarias. El 83,3% no cubrió la recomendación diaria de hierro y la ingesta de grasas saturadas y de hidratos de carbono simples fue excesiva. Se destacan bajos niveles de HDL-colesterol en el 84,6% de las internas. La descripción del estado nutricional considerando todas las variables estudiadas identifica 4 conglomerados. La práctica de actividad física al inicio de la condena, permite catalizar la situación de prisión. Se identifican cambios cuali y cuantitativos en las percepciones vinculadas a la alimentación. Conclusiones: Se evidencia la necesidad de promoción de estilos de vida saludables desde el ingreso al penal (AU)

Objective: Assessment of the nutritional status and level of physical activity, including a description of the food provided to a group of women serving prison in the the City of Santa Fe, and identification of the perceptions related to them. Methods: A cross-sectional study was carried out in a group of 30 women aged 20 to 59 years. Through interviews, the level of physical activity and dietary intake was determined and anthropometric measurements and laboratory tests were practised on them. Perceptions were surveyed with open questions. Descriptive statistics were applied and the analysis was made through hierarchical Cluster Analysis. Results: More than 60% are overweight or obese and 40% are sedentary. The 83.3% did not cover the daily recommendation of iron, and the intake of saturated fats and simple carbohydrates was excessive in all cases. Highlighted low levels of HDL-cholesterol in 84.6% of the inmates. The description of the nutritional status considering all the variables studied, identifies 4 clusters. Physical activity inside the prison is observed at the early stage of the imprisonment, as a source for catalyzing the prison situation. Qualitative and quantitative changes in perceptions related to food were identified. Conclusions: Highlighting the need to promote healthy lifestyles since the beginning of the imprisonment (AU)

Establishing hospice care for prison populations: An integrative review assessing the UK and USA perspective.

BACKGROUND: models of care based on the hospice model have delivered effective support to dying people since their inception. Over the last 20 years this form of care has also been introduced into the prison system (mainly in the United States) to afford terminally ill inmates the right to die with dignity. AIM: the aim of this review is to examine the evidence from the United States and the United Kingdom on the promotion of palliative care in the prison sector, summarizing examples of good practice and identifying barriers for the provision of end-of-life care within the prison environment both in the USA and UK. DESIGN: an integrative review design was adopted using the Green et al. model incorporating theoretical and scientific lines of enquiry. DATA SOURCES: literature was sourced from six electronic databases between the years 2000 and 2011; the search rendered both qualitative and quantitative papers, discussion papers, 'grey literature' and other review articles. RESULTS: the results highlight a number of issues surrounding the implementation of palliative care services within the prison setting and emphasize the disparity between the USA model of care (which emphasizes the in-prison hospice) and the UK model of care (which emphasizes palliative care in-reach) for dying prisoners. CONCLUSION: the provision of palliative care for the increasing prison population remains under-researched globally, with a notable lack of evidence from the United Kingdom.

Care or custody? An evaluation of palliative care in prisons in North West England.

This study aimed to evaluate health professionals' views about palliative care provision in prisons in the counties of Cumbria and Lancashire in the North West of England. Seventeen prison healthcare staff and nine specialist palliative care staff participated in semi-structured interviews and 16 prison healthcare staff completed a questionnaire designed to measure knowledge, skills and confidence in relation to palliative care. The findings highlighted tensions between the philosophies of care and custody, and the many challenges in providing palliative care in a custodial setting. This paper presents two illustrative case study examples, and suggests ways in which some of these challenges can be overcome in practice.

More than porridge.

In spite of a number of innovative projects, there are still concerns about the nutritional value of prison meals and the associated health risks.