The potential of practical checklists in successful health policy review and implementation.

The potential use of checklists to encourage the translation of policy into practice is outlined. The policy for the checklists is the WHO/UNODC declaration on women's health in prison; the checklists will be for decision makers and policy advisers; senior prison management staff; and prison health staff. The checklists will be piloted through the WHO network for prison and health and published in 2011.

Acute drug-related mortality of people recently released from prisons.

The rate of acute drug-related mortality, or overdose deaths, among prisoners in the immediate post-release period is unacceptably high. Such incidents result from many factors, including decreased tolerance after a period of relative abstinence during imprisonment and the concurrent use of multiple drugs which, with every additional illicit drug consumed in combination with opioids, nearly doubles the risk of death from opioids. Other important factors are the lack of pre-release counselling, post-release follow-up and failure to identify those at risk. Substance dependence is a chronic disorder with high relapse rates and often requires long-term continuous treatment. The deaths are preventable and a number of interventions including opioid substitution treatment reduces the risk of overdose among opioid users after release.

Ethics and values in prison practice.

A small series of pilot seminars on ethics and values in prison practice have been held over the past two years. This article outlines the background, the content and the relevance to prison staff. It concludes that a full trial of the approach for both staff and prisoners would seem to be necessary and that the seminars should be tried with public health practitioners.

Barriers to implementation of effective tuberculosis control in prisons.

The high prevalence and mortality from tuberculosis (TB) in prisons in Europe make them a priority target for the StopTB strategy. Implementation however is difficult and requires a whole prison approach, with due attention to the values and understanding of all staff and to prisoners' health literacy levels.

Mental health in prisons: great difficulties but are there opportunities?

Prisons carry a great burden of mental disability from major conditions (despite diversion schemes) to lesser forms. This article gives facts and figures which justify the call for urgent action. In the light of the WHO Trencin Statement on prisons and mental health and other reports, it lists the key aspects of an emerging new agenda for mental health and prisons.

Application of the Attention/Distraction: Inhibition/Excitation Scale to a group of mainstream children.

The Attention: Distraction/Inhibition Excitation Scale (ADIECAS) is a measure of individual differences hitherto used with children with special needs. The present study shows that the ADIECAS retains adequate factor structure and internal consistency with children who do not have special needs. Factor analysis yielded three dimensions: Attention-Distraction, Excitation-Inhibition and Responsiveness to Consequences. These factors predicted reading age, the discrepancy between chronological and reading ages and whether or not the child had been referred for statementing.

The psychometric properties of the Behaviour Assessment Record (the BAR schedule).

Two hundred and forty-seven completed Behaviour Assessment Records (BAR) for people with learning difficulties living in hospital, community residential facilities or the family home were subjected to item analysis and factor analysis. The instrument as a whole proved to be highly internally consistent, although the corrected item-total correlation coefficients suggest the redundancy of some items on individual sub-scales. Factor analysis produced a two-factor solution accounting for 32.9 and 10.8% of the variance. These factors were named Personal self-care and Use of public amenities. Summative scales based upon these factors were highly internally consistent. Comparisons are made between the internal consistency and factor structure of the BAR and those of similar measures of adaptive behaviour, such as the Social Training Achievement Record (Sturmey et al., 1988), the Pathways to Independence Checklist (Walsh & McConkey, 1989), and the Adaptive Behavior Scale (Nihira, 1969a, b, 1976).

Use of hospital beds: a cohort study of admissions to a provincial teaching hospital.

An instrument was developed to study the use of hospital beds and discharge arrangements of a cohort of 847 admissions to the John Radcliffe Hospital, Oxford, for a three week period during February-March 1986. For only 38% of bed days were patients considered to have medical, nursing, or life support reasons for requiring a provincial teaching hospital bed. The requirements for a bed in the hospital decreased with the patient's age and length of stay in hospital. For only a tenth of patients was the general practitioner concerned in discussions with hospital staff about the patient's discharge and less than one third of patients had been given more than 24 hours' notice of discharge. Several features might increase the proportion of bed days that are occupied by patients with positive reasons for being in hospital. Among these are an increased frequency of ward rounds by consultants, or delegating discharge decisions by consultants to other staff; providing diagnostic related protocols for planning the length of stay in hospital; planned discharges; and providing liaison nurses to help with communication with primary care staff.

Community hospitals: cornerstone of care for the future health service.

What is the impact of the changing pattern of care in community hospitals and what are the implications for staff? Dr Alex Gatherer, Oxfordshire AHA(T) area medical officer, with the help of Katrina Bishop and Alexandre Kalache, a clinical lecturer in community medicine at Oxford University, tried to answer these and other questions.