Utilization-Focused Evaluation

Governments, in both developed and less‐developed nations, promote rural tourism as an instrument of socioeconomic development. Tourism scholars highlight the use of evaluation as a tool in managing the development of tourism. Despite this, few evaluation studies appear to form an integral part of tourism development practice. Nevertheless, systematic evaluation is becoming a more common constituent of tourism policy and planning. However, the importance of evaluation lies not only in its technical correctness, but also in how the evaluation results are used. The emphasis on the use of evaluation findings in the utilization‐focused evaluation approach suggested by this article is congruent with this contention.     

Displacing Marginalized Bodies: How Human Rights Discourses Function in the Law and in Communities

In this article, we examine disability and eugenics discourses and the ways they function in spaces where vulnerable persons have been historically excluded by the state and blamed for their own “immiseration.” We ask how queer theories of repudiation, abjection, and vulnerability lend insight into the ways that people with intellectual disabilities are discursively located outside normative discourses of home, care, and quality of life, and whether these discourses shifted to serve this vulnerable population when historically the very places in question repudiated them, infringed on their human rights, and questioned their sexuality. To address these questions, we focus on the recent and impending closures of Virginia’s Training Centers, residential institutions for persons with intellectual disabilities now scheduled for staggered closures before 2020.     

Exploratory trial of schema-focussed therapy in a forensic personality disordered population

The management of needs and risks in personality disordered offender populations has become a focus for health and criminal justice services in the UK. Recent studies demonstrate the effectiveness of schema focussed therapy (SFT) for patients with borderline personality disorder. This study was an exploratory trial of the feasibility of implementing SFT in a population of patients with personality disorder in a high secure hospital in England. Preliminary evaluations of the effects of SFT were conducted to investigate whether those receiving SFT demonstrated significant improvements on measures of anger, impulsiveness, schemata and interpersonal style. No significant effects were evident although there was a significant increase in defectiveness/shame schema in the SFT group. Lack of effectiveness of SFT is likely due to the preliminary nature of this study. Future trials of SFT need to ensure comprehensive therapist preparation, control of TAU, bigger samples, address attrition and provide more intensive therapy.     

Secure pathways for women in the UK: lessons from the women’s enhanced medium secure services (WEMSS) pilots

Abstract

Women’s enhanced medium secure services (WEMSS) is a model of care aimed at providing a more appropriate level of security for women and, in so doing, reducing the number of women in high secure psychiatric services. In 2007, three Department of Health commissioned WEMSS pilots became operational. This study compared the clinical outcomes of women in WEMSS with control women in six standard medium secure services and one high secure service matched on key clinical and risk characteristics, in order to examine their pathways of care. Our findings confirm that the WEMSS pilots were successful in transitioning women from high secure services who had previously been thought unsuitable for medium secure services. However, WEMSS showed no additional clinical benefit, suggesting that these women could be cared for equally well within standard medium secure services. We make recommendations about WEMSS and the future shape of women’s secure care in England.     

‘Coping with the job’: prison staff responding to self-harm in three English female prisons: a qualitative study

This study considers how those who work in prisons are affected by and respond to repetitive self-harm of imprisoned women in English prisons. This paper considers the perspectives of custodial staff working in this area on a day-to-day basis. Semi-structured face-to-face interviews were conducted with 14 prison staff and explored using techniques of thematic analysis. The interviews examined: the emotional impact of working with and witnessing self-harm incidents, coping strategies used, training and the support available to prison staff. Findings indicate the strategies used by staff to cope emotionally with such incidents and these include presenting a ‘façade of coping’, rejecting support and becoming desensitised. It is concluded that staff felt they must portray themselves as coping well with self-harm in prison even when they were troubled and emotionally affected by it. However, some did describe accepting help when outside of the prison and this has implications for how support can be offered in the future. It is recommended that more should be done to support and train staff in this area.     

Guidelines for postmortem protocol for ocular investigation of sudden unexplained infant death and suspected physical child abuse

Postmortem examination is a cornerstone in identifying the cause of unexplained sudden death in children. Even in cases of suspected or known abuse, an autopsy may help characterize the nature of the abuse, which is particularly important in the forensic autopsy of children in the first 3 to 4 years of life when inflicted neurotrauma is most common. Forensic examinations are vital in cases that might otherwise be diagnosed as sudden infant death syndrome. The ocular autopsy in particular may demonstrate findings that were not appreciated on antemortem clinical examination. This protocol for postmortem examination of the eyes and orbits was developed to promote more consistent documentation of findings, improved clinical and forensic decision making, and more replicable and coherent research outcomes.