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Prison workers occupy a niche role. Balancing the care and welfare of prisoners while simultaneously restricting their freedoms is a stressful job, laced with danger, that occurs entirely within the bounded context of the prison. Here, wellbeing and professionalism are closely linked and articulated through a range of policies. This article explores the perceptions and experiences of staff in relation to a range of wellbeing and training policies in the Scottish Prison Service (SPS). We interviewed 10 SPS employees, some working directly with prisoners and others in more centralised policy development and support roles. Thematic analysis found a high degree of contentment with such policies but highlighted tensions between their implementation and specific challenges of the prison context. Emerging themes included: supporting wellbeing within the complex dynamic of the prison world; addressing inherent tensions borne out of the underlying threat of violence; and the impact of professionalization. We conclude that while the prison service aspires to offer employees wellbeing and professionalization opportunities similar to those in other sectors, there is a need for such policies to more clearly reflect the unique context of prison work. This might involve co-design of policies and more careful consideration of the pressures, tensions and idiosyncrasies of that rarefied environment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Fletcher, McKie, MacPherson and Tombs.)

Goals: To evaluate the contribution of the anal plug to the management of fecal incontinence in children and adults., Background: Effective management of fecal incontinence remains problematic. Previous studies of an anal plug have yielded conflicting results., Study: A randomized controlled trial was conducted. The intervention was the Conveen anal plug (Coloplast Limited) used for 12 months. Outcomes measures included: generic measures of child health [Functional Status II-R, Child Health Questionnaire (CHQ-PF50) and Dartmouth Primary Care Cooperative Information Project Charts]; generic measures of adult health for patients and carers (the SF-36, and Patient Generated and Carer Generated indices); condition-specific measures for adults and children; qualitative interviews, bowel charts, and diaries. The main outcome measure was a condition-specific score on a 0 to 100 scale, where 0 was the most severe and 100 was the least severe incontinence., Results: Thirty-one intervention and 17 control patients were recruited. Fecal incontinence was due to 1 of 3 reasons: congenital, acquired, and neurogenic. At baseline, patients managed their condition preemptively or protectively. Intervention patients used the plug as a complete management substitute or as an adjunct to existing management. The majority of intervention respondents retained the plug most of the time. There was greater improvement from baseline in mean condition-specific score in intervention group compared with control group but this difference was not statistically significant (t test P=0.053). Complete data analysis using analysis of covariance showed the mean difference between the treatment groups in condition-specific score of 9.9 (95% confidence interval-1.4, 21.1). Intention to treat analyses using imputation showed similar results. There was generally greater improvement in intervention groups subjects using other measures for children, adults, and carers., Conclusions: The anal plug is of benefit to the majority of patients. It does not suit all eligible patients with in situ plug retention being a problem for some.

Serum ferritin, serum vitamin B12, erythrocyte folate, plasma vitamin C and plasma 25-hydroxycholecalciferol levels were measured in 208 men and 197 women, >75 years old and living in the community, in order to assess micronutrient status. Anthropometric measurements (height, weight, demispan and mid-upper arm circumference) were made and a 114-item questionnaire covering a wide range of health and diet-related topics was administered by an interviewer. Only 4 % of subjects had a BMI <20, but the prevalence of marginal deficiency of the micronutrients ranged from 7 % for Fe to 47 % for vitamin D. There was no association between low micronutrient status (defined as being in the lowest third of the distribution of micronutrient status) and having BMI or mid-upper arm circumference in the lowest third of the distribution for any of the nutrients. Leaving food on the plate was strongly associated with both low Fe status and low vitamin D status. Having breakfast cereal less than once per week was strongly associated with low folate status, while having fresh fruit juice less than once per week, having had less than two portions of fruits and vegetables the previous day and believing that food is not important for health were strongly associated with low vitamin C status. Low vitamin D status was strongly associated with a wide range of general health and disability measures. Having a weekly household income of less than pound 150 was associated with low status of Fe, folate, vitamin C and vitamin D.