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The text discusses various symposiums and programs in Australia focused on drug and alcohol-related issues, including drug checking services, decriminalization of illicit drugs, and treatment for culturally diverse populations. The programs aim to provide value-based healthcare, culturally inclusive treatment, and support for CALD communities in accessing services. The research emphasizes the importance of culturally competent approaches and tailoring treatment programs to meet the unique needs of diverse populations. [Extracted from the article]

Introduction: Tropical climates in remote Aboriginal and Torres Strait Islander communities in northern Australia are conducive to the transmission of canine helminths such as hookworms, as well as ectoparasites such as fleas and ticks. In addition to their veterinary importance, these parasites may present a zoonotic risk either directly, or as potential vectors for bacterial pathogens. These factors necessitate efficacious and effective antiparasitic treatment programs for community dogs. Methods: A cluster-randomised trial was performed on three islands in the Torres Strait to examine the short-term efficacy and medium-term effectiveness of three treatment programs. Treatments administered included oral oxibendazole/praziquantel (Paragard®) and oral afoxolaner (Nexgard®); topical moxidectin/imidacloprid (Advocate®) and imidacloprid/flumethrin collars (Seresto®); and off-label oral ivermectin (Bomectin®). Canine faecal samples were collected and examined for endoparasites by faecal flotation and real-time PCR at baseline, 7-11 days after treatment and 6 months later. Results: The proportion of dogs positive for Ancylostoma caninum at baseline and negative at day 7-11 was 9% (95% CI 4.4-17.4) for dogs treated with oxibendazole, 56.4% (95% CI 41-70.7) for moxidectin, and 89.7% (95% CI 73.6-96.4) for ivermectin. Faecal flotation results showed a greater than 90% egg reduction in 29.2% (95% CI 19.9-40.5) of dogs treated with oxibendazole, 79.4% (95% CI 63.2-89.7) for moxidectin, and 95% (95% CI 76.4-99.1) for off- label ivermectin. Elimination of ectoparasite infestation was observed at day 7-11 in 69.9% (95% CI 56.7-80.1) of dogs treated with afoxolaner, 80% (95% CI 60.9-91.1) with imidacloprid/flumethrin collars, and 0% (95% CI 0-11.7) for off-label ivermectin. Mixed effects modelling revealed only treatment group to be significantly associated with outcome measures. Discussion: Based on these study results, the poor efficacy of oxibendazole against A. caninum renders it inept for treatment, while ivermectin and moxidectin were suitable. Ivermectin was unsuitable for ectoparasite treatment due to its poor efficacy, while afoxolaner and imidacloprid/flumethrin collars appear suitable. [ABSTRACT FROM AUTHOR]

The relationship between the working alliance and rates of recidivism for individuals on probation or parole has been underexplored, and what information has been reported provides inconsistent findings. This study sought out to explore this relationship further by examining the degree to which client perceptions (N = 145) of the working alliance were related to, and predicted, general and violent recidivism measured as reconviction. Results revealed that working alliance ratings were not significantly different between clients who recidivated and those who did not and did not predict future recidivism. Results also revealed that client age and risk predicted subsequent recidivism, while client perceptions of the working alliance did not. Implications for supervising officers in community corrections and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Opioid treatment programs (OTPs) permit patients to ingest daily methadone doses unsupervised and away from the clinic, a strategy that enhances treatment access and convenience but has the potential for mismanagement. Objective: This retrospective review, conducted during the COVID-19 pandemic (5/2020–1/2022), evaluates the feasibility and acceptability of a commercially available electronic pillbox to safely administer methadone take-home tablets in a large community-based OTP (census >500 people). Methods: Study participants (n = 24; 54% male, 46% female; M age = 63 years) had recently received more take-homes per visit to support national social distancing directives, and were instructed that they could maintain these privileges by agreeing to use the pillbox. Results: Results demonstrate good demand feasibility as most participants (71%) agreed to use the pillbox. Good implementation feasibility was observed through safe and reliable delivery of most take-home tablets, with a staff support line to resolve technical issues. Acceptability was modest as six participants (25%) requested to return the pillbox despite losing some take-home privileges. Conclusion: Results support continued use and study of the electronic pillbox to safely deliver and increase access to methadone take-home doses. [ABSTRACT FROM AUTHOR]

Violence in the workplace, unethical conduct, illegal behavior, and employees with poor integrity are problematic for any industry. When it comes to working in community-based corrections (CBC), however, poor integrity can cause serious threats to the safety of the employee, their peers, their clients, and the community they serve. The Critical Hire-Screen (CH-S) and Step One Survey II (SOS II) are two pre-employment integrity assessments used in various CBC agencies. The present study explored the degree to which the CH-S and SOS II correlated with and predicted supervisor ratings of correctional officer job performance. Disparate impact analyses were also conducted exploring the degree to which each tool's scale scores differed based on applicant age, gender and racial/ethnic status. Results revealed that only CH-S scale scores correlated with, and significantly differentiated between, supervisor ratings of job performance. Results also revealed that the CH-S and SOS II did not generate scale scores that significantly differed based on age, gender, or racial/ethnic status. Implications for correctional agencies are provided in this study. [ABSTRACT FROM AUTHOR]

The high rate of recidivism in Indonesia is caused by the legal paradigm and politics of society which place imprisonment as a premium remedium. Consequently, various problems arise in prisons, such as prison overcapacity and other problems. The government has made an effort to countermeasures by issuing a new Correctional Law and Criminal Code which carries a new sentencing paradigm through restorative justice; however, the panitentiary has not had a breakthrough that is in line with the new paradigm. Community-based correction which was first recognized in New Zealand is deemed appropriate to be applied in Indonesia with adjustments according to philosophical, sociological, and juridical foundations to fill the void in norms in arranging community-based correction as a form of fostering prisoners in jails. This study is a normative legal research with a literature study. This study uses statute, case, fact, and comparative approaches. Community-based correction implemented in New Zealand bears similarities to the fostering of convicts implemented in Indonesia, such as probation, parole, work release, and residential center or the halfway house program. In the future, the concept of fostering convicts based on the principles of restorative justice will be implemented using the pattern of community-based correction. Community-based correction is conceptualized in two forms, namely as an alternative to conviction and an alternative to imprisonment. As an alternative to conviction, the concept can accommodate the implementation of supervision and social work punishments that are regulated in the new Criminal Code. As an alternative to imprisonment, community-based correction can take the form of optimization of the function of open prisons by providing an opportunity for convicts with a maximum sentence of three years to be placed in open prisons from the start of serving their sentence. [ABSTRACT FROM AUTHOR]

Substance use disorders affect a significant number of pregnant persons in the USA and are associated with substantial maternal and neonatal morbidity and mortality. Treatment is complex and requires a comprehensive, interdisciplinary approach. Despite this, conventional perinatal medical systems are often without mental health and addiction medicine services and physically separated from established community treatment programs and resources. We outline an example of a multidisciplinary comprehensive care model integrating obstetrics, addiction psychiatry and psychology, neonatology, anesthesiology, social work and case management, established community services and resources, and the local legal system. Challenges with each component of the model are briefly described. Although outcome data is not available, the interdisciplinary clinic described represents a best practice approach based on existing interdisciplinary clinics aimed at improving substance use treatment engagement, maternal outcomes, and neonatal outcomes. Integration of addiction psychiatry/psychology, social work, and community services into prenatal care is crucial in achieving optimal outcomes for pregnant persons who use substances. We hope the recommendations based on identified challenges with establishing this model of care will help with program development across a variety of settings. Significance: What Is Already Known on This Subject? Although there are detailed accounts of interdisciplinary clinics focused on pregnant persons with substance use disorders, these authors are not aware of any published program overview that discusses integration of as many varied services for patient care and lessons learned within each specialty. What This Study Adds? There is a need for continued attention to best practice in care for pregnant persons with substance use disorders. The present article provides an outline for providers and medical facilities for development of interdisciplinary clinics to meet the needs of this vulnerable patient population. [ABSTRACT FROM AUTHOR]

Corrections staff experience high levels of stress in their jobs, often leading to turnover, absenteeism, psychosomatic diseases, and burnout. Stress can contribute to myriad professional and personal challenges such as depression, poor physical health, family conflict, and decreased life/job satisfaction. In efforts to develop wellness trainings specifically for corrections staff, the Pennsylvania Department of Corrections (PADOC) conducted a small, exploratory pilot test of a mindfulness training program with a randomized sample (N = 56) of facility- and community-based corrections staff. Without correcting for multiple tests in exploratory analyses, assessments collected at baseline and approximately 4 weeks later found statistically significant differences for several of the 19 questionnaires, specifically addressing mindfulness, fatigue, positive affect, decision-making, and resilience. After applying a Bonferroni correction, significance disappeared. This small exploratory pilot suggests the potential of mindfulness training for improving several functional domains in corrections staff in efforts to increase wellness. [ABSTRACT FROM AUTHOR]

Background: People who use drugs (PWUD) have difficulty participating in clinical research. We evaluated approaches to engage PWUD in clinical research, using facilitated telemedicine for hepatitis C virus (HCV) care as an example. Methods: We analyzed stakeholder interview transcripts and study-related data (i.e., progress reports, meeting minutes) from interrelated studies to understand engagement experiences at the patient, site, and organizational levels. Stakeholders include patient-participants, opioid treatment program (OTP) staff and administrators, and research team members involved in HCV management through facilitated telemedicine integrated into OTPs. Results: Three themes emerged. Initially, the research team sought understanding of the unique culture and community of each OTP (Theme 1). The team built trusting relationships through education, communication, and feedback (Theme 2). Finally, the research team enhanced collaborative care and incorporated the patients' voice to improve health outcomes (Theme 3). Patient-participants and OTP staff endorsed the integrated HCV care approach. Engagement practices are summarized as the CREATE framework (C = culture, R = respect, E = educate, A = advantage, T = trust, E = endorse). Conclusions: PWUD engagement in clinical research is maximized by building trusting relationships with open communication channels. Understanding the community, demonstrating respect, and augmenting knowledge are foundational for engaging PWUD in clinical research. These practices are transferable to engagement of PWUD in clinical research broadly. Plain English summary: People who use drugs rarely join clinical research studies for many reasons including mistrust of researchers and lack of access to healthcare. Their joining, however, is critical to understand how to address issues affecting their communities. For ten years, we have studied telemedicine (doctor visit through a computer) to increase healthcare access for people who use drugs with hepatitis C virus (HCV). HCV infection occurs commonly in people who use drugs and is curable in almost everyone who takes treatment. We place HCV treatment through facilitated telemedicine into drug treatment programs. A case manager who is familiar to patients oversees the telemedicine encounter with the doctor. We developed themes from interviews with patients, staff, and other involved people as well as from study documents. As a first step, researchers need to understand the culture and community of the drug treatment program. Knowing the culture permits researchers to connect the goals of the study with those of the drug treatment program. It also helps researchers build trust with the program staff. We have seen that trust between the researchers and the staff in the drug treatment program permits individuals with different jobs to work together to deliver HCV treatment resulting in a cure. During the entire process, a patient advisory committee made sure the patients were partners in the research. Based upon these results, we have developed a new approach, CREATE (C = Culture, R = respect, E = educate, A = advantage, T = trust, E = endorse), that explains each step in the process. [ABSTRACT FROM AUTHOR]

Objective: The Australian Government's landmark 2019 implementation of dedicated Medicare items for people with eating disorders was the first of its kind for a mental illness. We investigate the first 24 months of uptake of these items across regions, settings and healthcare disciplines, including intermediate changes to the program prompted by the COVID-19 pandemic. Methods: This was a descriptive study using item data extracted from the Australian Medicare Benefits Schedule database for November 2019 to October 2021. Data were cross-tabulated by discipline, setting, consultation type and region. Results: During the first 24 months of implementation of the scheme, 29 881 Eating Disorder Treatment and Management Plans (or care plans) were initiated, mostly by general practitioners with mental health training. More than 265 000 psychotherapy and dietetic sessions were provided, 29.1% of which took place using telehealth during the pandemic. Although the program offers up to 40 rebated psychological sessions, fewer than 6.5% of individuals completed their 20-session review under the scheme. Conclusions: Uptake of the Medicare item for eating disorders was swift, and the item was used broadly throughout the pandemic. Although feedback from those with lived experience and experts has been overwhelmingly positive, data show that strategic adjustment may be needed and further evaluation conducted to ensure that the reform achieves the best outcomes for patients and families, and its policy intent. [ABSTRACT FROM AUTHOR]

A considerable amount of previous research has examined the iatrogenic effects of mass imprisonment. This work has often considered the fact that the sentencing of people for low-level supervision violations is a contributing factor to the prison population. Relatively little work, however, has examined the factors which specifically influence the sentencing of probation and parole violators for technical and other low-level infractions. The present study analyzed over 44,000 cases of individuals who appeared in federal courts between 2013 and 2017 for relatively minor violations of federal community-based supervision. Using multilevel analysis to account for the nested quality of federal sentencing data, the study examined assorted individual-level legal and extra-legal effects on various sentencing outcomes. Effects were found for gender, having admitted to supervision violations, and predicate offense of conviction. Implications are presented. [ABSTRACT FROM AUTHOR]

The Correction Notice in the Security Journal addresses errors in the article "Community-based vigilante violence and corporate social responsibility in Nigeria's oil-producing region." The author's name Emmanuel Ejiofo Nwanmuoh was incorrectly written as Emmanuel Ejiofor Nwamuo, and the author's email address was also incorrect. The original article has been updated to reflect the correct information. The Correction Notice was reported by multiple authors and published by Springer Nature. [Extracted from the article]

In this study, the authors assessed return on investment (ROI) associated with a forensic assertive community treatment (FACT) program. A retrospective secondary data analysis of a randomized controlled trial comprising 70 legal-involved patients with severe mental illness was conducted in Rochester, New York. Patients were randomly assigned to receive either FACT or outpatient psychiatric treatment including intensive case management. Unit of service costs associated with psychiatric emergency department visits, psychiatric inpatient days, and days in jail were obtained from records of New York State Medicaid and the Department of Corrections. The total dollar value difference between the two trial arms calculated on a per-patient-per-year (PPPY) basis constituted the return from the FACT intervention. The FACT investment cost was defined by the total additional PPPY cost associated with FACT implementation relative to the control group. ROI was calculated by dividing the return by the investment cost. The estimated return from FACT was $27,588 PPPY (in 2019 dollars; 95% confidence interval [CI]=$3,262–$51,913), which was driven largely by reductions in psychiatric inpatient days, and the estimated investment cost was $18,440 PPPY (95% CI=$15,215–$21,665), implying an ROI of 1.50 (95% CI=0.35–2.97) for FACT. The Rochester FACT program was associated with approximately $1.50 return for every $1 spent on its implementation, even without considering potential returns from other sources, including reductions in acute medical care, crime-related damages, and public safety costs. ROI estimates were highly dependent on context-specific factors, particularly Medicaid reimbursement rates for assertive community treatment and hospital stays. [ABSTRACT FROM AUTHOR]

Functional neurological disorder (FND) in children and adolescents involves the biological embedding of lived experience in the body and brain. This embedding culminates in stress-system activation or dysregulation and in aberrant changes in neural network function. In pediatric neurology clinics, FND represents up to one-fifth of patients. Current research shows good outcomes with prompt diagnosis and treatment using a biopsychosocial, stepped-care approach. At present, however--and worldwide--FND services are scarce, the result of long-standing stigma and ingrained belief that patients with FND do not suffer from a real ("organic") disorder and that they therefore do not require, or even deserve, treatment. Since 1994, the Mind-Body Program for children and adolescents with FND at The Children's Hospital at Westmead in Sydney, Australia--run by a consultation-liaison team--has delivered inpatient care to hundreds of patients with FND and outpatient care to hundreds of others. For less-disabled patients, the program enables community-based clinicians to implement biopsychosocial interventions locally by providing a positive diagnosis (by a neurologist or pediatrician), a biopsychosocial assessment and formulation (by clinicians from the consultation-liaison team), a physical therapy assessment, and clinical support (from the consultation-liaison team and the physiotherapist). In this Perspective we describe the elements of a biopsychosocial mind-body program intervention capable of providing, as needed, effective treatment to children and adolescents with FND.Our aimis to communicate to clinicians and institutions around the world what is needed to establish effective community treatment programs, as well as hospital inpatient and outpatient interventions, in their own health care settings. [ABSTRACT FROM AUTHOR]

Body-worn cameras (BWCs) among police officers have garnered mixed support among community members. On the one hand, proponents of BWCs contend that there are benefits of BWCs such as reduction of complaints, increase legitimacy, decrease unlawful shootings, and increase transparency. On the other, certain community members maintain less support for BWCs, citing that while police officers wear BWCs, it violates police–citizen interaction privacy. Although there is mixed support for BWCs among community members, little is known as to whether race plays a role in support for BWCs and whether confidence in the police relates to reporting crime/procedural justice, leading to support for BWCs. The current study used two mediation moderation analyses to examine whether race moderated the relationship between confidence in the police and reporting crime/procedural justice, leading to support for BWCs while controlling for police legitimacy and effectiveness. The first model suggests that race moderated the relationship between confidence in the police and reporting crime but not the relationship between reporting crime and support for BWCs. The second model revealed that race did not moderate the relationship between confidence in the police and procedural justice. Also, race did not moderate the relationship between procedural justice and support for BWCs. Implications are discussed. [ABSTRACT FROM AUTHOR]

The death rate from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in 2022 was lower than the death rate in 2021, when the infection rate increased. Hybrid immunity provided by a combination of vaccination and infection, including asymptomatic infection, may confer effective protection against death. We explored the combined effect of asymptomatic infection and hybrid immunity by studying T-cell and antibody responses against SARS-CoV-2 among individuals treated in home health care services 6 months after SARS-CoV-2 exposure. Asymptomatic SARS-CoV-2 infection was demonstrated in 24.4% of close contacts. The levels of immunity were not different between patients and close contacts. Anti-RBD IgG against SARS-CoV-2 increased in a dose-dependent manner with the number of vaccine doses. Interestingly, the T-cell response decreased soon after a booster dose of vaccine. Asymptomatic SARS-CoV-2 infection could not enhance immunity against SARS-CoV-2 among vaccinated close contacts. Full vaccination was crucial to provide hybrid immunity. However, when designing vaccine strategies, T-cell exhaustion after multiple vaccinations should be considered. [ABSTRACT FROM AUTHOR]

Prior research has identified the important role of emotional dependency in the dynamics of chronic intimate partner violence. The main objectives of this paper are to analyze the emotional and other related psychological variables (anxiety, depression, self-esteem, and anger) in male batterers and male non-batterers when they are involved in lasting relationships. The sample consisted of 100 people. A group of 50 male batterers in community treatment was compared to a group of 50 male non-batterers on measures of emotional dependency. Male batterers scored much higher than male non-batterers on emotional dependency. Furthermore, emotional dependency in male batterers was positively associated with depression, but not with anxiety, self-esteem, and anger. These findings support that emotional dependency in men is an important factor in the motivational dynamics of intimate partner violence. [ABSTRACT FROM AUTHOR]

Background: Implementing ecological momentary assessment (EMA) methodology to evaluate the substance use disorder (SUD) treatment pipeline has clear advantages, including learning about participants' day-to-day experiences to aid in the improvement of services and accessibility for those seeking treatment. Given that the SUD treatment pipeline spans long periods of time, EMA burst designs (deployment of multiple short EMA periods spread over time) can be advantageous for evaluating the treatment pipeline over time while keeping participant burden low. Objectives: This feasibility study describes (1) the process and study design of implementing EMA burst methodology to evaluate the SUD treatment pipeline experience; (2) study implementation from the perspective of researchers, including discussion of collaboration with community partners; and (3) participant feedback on the experience of engaging with this type of research. Method: EMA metrics, feasibility ratings, and general experience ratings in the study are presented from 22 participants (64% women) who participated in a parent EMA study evaluating the SUD treatment pipeline and 8 who provided feedback in a follow-up survey. Results: Participants found the EMA burst design to be acceptable and not burdensome, although technology issues were present for some participants. Steps to partnering with community treatment programs and implementation of a burst design are outlined. Conclusions: Strategies and recommendations for implementation of an EMA burst study with community partners are provided, including aspects of study design, technology issues, retention, and funding. [ABSTRACT FROM AUTHOR]

While the COVID-19 pandemic disrupted healthcare delivery everywhere, persons with carceral system involvement and opioid use disorder (OUD) were disproportionately impacted and vulnerable to severe COVID-associated illness. Carceral settings and community treatment programs (CTPs) rapidly developed protocols to sustain healthcare delivery while reducing risk of COVID-19 transmission. This survey study assessed changes to OUD treatment, telemedicine use, and re-entry support services among carceral and CTPs participating in the National Institute on Drug Abuse (NIDA)-funded study, Long-Acting Buprenorphine vs. Naltrexone Opioid Treatments in Criminal Justice System-Involved Adults (EXIT-CJS) study. In December 2020, carceral sites (n = 6; median pre-COVID 2020 monthly census = 3468 people) and CTPs (n = 7; median pre-COVID 2020 monthly census = 550 patients) participating in EXIT-CJS completed a cross-sectional web-based survey. The survey assessed changes pre- (January–March 2020) and post- (April–September 2020) COVID-19 in OUD treatment, telemedicine use, re-entry supports and referral practices. Compared to January–March 2020, half of carceral sites (n = 3) increased the total number of persons initiating medication for opioid use disorder (MOUD) from April–September 2020, while a third (n = 2) decreased the number of persons initiated. Most CTPs (n = 4) reported a decrease in the number of new admissions from April–September 2020, with two programs stopping or pausing MOUD programs due to COVID-19. All carceral sites with pre-COVID telemedicine use (n = 5) increased or maintained telemedicine use, and all CTPs providing MOUD (n = 6) increased telemedicine use. While expansion of telemedicine services supported MOUD service delivery, the majority of sites experienced challenges providing community support post-release, including referrals to housing, employment, and transportation services. During the COVID-19 pandemic, this small sample of carceral and CTP sites innovated to continue delivery of treatment for OUD. Expansion of telemedicine services was critical to support MOUD service delivery. Despite these innovations, sites experienced challenges providing reintegration supports for persons in the community. Pre-COVID strategies for identifying and engaging individuals while incarcerated may be less effective since the pandemic. In addition to expanding research on the most effective telemedicine practices for carceral settings, research exploring strategies to expand housing and employment support during reintegration are critical. [ABSTRACT FROM AUTHOR]

Primary care physicians (PCPs) in Hawai'i face many challenges in treating patients with substance use disorders (SUD) who tend to have higher medical complexity and thus require more resources. PCPs play a vital role in identifying early misuse, integrating and coordinating care for patients with SUD including office-based interventions like medication-assisted treatment, and connecting patients to community treatment programs. In addition to enormous burdens to care for and increasingly complex patient panels, the challenges include lack of education on addiction medicine, insufficient resources and SUD treatment programs in the office and community, low reimbursement for the complexity of care provided, and an overall physician shortage which drives higher patient volume and less time for any given physician. This article suggests responses to address these challenges such as providing more training and continuing education in SUD for PCPs and trainees, enhancing team-based care to better support PCPs, and funding more SUD treatment programs. More funding should widen accessibility to treatment and reduce the overall burden on the health care system by preventing or treating the disease early, which is a core principle of primary care. Additionally, incentives to practice in Hawai'i in primary care, and especially to treat patients with SUD, need to be improved. Such steps must be taken to address the overall physician shortage that limits patients' access to SUD treatment. A collaborative care model between PCPs, care managers, and addiction specialists is an example of an integrated care system that may address many of these challenges in the short term. To truly improve care for all in Hawai'i, however, system wide interventions are essential to increase the incentive for PCPs to remain and practice in Hawai'i to take care of its unique population, including those dealing with SUD. [ABSTRACT FROM AUTHOR]

Adolescents are developmentally distinct from adults in ways that merit a tailored response to juvenile crime. Normative adolescent brain development is associated with increases in risk taking, which may include criminal behavior. Juvenile delinquency peaks during the adolescent years and declines in concert with psychosocial maturation. However, current U.S. approaches to juvenile justice are misaligned with youth's developmental needs and may undermine the very psychosocial development necessary for youth to transition out of crime and lead healthy adult lives. In this article, I discuss empirically supported and efficacious responses to juvenile crime in the United States, as well as opportunities for further developmental reform of the juvenile justice system. Developmentally appropriate responses to juvenile crime prioritize community‐based corrections and engage youth's social context in the rehabilitative process. The juvenile justice system shares the responsibility to prepare youth to live fulfilling, productive adult lives; that responsibility can be achieved by partnering with developmental scientists to inform juvenile justice practice and policy. [ABSTRACT FROM AUTHOR]

The article discusses the enduring relevance of Assertive Community Treatment (ACT) in supporting individuals with severe mental illness. Topics include recent trends in ACT availability, primary care integration within ACT programs, and adaptations for specific populations like the elderly, those experiencing housing instability, and forensically involved individuals.

Introduction: Schizophrenia is a chronic, debilitating mental illness that contributes significantly to the global burden of disease. Assertive outreach treatment for patients with schizophrenia and psychotic disorders has been implemented to improve treatment adherence and outcomes.The suitability of this model of care outside the western context has not been fully established. The Psychosis Recovery Outreach Program (PROP),staffed by a multidisciplinary team that applies principles of early intervention and assertive outreach, was initiated in February 2016 at a leading psychiatric facility in Lebanon. Objectives: The aim of this study is to identify and analyze clinical and demographic variables associated with patient enrollment in PROP, out of a typical clinical population attending a psychiatric outpatient department. Methods: This retrospective study included patients above 18 y.o. at time of first point of care with a primary diagnosis of psychosis according to the International Classi-fication of Diseases 10 (ICD-10), and who presented to the outpatient psychiatry department at the American University of Beirut Medical Center (AUBMC) and were following up in PROP. We collected twelve-month data and used logistic regression models to identify predictor variables for enrollment in the service compared to those receiving standard treatment. Results: In total, 45 patients participated in the study. Patients were mostly males (77.8%), younger than 39 years (80%), of college or higher education (68.2%), and diagnosed with schizophrenia (46.7%) or schizoaffective disorder (48.9%). About one-quarter (22.7%) had a comorbid cannabis use disorder. A majority received more than one oral antipsychotic (75.6%) while half (51.1%) were maintained on a long-acting injectable (LAI) antipsychotic.The following variables were significant predictors of enrollment in PROP: having a comorbid cannabis use disorder (OR 2.83 [1.25 – 6.37]), being prescribed a LAI antipsychotic (OR 9.99 [4.93-20.24]) or more than one oral antipsychotic (OR 4.57 [2.22-9.39]), visiting the emergency department more than once (OR 8.7 [2.64-28.68]), and admission to the psychiatry unit (OR 13.91[3.17-60.94]). In addition, those following up in PROP were younger and less likely to be in the oldest age group (over 54 years) [OR 0.11 (0.01-0.93)], less likely to be females (OR0.39 [0.18-0.81]), and less likely to be diagnosed with "other psychotic disorder" as com-pared to schizophrenia (OR 0.14 [0.03 – 0.62]). Conclusions: PROP was the first community treatment program to use the principles of assertive outreachin Lebanon. Our findings highlight that the assertive out-reach model of care is applicable to its target population in the context of psychiatric care in Lebanon, namely young individuals with psychosis, higher comorbidities and a severe course of illness. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

The rate of admission to treatment facilities for psychiatric illness in youth is rising. There is also concern for their use of screen-time behaviors. The purpose of the present study was to explore hospitalized youth ratings for their utilization of social media and electronic devices, and their school experiences including bullying, and to compare their ratings to the provincial norm. The discharge plans were also examined. A survey with standardized questions taken from a provincial survey was administered while youth were in hospital. The mean age of the 111 youth who participated was 15.3 years (SD 1.4), and 78 (70%) identified as female. A high percentage of youth reported five or more hours of daily social media use, being bullied and bullying others; 57% reported a moderate to severe problem with digital media use. Adolescent patients reported greater problematic behaviors than the average adolescent. An unexpected finding was that many patients were discharged from the hospital to residential treatment programs. Youth reported many concerns with bullying, high use of electronics and poor school experiences. Many patients were discharged to specialized community residential treatment programs, which can be seen as essential components for the continuity of mental health treatment. [ABSTRACT FROM AUTHOR]

Objective: This is the first randomized controlled trial to compare Acceptance and Commitment Therapy (ACT) with the Duluth Model curriculum, which took place in community-based corrections for the treatment of men convicted of domestic violence. ACT is a third-wave cognitive–behavioral approach that utilizes experiential methods to foster psychological flexibility. The Duluth Model curriculum is an educational approach grounded in feminist theory that focuses on changing attitudes toward women and unlearning power and control motivations. This trial was preregistered at ClinicalTrials.gov (registration number: NCT03609801). Method: This study included 338 men who were court-mandated to complete a domestic violence program after being convicted of assault against a female partner. Participants were randomized to complete the 24 sessions of the ACT program or the Duluth Model Men's Nonviolence Classes. Outcomes included criminal justice data (domestic violence charges, other violent charges, and nonviolent charges) incurred during the 1 year following program dropout or completion, and victim reports of intimate partner violence (IPV; aggression, controlling behaviors, and stalking/harassment). Results: In intent-to-treat comparisons to Duluth, ACT participants did not show a difference in domestic assault charges at 1 year posttreatment (p =.44). ACT participants acquired significantly fewer violent charges (p =.04) and nonviolent charges (p =.02) compared to Duluth participants. Data from victims indicated that victims of ACT participants reported significantly fewer IPV behaviors than victims of Duluth participants on the Conflict Tactics Scale (d =.78), the Controlling Behaviors Scale (d =.66) and the Stalking Behavior Checklist (d =.71) at 1 year posttreatment. Conclusions: An ACT-based group intervention delivered in community corrections reduced violent and nonviolent criminal charges compared to the Duluth classes. Domestic violence charges did not differ between groups but victim reports indicated that ACT participants engaged in fewer IPV behaviors. What is the public health significance of this article?: This study suggests that Acceptance and Commitment Therapy (ACT) is an effective treatment for domestic violence among men court-ordered to complete a batterers intervention program. [ABSTRACT FROM AUTHOR]

Certain subpopulations like female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID) often have higher prevalence of HIV/AIDS and are difficult to map directly due to stigma, discrimination, and criminalization. Fine-scale mapping of those populations contributes to the progress toward reducing the inequalities and ending the AIDS epidemic. In 2016 and 2017, the PLACE surveys were conducted at 3290 venues in 20 out of the total 28 districts in Malawi to estimate the FSW sizes. These venues represent a presence-only dataset where, instead of knowing both where people live and do not live (presence–absence data), only information about visited locations is available. In this study, we develop a Bayesian model for presence-only data and utilize the PLACE data to estimate the FSW size and uncertainty interval at a 1.5 × 1.5 -km resolution for all of Malawi. The estimates can also be aggregated to any desirable level (city/district/region) for implementing targeted HIV prevention and treatment programs in FSW communities, which have been successful in lowering the incidence of HIV and other sexually transmitted infections. for this article, including a standardized description of the materials available for reproducing the work, are available as an online supplement. [ABSTRACT FROM AUTHOR]

This article examines issues of accountability and transparency in Alberta's Mental Health Review Panel process. A person who is involuntarily admitted to a mental health facility, or who is subject to a community treatment order (CTO), can appeal to the Review Panel to have their admission certificates or CTO cancelled. This process is intended to provide access to a decision-maker to review decisions that affect the liberty of those living with mental illness. Unfortunately, Alberta's Mental Health Review Panels are not transparent or accountable decision-makers. The article begins with a brief outline explaining the delivery of mental health care in Canada, followed by a description of Canadian law on CTOs. The article then examines Alberta's Mental Health Review Panels -- first in terms of their role in relation to CTOs, followed by concerns about accountability and transparency in the Review Panel process. Finally, the article looks at legal and system reforms that will enhance the accountability of the process. [ABSTRACT FROM AUTHOR]

Background: Self-referral to inpatient treatment (SRIT) is built on user participation and patient autonomy. SRIT was conducted for patients with severe mental disorders in a Norwegian Community Mental Health Centre. The aims of the present study were to describe the implementation of SRIT, explore the professionals' experiences of SRIT and assess the costs entailed.Methods: Qualitative document analysis, interviews with professionals and quantitative analysis of register data from a randomized controlled trial were used.Results: SRIT seemed to be implemented as intended. According to the professionals, SRIT allowed the patients to cope, be empowered, more active and responsible. Some professionals experienced increased responsibility for patients' medication and for assessing health and suicide risks. SRIT did not reduce hospital costs. The professionals were satisfied with nurse-led SRIT treatment.Conclusions: SRIT appears to be a high-quality mental health service that empowers and activates patients. Nurse-led treatment may entail more efficient use of professional resources. In future implementations of SRIT, the efficient use of service resources and the administration of beds should be investigated. More flexible availability should be considered in line with the intentions behind SRIT, as well as ensuring adequate professional training in assessing health and suicide risk. [ABSTRACT FROM AUTHOR]

Background: Integrated Management Program Advancing Community Treatment of Atrial Fibrillation (IMPACT-AF) was a pragmatic, cluster randomized trial assessing the effectiveness of a clinical decision support (CDS) tool in primary care, Nova Scotia, Canada. We evaluated if CDS software versus Usual Care could help primary care providers (PCPs) deliver individualized guideline-based AF patient care.Methods: Key study challenges including CDS development and implementation, recruitment, and data integration documented over the trial duration are presented as lessons learned.Results: Adequate resources must be allocated for software development, updates and feasibility testing. Development took longer than projected. End-user feedback suggested network access and broadband speeds impeded uptake; they felt further that the CDS was not sufficiently user-friendly or efficient in supporting AF care (i.e., repetitive alerts). Integration across e-platforms is crucial. Intellectual property and other issues prohibited CDS integration within electronic medical records and provincial e-health platforms. Double login and data entry were impediments to participation or reasons for provider withdrawal. Data integration challenges prevented easy and timely data access, analysis, and reporting. Primary care study recruitment is resource intensive. Altogether, 203 PCPs and 1145 of their patients participated, representing 25% of eligible providers and 12% of AF patients in Nova Scotia, respectively. The most effective provider recruitment strategy was in-office, small group lunch-and-learns. PCPs with past research experience or who led patient consent were top recruiters. The study office played a pivotal role in achieving patient recruitment targets.Conclusions: A rapid growth in healthcare data is leading to widespread development of CDS. Our experience found practical issues to address for such applications to succeed. Feasibility testing to assess the utility of any healthcare CDS prior to implementation is recommended. Adequate resources are necessary to support successful recruitment for future pragmatic trials. CDS tools that integrate multiple co-morbid guidelines across eHealth platforms should be pursued.Trial Registration: ClinicalTrials.gov NCT01927367. Registered on August 22, 2013. [ABSTRACT FROM AUTHOR]

There is a need for community treatment programs for people who are sexually attracted to children, but individuals report difficulty accessing services. Individuals who are sexually attracted to children (n = 293) completed an online anonymous survey that revealed a significant positive association between maladaptive coping and two factors of the treatment motivation measure. The association between maladaptive coping and treatment motivation was attenuated at higher levels of ego dystonic distress/aversion. Results highlight the importance of targeting stigma toward those who are sexually attracted to children to increase treatment seeking behavior. [ABSTRACT FROM AUTHOR]

The article focuses on the history of halfway houses in the United States during the 1960s and 1970s. The author discusses how community treatment initiatives began, explores the relationship between mass incarceration and rehabilitation, and examines the the role of private interests, specifically religious organizations.

The article examines incarcerated mothers and the socioeconomic benefits of community-based alternatives for nonviolent offenders in the U.S. It mentions high costs could be substantially mitigated through community-based alternatives to incarceration that adequately take into account the unique circumstances of incarcerated mothers and their children and provide better long-term outcomes at a fraction of the price.