Multiple traumatic experiences, post-traumatic stress disorder and offending behaviour in female prisoners.

BACKGROUND: Although it is well established that prisoners commonly have histories of childhood trauma, little is known about mediators between exposure to trauma and criminal behaviour. HYPOTHESES: We hypothesised that the experience of trauma in adulthood, post-traumatic stress disorder (PTSD) and emotional dysregulation would mediate the relationship between childhood traumatic events and later criminal behaviour. METHODS: Eighty-nine female prisoners were interviewed using standardised scales, in a cross-sectional study design. History of traumatic events, DSM-5 PTSD and emotional regulation were assessed, along with offending and demographic information. A series of regression and mediation analyses were undertaken on the data. RESULTS: Almost all (91%) of the 89 women reported both childhood and adulthood trauma. Over half (58%) met the criteria for DSM-5 PTSD. Multiple traumas were significantly associated with seriousness of offence, as indicated by sentence length. Adult experience of trauma was the only significant mediator between childhood trauma and subsequent offending. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Women who have experienced multiple traumatic events may be more likely to commit serious offences, so it is very important to assess and meet their trauma-related needs. While prisons should never be used as substitutes for healthcare facilities, when women or girls are sent to prison, the opportunity for constructive interventions must be seized. Copyright © 2017 John Wiley & Sons, Ltd.

Knowledge and confidence of the Mental Health Act in Scotland: a survey of general practitioners.

AIMS AND METHOD: Front-line clinician general practitioners may be required to assist in the administration of mental health legislation. Limited training has been an issue previously identified. This study aims to ascertain levels of training, knowledge and confidence of general practitioners in Scotland in relation to the mental health act. An anonymous online survey of all general practitioners in one Scottish health board was completed. RESULTS: Eighty general practitioners in Forth Valley responded to the survey; 55% had never received any previous training in the mental health act. The majority rated knowledge of the act as fair (50%) and confidence in using the act as poor (44%). No relationship was found between previous training and current knowledge or confidence. Previous practical use of the act was associated with better current knowledge (p = 0.0074) and confidence in using the act (p = 0.0005). Of the respondents, 99% were keen to pursue further training in the act. CLINICAL IMPLICATIONS: Further practical training for general practitioners in the use of the mental health act is required to improve knowledge and confidence in this important area.

Outcome effectiveness of the widely adopted EFNEP curriculum Eating Smart-Being Active.

OBJECTIVE: To determine the effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) curriculum Eating Smart-Being Active (ESBA). DESIGN AND SETTING: A quantitative, multi-state, nonequivalent comparison group pretest-posttest design was used to compare nutrition-related behavior changes in participants. ESBA was compared to previously used curricula for 3 different time periods in 5 states using the EFNEP evaluation tool. PARTICIPANTS: Adults enrolled in EFNEP who completed their entry and exit paperwork during any of the 3 time points. INTERVENTION: An 8-lesson adult curriculum based on the Dietary Guidelines for Americans and MyPlate. ANALYSIS: Analysis of variance and covariance (with pretests scores and demographic variables as covariates) were used to analyze data with significance at P ≤ .05. RESULTS: ESBA elicited a mean positive behavior change for food resource management (P < .01), food safety (P ≤ .001), nutrition (P < .001), and physical activity level in participating states (P ≤ .01). Compared with previous curricula, ESBA produced better mean outcomes in food resource management, nutrition, physical activity, and intakes of fruit and vegetables. CONCLUSION AND IMPLICATIONS: ESBA is effective at eliciting positive nutrition-related behavior change. The results of this multi-state, practice-based approach suggest that ESBA is effective in multiple settings and has external validity for use in EFNEP and other community nutrition programs.