Examining facilitative services for entry into substance use disorder treatment: A cluster analysis of treatment facilities.

OBJECTIVES: We examined services to facilitate access to entering substance use disorder (SUD) treatment among a national sample of SUD treatment facilities. METHODS: We analyzed data from the National Survey of Substance Abuse Treatment Services (N-SSATS) 2020. Facilities were included in the sample based on criteria such as SUD treatment provision and being in the U.S. Cluster analysis was conducted using variables including ownership, levels of care, and whether facilities provide services or accept payment options aimed at reducing treatment barriers. National and state-level data on the percentage of facilities in each cluster were presented. RESULTS: Among N = 15,788 SUD treatment facilities four distinct clusters were identified: Cluster 1 consisted of for-profit and government outpatient facilities with high proportions of services to reduce barriers (22.2%). Cluster 2, comprised of non-profit outpatient facilities, offered the most comprehensive array of services to minimize barriers to treatment among all four clusters (25.2%). Cluster 3 included facilities with diverse ownership and care levels and provided a moderate to high degree of services aimed at reducing entry barriers to treatment (26.0%). Cluster 4 was primarily for-profit outpatient facilities with a low proportion of these services (26.6%). CONCLUSIONS: This study revealed facility-level groupings with different services to reduce barriers to SUD treatment across various clusters of SUD treatment facilities. While some facilities offered extensive services, others provided fewer. Differences in cluster distributions point to possible facilitators to treatment access for some persons seeking admission to specific treatment facilities. Efforts should be made to ensure that individuals seeking SUD treatment can access these services, and facilities should be adequately equipped to meet their diverse needs.

Detection of Leishmania DNA in Phlebotomine Sand Flies in Tsatee, a Community in the Volta Region, Ghana.

Leishmania parasites, which are spread by infected female sand flies, are the cause of the disease leishmaniasis. Although cutaneous leishmaniasis has been found to occur in the Volta Region, there is limited data on vector species and reservoirs. This study focused on the Tsatee community, in the South Dayi District of the Volta Region, and is aimed at identifying the sand fly fauna and detecting the presence of Leishmania DNA by the use of primers that target the conserved region of Leishmania spp. minicircle DNA of the parasite kinetoplast. The miniature light traps and hand aspirators provided by the Centers for Disease Control and Prevention (CDC) were used to collect outdoor and indoor sand flies for five months in a guinea woodland and semideciduous forest area. From the collections, 4,580 phlebotomine sand flies were obtained and identified, and females were examined for Leishmania DNA using PCR. The male flies were 1,202 (26.24%), non-blood-fed females were 3,321 (72.51%), and 57 (1.25%) were blood-fed females. It was observed that Sergentomyia species constituted 99.91% of the total collected sand flies with S. africana (76.77%) as the predominant species. Phlebotomus rodhaini (0.09%) was the only Phlebotomus species identified from the study area. From 283 non-blood-fed sand fly pools and 57 individual blood-fed species screened, Leishmania DNA was detected in 12 (4.24%) pools and 8 (14.04%) individuals, respectively. It was observed that Leishmania DNA was detected in all the sand fly species identified except S. collarti. This study reports the first detection of Leishmania DNA in P. rodhaini in Ghana, with an infection rate of 33.33% (95% CI, 1.23-88.32). The findings suggest that the role of Phlebotomus in disease transmission in the study area cannot be discounted. Future studies should include continuous surveillance, blood meal preferences, and vector competence of the various infected phlebotomine sand flies to create effective control measures.

Swapping Carrots for Sticks: Forensic science provider views of the Forensic Regulator Act 2021.

In April 2021, the Forensic Science Regulator Act 2021 received Royal Assent, providing new statutory powers for the Forensic Science Regulator (FSR) of England and Wales. These powers are intended to enable the FSR to compel forensic science providers (FSPs) comply with quality standard requirements. The FSR has until now relied upon 'soft power' and arguments of benefits to be gained if FSPs achieve accreditation and adhere to the Code of Practice. Reaching the limits of persuasive powers, the FSR Act now introduces powers to penalise FSPs who remain unaccredited or fall below published standards. To gauge the potential impact, forensic scientists were asked to anticipate effects of the Act. Practitioners indicated that the new statutory powers could instil a sense of urgency among police force forensic science units in particular, in prioritising quality and investing in accreditation. However, there are significant capacity limitations which may hamper more widespread and sustainable change, such as financial pressures faced by FSPs, as well as resource constraints within the FSR role. Changing from a regulatory approach focussed upon voluntary cooperation, support and encouraging intrinsic motivations (i.e 'carrots'), for one reliant upon deterrence in the forms of threats of sanctions and punishment ('sticks'), could prevent real improvements in quality and undermine the achievement of regulatory aims. The FSR Act is unable to address problems with forensic science provision, that militate against the quality of forensic science services. Thus, benefits accrued from swapping carrots for sticks may be illusory and may ultimately prove counterproductive.

African-Centered Social Work in the 21st Century: A Content Analysis.

Endorsement of African-centered theory and practice are widespread within Black communities across the United States. The usage of African-centered frameworks is also common among many Black social workers. However, past research suggests that African-centered theory and subsequent models of practice are marginalized within social work literature and curricula. Since advocacy began for the inclusion of African-centered approaches to practice during the mid to late 1990s, there have been no strategic analyses tracing how African-centered scholarship has advanced within social work. This study sought to examine to what extent the African-centered framework is included within scholarship among prominent social work journals. A content analysis was conducted of articles in six major social work journals published between 2000 and 2019. A total of 42 articles met the criteria for inclusion. While there has been a level of change in the number of published articles of African-centered social work, findings suggest that relative to other practice modalities/models, African-centered scholarship is noticeably lacking in social work literature. The article concludes with implications to advance culturally responsive research and practice with communities of African descent.

Ethics as Lived Practice. Anticipatory Capacity and Ethical Decision-Making in Forensic Genetics.

Greater scrutiny and demands for innovation and increased productivity place pressures on scientists. Forensic genetics is advancing at a rapid pace but can only do so responsibly, usefully, and acceptably within ethical and legal boundaries. We argue that such boundaries require that forensic scientists embrace 'ethics as lived practice'. As a starting point, we critically discuss 'thin' ethics in forensic genetics, which lead to a myopic focus on procedures, and to seeing 'privacy' as the sole ethical concern and technology as a mere tool. To overcome 'thin' ethics in forensic genetics, we instead propose understanding ethics as an intrinsic part of the lived practice of a scientist. Therefore, we explore, within the context of three case studies of emerging forensic genetics technologies, ethical aspects of decision-making in forensic genetics research and in technology use. We discuss the creation, curation, and use of databases, and the need to engage with societal and policing contexts of forensic practice. We argue that open communication is a vital ethical aspect. Adoption of 'ethics as lived practice' supports the development of anticipatory capacity-empowering scientists to understand, and act within ethical and legal boundaries, incorporating the operational and societal impacts of their daily decisions, and making visible ethical decision making in scientific practice.

Accreditation of forensic science service providers.

Short commentary on the new UK Accreditation of Forensic Service Providers Regulations 2018.

Forensic science in Ghana: A review.

The use of forensic science continues to grow across the world. In Ghana, major advancements took off in 2011, including the introduction of modern DNA profiling and the establishment of an automated fingerprint identification system. These developments have led to some positive impacts on the delivery of justice, including the exoneration of a wrongly incarcerated individual. However, a review of the policy-related aspects of forensic science shows gaps in legislation, governance, service provision, quality assurance and accreditation, education and research. An important recommendation to improve forensic science in Ghana is the creation of a "national policy strategy", a blueprint informed by relevant stakeholders, best practice from other countries and the status of the field. Resolutions to the policy issues identified in this review will ensure a more robust application of forensic science in delivering safe justice and enhancing public security.

Numerical investigation of heat transfer in parallel channels with water at supercritical pressure.

Thermal phenomena such as heat transfer enhancement, heat transfer deterioration, and flow instability observed at supercritical pressures as a result of fluid property variations have the potential to affect the safety of design and operation of Supercritical Water-cooled Reactor SCWR, and also challenge the capabilities of both heat transfer correlations and Computational Fluid Dynamics CFD physical models. These phenomena observed at supercritical pressures need to be thoroughly investigated. An experimental study was carried out by Xi to investigate flow instability in parallel channels at supercritical pressures under different mass flow rates, pressures, and axial power shapes. Experimental data on flow instability at inlet of the heated channels were obtained but no heat transfer data along the axial length was obtained. This numerical study used 3D numerical tool STAR-CCM+ to investigate heat transfer at supercritical pressures along the axial lengths of the parallel channels with water ahead of experimental data. Homogeneous axial power shape HAPS was adopted and the heating powers adopted in this work were below the experimental threshold heating powers obtained for HAPS by Xi. The results show that the Fluid Centre-line Temperature FCLT increased linearly below and above the PCT region, but flattened at the PCT region for all the system parameters considered. The inlet temperature, heating power, pressure, gravity and mass flow rate have effects on WT (wall temperature) values in the NHT (normal heat transfer), EHT (enhanced heat transfer), DHT (deteriorated heat transfer) and recovery from DHT regions. While variation of all other system parameters in the EHT and PCT regions showed no significant difference in the WT and FCLT values respectively, the WT and FCLT values respectively increased with pressure in these regions. For most of the system parameters considered, the FCLT and WT values obtained in the two channels were nearly the same. The numerical study was not quantitatively compared with experimental data along the axial lengths of the parallel channels, but it was observed that the numerical tool STAR-CCM+ adopted was able to capture the trends for NHT, EHT, DHT and recovery from DHT regions. The heating powers used for the various simulations were below the experimentally observed threshold heating powers, but heat transfer deterioration HTD was observed, confirming the previous finding that HTD could occur before the occurrence of unstable behavior at supercritical pressures. For purposes of comparing the results of numerical simulations with experimental data, the heat transfer data on temperature oscillations obtained at the outlet of the heated channels and instability boundary results obtained at the inlet of the heated channels were compared. The numerical results obtained quite well agree with the experimental data. This work calls for provision of experimental data on heat transfer in parallel channels at supercritical pressures for validation of similar numerical studies.