Probation practice and attention-deficit hyperactivity disorder.

RATIONALE: Twenty-one Community Rehabilitation Companies were set up following the division of the National Probation Services during 'Transforming Rehabilitation' in England and Wales, under a 2013 Ministry of Justice initiative. Reunification commenced in 2018. A study completed prior to these changes suggested that probation officers had had little training in recognising attention-deficit hyperactivity disorder (ADHD) and may have been underestimating its prevalence among their clientele. Given the substantial changes in probation staffing and organisation since 2018, a new study seems warranted. AIMS: The aim of the study was to understand experiences of people under a community sentence who reported having ADHD and of probation staff working with them. METHODS: Using a qualitative research design, one-to-one semi-structured interviews were conducted with client facing probation staff recruited from one Community Rehabilitation Company. Service users undertaking a community sentence who had been diagnosed with or self-identified as having ADHD were then identified and recruited by these staff; those who consented were also interviewed. Transcripts were analysed using a thematic analytic approach. RESULTS: Thirteen probation staff and six male offenders under community sentences, agreed to participate and completed interviews. The overarching themes emerging from the two groups were similar, both reflecting on descriptions of ADHD; treatment of ADHD; experiences of having or working with ADHD in the wider community and in the criminal justice system specifically and visions of future support needs tied to the order. In addition, probation officers specifically raised the matter of payment by results. Both service users and probation staff identified gaps in knowledge, experience and services, but areas of good practice were also identified. CONCLUSION: The findings highlight the continuing under-acknowledgement of tailored clinical support for people serving a community sentence who have ADHD together with a lack of support and training about ADHD for probation staff. Return to the national organisation of probation services and recognition of need for a range of relevant skills offers a great opportunity for re-evaluating supervision and management of offenders under community sentences who have ADHD. These findings provide the basis for a template for developing knowledge and support provision for probation staff to recognise ADHD, or its likelihood, and their capacity to follow through with appropriately informed personalised supervision plans and access to specialist service advice and support.

Developing textile sustainability education in the curriculum: pedagogical approaches to material innovation in fashion.

The textile industry needs to adopt environmentally sustainable approaches to address ecologically damaging practices. Whilst driven by initiatives such as Textiles 2030, it is current students who will carry this agenda forward. This project investigated pedagogical approaches to develop sustainable textiles for the fashion design curriculum. Pilot studies, using bacterial cellulose (BC) as a material for millinery, revealed members of the public were prepared to experiment with this novel material, and BC was compatible with traditional hat-making techniques. A further study challenged secondary school students, based on an experiential learning model, to grow their own BC biofilm, exploring this as a sustainable apparel fabric. Initial attitudes of reluctance developed into acceptance once engaged in the practical activity. This study illustrates that with appropriate communication and education strategies, the principles of sustainability in fashion, and the acceptability of novel materials, can be engendered in different audiences.

Hands on Biofilm! Utilizing a public audience in a citizen science project to assess yield variability when culturing kombucha pellicle.

The pellicle biofilm generated during the Kombucha tea fermentation process has, when dried, textile-like properties that may have real-life applications. However, pellicle yield can vary depending on inoculation and incubation conditions, which affects research investigations on the properties of the pellicle. To generate data on variability to help define optimum pellicle growth conditions, as part of a public engagement event about biofilm, a citizen science activity was hosted whereby visitors to a science festival were invited to select incubation conditions and inoculate different media with liquid or solid (pellicle). More than 220 samples were inoculated (in excess of 1200 visitors, mainly in family groups). The most popular incubation conditions were coconut water or tea medium, 30°C/room temperature and liquid inoculum. The most productive/reproducible in terms of yield and variability were tea medium, 30°C, and liquid inoculum, which reflect some of the conditions most used in the domestic setting for kombucha culture. The event provided both useful research data and generated public interest in a research area of which many will have been unaware. Interest in the results of the activity, available several weeks after the activity, was sustained using email contact and FlickR for the dissemination of images and data.

Hands On Biofilm! A multidisciplinary public engagement event using kombucha tea pellicle as an accessible example of biofilm.

Public engagement with science has become increasingly important for the scientific community. There are many documented public engagement events that focus on aspects of microbiology, but relatively few utilise biofilms as a topic, despite their importance. Kombucha tea pellicles are easy to grow biofilms, facilitating their use within the public domain as examples of these complex communities. The aim of this work was to deliver a public engagement event that introduced visitors to general concepts about biofilm, and applications around sustainability, using kombucha. The event encouraged visitors to: build a biofilm using model clay; inoculate kombucha tea cultures using different incubation conditions, as part of a citizen science experiment to assess impact on pellicle biofilm yield; create garments and drapes on mini-mannequins using dried kombucha pellicle fabric, and demonstrate the range and importance of fermented foods (including kombucha tea), and 'good bacteria'. Quantitative and qualitative indicators of engagement were built into the activities. More than 1200 visitors, mainly in family groups, visited the event over a 4-h period. Knowledge of biofilms was low at the beginning of the event. Participation in all activities was high. Indicators of quantitative engagement were impressive, but it was difficult to obtain qualitative evidence other than observations from the delivery team (nineteen members) because of the intensity of the event and volume of visitors. The event was clearly successful in terms of fulfilment of aims, audience engagement and enthusiasm: the embedded evaluations helped to evidence the impact and reach of the event, enabling confidence in dissemination of good practice in the enhancement of public understanding of the importance of biofilm in general, and kombucha in particular.

Reproducibility of Bacterial Cellulose Nanofibers Over Sub-Cultured Generations for the Development of Novel Textiles.

The textile industry is in crisis and under pressure to minimize the environmental impact on its practices. Bacterial cellulose (BC), a naturally occurring form of cellulose, displays properties superior to those of its cotton plant counterpart, such as enhanced purity, crystallinity, tensile strength, and water retention and is thus suitable for an array of textile applications. It is synthesized from a variety of microorganisms but is produced in most abundance by Komagataeibacter xylinus. K. xylinus is available as a type strain culture and exists in the microbial consortium commonly known as Kombucha. Whilst existing literature studies have described the effectiveness of both K. xylinus isolates and Kombucha in the production of BC, this study investigated the change in microbial communities across several generations of sub-culturing and the impact of these communities on BC yield. Using Kombucha and the single isolate strain K. xylinus as inocula in Hestrin and Schramm liquid growth media, BC pellicles were propagated. The resulting pellicles and residual liquid media were used to further inoculate fresh liquid media, and this process was repeated over three generations. For each generation, the thickness of the pellicles and their appearance under SEM were recorded. 16S rRNA sequencing was conducted on both pellicles and liquid media samples to assess changes in communities. The results indicated that the genus Komagataeibacter was the most abundant species in all samples. Cultures seeded with Kombucha yielded thicker cellulose pellicles than those seeded with K. xylinus, but all the pellicles had similar nanofibrillar structures, with a mix of liquid and pellicle inocula producing the best yield of BC after three generations of sub-culturing. Therefore, Kombucha starter cultures produce BC pellicles which are more reproducible across generations than those created from pure isolates of K. xylinus and could provide a reproducible sustainable model for generating textile materials.

Gang Members, Gang Affiliates, and Violent Men: Perpetration of Social Harms, Violence-Related Beliefs, Victim Types, and Locations.

Adult gang involvement attracts little empirical attention, so little is known about how they compare to nongang violent men in social harms beyond gang contexts. This study, based on unpublished data of 1,539 adult males, aged 19 to 34, from the Coid et al. national survey, compared gang members' (embedded in a gang; n = 108), affiliates' (less embedded in a gang; n = 119), and violent men's (no gang association; n = 1,312) perpetration of social harms by assessing their violence-related dispositions and beliefs, victim types, and locations of violence. Results showed that compared with violent men, gang members and affiliates were equally more likely to: cause social harms to a wider range of victims, including family and friends; seek violence; be excited by violence; and carry weapons. Gang members and affiliates were equally more likely than violent men to be violent at home, in friends' homes, and at work; they also thought about hurting people, but felt regret for some of their violence. A decreasing gradient was identified in gang members' (highest), affiliates' (next highest) and violent men's (lowest) beliefs in violent retaliation when disrespected, the use of violence instrumentally and when angry, and worry about being violently victimized. Implications of findings are that interventions need to address anger issues across all levels of adult gang membership. Importantly, adult gang members' regrets regarding violence and anxiety about being violently victimized could be key factors that interventions could use to help them relinquish their gang involvement.

Interpersonal violence in a deprived Scottish urban area with aggregations of physical health risks and psychiatric morbidity: an ecological study.

BACKGROUND: Glasgow, Scotland, has previously shown exceptional levels of violence among young men, shows aggregations of health conditions, with shortened life expectancy. Health conditions can be both causes and consequences of violence, of shared community-level socio-economic risk factors, and can result from large-scale social forces beyond the control of populations with high levels of violence. The aim of the study was to provide an in depth understanding of the Public Health problem of violence among young adult men in Glasgow East. METHOD: Ecological investigation of violence and its associations with health conditions in areas of contrasting socioeconomic deprivation. National survey of 1916 British men aged 18-34 years, augmented by a sub-sample of 765 men in Glasgow East (GE). Participants completed questionnaires covering current physical and sexual health, psychiatric symptoms, substance misuse, lifestyle, and crime and violence. RESULTS: The 5-year prevalence of violence was similar in both surveys but fights involving weapons (AOR 3.32, 95% CI 2.29-4.79), gang fights (AOR 2.30, 95% CI 1.77-2.98), and instrumental violence supporting criminal lifestyles were more common in GE, where 1 in 9 men had been in prison. Violent men in both samples reported poorer physical and sexual health and all types of psychiatric morbidity except depression, with multiple high-risk behaviours for both future poor health and violence. Associations between drug and alcohol dependence and violence in GE could not be entirely explained by deprivation. CONCLUSION: Violence in deprived urban areas is one among many high-risk behaviours and lifestyle factors leading to, as well as resulting from, aggregations of both psychiatric and physical health conditions. Poverty partly explained raised levels of violence in GE. Other factors such as drug and alcohol misuse and macho attitudes to violence, highly prevalent among men in this socially excluded community, also contributed. Multi-component preventive interventions may be needed in deprived areas and require future investigations into how multiple co-existing risk factors produce multimorbidity, including psychiatric disorders, substance misuse, poor physical health and violence.

Comparison of Emotional Dispositions Between Street Gang and Non-Gang Prisoners.

Effectively recognizing, identifying, and utilizing emotional stimuli is essential for successful social interactions, with deficits in these robustly identified as risk factors for offending. Psychological understanding of street gang membership is limited, particularly surrounding emotional dispositions distinguishing street gang from non-gang offenders. This study examined how street gang members compare with non-gang offenders on trait emotional intelligence (TEI), antisocial personality disorder (ASPD), callous-unemotional traits, anger rumination, and aggression. Recruited through volunteer sampling, participants included 73 (44 street gang and 29 non-gang) male offenders incarcerated at a U.K. Category C prison. Participants completed seven questionnaires assessing emotional dispositions, social desirability, and, consistent with the Eurogang definition, street gang membership. To compare participants' demographics and identify the predictors of street gang membership, chi-square and discriminant function analyses were conducted. With a significant discriminant function, Λ = .80, χ2(6) = 14.96, p = .021, high levels of ASPD, anger rumination, and aggression and low levels of TEI predict street gang membership. Compared with non-gang prisoners, street gang prisoners did not differ on callous-unemotional traits, age, or ethnicity. Results suggest that, compared with non-gang prisoners, street gang members were more likely to possess dysfunctional emotional dispositions. Findings from this research have important implications in terms of developing interventions for street gang membership. Specifically, this research supports the need for gang-specific early intervention and prevention programs, with emotion-focused components. Ideas for future research are discussed, including the identification of further sociocognitive, personality, and emotional traits distinguishing street gang from non-gang offenders.

Gang membership and sexual violence: associations with childhood maltreatment and psychiatric morbidity.

BACKGROUND: Gang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs. AIMS: To investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members. METHOD: Cross-sectional survey of 4665 men 18-34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments. RESULTS: Antisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour. CONCLUSIONS: Gang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions.

Effectiveness and Efficiency of Persuasive Space Graphics (PSG) in Motivating UK Primary School Children's Hand Hygiene.

Good hand hygiene is necessary to control and prevent infections, but many children do not adequately wash their hands. While there are classroom communications targeted at children, the toilet space, the location of many hand hygiene activities, is neglected. This paper describes an initial evaluation of "123" persuasive space graphics (images and messages integrated within an architectural environment that encourage specific actions). The effectiveness (whether hand hygiene improves) and efficiency (the ease with which a setting can adopt and implement an intervention) is evaluated in three UK schools and one museum. Five evaluations (participant demographic, handwashing frequency, handwashing quality, design persuasiveness, stakeholder views) were conducted. In the school settings, persuasive space graphics increased the quality and frequency of handwashing. In the museum setting, frequency of handwashing slightly increased. In all settings children found the graphics persuasive, and stakeholders also believed them to be effective. Stakeholders considered persuasive space graphics a low-cost and time-efficient way to communicate. It can be concluded that persuasive space graphics are effective in increasing hand hygiene, particularly in school settings where children have a longer exposure to the graphics. Persuasive space graphics are also an efficient low-cost means of communicating hand hygiene.

Team-based suicide prevention: lessons learned from early adopters of collaborative care.

Suicide prevention in clinical settings requires coordination among multiple clinicians with expertise in different disciplines. We aimed to understand the benefits and challenges of a team approach to suicide prevention in primary care, with a particular focus on Veterans. The Veterans Health Administration has both a vested interest in preventing suicide and it has rapidly and systematically adopted team-based approaches for primary care interventions, including suicide prevention. We conducted eight focus groups and eight in-depth interviews with primary care providers (PCPs), behavioral health providers and nurses located in six regions within one Veterans Administration Catchment Area in the northeast of the US. Transcripts were analyzed using simultaneous deductive and inductive content analysis. Findings revealed that different clinicians were thought to have particular expertise and roles. Nurses were recognized as being well positioned to identify subtle changes in patient behavior that could put patients at risk for suicide; behavioral health providers were recognized for their skill in suicide risk assessment; and PCPs were felt to be an integral conduit between needed services and treatment. Our findings suggest that clinician role-differentiation may be an important by-product of team-based suicide prevention efforts in VHA settings. We contextualize our findings within both a processual and relational interprofessional framework and discuss implications for the implementation of team-based suicide prevention.

"I Despise Myself for Thinking about Them." A Thematic Analysis of the Mental Health Implications and Employed Coping Mechanisms of Self-Reported Non-Offending Minor Attracted Persons.

'Non-offending pedophiles' or 'minor attracted persons' are individuals who suppress an attraction to children. Previous analyses of this population's mental illness employed overt self-report methods, limited by social desirability. Additionally, studies assessing the coping mechanisms employed to remain offense-free are underpowered; understanding of these would facilitate the rehabilitation of prior offenders. A thematic analysis of coping mechanisms and mental illness was conducted on 5,210 posts on the 'Virtuous Pedophiles' forum. Four themes emerged for coping mechanisms: Managing risk and attraction to children, Managing mood, Managing preferences prosocially and Friends, family and relationships, with 13 subthemes. Five themes emerged for mental ill-health, including: Addiction, Anxiety, Depression, Self-hatred/Self-harm/Suicide and Other. Self-hatred/Self-harm/Suicide accounted for almost a third of discussed mental ill-health. These results highlight the severity of mental ill-health amongst this population and the coping mechanisms employed to remain offense-free.

Bioinspiration in Fashion-A Review.

This paper provides an overview of the main technologies currently being investigated in the textile industry as alternatives to contemporary fashion fabrics. The present status of the textile industry and its impact on the environment is discussed, and the key drivers for change are highlighted. Historical use of bioinspiration in synthetic textiles is evaluated, with the impact of these developments on the fashion and apparel industries described. The review then discusses the move to nature as a supplier of new fabric sources with several alternatives explored, drawing special attention to the sustainability and performance aspects of these new sources.

Differentiating Gang Members, Gang Affiliates, and Violent Men on Their Psychiatric Morbidity and Traumatic Experiences.

OBJECTIVE: Little is known about the differences between gang members and gang affiliates-or those individuals who associate with gangs but are not gang members. Even less is known about how these groups compare with other violent populations. This study examined how gang members, gang affiliates, and violent men compare on mental health symptoms and traumatic experiences. METHOD: Data included a sample of 1,539 adult males, aged 19 to 34 years, taken from an earlier survey conducted in the United Kingdom. Participants provided informed consent before completing questionnaires and were paid £5 for participation. Logistic regression analyses were conducted to compare participants' symptoms of psychiatric morbidity and traumatic event exposure. RESULTS: Findings showed that, compared to violent men and gang affiliates, gang members had experienced more severe violence, sexual assaults, and suffered more serious/life-threatening injuries. Compared to violent men, gang members and gang affiliates had made more suicide attempts; had self-harmed more frequently; and had experienced more domestic violence, violence at work, homelessness, stalking, and bankruptcy. Findings further showed a decreasing gradient from gang members to gang affiliates to violent men in symptom levels of anxiety, antisocial personality disorder, pathological gambling, stalking others, and drug and/or alcohol dependence. Depression symptoms were similar across groups. CONCLUSIONS: The identified relationship between gang membership, affiliation, and adverse mental health indicates that mental health in gang membership deserves more research attention. Findings also indicate that criminal justice strategies need to consider gang members' mental health more fully, if gang membership is to be appropriately addressed and reduced.

Gang Membership: Links to Violence Exposure, Paranoia, PTSD, Anxiety, and Forced Control of Behavior in Prison.

OBJECTIVE: Gang membership inherently links to violence, and violent experiences strongly relate to posttraumatic stress disorder (PTSD), anxiety, and paranoia. Yet to date, gang members' mental health has received little attention, and their paranoia has not been examined. This study, using established measures, assessed street gang and nongang prisoners' levels of violence exposure, symptoms of PTSD, paranoia, and anxiety, forced behavioral control, and segregation in prison. METHOD: Participants were 65 (32 gang and 33 nongang) prisoners, recruited using opportunity sampling. Participants provided informed consent and were interviewed individually. Interviews were anonymized to maintain confidentiality. Chi-square and discriminant function analyses were used to compare participants' demographics, segregation levels, mental health symptoms, and to identify predictors of street gang membership. RESULTS: As compared to nongang prisoners, street gang prisoners have higher levels of exposure to violence, symptoms of paranoia, PTSD, anxiety, and forced control of their behavior in prison. Street gang prisoners were not more likely to be segregated, but they were more likely to belong to ethnic minorities. Street gang prisoners were only found to be younger than nongang prisoners, when other variables were controlled for. CONCLUSIONS: Mental health deserves more attention in gang research. The implications of findings are that gang membership may undermine members' mental health, and/or that individuals with existing mental health problems may be those attracted to gang membership. Moreover, justice responses, via policies and intervention strategies, need to identify and address the mental health needs in gang member prisoners, if successful rehabilitation of gang members is to be achieved.

Support for the predictive validity of the multifactor offender readiness model (MORM): forensic patients' readiness and engagement with therapeutic groups.

BACKGROUND: Treatment non-engagement in forensic health settings has ethical and economic implications. The multifactor offender readiness model (MORM) provides a framework for assessing treatment readiness across person, programme and contexts. AIMS: To answer the following question: Are the internal factors of the MORM associated with likelihood of engagement in groups by patients in forensic mental health services? METHOD: In a retrospective design, associations were investigated between internal factors of the MORM, measured as part of assessment for group participation, and the outcomes of treatment refusal, treatment dropout and treatment completion. RESULTS: One hundred and eighteen male patients in a high security hospital consecutively referred for group treatment agreed to participate. Internal factors of the MORM associated with treatment refusals included: psychopathic cognition, negative self-evaluation/affect and effective goal-seeking strategies. Those associated with dropouts included emotional dysregulation, low competencies to engage and low levels of general distress. MORM factors associated with completion included: low motivation, ineffective goal-seeking strategies, absence of psychopathic cognition, high levels of general distress and competency to engage. CONCLUSIONS: Internal factors of the MORM could be useful contributors to decisions about treatment readiness for hospitalised male offender-patients. Up to one in three programmes offered were refused, so clinical use of the MORM to aid referral decisions could optimise the most constructive use of resources for every individual. Copyright © 2016 John Wiley & Sons, Ltd.

Opportunities for Academic Pathology: The Thoughts and Perspectives of a Legal Observer.

As American health care undergoes great change, academic pathology is uniquely positioned to establish pathologists as key to the new health-care environment. Pathologists are at the forefront of major innovations in health care and are specialists who interact with all other medical specialists and essentially the entire range of health-care services. Academic pathologists benefit from being subspecialist experts who provide care to patients referred from large geographic areas, who can attain high academic stature over the course of their careers, and who serve as mentors for learners across virtually all medical specialties. Academic medical centers, in turn, have excellent credibility in the community, strong information technology infrastructure with the ability for data accrual and analysis not available in community health-care settings, and strong liaisons with civic authorities and policy makers. However, pathologists have to overcome their own tendencies toward modesty and lack of assertiveness, in order to help counter the significant trends in the health-care marketplace that disempower health-care providers and place health industry decision-making in the hands of nonmedical stakeholders. Specifically, academic pathologists need to proactively play a major role in institutional efforts to improve performance in quality, patient safety, efficiency, and coordinated care delivery and become leaders in the delivery of effective and efficient patient care. They need to play an essential role in utilization management, including molecular testing. They need to develop their value propositions for payers and seek to gain access to payers in order to represent these value statements. They should gain visibility directly to patients seeking expertise for second opinions and pursue opportunities for outreach programs in the community well beyond the academic medical center. Absent such efforts by academic pathologists, pathology is at risk of continued commoditization by nonpathologists, with weakening of the value proposition that pathology might bring forward.

High failure rates of the Spectron EF stem at a minimum of 10 year's follow-up.

We prospectively followed 112 hips, undergoing THA with a Spectron EF stem. At mean follow-up of 11.2years, 21 patients had died. We obtained radiological follow-up in 99% and clinical follow-up in 100% of the surviving 91 hips. Fifty-four percent demonstrated osteolysis in at least one Gruen zone. Twenty-two hips required revision for all causes, with a further five stems radiologically loose. With endpoint being stem revision for aseptic loosening or radiological failure, survivorship at 11years was 0.783. We believe the addition of a rougher surface finish has contributed to the high levels of osteolysis and stem failure seen with the Spectron EF.