Interagency training to support the liaison and diversion agenda

Background In England and Wales there are an unacceptably large number of people in prison or in contact with the criminal justice system who have mental health issues. Integrated and effective interagency collaboration is required between the criminal justice system and mental health services to ensure early diagnosis, treatment, appropriate sentencing or diversion of these individuals from the criminal justice systems into mental health services. Liaison and diversion schemes are proposed as a means to integrated service provision through positioning mental health professionals within the criminal justice system. These schemes were recommended by the Bradley Report (2009) to be rolled out for all police custody suites and courts by 2014 in a National Diversion Programme. Working within these schemes, at the interface of the criminal justice system and mental health services, has its challenges (Hean et al., 2009) and the workforce from both systems must be prepared to address these. This was recognised by Bradley when he recommended that: “where appropriate, training should be undertaken jointly with other services to encourage shared understanding and partnership working. Development of training should take place in conjunction with local liaison and diversion services (p111; Bradley, 2009). The form this joint training should take is as yet unexplored. We have proposed elsewhere that joint training should equip different agencies and professionals with the skills and knowledge required to collaborate effectively, and not only focus on mental health awareness courses for those in police, prison and courts services (Hean et al. 2011). The criminal justice system and mental health services need to come together to learn about, from, and with each other in interagency training. Aim We present in this report our vision of what this joint interagency training between the criminal justice and mental health services should contain, how it may be delivered and its potential benefits. We explore the receptiveness of professionals from the criminal justice and mental health services to interagency training and explore their perceptions of the challenges to interagency working between the two systems. We focus particularly on one particular dimension: an interagency crossing boundary workshop and its theoretical underpinnings. We explore professionals’ expectations of this type of intervention as well as their perceptions of the knowledge and skills required to deliver the emerging liaison and diversion agenda in general and the content and delivery of interagency training in the future. These findings are synthesized into a series of recommendations and a model of interagency training that will prepare professionals in both agencies to respond to the liaison and diversion agenda more effectively and work collaboratively in the interest of the mentally ill offender. Method A crossing boundary workshop (Engeström, 2001) was delivered in December 2011 to a sample of 52 professionals from a range of non-health professionals associated with criminal justice system (probation, police and courts) and professionals from the mental health system or health domain (learning disability, substance misuse and mental health services). The receptiveness of criminal justice system and mental health service professionals to interagency training was assessed through the Readiness for Interprofessional Learning Scale (Reid et al., 2005) administered to respondents before the workshop. Perceptions of the challenges facing interagency working and the expectations of the workshop were explored through interactive exercises. Professionals from both agencies participated in a series of 6 parallel focus groups to discuss how to prepare the workforce to respond effectively to the liaison/diversion agenda and the constraints they worked under in terms of commissioning, delivering and attending this training. Findings Professionals from both the mental health and criminal justice systems need to build empathic relationships with staff from other agencies. They stressed the importance of actual face-to-face contact between professionals from different agencies to achieve this and saw interagency relationships as being built through increased knowledge of other agencies and the orchestrating of formal facilitated contact between them. They were strongly in favour of interagency training and its contribution to enhanced collaborative competence across the workforce and, in the long term, improved offender mental health. They believed interagency training would develop in the workforce a greater knowledge of other agencies and help them understand other professionals’ roles and responsibilities. They believed interagency training should occur pre-qualification, through into continued professional development and contain a variety of interagency training experiences. Professionals from both systems shared a high level of person centredness in their approach to their practice and stressed the importance of training being grounded and delivered in a real world environment. Participants acknowledged that training opportunities are under threat due to financial and time limitations and that joint commissioning, shared resources and economies of scale must be considered. Recommendations • A training package should be developed to prepare professionals both from the mental health and criminal justice system for the liaison and diversion agenda and integrated service provision. This training must offer a strong interagency component aimed at developing interagency collaboration skills and interagency knowledge. A four-stage training model is proposed in this report. This incorporates pre-registration or undergraduate training for trainee professionals in the mental health services and criminal justice system, general awareness training, interagency training for continuing professional development and the development of interagency reflective practice opportunities. This model may be supplemented by a variety of on-line resources, some of which are described. • These interagency training models should be developed in partnership between universities and local facilitators from within the criminal justice system and mental health services to provide both the theoretical and evidence based rigour associated with developing collaborative practice curricula alongside the real world contextual knowledge required of these programmes. • In the long term, interagency training should be delivered in practice by practitioners to ensure the continued validity and sustainability of these programmes. Training should be sensitive to changes in the workforce due to turnover and the pressures of organisational change. • In times of economic constraint, training should be well targeted at staff and organisations essential to the liaison and diversion agenda. • An interagency commissioning approach will be required to deliver the training package outlined to support the liaison and diversion agenda, and especially if there is to be joint training and sharing of resources

Improving collaborative practice to address offender mental health: criminal justice and mental health service professionals’ attitudes towards interagency training, current training needs and constraints,

Background Professionals from the mental health and criminal justice system must collaborative effectively to address offender mental health but interprofessional training is lacking. Pedagogical frameworks are required to support the development of training in this new area. Aim To inform this framework this paper explores the readiness of professionals towards interprofessional training and demographic differences in these. It explores expectations of interprofessional training, perceived obstacles to collaborative working, interprofessional training needs and challenges facing delivery. Method A concurrent mixed methods approach collected data from professionals attending a crossing boundaries interprofessional workshop. Data was collected through a combination of the RIPLS questionnaire (n=52), free text questions (n=52) and focus groups (n=6). Findings and Conclusions Mental health and criminal justice professionals’ attitudes towards interprofessional learning were positive (x=17.81; n=43). They did not see their own service as insular (x =4.02; n=44) and reported strong person centredness (x= 6.07; n=43). This suggests professionals are open to the introduction and implementation of future interprofessional training. There were no significant demographic differences in these attitudes. Professionals raised a range of generic curriculum and educator mechanisms in the development of future interprofessional training suggesting the transfer of pedagogical frameworks from established interprofessional programmes into this new arena is feasible. Context specific factors such offender national policy agendas and the challenges of user involvement using mentally ill offenders must be taken into account. Greater clarity on multi versus interprofessional training is still required with this group of professionals. Key words: mental health, offenders, criminal justice, interprofessional training

Rhizobacteria Impact Colonization of Listeria monocytogenes on Arabidopsis thaliana Roots

In spite of its relevance as a foodborne pathogen, we have limited knowledge about Listeria monocytogenes in the environment. L. monocytogenes outbreaks have been linked to fruits and vegetables; thus, a better understanding of the factors influencing its ability to colonize plants is important. We tested how environmental factors and other soil- and plant-associated bacteria influenced L. monocytogenes\u27 ability to colonize plant roots using Arabidopsis thaliana seedlings in a hydroponic growth system. We determined that the successful root colonization of L. monocytogenes 10403S was modestly but significantly enhanced by the bacterium being pregrown at higher temperatures, and this effect was independent of the biofilm and virulence regulator PrfA. We tested 14 rhizosphere-derived bacteria for their impact on L. monocytogenes 10403S, identifying one that enhanced and 10 that inhibited the association of 10403S with plant roots. We also characterized the outcomes of these interactions under both coinoculation and invasion conditions. We characterized the physical requirements of five of these rhizobacteria to impact the association of L. monocytogenes 10403S with roots, visualizing one of these interactions by microscopy. Furthermore, we determined that two rhizobacteria (one an inhibitor, the other an enhancer of 10403S root association) were able to similarly impact 10 different L. monocytogenes strains, indicating that the effects of these rhizobacteria on L. monocytogenes are not strain specific. Taken together, our results advance our understanding of the parameters that affect L. monocytogenes plant root colonization, knowledge that may enable us to deter its association with and, thus, downstream contamination of, food crops. IMPORTANCE Listeria monocytogenes is ubiquitous in the environment, being found in or on soil, water, plants, and wildlife. However, little is known about the requirements for L. monocytogenes\u27 existence in these settings. Recent L. monocytogenes outbreaks have been associated with contaminated produce; thus, we used a plant colonization model to investigate factors that alter L. monocytogenes\u27 ability to colonize plant roots. We show that L. monocytogenes colonization of roots was enhanced when grown at higher temperatures prior to inoculation but did not require a known regulator of virulence and biofilm formation. Additionally, we identified several rhizobacteria that altered the ability of 11 different strains of L. monocytogenes to colonize plant roots. Understanding the factors that impact L. monocytogenes physiology and growth will be crucial for finding mechanisms (whether chemical or microbial) that enable its removal from plant surfaces to reduce L. monocytogenes contamination of produce and eliminate foodborne illness

Corn Germ as a Source of Supplemental Fat for Cows in late Gestation

To evaluate corn germ as a source of supplemental fat, 217 two to twelve-year-old cows receiving grass hay free choice were supplemented with either 2.75 lb of corn germ (dry basis) or an equal amount of crude protein from soybean meal (0.80 lb dry matter) starting approximately 50 days prior to the first expected calving. Cows were removed from treatment the day they calved and where managed as a group through the breeding season. Supplement treatment did not affect cow weight change or body condition score. Corn germ did not improve any measure of reproduction, including the percentage of cows cycling or conceiving in the first 21 days of the breeding season or the days from calving to the onset of cyclicity or conception. Calf performance, calf health or indicators of colostrum absorption (total serum protein or IgG) were not influenced by supplement treatment. The results were similar whether all age groups were included in the analysis or when only data for the two and three year old cows were included in the data set. Under the conditions of this study there was no advantage to feeding a source of supplemental fat from corn germ during late gestation

Effects of an Anabolic Implant and Transport on Metabolic Status and Muscle Traits of Feedlot Steers

A study was repeated over 2 years to determine the effect of feeding different levels of dry distillers grains with solubles (DDGS) and wet distillers grains with solubles (WDGS) on the performance of finishing cattle. In each year, 120 steers (756 ± 22 lb) were weighed, and randomly allocated to 15 pens. The pens were then assigned to one of five treatments: 1) corn-soybean meal (CON); 2) 20% DDGS; 3) 20% WDGS; 4) 40% DDGS; or 5) 40% WDGS. The basal diet consisted of 10% alfalfa hay, 4% molasses, 2% supplement, 10.5% SBM and 73.5% cracked corn. The WDGS and DDGS were added to replace all the SBM and part of the cracked corn. Steers were fed these diets for 138 and 129 days in years 1 and 2, respectively. Body weight was recorded prior to feeding at the start of the trial and every 28 days. Steers were harvested at a commercial facility and carcass data were collected. No treatment x year interactions occurred, thus data were pooled over the 2 years. There was an interaction between wet vs. dry and 20% vs. 40% distillers grains with solubles (DGS) for cumulative DMI. Steers fed 20% and 40% DDGS had the highest DMI, but feeding 40% WDGS significantly depressed (P \u3c 0.01) DMI. Cumulative ADG was similar across all treatments; however, steers fed 40% DGS had greater G:F (P \u3c 0.05) than those fed 20% DGS, and those fed WDGS were more efficient (P \u3c 0.01) than those fed DDGS. Pooled carcass data showed that steers fed DGS had greater (P \u3c 0.01) 12th rib fat compared to CON resulting in steers fed DGS having greater (P \u3c 0.05) Yield Grades compared to CON steers. Steers fed 20% DDGS and 20% WDGS had numerically higher (P \u3c 0.05) marbling scores compared to steers fed CON, 40% DDGS and 40% WDGS. Hot carcass weight, ribeye area, and percent kidney, pelvic, and heart fat were similar across all treatments. In conclusion, feeding DDGS and WDGS at 20 and 40% of the diet DM can be used to replace SBM in finishing diets to achieve similar gains and efficiencies. However, Yield Grades were greater for steers fed DGS compared to those fed the corn-soybean meal diet

Neuromuscular Performance Changes Throughout the Menstrual Cycle in Physically Active Females

OBJECTIVES: To determine changes in neuromuscular performance throughout the menstrual cycle in females aged 18-25. METHODS: Fifty physically active college females (25 on oral contraceptives (OC)) were recruited to participate. Data collection visits coincided with early-follicular (Fp), ovulatory (Op), and the mid-luteal (Lp) phases. Isokinetic peak torque at the knee (IPT) was measured at 60°/sec, 180°/sec, and 300°/sec. Grip force was measured using a handheld dynamometer. Plasma estradiol and progesterone confirmed menstrual cycle and serum relaxin was screened as a potential covariate. RESULTS: Grip strength was lower during Fp (30.1±0.7kg) than during Op (31.5±0.7 kg, p=0.003) and Lp (32.6±0.7 kg, p CONCLUSIONS: Results indicate that muscular performance is diminished during Fp and the lack of group-by-phase interaction indicates that this effect is not hormone-related. These data indicate that females may be at a greater risk of injury due to decreased strength during Fp than other phases of their cycle

Identification of Genes Associated with Water Restriction Expressed in the Renal Cortex and Hypothalamus in Cattle

The short-term objective of this study is to discover genes associated with water restriction expressed in the renal cortex and hypothalamus in beef calves. The long-term goal is to understand genes and pathways important for thirst response in cattle. This knowledge may lead to discovery of genetic variants associated with water intake. Identification of animals with genetic potential to grow and thrive under drought conditions would be an asset to beef producers and communities which rely on beef production for a large part of their livelihoods. Both selected tissue types are known to be involved in response to hypertonicity (e.g., water restriction or dehydration)

Impact of Dietary Resistant Starch Type 4 on Human Gut Microbiota and Immunometabolic Functions

Dietary modulation of the gut microbiota impacts human health. Here we investigated the hitherto unknown effects of resistant starch type 4 (RS4) enriched diet on gut microbiota composition and short-chain fatty acid (SCFA) concentrations in parallel with host immunometabolic functions in twenty individuals with signs of metabolic syndrome (MetS). Cholesterols, fasting glucose, glycosylated haemoglobin, and proinflammatory markers in the blood as well as waist circumference and % body fat were lower post intervention in the RS4 group compared with the control group. 16S-rRNA gene sequencing revealed a differential abundance of 71 bacterial operational taxonomic units, including the enrichment of three Bacteroides species and one each of Parabacteroides, Oscillospira, Blautia, Ruminococcus, Eubacterium, and Christensenella species in the RS4 group. Gas chromatography-mass spectrometry revealed higher faecal SCFAs, including butyrate, propionate, valerate, isovalerate, and hexanoate after RS4-intake. Bivariate analyses showed RS4-specific associations of the gut microbiota with the host metabolic functions and SCFA levels. Here we show that dietary RS4 induced changes in the gut microbiota are linked to its biological activity in individuals with signs of MetS. These findings have potential implications for dietary guidelines in metabolic health management

Effect of Human Disturbance on Small Mammal Communities in Itasca State Park, Minnesota

We determined effects of different levels of human disturbance on small mammal richness and relative abundance from live-trapping data obtained in Itasca State Park in northwestern Minnesota. We developed a quantitative measure of human disturbance based on disturbance units and trapped small mammals on three study sites, each reflecting a different level of disturbance. Our data revealed that small mammal diversity decreased with increasing human disturbance. Amount of ground cover and litter depth also appeared to be important in explaining differences in the demographic patterns of small mammals among sites

Intravenous Ghrelin Infusion Affects Plasma Growth Hormone Concentrations, Dry Matter Disappearance, and Length of Time Spent Feeding

Six steers (915 ± 37.8 kg) were used in a crossover design to determine the effects of intravenous infusion of bovine ghrelin (BGR) on plasma growth hormone (GH) concentrations, length of time spent feeding, and dry matter disappearance per unit of metabolic weight. Steers were fed individually once daily (0800 h) and allowed to consume ad libitum until 2000 h when feed was removed. Daily feed allotment was sufficient to result in ≥ 10% feed refusal. Serial blood samples were collected from steers fitted with an indwelling jugular catheter at 15-min intervals from 0600 h through 1800 h. Harvested plasma was assayed for ghrelin and GH concentrations. Saline (SAL) or BGR was infused via jugular catheter at 1200 h and 1400 h. Treatment infusion times were selected on the basis of the observation that steers did not consistently feed at these times. Exogenous BGR was infused to achieve a plasma concentration of 1000 pg/mL. This dosage was chosen on the basis of previous research that indicated a peak ghrelin concentration of 1000 pg/mL for fasting steers. Steers were allowed 5 d to adjust between treatment periods and then treatments were switched between steer groups and the sampling period repeated. Compared to SAL steers, average plasma ghrelin concentration was elevated (P ≤ 0.0001) at the first post-infusion sampling for BGR steers at both infusion. Bovine ghrelin infusion resulted in elevated (P ≤ 0.005) plasma GH concentrations compared to SAL steers after the first infusion. The second infusion of BGR resulted in numerically higher GH concentrations, but this difference was not statistically different from SAL steers or baseline concentrations. Both plasma ghrelin and GH concentrations returned to baseline 30 min post-BGR infusion. Length of time spent feeding (P = 0.03) and dry matter disappearance per unit of metabolic body weight (P = 0.05) for the combined infusion times were increased for steers infused with BGR. Bovine ghrelin is a compound that has the potential to elevate plasma GH concentrations and to increase length of time spent feeding and dry matter disappearance per unit of metabolic body weight