Providing substance use disorder treatment in correctional settings: knowledge gaps and proposed research priorities-overview and commentary.

This manuscript is the product of the authors' discussions, literature overview, and consultation with experts in the field, and identifies important gaps in the evidence base for substance use disorder (SUD) treatment effectiveness within criminal justice (CJ) settings. Lacking from the extant literature are longitudinal investigations of treatment related outcomes during and after incarceration. Such studies could provide rich contextual data about treatment delivery and effectiveness across the CJ continuum, and would provide important insight into individual characteristics (e.g., motivation, treatment modality preferences, treatment completion rates, etc.) as well as institutional and environmental factors (e.g., appropriate staffing, space limitations for individual treatment sessions, distribution of medications, etc.). We also identified the importance of reproducibility within CJ research, and the unfortunate reality of too many single studies conducted in single (or relatively few) correctional facilities. Some of this has been because the studies designed to produce that evidence are not prioritized for funding, which has continually placed researchers in a position where we cannot make firm conclusions or recommendations based on available evidence. The importance of replicating the foundational studies in this field cannot be overstated. We hope this article spurs other researchers to join in the healthy process of questioning the existing state of the CJ-based SUD treatment research, what should be re-examined, and how we can lay a stronger foundation for the future.

Designed to Do Good: Key Findings on the Development and Operation of First Responder Deflection Programs.

Opioids and drug overdoses have claimed more than 750 000 American lives since the late 1990s. Overdoses since the mid-2010s have risen dramatically, due to synthetic opioids such as fentanyl whose lethality is disproportionately greater than street drugs of earlier decades. Until recently, most police and other first responders lacked resources beyond arrest to respond to overdoses and other nonviolent crimes. Largely in response to the opioid crisis and synthetic opioid-related overdoses, first responder deflection (FRD) has emerged as an alternative. First responder deflection has enabled first responders across the United States to save lives by training them to administer naloxone, a medication that blocks opioid receptors after overdose, then linking these individuals to community-based treatment and services. Consequently, FRD has helped keep many citizens out of the justice system entirely, giving them a chance to rebuild their lives and become productive members of their communities. To this end, TASC's Center for Health and Justice and National Opinion Research Center at The University of Chicago collaborated on a national FRD survey encompassing a comprehensive overview of the field and its role in responding to the opioid crisis. The findings reveal how FRD offers alternatives to traditional policing, including its role in advancing racial and social equity by aligning public health and public safety for those who otherwise might enter the justice system. This article will discuss the methodology, key findings, and policy implications of this national survey (encompassing more than 300 active FRD programs). We will present results on the development of FRDs and how they operate. Results will cover the extensive involvement of law enforcement agencies in initiating FRD initiatives; the role of non-first responder partners in providing treatment and services through FRD; and the scope of Medication-Assisted Treatment in these programs, among other important findings.

Naloxone Plus, Plus Some: Examining Ohio's Quick Response Teams Through the Lens of Deflection.

There were nearly 50 000 opioid-related deaths in 2019 in the United States.* The dramatic frequency of opioid overdoses and fatalities has led to strained community resources, especially among hospitals and first responders (law enforcement, fire, and emergency medical services). In response to rising overdose rates, many first responders have implemented programs that align public health and public safety responses to overdoses. Often called "Quick Response Teams" (QRTs), these programs leverage a collaborative team to respond to those at risk of overdose, or who have survived an overdose. The initial QRT was implemented in Colerain Township, Ohio, in 2015.† Today, QRTs are a widely accepted "model" overdose response program.‡ Despite the popularity of QRTs, research on the model is limited. In this article, the authors use existing qualitative and quantitative data from QRTs across the state of Ohio to examine QRTs. Using the lens of the Police, Treatment and Community Collaborative's 5 deflection pathways, the authors answer four key questions: (1) What is the scale of QRTs in Ohio, and how are QRTs in our sample structured? (2) Whom are the QRTs serving? (3) How many pathways of deflection are reflected in Ohio's QRTs? (4) What can these data teach us about the context of the QRT work and (more generally) collaborative overdose response? After examining the QRTs and their data, the authors provide suggestions to help researchers, practitioners, and funders better understand QRTs and similar public health/public safety partnerships.

Household Rituals and Merchant Caravanners: The Phenomenon of Early Bronze Age Donkey Burials from Tell es-Sâfi/Gath, Israel.

Most studies of ritual and symbolism in early complex societies of the Near East have focused on elite and/or public behavioural domains. However, the vast bulk of the population would not have been able to fully participate in such public displays. This paper explores the zooarchaeological and associated archaeological evidence for household rituals in lower-stratum residences in the Early Bronze Age (EB) of the southern Levant. Data from the EB III (c. 2850-2550 BCE) deposits excavated at the site of Tell es-Sâfi/Gath, Israel, are illustrative of the difficulty in identifying the nature of household rituals. An integrated analytical approach to the architecture, figurines, foundation deposits, and domestic donkey burials found in lower-stratum domestic residences provides insights into the nature of household rituals. This integrated contextual perspective allows the sacred and symbolic role(s) of each to be understood and their importance for EB urban society to be evaluated.

Fingerprint evidence for the division of labour and learning pottery-making at Early Bronze Age Tell es-Sâfi/Gath, Israel.

The organization of craft production has long been a marker for broader social, economic and political changes that accompanied urbanism. The identity of producers who comprised production groups, communities, or workshops is out of reach using conventional archaeological data. There has been some success using epidermal prints on artefacts to identify the age and sex of producers. However, forensic research indicates that a combination of ridge breadth and ridge density would best identify the age and sex of individuals. To this end, we combine mean ridge breadth (MRB) and mean ridge density (MRD) to distinguish the age and sex of 112 fingerprints on Early Bronze Age (EB) III pottery from the early urban neighbourhood at Tell es-Sâfi/Gath, Israel, dating to a 100 year time span. Our analysis accounts for the shrinkage of calcareous fabrics used to make six type of vessels, applies a modified version of the Kamp et al. regression equation to the MRB for each individual print, and infers sex by correlating MRD data to appropriate modern reference populations. When the results are combined, our analyses indicate that most fingerprints were made by adult and young males and the remainder by adult and young females. Children's prints are in evidence but only occur on handles. Multiple prints of different age and sex on the same vessels suggest they were impressed during the training of young potters. Production appears dominated by adult and young males working alone, together, and in cooperation with adult and/or young females. Vessels with prints exclusively by females of any age are rare. This male dominant cooperative labour pattern contrasts recent studies showing that adult women primarily made Neolithic figurines in Anatolia, and more females than males were making pottery prior to the rise of city-states in northern Mesopotamia.

Results of a randomized, double-blind, vehicle-controlled efficacy trial of pimecrolimus cream 1% for the treatment of moderate to severe facial seborrheic dermatitis.

BACKGROUND: Seborrheic dermatitis is commonly treated with anti-inflammatory products, including topical corticosteroids. Pimecrolimus cream 1% also exerts anti-inflammatory activity by inhibiting T-cell cytokine production. OBJECTIVE: We sought to compare the efficacy and safety of twice-daily pimecrolimus for treatment of moderate to severe facial seborrheic dermatitis. METHODS: This double-blind, vehicle-controlled, 4-week trial randomized patients with seborrheic dermatitis to pimecrolimus or vehicle (1:1). Clinical assessments (erythema [0-3] and scaling [0-3] combined for a total area score [0-6]) were performed at weeks 0, 2, and 4. Inclusion criteria included total area score 4 or greater and erythema 2 or greater. The prespecified primary variable, change from baseline in total area score at week 4, was analyzed using a two-sample t test for intent-to-treat and per protocol populations. RESULTS: In all, 96 adults of mean age 59.6 years, 88.5% male, were randomized (n = 47 pimecrolimus; 49 vehicle). At week 4, the mean change from baseline in total area score was 3.7 versus 3.3 for pimecrolimus and vehicle groups, respectively (intent-to-treat: P = .1913; 95% confidence interval (CI) for difference [-0.195, 0.961]). Per protocol analysis (n = 41 pimecrolimus; 46 vehicle) indicated a significant difference between groups (mean change 3.9 pimecrolimus vs 3.2 vehicle; P = .0156; CI [0.129, 1.197]). The superiority of pimecrolimus was observed as early as week 2 (intent-to-treat: P = .0062; CI [0.132, 0.777]; per protocol: P = .0012; CI [0.410, 1.593]). No drug-related serious adverse events occurred. The most frequent drug-related adverse events were local, mild, and transient (pimecrolimus = 26%; vehicle = 12%). LIMITATIONS: Generalizability is limited by the elderly male study population. CONCLUSION: This study suggests that pimecrolimus cream 1% is an effective and well-tolerated treatment for moderate to severe facial seborrheic dermatitis.