Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.

BACKGROUND: Opioid use disorder (OUD) is among the most prevalent medical condition experienced by incarcerated persons, yet medication assisted therapy (MAT) is uncommon. Four jail and prison systems partnered with researchers to document their adoption of MAT for incarcerated individuals with opioid use disorders (OUD) using their established treatment protocols. Employing the EPIS (Exploration, Planning, Implementation, and Sustainment) framework, programs report on systematic efforts to expand screening, treatment and provide linkage to community-based care upon release. RESULTS: All four systems were engaged with implementation of MAT at the outset of the study. Thus, findings focus more on uptake and penetration as part of implementation and sustainment of medication treatment. The prevalence of OUD during any given month ranged from 28 to 65% of the population in the participating facilities. All programs developed consistent approaches to screen individuals at intake and provided care coordination with community treatment providers at the time of release. The proportion of individuals with OUD who received MAT ranged considerably from 9 to 61%. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Government leadership, dedicated funding and collaboration with community treatment providers were deemed essential to adoption of MAT during implementation phases. Facilitators for MAT included increases in staffing and staff training; group education on medication assisted therapies; use of data to drive change processes; coordination with other elements of the criminal justice system to expand care; and ongoing contact with individuals post-release to encourage continued treatment. Barriers included lack of funding and space and institutional design; challenges in changing the cultural perception of all approved treatments; excluding or discontinuing treatment based on patient factors, movement or transfer of individuals; and inability to sustain care coordination at the time of release. CONCLUSIONS: Adoption of evidence-based medication assisted therapies for OUD in prisons and jails can be accomplished but requires persistent effort to identify and overcome challenges and dedicated funding to sustain programs.

A Team Training Field Research Study: Extending a Theory of Team Development.

Recent advances in the science of teams have provided much insight into the important attitudes (e.g., team cohesion and efficacy), cognitions (e.g., shared team cognition), and behaviors (e.g., teamwork communications) of high performing teams and how these competencies emerge as team members interact, and appropriate measurement methods for tracking development. Numerous training interventions have been found to effectively improve these competencies, and more recently have begun addressing the problem of team dynamics. Team science researchers have increasingly called for more field studies to better understand training and team development processes in the wild and to advance the theory of team development. In addition to the difficulty of gaining access to teams that operate in isolated, confined, and extreme environments (ICE), a major practical challenge for trainers of ICE teams whose schedules are already strained is the need to prioritize the most effective strategies to optimize the time available for implementation. To address these challenges, we describe an applied research experiment that developed and evaluated an integrated team training approach to improve Tactical Combat Casualty (TC3) skills in U.S. Army squads. Findings showed that employing effective team training best practices improved learning, team cognition, emergent team processes, and performance. We recommend future research should focus on understanding the types of training strategies needed to enable teams and team leaders to develop from novices to experts. Effectively modifying training to scale it to team expertise requires more research. More laboratory and field research is needed to further develop measures of team knowledge emergence for complex task domains, and include other potential emergent factors such as team leadership and resilience. Practical implications for research include developing automated tools and technologies needed to implement training and collect team data, and employ more sensitive indicators (e.g., behavioral markers) of team attitudes, cognitions and behaviors to model the dynamics of how they naturally change over time. These tools are critical to understanding the dynamics of team development and to implement interventions that more effectively support teams as they develop over time.

Assessing Counter-Terrorism field training with multiple behavioral measures.

Development of behavioral pattern recognition and analysis skills is an essential element of Counter-Terrorism training, particularly in the field. Three classes of behavioral measures were collected in an assessment of skill acquisition during a US Joint Forces Command-sponsored course consisting of Combat Tracking and Combat Profiling segments. Measures included situational judgment tests, structured behavioral observation checklists, and qualitative assessments of the emergence of specific knowledge-skills-attitudes over the course of the training. The paper describes statistical evidence across the three types of measures that indicate that behavioral pattern recognition and analysis skills were successfully acquired by most students (a mix of Army and civilian law enforcement personnel) during the field training exercises. Implications for broader training of these critical skills are also discussed.

Golden hamsters are nocturnal in captivity but diurnal in nature.

Daily activity rhythms are nearly universal among animals and their specific pattern is an adaptation of each species to its ecological niche. Owing to the extremely consistent nocturnal patterns of activity shown by golden hamsters (Mesocricetus auratus) in the laboratory, this species is a prime model for studying the mechanisms controlling circadian rhythms. In contrast to laboratory data, we discovered that female hamsters in the wild were almost exclusively diurnal. These results raise many questions about the ecological variables that shape the activity patterns in golden hamsters and the differences between laboratory and field results.