No abstract

David has more than twenty years experience, in both the private and public sectors, of the thermal modelling of buildings and adaptation to climate change. He is a member of various national committees covering natural ventilation, the design of schools and the indoor environment. He has worked for central government on various aspects of the Building Regulations and has been a reviewer for the Intergovernmental Panel on Climate Change. He has been directly involved in the design of over 100 buildings often within a commercial framework. He specialises in the measurement and simulation of physical parameters, such as temperature and indoor air quality within buildings and the use of renewable energy within the built environment. He is the author of two books (one on optimisation (World Scientific, 1999) and one on energy and climate change (Wiley, 2008)) and of over 150 publications and reports. Amongst his current projects, he is PI of the £500k EPSRC funded PROMETHEUS project on resilience to climate change in the buildings sector.

Background and aims Opioid agonist treatment is effective but resource intensive to administer safely in custodial settings, leading to significant under‐treatment of opioid dependence in these settings world‐wide. This study assessed the safety of subcutaneous slow‐release depot buprenorphine in custody. Design Open‐label, non‐randomized trial. Setting Correctional centres in New South Wales, Australia. Participants Sixty‐seven men and women, aged ≥ 18 years of various security classifications with a diagnosis of moderate to severe DSM‐5 opioid use disorder currently serving a custodial sentence of ≥ 6 months were recruited between November 2018 and July 2019. Patients not in opioid agonist treatment at recruitment commenced depot buprenorphine; patients already stable on oral methadone treatment were recruited to the comparison arm. Intervention and comparator Depot buprenorphine (CAM2038 weekly for 4 weeks then monthly) and daily oral methadone. Measurements Safety was assessed by adverse event (AE) monitoring and physical examinations at every visit. Participants were administered a survey assessing self‐reported diversion and substance use at baseline and weeks 4 and 16. Findings Retention in depot buprenorphine treatment was 92.3%. Ninety‐four per cent of patients reported at least one adverse event, typically mild and transient. No diversion was identified. The prevalence of self‐reported non‐prescribed opioid use among depot buprenorphine patients decreased significantly between baseline (97%) and week 16 (12%, odds ratio = 0.0035, 95% confidence interval = 0.0007–0.018, P < 0.0001). Conclusions This first study of depot buprenorphine in custodial settings showed treatment retention and outcomes comparable to those observed in community settings and for other opioid agonist treatment used in custodial settings, without increased risk of diversion.

This study tested evidence for antisocial attitudes as a mechanism of change in offender treatment by examining whether the Measures of Antisocial Attitudes and Associates (MCAA) and within-treatment change in scores on this scale have predictive validity for risk of reoffending. Pretreatment and posttreatment scores on the MCAA were obtained from a large sample of 1,858 offenders who had completed offender treatment programs while in custody (n = 854) or in the community (n = 1,004). Individual within-treatment change was calculated with simple difference scores as well as categorizations of clinically significant change. Results showed that discrete scores on a number of MCAA measures were associated with reoffending hazard at pretreatment and at posttreatment. Change over treatment was also highly significant at the group level whereas a modest proportion of offenders achieved clinically significant change. None of the measures of within-treatment change were significantly associated with reoffending, however. The results suggest that self-reported antisocial attitudes may not be a valid indicator of causal mechanisms of treatment or change in offenders' risk of reoffending as a result of completing treatment. (PsycINFO Database Record

The purpose of this study was to compare a relatively new therapeutic option for substance abuse treatment, Health Realization, and 12-Step approaches offered in women's residential programs. The study was sponsored by a large California county's Department of Alcohol and Drug Services, which had offered Health Realization treatment for a number of years. This study constitutes the first systematic evaluation of Health Realization as a substance abuse treatment program for adult women in a residential treatment setting. This was a randomized study with two observations-admission and 9 months post-admission. The results showed that clients in both Health Realization and 12-Step treatment exhibited comparable outcomes on domains such as substance use, criminal justice involvement, employment, housing, adverse effects of substance use and psychological well being. Substance use declined significantly between admission and follow-up in both treatment groups, irrespective of duration of treatment. Similarly, adverse effects of substance use declined between admission and 9-month follow-up. Health Realization and 12-Step treatment offered comparable benefits for women in residential substance abuse treatment programs.