Strategies for supervising people with mental illnesses on probation caseloads: results from a nationwide study

Probation officers are tasked with supervising the largest number of people living with mental illnesses in the criminal legal system, with an estimated 16-27% of individuals on probation identified as having a mental health condition. While academic research has recently focused on building the evidence base around the prototypical model of specialty mental health probation, less focus has been directed to the individual components of specialized mental health caseloads and other strategies agencies use to supervise people with mental illnesses. More specific information about these strategies would benefit probation agencies looking to implement or enhance supervision protocols for people with mental illnesses. This article describes the results from a nationwide study examining (1) probation agencies' mental health screening and identification methods; (2) characteristics of mental health caseloads, including eligibility criteria, officer selection, required training, and interfacing with service providers; and (3) other strategies agencies use to supervise people with mental illnesses beyond mental health caseloads. Strategies for identifying mental illnesses varied, with most agencies using risk needs assessments, self-report items asked during the intake process, or information from pre-sentencing reports. Less than a third of respondents reported using screening and assessment tools specific to mental health or having a system that tracks or "flags" mental illnesses. Results also showed wide variation in mental health training requirements for probation officers, as well as variation in the strategies used for supervising people with mental illnesses (e.g., mental health caseloads, embedded mental health services within probation, modified cognitive behavioral interventions). The wide variation in implementation of supervision strategies presents (1) an opportunity for agencies to select from a variety of strategies and tailor them to fit the needs of their local context and (2) a challenge in building the evidence base for a single strategy or set of strategies.

Recombinant nucleocapsid protein is potentially an inexpensive, effective serodiagnostic reagent for infectious bronchitis virus

The nucleocapsid protein of the Gray strain of infectious bronchitis virus (IBV) is highly immunogenic and cross-reactive among various distinct serotypes. Recombinant nucleocapsid polypeptide expressed in bacteria with a histidine tag at the amino terminus has been used as antigen for developing an assay to detect IBV-specific antibody. This fusion protein was produced readily in bacteria and easily purified with a nickel column which bound to the histidine tag. Conditions were optimized for using these preparations for an IBV-specific ELISA. Although differences in optical densities could be detected between pre-immune and positive sera for the Ark, Mass, and Gray strains with antigen concentrations between 50 and 0.1 microg per well, the greatest differences could be detected with 3 and 1.5 microg of protein per well. Maximum differences in optical densities between pre-immune and positive sera were obtained using 2.4 microg per well of protein and sera diluted between 1:80 and 1:160. In addition, as little as 30 ng/dot of recombinant nucleocapsid consistently detected IBV-specific sera in immunoblot assays which have convenient field applications.

Influence of ORF2 on host cell tropism of feline immunodeficiency virus

Feline immunodeficiency virus (FIV) is a lentivirus associated with an immunodeficiency syndrome of the domestic cat. A short open reading frame (ORF2), of unknown function, is present in all FIV isolates. We have investigated the role of ORF2 in determining the cell tropism of two infectious molecular clones of FIV. FIV-PPR is able to productively infect feline peripheral blood leukocytes (PBLs) and a T lymphocyte cell line (MCH5-4), but not a feline astrocyte cell line (G355-5) or Crandell feline kidney cells (CrFK). In contrast, FIV-34TF10 is able to productively infect G355-5 and CrFK cells, but not PBLs or MCH5-4 cells. The major difference in these FIV clones is that ORF2 in FIV-PPR is capable of encoding a 79-amino-acid peptide, whereas there is a stop codon in ORF2 after 43 amino acids in FIV-34TF10. We performed site-directed mutagenesis to change the stop codon (TGA) in FIV-34TF10 to a tryptophan (TGG), the amino acid present at this location in FIV-PPR. FIV-34TF10 with ORF2 repaired (FIV-ORF2rep) productively infected PBLs, MCH5-4 cells, and primary macrophages, as well as CrFK and G355-5 cells, indicating that a protein encoded by ORF2 plays a role in determining the host cell tropism of FIV. ORF2 contains hydrophobic, acidic, and leucine-rich domains similar to those shown to be important for transactivating proteins of other lentiviruses. Coexpression of a plasmid expressing the ORF2 gene product with another construct expressing the chloramphenicol acetyl transferase (CAT) gene driven by the FIV LTR, resulted in transactivation of CAT expression in both feline and human cells.

Intraventricular administration of a FIV-envelope protein induces sleep architecture changes in rats

Fifteen adult male Sprague-Dawley rats were implanted with a set of electrodes for standard sleep recordings. A stainless steel cannula was also implanted into the lateral ventricle of these rats. Fifteen additional rats were implanted with a cannula alone. Rats with electrodes were habituated for 3 days or more to the recording environment, then placed into 3 groups (n = 5). One group received saline (i.c.v.), while the other two groups received either the feline immunodeficiency virus envelope glycoprotein (FIV SU-Env) or a fragment of the Epstein-Barr virus envelope glycoprotein (EB gp105). Rats were then recorded for electrographic sleep-wake cycle evaluation for the following 4 h. Core temperature was assessed through a thermistor probe inserted into the rectum, immediately before and 1, 2, 3 and 4 h after the i.c.v. treatment condition. Results demonstrated that compared to saline, FIV SU-Env increased wakefulness and decreased REM sleep throughout the 4 h of recording. Likewise, FIV SU-Env decreased SWS2 for 2 h. In addition, EB gp105 administration elicited minor modifications of the sleep-wake cycle, causing only a transient reduction of REM sleep in the first hour of recording. None of the treatments altered body temperature. These findings strongly support and extend studies in FIV-infected cats in which we have found similar sleep abnormalities. In addition, these results are consistent with the hypothesis that the FIV SU-Env proteins are responsible for these neurological disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

The introduction of a quality assessment scheme for extra-laboratory blood glucose analysis

An external quality assessment scheme is described for on-ward testing of blood glucose by nursing staff using the Glucometer II/Glucostix system. This involved the distribution of two concentrations of glucose solutions to the wards at 2-week intervals. Initially, results were examined prior to the introduction of a formal training programme for use of the blood glucose meters when the hospital CV was 25% (low glucose) and 19% (high glucose). Some improvement was shown after 6 months, with CVs of 13 and 8%, and a greater improvement after 12 months with CVs of 6 and 8%, respectively. A ward report was designed to allow easy interpretation of performance by the participants in the scheme. The introduction of this report was well received and generated enthusiasm among the ward staff.

Generalized choreiform movements as a complication of methyldopa therapy in chronic renal failure

A patient who developed bilateral choreiform movements in association with methyldopa therapy and deteriorating renal function without evidence of cerebrovascular disease is reported.

Acquired pure red-cell aplasia associated with an increase of T cells bearing receptors for the Fc of IgG

A case of steroid-resistant acquired pure red-cell aplasia associated with a relative and absolute increase of TG cells is described. Removal of T cells enhanced erythroid colony and burst formation in vitro, and it is suggested that TG cells may be implicated in the pathogenesis of this case of acquired pure red-cell aplasia.

Prolonged dystonic reaction to chlorpromazine in myxoedema coma

A case of myxoedema coma is reported where the administration of chlorpromazine resulted in a prolonged dystonic reaction. A similar challenge with a butyrophenone when the patient was on thyroxine caused a similar but much abbreviated response.

Increased vasopressin excretion in patients with hypothyroidism

Twenty-four h urinary vasopressin excretion was measured by bioassay in 15 patients with untreated hypothyroidism and compared with plasma sodium concentration. Four patients had raised excretion of an antidiuretic substance and in 3 of these patients excretion was reduced after thyroid replacement therapy. The criteria applied supported the view that the antidiuretic substance was arginine vasopressin. Plasma sodium concentration was normal in all these 4 patients. A further 4 patients had hyponatraemia without raised arginine vasopressin excretion. The results suggest that: (1) excess arginine vasopressin secretion is not the cause of the hyponatraemia of hypothyroidism and (2) an increased secretion of arginine vasopressin does occur in some cases of normonatraemic hypothyroidism, the cause requiring further elucidation.

Blood lactate and pyruvate levels in diabetic patients treated with biguanides with and without sulphonylureas

Blood lactate and pyruvate were measured two to three hours after breakfast in 153 patients with maturity-onset (type 2) diabetes. Blood lactate was raised in 56% of all patients taking phenformin and in 35% of all patients taking metformin, while 75% and 35% respectively had raised pyruvate. Mean blood lactate level was raised at 2.2 mmol/1 (range 0.2-4.4 mmol/1) in the patients on phenformin and 1.7 mmol/1 (range 0.2-4.3 mmol/1) in those on metformin, with mean blood pyruvate levels of 0.122 mmol/1 (range 0.050-0.215 mmol/1) and 0.111 mmol/1 (range 0.038-0.259 mmol/1) respectively. In patients treated with a sulphonylurea drug alone mean blood lactate and pyruvate levels were not increased and were no different in those receiving sulphonylurea therapy in addition to a biguanide from those receiving a biguanide alone. Blood lactate did not correlate with any clinical or biochemical measurement in any of the treatment groups except for a correlation with serum creatinine in those patients taking metformin alone. The finding of raised blood lactate levels in diabetic patients treated with metformin suggests that this drug should be prescribed with caution.

Augmentation of vasopressin antidiuresis by prolactin with a note on the contamination of International Standard prolactin

Department of Physiology, Charing Cross Hospital Medical School, London, W6

(Received 7 April 1977)

It has been reported (Horrobin, Burstyn, Lloyd, Durkin, Lipton & Muiruri, 1971; Buckman & Peake, 1973; Wallin & Lee, 1976) that prolactin affects salt and water metabolism. To assess any interaction of the antidiuretic hormone arginine-vasopressin (AVP) and prolactin, four experiments were performed.

The antidiuretic action of AVP was measured by the standard AVP bioassay method using the water-loaded ethanol-anaesthetized rat described by Jeffers, Livesey & Austin (1942) with the minor modifications of Forsling, Jones & Lee (1968). Male Wistar rats (150-200 g) were used with at least six preparations for each experiment. When stable antidiuretic responses to standard AVP (3rd International Standard, 1957, National Institute for Biological Standards, London) were obtained, the infusion fluid was changed to one containing the appropriate hormone for the experiment and the effect of AVP within the succeeding hour compared

Normal excretion of vasopressin and the effect of everyday activity

The urinary excretion of arginine vasopressin (AVP) was measured by bioassay in normal subjects at rest, on reduced physical activity and on routine everyday activity. The values obtained under rest conditions were all less than 10 mu/24 h with a mean less than 6.6 mu/24 h. Excretion of vasopressin increased with increasing activity, despite free access to water to mean values of 17 mu/24 h and 29 mu/24 h under conditions of reduced and routine every day activity respectively.