Aggression

2015 ◽  
Author(s):  
Robert L. Trestman
Keyword(s):  
Environmental Management ◽  
Correctional Officers ◽  
Elevated Risk ◽  
Motivating Factors ◽  
Homicide Rates ◽  
Lethal Violence ◽  
Management Evaluation ◽  
Correctional Settings ◽  
Assaultive Behavior

Managing aggression is a challenge for psychiatry in all settings. Recognizing opportunities for appropriate assessment and intervention in correctional settings is an important component of correctional psychiatry. Studies reflect significant risks of violence for both correctional officers and inmates. Although prison homicides occur at rates below estimated community homicide rates, the rate of non-lethal violence is substantial. The data for assault are less clear, as definitions of what constitutes assault vary. Inmate-on-inmate assault has been estimated to range from 2 per 1000 inmates to as high as 200 per 1000 inmates. However assault is defined, correctional officers who have been the target of offender violence have elevated risk of emotional exhaustion and burnout. Effectively addressing aggression requires a thoughtful and comprehensive approach that may incorporate elements of environmental management, evaluation of potential motivating factors, differential diagnosis, and a coordinated intervention. This always involves includes effective communication among stakeholders including the patient. Recommended milieu changes and psychotherapeutic and / or pharmacologic interventions need to be explicitly defined; available data are described in this chapter. Consistent oversight and follow up to measure the effects of each component of the intervention(s) is critical, as aggressive behavior may be both habitual and episodic. This chapter reviews the factors that contribute to the broad range of assaultive behavior observed in correctional settings, and some of the pragmatic issues and opportunities for assessment, diagnosis, and treatment of aggressive behaviors, both impulsive and predatory.

Aggression

2017 ◽  
Author(s):  
Robert L. Trestman
Keyword(s):  
Environmental Management ◽  
Correctional Officers ◽  
Elevated Risk ◽  
Motivating Factors ◽  
Homicide Rates ◽  
Lethal Violence ◽  
Management Evaluation ◽  
Correctional Settings ◽  
Assaultive Behavior

Managing aggression is a challenge for psychiatry in all settings. Recognizing opportunities for appropriate assessment and intervention in correctional settings is an important component of correctional psychiatry. Studies reflect significant risks of violence for both correctional officers and inmates. Although prison homicides occur at rates below estimated community homicide rates, the rate of non-lethal violence is substantial. The data for assault are less clear, as definitions of what constitutes assault vary. Inmate-on-inmate assault has been estimated to range from 2 per 1000 inmates to as high as 200 per 1000 inmates. However assault is defined, correctional officers who have been the target of offender violence have elevated risk of emotional exhaustion and burnout. Effectively addressing aggression requires a thoughtful and comprehensive approach that may incorporate elements of environmental management, evaluation of potential motivating factors, differential diagnosis, and a coordinated intervention. This always involves includes effective communication among stakeholders including the patient. Recommended milieu changes and psychotherapeutic and / or pharmacologic interventions need to be explicitly defined; available data are described in this chapter. Consistent oversight and follow up to measure the effects of each component of the intervention(s) is critical, as aggressive behavior may be both habitual and episodic. This chapter reviews the factors that contribute to the broad range of assaultive behavior observed in correctional settings, and some of the pragmatic issues and opportunities for assessment, diagnosis, and treatment of aggressive behaviors, both impulsive and predatory.

scholarly journals Long-Term Incidence of Advanced Colorectal Neoplasia in Patients with Serrated Polyposis Syndrome: Experience in a Single Academic Centre

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1066
Author(s):  
Daniel Rodríguez-Alcalde ◽  
Guillermo Castillo-López ◽  
Jorge López-Vicente ◽  
Luis Hernández ◽  
Mercedes Lumbreras-Cabrera ◽  
...  
Keyword(s):  
Total Colectomy ◽  
Colorectal Neoplasia ◽  
Elevated Risk ◽  
Advanced Adenoma ◽  
Polyposis Syndrome ◽  
Serrated Polyp ◽  
Advanced Colorectal Neoplasia ◽  
Median Interval

Serrated polyposis syndrome (SPS) implies a slightly elevated risk of colorectal cancer (CRC) during endoscopic follow-up, but its natural course is still not well known. The main objective of this study was to describe the long-term risk of developing advanced neoplasia (AN) in these patients. Until October 2020, individuals who fulfilled 2010 WHO criteria I and/or III for SPS were retrospectively recruited. We selected those under endoscopic surveillance after resection of all lesions >3 mm in a high-quality colonoscopy. We excluded patients with total colectomy at diagnosis and those with any interval between colonoscopies >3.5 years. We defined AN as advanced serrated polyp (≥10 mm and/or with dysplasia), advanced adenoma, or CRC. In 109 patients, 342 colonoscopies were performed (median = 3, median interval = 1.8 years) during a median follow-up after colonic clearance of 5.0 years. Five-year cumulative incidences of AN were 21.6% globally, and 5.6%, 10.8%, and 50.8% in patients who fulfilled criterion I, III, and both, respectively (p < 0.001). No CRC was diagnosed and only 1 (0.9%) patient underwent surgery. In conclusion, cumulative incidences of AN could be lower than previously described, at least in patients who fulfil the 2010 WHO criterion III alone. Therefore, low-risk individuals might benefit from less stringent surveillance.

scholarly journals Arthroscopic posterior-inferior capsular release in the treatment of overhead athlete with GHIRD: a case report

2018 ◽  
Vol 7 (1) ◽  
pp. 301
Author(s):  
Stedy Adnyana Christian ◽  
I. G. N. Wien Aryana ◽  
I. B. Aditya Wirakarna ◽  
I. G. B. Indra Angganugraha P. J. ◽  
Komang Arie Trysna Andika ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Nonoperative Treatment ◽  
Shoulder Function ◽  
Successful Outcome ◽  
Overhead Athletes ◽  
Capsular Release ◽  
Management Evaluation ◽  
Glenohumeral Internal Rotation Deficit ◽  
Pathologic Findings

Glenohumeral internal rotation deficit (GHIRD) is one of most controversial joint diseases in terms of diagnosis and treatment. The use of arthroscopy has improved the recognition of pathologic findings in glenohumeral internal rotation deficit (GHIRD) and allowed a better understanding of the etiology of it and the correlation between symptoms and lesion patterns. We present our technique for arthroscopic posterior-inferior capsular release in athlete with symptomatic glenohumeral internal rotation deficit (GIRD) that was unresponsive to nonoperative treatment and was preventing him from returning to sport. By this technique resulted in a successful outcome. We evaluate a 28 years old male with right shoulder pain and limitation in abduction internanal rotation after 3 months conservative treatment. We performed Arthrospcopic posterior-inferior capsular release. After 2 months correspondingly, we performed follow-up assessments on shoulder function (using the ases and rowe score) and pain (using a visual analogue scale) were made. Arthroscopic posterior-inferior capsular release can be recommended as a reasonable operative solution for overhead athletes with symptomatic GIRD that has not responden to conservative management. Evaluation of patient in whom we performed arthroscopic repair base on ases and rowe score. Arthroscopic posterior-inferior capsular release showed satisfactory shoulder function after 2 months follow up correspondingly.

scholarly journals Lethal Violence: A Global View on Homicide

2019 ◽  
Author(s):  
Dietrich Oberwittler
Keyword(s):  
Early Modern Period ◽  
World Health ◽  
Homicide Rates ◽  
Welfare Policies ◽  
Lethal Violence ◽  
State Institutions ◽  
The Pacific ◽  
Other World ◽  
And Gender ◽  
Health Organization

As the most serious crime, homicide is both relevant and suitable for cross-national comparisons. The global homicide rate of ca. 6 per 100,000 people is an average of hugely diverging national rates ranging from 0.25 in Singapore to ca. 100 in El Salvador. The validity of global homicide statistics suffers from various differences in definitions as well as reporting and registration processes. Both criminal justice and causes of death statistics are used by the World Health Organization to construct rates, yet these are available only for a minority of countries. An overview on homicide in history and non-state societies shows that violence levels were considerably higher compared to those in today’s developed world and have dropped dramatically in Europe and North America during the early modern period. The rates first increased and then declined between ca.1960 and today in most developed nations in a synchronized manner, hinting at common influences. In recent years, homicide trends have shown a polarizing pattern, with increasing rates in Latin America and decreasing rates in most other world regions, especially East Asia and the Pacific, where rates have fallen below the European average concurrent with rising scores on the Human Development Index. Except in Eastern Europe, the frequency of homicide is strongly linked to the use of firearms, which account for 44% of homicide cases worldwide. Longitudinal studies have produced robust evidence for the pivotal role of deprivation and inequality in fostering lethal violence and of social welfare policies in reducing it. Although the transition to democratic political systems seems to increase homicide rates temporarily, the legitimacy of state institutions and the suppression of corruption are connected to lower homicide rates. Because of conceptual and methodological problems, questions concerning the generalizability of effects across space and time remain. Nevertheless, the research findings are sufficiently robust to draw important conclusions for violence prevention: reductions in poverty and income inequality, investments in welfare policies and gender equality, and improvements in the legitimacy of state institutions will help to bring homicide rates down.

Abstract MP86: The Joint Effect of Outdoor Recreational Activity and 25-Hydroxyvitamin D on Cardiovascular Mortality in THE NHANES III Population

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Macarius Donneyong ◽  
Carlton A Hornung
Keyword(s):  
Elevated Risk ◽  
Physical Activities ◽  
Mortality Data ◽  
Nhanes Iii ◽  
Additive Interaction ◽  
Joint Effects ◽  
The Past ◽  
Increased Risk ◽  
Cvd Mortality

Purpose Recreational physical activity (PA) reduces the risk of cardiovascular disease (CVD) morbidity and mortality. Outdoor-based recreational physical activities (ORA) have been reported to be associated with elevated 25(OH)D levels. We investigate the joint effects of frequent ORA and 25(OH)D levels on the risk of CVD mortality and the modifying effects of 25(OH)D. Methods Our sample consisted of 13,031 nationally representative adults (20 - 90 years old) free from CVD and cancer at baseline in the NHANES III (1988 - 1994) linked mortality dataset with follow-up mortality data through 2006. CVD mortality was based on reported deaths with corresponding ICD-10 codes for CVD as underlying cause of death. ORA was defined as self-reported participation in recreational physical activities considered to have occurred outdoors in the past month. Time to CVD mortality was estimated from multivariable adjusted Cox proportional hazards (CPH) models. A joint effects model was used in estimating multiplicative and additive interaction between ORA and 25(OH)D. Results A crude unweighted CVD mortality rate of 7.4% (964/13,031) occurred during a median follow-up of 14.33 years. Frequency of ORA <5 in the past month (HR=1.38, 95%CI:1.09 - 1.75) and 25(OH)D <30 ng/mL (HR=1.28, 95%CI:1.01 - 1.60) were associated with increased risk of CVD mortality compared to ORA ≥5 and 25(OH)D ≥30 ng/mL respectively, in a multivariable adjusted CPH model. In the joint effects model, frequency of ORA <5 and 25(OH)D <30 ng/mL (HR=1.81, 95%CI:1.05 - 3.10) and frequency of ORA <5 and 25(OH)D ≥30 ng/mL (HR=1.33, 95%CI:1.02 - 1.73) were associated with elevated risk of CVD mortality compared to the joint effects of ORA ≥5 and 25(OH)D ≥30 ng/mL. The joint effects model indicated the presence of multiplicative interaction. The synergy index, 1.52 (95%CI:0.31 - 7.41) suggested presence of additive interaction even though not statistically significant. Conclusion Lower frequency of ORA and serum 25(OH)D levels were jointly associated with elevated risk of CVD mortality. Serum 25(OH)D modified the risk of CVD mortality associated with lower frequency of outdoor-based recreational activities.

scholarly journals Well-Being Interventions for Correctional Officers in a Prison Setting: A Review and Meta-Analysis

2019 ◽  
Vol 47 (1) ◽  
pp. 3-21 ◽  
Author(s):  
Trisha J. Evers ◽  
James R. P. Ogloff ◽  
Justin S. Trounson ◽  
Jeffrey E. Pfeifer
Keyword(s):  
Fixed Effects ◽  
Correctional Officers ◽  
Meta Analysis ◽  
Exercise Program ◽  
Well Being ◽  
Eligibility Criteria ◽  
Quasi Experimental ◽  
Correctional Settings ◽  
Rigorous Study ◽  
Study Designs

This review and meta-analysis evaluated the effectiveness of well-being interventions offered to correctional officers within prison settings. A search strategy was developed and 11 databases were searched to identify eligible studies. Articles were screened against preset eligibility criteria, and quality was assessed using the Downs and Black Checklist. Nine studies were identified, including four single-group design and five quasi-experimental designed studies. Interventions comprised a mixture of crisis interventions, psychoeducational programs, and an exercise program. For those studies with sufficient data, a meta-analysis was conducted to examine intervention effects on stress and psychopathology. Fixed-effects meta-analysis showed that treatment had no effect on stress or psychopathology. Of those studies that could not be included in the meta-analysis, there were mixed outcomes. These findings highlight the need for more rigorous study designs and suggest further research is needed to examine the theoretical mechanisms in the development of interventions within correctional settings.

scholarly journals Mental disorders and cause-specific mortality

2001 ◽  
Vol 179 (6) ◽  
pp. 498-502 ◽  
Author(s):  
Matti Joukamaa ◽  
Markku HeliöVaara ◽  
Paul Knekt ◽  
Arpo Aromaa ◽  
Raimo Raitasalo ◽  
...  
Keyword(s):  
Mental Disorders ◽  
General Health Questionnaire ◽  
Elevated Risk ◽  
Men And Women ◽  
Relative Risks ◽  
Specific Mortality ◽  
Nationally Representative ◽  
The Impact ◽  
State Examination

BackgroundThe impact of clinically diagnosed mental disorders on mortality in the general population has not been established.AimsTo examine mental disorders for their prediction of cause-specific mortality.MethodMental disorders were determined using the 36-item version of the General Health Questionnaire and the Present State Examination in a nationally representative sample of 8000 adult Finns.ResultsDuring the 17-year follow-up period 1597 deaths occurred. The presence of a mental disorder detected at baseline was associated with an elevated mortality rate. The relative risk in men was 1.6 (95% confidence interval 1.3–1.8) and in women, 1.4 (95% Cl 1.2–1.6). In men and women with schizophrenia the relative risks of death during the follow-up period were 3.3 (95% Cl 2.3–4.9) and 2.3 (95% Cl 1.3–3.8) respectively, compared with the rest of the sample. In both men and women with schizophrenia the risk of dying of respiratory disease was increased, but the risk of dying of cardiovascular disease was increased only in men with neurotic depression.ConclusionsSchizophrenia and depression are associated with an elevated risk of natural and unnatural deaths.

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