Mortality in Prisons: The Experience of the Bureau of Legal Medicine of Milan (Italy) (1993–2017)

We undertook a retrospective analysis of deaths that took place in prisons in Milan between 1993 and 2017, by identifying cases from a total of 24,101 autopsies that were performed at the Section of Forensic Medicine of the University of Milan. From the archives of this institution, we found 227 autopsy reports relating to deaths that had taken place in one of Milan’s three detention facilities. These deaths were divided into two types: natural deaths ( n=135; 59.5%) and violent deaths ( n=92; 40.5%). The groups have different characteristics: while natural deaths mostly resulted from cardiovascular diseases, suicides were mainly the result of hanging. Further, people who died by suicide often had a history of psychiatric disease and/or drug abuse, and over a quarter of them had previous suicide attempts and/or had declared suicidal intentions. This study confirms the need for good quality healthcare services for prisoners, given that they remain a population at high risk of early death.

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Nine Psychiatric Inpatients who Leaped from a Height*

The Canadian Journal of Psychiatry ◽

10.1177/070674378402900209 ◽

1984 ◽

Vol 29 (2) ◽

pp. 129-131 ◽

Cited By ~ 6

Author(s):

Gary W. Small ◽

Jerrold F. Rosenbaum

Keyword(s):

High Risk ◽

Social Isolation ◽

Suicide Attempts ◽

Treatment Plan ◽

Psychiatric Inpatients ◽

Recent Change ◽

Hospital Treatment ◽

Common Features ◽

History Of ◽

Chronic Psychosis

The authors describe nine psychiatric inpatients from the same hospital who leaped from a height. Common features included youth, social isolation, diagnosis of schizophrenia, and chronic psychosis despite neuroleptic therapy. All had prolonged hospitalizations and a history of assaults, suicide attempts, or both. The authors suggest that these characteristics in conjunction with a recent change in hospital treatment plan or loss of social sup-ports may identify patients at high-risk for violent self-destructive acts.

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Gender and Racial Differences for Suicide Attempters and Ideators in a High-Risk Community Corrections Population

Crisis ◽

10.1027/0227-5910/a000160 ◽

2013 ◽

Vol 34 (1) ◽

pp. 50-62 ◽

Cited By ~ 11

Author(s):

Cheryl B. McCullumsmith ◽

C. Brendan Clark ◽

Adam Perkins ◽

Jessaka Fife ◽

Karen L. Cropsey

Keyword(s):

Risk Factors ◽

African American ◽

High Risk ◽

Psychotropic Medication ◽

Suicide Attempts ◽

Community Corrections ◽

History Of ◽

And Gender ◽

Gender Groups ◽

Corrections Population

Background: Community corrections populations are a high-risk group who carry multiple suicide risk factors. Aims: To identify factors correlated with historical suicide attempts and ideation among African-American men, African-American women, White men, and White women in a community corrections population. Method: Self-report data from 18,753 enrollees in community corrections were analyzed. Multinomial logistic regression analyses were conducted to determine associations between historical suicidal ideation and attempts among the four demographic groups. Results: Participants with historical suicide attempts tended to be younger, White, female, be taking psychotropic medication, have a history of physical or sexual abuse, and meet criteria for dependence on alcohol, amphetamines, cocaine, opioids, or sedatives. Five variables were commonly associated with suicide attempts for all four race/gender groups: younger age, being on disability or retirement, taking psychotropic medication, history of sexual or physical abuse, and cocaine dependence. Other demographic variables had race or gender specificities as risk factors for suicide attempts. Conclusions: Participants had high rates of historical suicide attempts with unique correlates differentiating attempters from ideators among different racial and gender groups. Cocaine dependence was universal predictor of suicide attempts, while other substance dependencies show specific racial and gender profiles associated with suicide attempts.

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The history of missions: an academic discipline

Studies in Church History ◽

10.1017/s0424208400004915 ◽

1970 ◽

Vol 6 ◽

pp. 149-170

Author(s):

S. C. Neill

Keyword(s):

Academic Discipline ◽

Early Death ◽

The United States ◽

Accurate Information ◽

Full Time ◽

Scale Theory ◽

Interesting Difference ◽

History Of ◽

The University ◽

World Mission

Everyone knows that the Christian world mission exists. Not everyone would be prepared to agree that the mission should be regarded as a fit subject for academic study.There is an interesting difference in the manner in which this question has been dealt with in Germany, in the United States, and in Britain.The Germans are the great theorists; it is not surprising that Germany was the first country to develop a full-scale theory of missions and to invent the unpleasing hybrid ‘missiology’. The first plan for academic teaching of missiology came from Karl Graul, director of the Leipzig mission, who in 1864 drew up a plan for such teaching in the university of Erlangen, and had actually delivered an admired introductory lecture on the subject. His early death made impossible the realization of the plans that he had drawn up. The first full-time professor of missions was Gustav Warneck, whose immense Missionslehre began to appear in 1897, the year in which its author was appointed as professor in the old pietistic university of Halle. Warneck the theorist was followed by the historian Julius Richter in Berlin. Richter was a typically German toiler, whose volumes on various regions of the earth are full of minutely accurate information, a little marred by the all too obvious view of the writer that only Germans understand how to carry out the task of mission, and that the British have never done anything but make mistakes in the political as well as in the religious field.

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Multistate Markov Model to Predict the Prognosis of High-Risk Human Papillomavirus-Related Cervical Lesions

Cancers ◽

10.3390/cancers12020270 ◽

2020 ◽

Vol 12 (2) ◽

pp. 270 ◽

Cited By ~ 1

Author(s):

Ayumi Taguchi ◽

Konan Hara ◽

Jun Tomio ◽

Kei Kawana ◽

Tomoki Tanaka ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Markov Model ◽

Continuous Time ◽

Retrospective Cohort ◽

Intraepithelial Neoplasia ◽

Cervical Lesions ◽

History Of ◽

The University ◽

High Risk Hpv

Cervical intraepithelial neoplasia (CIN) has a natural history of bidirectional transition between different states. Therefore, conventional statistical models assuming a unidirectional disease progression may oversimplify CIN fate. We applied a continuous-time multistate Markov model to predict this CIN fate by addressing the probability of transitions between multiple states according to the genotypes of high-risk human papillomavirus (HPV). This retrospective cohort comprised 6022 observations in 737 patients (195 normal, 259 CIN1, and 283 CIN2 patients at the time of entry in the cohort). Patients were followed up or treated at the University of Tokyo Hospital between 2008 and 2015. Our model captured the prevalence trend satisfactory, particularly for up to two years. The estimated probabilities for 2-year transition to CIN3 or more were the highest in HPV 16-positive patients (13%, 30%, and 42% from normal, CIN1, and CIN2, respectively) compared with those in the other genotype-positive patients (3.1–9.6%, 7.6–16%, and 21–32% from normal, CIN1, and CIN2, respectively). Approximately 40% of HPV 52- or 58-related CINs remained at CIN1 and CIN2. The Markov model highlights the differences in transition and progression patterns between high-risk HPV-related CINs. HPV genotype-based management may be desirable for patients with cervical lesions.

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A descriptive, retrospective case series of patients with factitious disorder imposed on self

BMC Psychiatry ◽

10.1186/s12888-021-03582-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Antoine Bérar ◽

Guillaume Bouzillé ◽

Patrick Jego ◽

Jean-Sébastien Allain

Keyword(s):

Suicide Attempts ◽

Case Series ◽

Healthcare Services ◽

University Hospital ◽

Factitious Disorder ◽

Retrospective Case ◽

Medical Interventions ◽

Health Related ◽

History Of ◽

Patient Refusal

Abstract Background Despite cases of factitious disorder imposed on self being documented in the literature for decades, it appears to remain an under-identified and under-diagnosed problem. The present study aimed to explore factitious disorder imposed on self in a series of French patients. Methods Patients 18 years old and over with factitious disorder imposed on self were retrospectively included by two independent reviewers according to DSM-5 criteria in Rennes University Hospital for the period 1995 to 2019. Patients were identified from a clinical data warehouse. Results 49 patients with factitious disorder imposed on self were included. Among them, 36 (73.5%) were female. The average age at diagnosis was 38.4 years. The 16 patients with a health-related profession were all female. Direct evidence of falsification was found in 20.4% of cases. Falsification was mainly diagnosed on the basis of indirect arguments: history of factitious disorder diagnosed in another hospital (12.2%), extensive use of healthcare services (22.4%), investigations that were normal or inconclusive (69.4%), inconsistent or incomplete anamnesis and/or patient refusal to allow access to outside information sources (20.4%), atypical presentation (59.2%), evocative patient behaviour or comments (32.7%), and/or treatment failure (28.6%). Dermatology and neurology were the most frequently involved specialities (24.5%). Nine patients were hospitalized in intensive care. Some of them received invasive treatments, such as intubations, because of problems that were only reported or feigned. The diagnosis of factitious disorder imposed on self was discussed with the patient in 28 cases (57.1%). None of them admitted to making up the disorder intentionally. Two suicide attempts occurred within 3 months after the discussion of the diagnosis. No deaths were recorded. 44.9% of the patients returned to the same hospital at least once in relation to factitious disorder imposed on self. Conclusions The present study reinforces data in favour of a predominance of females among patients with factitious disorder imposed on self. This diagnosis is difficult and is based on a range of arguments. While induced cases can be of low severity, cases that are only feigned can lead to extreme medical interventions, such as intubation.

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Adverse Outcomes, Polysubstance Use, and Polypharmacy in Older Veterans

Innovation in Aging ◽

10.1093/geroni/igaa057.2687 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 746-747

Author(s):

Amy Byers

Keyword(s):

High Risk ◽

Suicide Prevention ◽

Suicide Attempts ◽

Late Life ◽

Adverse Outcomes ◽

Emergency Department Visits ◽

Adverse Health Outcomes ◽

Polysubstance Use ◽

History Of ◽

Sedative Hypnotics

Abstract This session will provide information about adverse health outcomes, including suicide, suicide attempts and unintended death, that may be related to polysubstance use and polypharmacy in older adults, particularly older veterans. It will further provide information that will help support late-life suicide prevention and intervention efforts. Older veterans (age50 and older) have the highest number of lives lost to suicide, make up majority of the veteran population, and are highly likely to experience conditions (e.g., chronic pain, sleep disorders, musculoskeletal) associated with commonly prescribed medications that are potential markers for suicide risk (hereafter referred to as “high-risk” drug categories), including benzodiazepines, sedative-hypnotics, opioids, antidepressants, antipsychotics, and antiepileptics. The research presented in this session will highlight important patterns in high-risk drug prescribing and use and related outcomes in late life. The presentations will underscore various groups of older veterans that may be important to consider and, yet, neglected in the polysubstance and polypharmacy and suicide prevention conversation, including those who recently attempted suicide, veterans with late-life posttraumatic stress disorder (PTSD), and older veterans transitioning from prison to community. Drs. Maust and Morin will present findings on prescribing and use of high-risk medications in late life, including an overview of trends in polypharmacy and associations with suicide attempts. Drs. Byers and Barry will speak about older veterans with PTSD and those with a history of incarceration, with information on suicide, unintended death by overdose, and substance use disorder-related emergency department visits and hospitalizations, emphasizing importance of care transition models for prevention. Aging, Alcohol and Addictions Interest Group Sponsored Symposium.

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A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R)

Psychological Medicine ◽

10.1017/s0033291706008786 ◽

2006 ◽

Vol 36 (12) ◽

pp. 1747-1757 ◽

Cited By ~ 143

Author(s):

GUILHERME BORGES ◽

JULES ANGST ◽

MATTHEW K. NOCK ◽

AYELET MERON RUSCIO ◽

ELLEN E. WALTERS ◽

...

Keyword(s):

High Risk ◽

Suicide Ideation ◽

Suicide Attempts ◽

Characteristic Curve ◽

Risk Index ◽

Parental Psychopathology ◽

Risk Category ◽

National Comorbidity Survey Replication ◽

National Comorbidity Survey ◽

History Of

Background. Clinical judgments about the likelihood of suicide attempt would be aided by an index of risk factors that could be quickly assessed in diverse settings. We sought to develop such a risk index for 12-month suicide attempts among suicide ideators.Method. The National Comorbidity Survey Replication (NCS-R), a household survey of adults aged 18+, assessed the 12-month occurrence of suicide ideation, plans and attempts in a subsample of 5692 respondents. Retrospectively assessed correlates include history of prior suicidality, sociodemographics, parental psychopathology and 12-month DSM-IV disorders.Results. Twelve-month prevalence estimates of suicide ideation, plans and attempts are 2·6, 0·7 and 0·4% respectively. Although ideators with a plan are more likely to make an attempt (31·9%) than those without a plan (9·6%), 43% of attempts were described as unplanned. History of prior attempts is the strongest correlate of 12-month attempts. Other significant correlates include shorter duration of ideation, presence of a suicide plan, and several sociodemographic and parental psychopathology variables. Twelve-month disorders are not powerful correlates. A four-category summary index of correlates is strongly related to attempts among ideators [area under the receiver operator characteristic curve (AUC)=0·88]. The distribution (conditional probability of attempt) of the risk index is: 19·0% very low (0·0%), 51·1% low (3·5%), 16·2% intermediate (21·3%), and 13·7% high (78·1%). Two-thirds (67·1%) of attempts were made by ideators in the high-risk category.Conclusions. A short, preliminary risk index based on retrospectively reported responses to fully structured questions is strongly correlated with 12-month suicide attempts among ideators, with a high concentration of attempts among high-risk ideators.

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Assessing the global risk of cardiovascular disease among a group of university students: population-based cross-sectional study in Yaoundé, Cameroon

BMJ Open ◽

10.1136/bmjopen-2019-030594 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030594

Author(s):

Jobert Richie Nansseu ◽

Felix Assah ◽

Saint-Just Petnga ◽

Bibiane Siaheu Kameni ◽

Hebert Donald Fosso Tene ◽

...

Keyword(s):

Cardiovascular Disease ◽

High Risk ◽

Cross Sectional Study ◽

Sectional Study ◽

Global Risk ◽

Cvd Risk ◽

Cross Sectional ◽

Risk Distribution ◽

History Of ◽

The University

ObjectiveTo describe the global cardiovascular disease (CVD) risk distribution in a young adult-aged population living in Yaoundé, Cameroon and depict factors likely influencing this risk distribution.DesignA cross-sectional study between May and July 2017.SettingThe University of Yaoundé I, Cameroon.ParticipantsAny university student aged 18 years and above, with no known history of CVD, found at the campus during recruitment and who voluntarily agreed to be included in the study.Primary and secondary outcome measuresThe global risk of CVD was measured with the non-laboratory-based INTERHEART Modifiable Risk Score.ResultsA total of 949 participants (54% males) were recruited; the median age was 23 (IQR 21–26) years. The CVD risk varied between 2 and 21, with a median of 9 (IQR 7–12); 51.2% of students had a low risk of CVD, 43.7% had a moderate risk and 5.1% presented a high risk of CVD. The number of years since first registration at the university (β=0.08), history of sudden death among biological parents (β=1.28), history of hypertension among brothers/sisters (β=1.33), history of HIV infection (β=4.34), the Alcohol Use Disorder Identification Test-Consumption score (β=0.13), regular exposure to firewood smoke (β=1.29), eating foods/drinks with too much sugar ≥1 time/day (β=0.96), eating foods/snacks with too much oil ≥3 times/week (β=1.20) and eating dairy products≥1 time/day (β=0.61) were the independent factors likely influencing participants’ global risk of CVD.ConclusionAlmost 50% of participants had moderate or high risk of CVD. Specific interventions targeting major CVD risk factors should be put in place among young adults to prevent or reduce this upcoming overburdened picture of CVD.

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The Perspectives of Young Adults on Recovery from Repeated Suicide-Related Behavior

Crisis ◽

10.1027/0227-5910.30.3.120 ◽

2009 ◽

Vol 30 (3) ◽

pp. 120-127 ◽

Cited By ~ 23

Author(s):

Yvonne Bergmans ◽

John Langley ◽

Paul Links ◽

James V. Lavery

Keyword(s):

Young Adults ◽

Grounded Theory ◽

High Risk ◽

Qualitative Study ◽

Suicide Attempts ◽

Turning Points ◽

Major Elements ◽

Study Results ◽

History Of ◽

Fluid Pathway

Background: This qualitative study sought to develop an understanding of how young adults between the ages of 18–25 years, who have a history of two or more suicide attempts, transition away from high-risk suicide-related behaviors. Aims: To understand the transition to safer behaviors and to provide clinical suggestions for those who provide care to this population. Methods: Sixteen young adults under the age of 25 years, who had completed at least one cycle of intervention for people with repeated suicide attempts, participated in this qualitative, grounded theory study. Results: The young adults described a pathway that included three major elements: (a) “living to die”, (b) ambivalence and tipping/turning points, and (c) a process of recovery that included small steps or phases (pockets of recovery) toward life. The journey was not always experienced as steady movement forward, and the potential for relapse either in the young people’s behavior or their wish to engage in their relationship with death could ebb and flow. Conclusions: Clinicians need to be aware that the struggle to live is a process involving a fluid pathway moving between three key elements.

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