scholarly journals The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm

2021 ◽  
Vol 12 ◽  
Author(s):  
Matina Shafti ◽  
Peter James Taylor ◽  
Andrew Forrester ◽  
Daniel Pratt
Keyword(s):  
Emotional Regulation ◽  
Risk Group ◽  
High Risk Group ◽  
Emotional Dysregulation ◽  
Future Studies ◽  
Treatment And Prevention ◽  
Emotional Model ◽  
Self Harm ◽  
Stress Models

There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.

Deliberate self-harm in young people: attendance at a paediatric emergency department

2009 ◽  
Vol 26 (3) ◽  
pp. 114-118 ◽  
Author(s):  
Sophia Morgan ◽  
Sinead Byrne ◽  
Carole Boylan ◽  
Stephen McLearie ◽  
Carol Fitzpatrick
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Medical Records ◽  
Risk Group ◽  
High Risk Group ◽  
Deliberate Self Harm ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Appropriate Treatment ◽  
Self Harm

AbstractObjectives: Deliberate self-harm (DSH) is the strongest predictor of suicidal behaviour. This retrospective study reviewed all DSH presentations to our Paediatric Emergency Department between 2002-2006.Method: Using database and medical records we profiled these presentations. Data was coded and statistically analysed.Results: There were 253 DSH attendances. Twenty-four percent were living in care, 15% were under 12 years and 14% presented more than once. Overdoses (61%) were more common than cutting (16%) and 56% had a psychiatric condition.Conclusions: DSH presents an ongoing challenge to child and adolescent mental health services and those working in suicide prevention. Identifying the characteristics of these young people is essential to providing appropriate treatment for this high-risk group.

The Role of Employment Diversification in Reducing Vulnerability to Poverty among Marginal and Small-holder Agricultural Households in India

2018 ◽  
Vol 12 (1) ◽  
pp. 88-112 ◽  
Author(s):  
Sagarika Dey
Keyword(s):  
Risk Group ◽  
Jel Classification ◽  
High Risk Group ◽  
Agricultural Activity ◽  
Livelihood Security ◽  
Vulnerability To Poverty ◽  
Agricultural Households ◽  
Poverty Status ◽  
Small Holder

This article combines two relatively nascent and inter-related approaches to poverty analysis and measurement, that is, the asset-based approach and the vulnerability approach to assess the poverty status of various land-owning classes in rural India. Contingent on the finding that marginal and small-holder households constitute a high-risk group in terms of the incidence of current poverty and vulnerability to future poverty, the study explores the role of non-agricultural activity in providing livelihood security and tackling poverty and vulnerability among land-poor rural households. The findings reveal that while most types of rural non-farm employment have significant poverty-reducing effects, human capital constitutes the most potent element in tackling poverty in the target group. We therefore suggest that an emphasis on skill upgradation of marginal and small landholders, coupled with policies directed towards development of non-farm activity, could provide an effective, permanent solution for curbing poverty and mitigating livelihood risks among these households. JEL Classification: I31, I32, J21, O18

Abstract 19763: Role of HAS-BLED Score on Major Bleeding in Atrial Fibrillation Undergoing Percutaneous Coronary Intervention With Drug-eluting Stents

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoshitaka Ito ◽  
Kazuhiro Naito ◽  
Katsuhisa Waseda ◽  
Hiroaki Takashima ◽  
Akiyoshi Kurita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Stent Implantation ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk

Background: While anticoagulant therapy is standard management for atrial fibrillation (Af), dual antiplatelet therapy (DAPT) is needed after stent implantation for coronary artery disease. HAS-BLED score estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in Af care. However, it is little known about usefulness of HAS-BLED score in Af patient treated with coronary stents requiring DAPT or DAPT plus warfarin (triple therapy: TT). The aim of this study was to evaluate the role of HAS-BLED score on major bleeding in Af patients undergoing DAPT or TT. Methods: A total of 837 consecutive patients were received PCI in our hospital from Jan. 2007 to Dec. 2010, and 66 patients had Af or paroxysmal Af at the time of PCI. Clinical events including major bleeding (cerebral or gastrointestinal bleeding) were investigated up to 3 years. Patients were divided into 2 groups based on HAS-BLED score (High-risk group: HAS-BLED score≥4, n=19 and Low-risk group: HAS-BLED score<4, n=47). DAPT therapy was required for a minimum 12 months after stent implantation and warfarin was prescribed based on physicians’ discretion. Management/change of antiplatelet and anticoagulant therapy during follow-up periods were also up to physicians’ discretion. Results: Baseline characteristics were not different between High-risk and Low-risk group except for age. Overall incidence of major bleeding was observed in 8 cases (12.1%) at 3 years follow-up. Major bleeding event was significantly higher in High-risk group compared with Low-risk group (31.6% vs. 4.3%, p=0.002). However, management of DAPT and TT was not different between the 2 groups. Among component of HAS-BLED score, renal dysfunction and bleeding contributed with increased number of the score. Conclusion: High-risk group was more frequently observed major bleeding events compared with Low-risk group in patients with Af following DES implantation regardless of antiplatelet/anticoagulant therapy.

scholarly journals Uptake and Perceptions of E-cigarette use in Vascular Patients

2018 ◽  
Vol 14 (2) ◽  
pp. 83-87
Author(s):  
Rachael Taylor ◽  
David Sidloff ◽  
Robert D. Sayers ◽  
Matthew J. Bown ◽  
Athanasios Saratzis
Keyword(s):  
Smoking Cessation ◽  
Risk Group ◽  
Electronic Cigarettes ◽  
High Risk Group ◽  
Cigarette Use ◽  
Structured Interviews ◽  
Tobacco Products ◽  
Patterns Of Use ◽  
Initial Interviews

Introduction: Smoking is one of the most important risk factors for cardiovascular disease (CVD). Electronic cigarettes (e-cigarettes) are becoming increasingly popular. However, little is known regarding their patterns of use in patients with established CVD.Aims: We aimed to assess the perceptions and patterns of use of e-cigarettes in patients presenting to a vascular clinic.Methods: We performed a qualitative study to identify perceptions and beliefs about e-cigarettes. Semi-structured interviews of consecutive patients consenting to participate were performed over five-months. Individuals were recruited from a vascular surgery outpatient clinic. Initial interviews were based on a questionnaire. Further structured interviews were conducted with patients currently using e-cigarettes, which were transcribed and analysed to assess perceptions and patterns of use.Results/Findings: Four overarching themes emerged: attraction to e-cigarettes as a harm reduction/smoking cessation strategy; uncertainty regarding the risks of e-cigarettes; use of various types of smoking cessation strategies; dual use and often complete relapse to tobacco products.Conclusions: Patients with established CVD view e-cigarettes as a means of smoking cessation; however, many relapse to tobacco products or use both simultaneously. Further research is necessary regarding the role of e-cigarettes in smoking cessation in this high-risk group.

Grommets and cholesteatoma in children

1988 ◽  
Vol 102 (11) ◽  
pp. 1000-1002 ◽  
Author(s):  
R. Herdman ◽  
J. L. W. Wright
Keyword(s):  
Retrospective Study ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Risk Group ◽  
High Risk Group ◽  
Cortical Mastoidectomy ◽  
History Of ◽  
Epithelial Invasion ◽  
Tympanic Membrane Retraction

Cholesteatoma in children may be a sequel to chronic exudative otitis media with tympanic membrane retraction but he the role of grommets in the possible facilitation of squamous epithelial invasion into the middle ear is not yet clear. A retrospective study was made of the history and prior treatment in 25 children who underwent mastoidectomy for cholesteatoma at St. Mary's Hospital between 1975 and 1986. Thirteen patients had undergone previous middle ear aeration procedures which included myringotomy, cortical mastoidectomy and grommets. There was no difference in the site or severity of cholesteatoma in the operated and non-operated cases. Of the seven patients with a history of multiple grommets three had primarily attic, and three had primarily mesotympanic disease. The latter had greater ossicular erosion. One patient with an intact tympanic membrane had grommet insertion subsequently developed a cholesteatoma. While cholesteatoma due directly to the presence of grommets is rare, it appears that children who require multiple grommet insertions constitute a high risk group and should be very closely monitored.

scholarly journals Development and validation of an individualized immune-related gene pairs prognostic signature in papillary renal cell carcinoma

2020 ◽  
Author(s):  
Xianghong Zhou ◽  
Shi Qiu ◽  
Di Jin ◽  
Kun Jin ◽  
Xiaonan Zheng ◽  
...  
Keyword(s):  
Gene Expression ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Related Gene ◽  
Prognostic Signature ◽  
Gene Pairs ◽  
Immune Related Gene ◽  
Immune Related Genes

Abstract Background: Papillary renal carcinoma (PRCC) is one of the important subtypes of kidney cancer, with a high degree of heterogeneity. At present, there is still a lack of robust and accurate biomarkers for the diagnosis, prognosis and treatment selection of PRCC. Considering the important role of tumor immunity in PRCC, we aim to construct a signature based on immune-related gene pairs (IRGPs) to estimate the prognostic of patients with PRCC.Methods: We obtained gene expression profiling and clinical information of patients with PRCC from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), which were divided into discovery and validation cohorts, respectively. The immune-related genes in the samples were used to construct gene pairs, and the immune-related genes pairs (IRGPs) with robust impact for overall survival (OS) were screened out to construct the signature by univariate analysis, multivariate Cox analysis, and least absolute shrinkage and selection operator (Lasso) analysis. Then we verified the prognostic role of the signature, and assessed the relationship between this signature with tumor immune infiltration and functional pathways.Results: A total of 315 patients were included in our study, and divided to discovery (n=287) and validation (n=28) cohorts. Finally, we selected 14 IRGPs with a panel of 22 unique genes to construct the prognostic signature. According to the signature, we stratified patients into high-risk group and low-risk group. In both discovery and validation cohorts, the results of Kaplan-Meier analysis showed that there were significant differences in OS between the two groups (p<0.001). Combined with multiple clinical pathological factors, the results of multivariate analyses confirmed that this signature was an independent predictor of OS (HR, 3.548; 95%CI, 2.096−6.006; p<0.001). The results of immune infiltration analysis demonstrated that the abundance of multiple tumor-infiltration lymphocytes such as CD8+ T cells, Tregs, and T follicular cell helper were significantly higher in the high-risk group. Functional analysis showed that multiple immune-related signaling pathways were enriched in the high-risk group.Conclusions: We successfully established an individualized prognostic immune-related gene pairs signature, which can accurately and independently predict the OS of patients with PRCC.

scholarly journals International and russian experience in treating children’s flu

2018 ◽  
pp. 137-145
Author(s):  
V. F. Uchaikin ◽  
O. V. Kladova ◽  
F. S. Kharlamova ◽  
N. L. Valts ◽  
Yu. V. Kompaniets ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Good Manufacturing Practice ◽  
Dosage Forms ◽  
High Risk Group ◽  
Russian Market ◽  
The Past ◽  
Treatment And Prevention ◽  
The World ◽  
Extensive Clinical Experience

The article presents an extensive clinical experience about the treatment and prevention of influenza by oseltamivir for children and adults including high-risk group patients through different countries around the world over the past 17 years. The article reveals the causes of resistance to oseltamivir with a relative evolution proportion. The new domestic drug Nomides (oseltamivir), which manufactured by Pharmasintez JSC (Russia) in accordance with the Good Manufacturing Practice (GMP), has been represented in the article by unique dosage forms 30 and 45 mg on the Russian market for childrens older than one years old.

scholarly journals Examining the Relationship between Fire Interest and Firesetting: Contributions of Previous Experience with Fire and Self and Emotional Regulation

2021 ◽  
Author(s):  
Rosalie Sherrell
Keyword(s):  
Regression Analysis ◽  
Emotional Regulation ◽  
Sensation Seeking ◽  
Economic Cost ◽  
Emotional Dysregulation ◽  
Previous Exposure ◽  
Unique Predictor ◽  
In Fire ◽  
The Relationship

<p>Deliberate firesetting is an international problem with significant personal and economic cost. Interest in fire has previously been identified as a unique predictor of deliberate firesetting, however little is known about how fire interest interacts with other factors to produce firesetting. This research aimed to gain a deeper understanding of the role of fire interest by exploring how this construct interacts with previous exposure to fire and aspects of self and emotional regulation, and how this relates to firesetting behaviour. Two anonymous online studies were conducted among New Zealand adult community samples: Study 1 examined the relationship between fire interest, previous exposure to fire, emotional dysregulation, impulsivity, and sensation seeking (N = 146); Study 2 replicated the first study and explored the relationship between these factors and engagement in deliberate firesetting (N = 149). Results from both studies showed that only previous exposure to fire and sensation seeking were consistently positively correlated with fire interest, however, when other variables were controlled for via multiple regression analysis, the thrill/adventure seeking facet of sensation seeking was the only significant predictor of fire interest. In Study 2, logistic regression showed that only fire interest and impulsivity were significant predictors of deliberate firesetting. Moderation analyses indicated that thrill/adventure seeking moderates the relationship between fire interest and firesetting behaviour, while impulsivity does not. These findings extend previous research and theory by providing an initial understanding of how various factors may influence an individual’s level of fire interest and their engagement in deliberate firesetting. </p>

scholarly journals The Role of Postoperative Radiotherapy and Prognostic Model in Primary Squamous Cell Carcinoma of Parotid Gland

2021 ◽  
Vol 10 ◽  
Author(s):  
Wenlong Qiu ◽  
Yong Yang ◽  
Shiran Sun ◽  
Fengge Zhou ◽  
Yi Xu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Survival Benefit ◽  
Prognostic Model ◽  
Risk Group ◽  
Postoperative Radiotherapy ◽  
High Risk Group ◽  
Seer Database

BackgroundPrimary squamous cell carcinoma of parotid gland (parotid SCC) is a high malignant histologic subtype of parotid cancers with aggressive clinical presentation. However, the clinical features and survival benefit of postoperative radiotherapy (PORT) for primary parotid SCC are not well known.MethodsA retrospective population-based study was performed to identify the role of PORT in parotid SCC patients diagnosed between 1975 and 2016 from SEER database. A prognostic risk model was established based on patient clinical features, including age, tumor stage, and node involvement status. Patients were stratified into high, intermediate, and low risk according to this model. The survival benefit of radiotherapy was compared in the whole cohort and different risk groups.ResultsNine hundred thirty-one parotid SCC patients were extracted from SEER database, 634 (68.1%) in the RT group and 286 (30.7%) in the non-RT group. Overall, 503 (54.0%) deaths occurred, with a median follow-up of 84 months, the 5-year OS was 43.6% in the whole cohort, 47.7 vs 35.9% in patients with/without PORT (P = 0.005), and 58.9 vs. 38.8 vs. 27.1% in low-, intermediate-, and high-risk group (P &lt; 0.001). Compared with surgery alone, PORT significantly improved the OS of patients with medium risk (47.5 vs. 20.6, P &lt; 0.001), whereas not in the low risk (61 vs. 54%, P = 0.710) and high (25.6 vs. 28.7%, P = 0.524).ConclusionThis prognostic model can separate the patients with parotid squamous cell carcinoma into different risk. PORT significantly improved the OS of patients with intermediate risk, whereas high-risk group may need more intensive treatment strategies.

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