October 2017 - Page 15 of 22 - searchfortruth.info

Prior Crime Specialization and Its Relationship to Homicide Crime Scene Behavior Type

January 22, 2019October 11, 2017 by admin

Abstract

The present study explored the link between offenders’ prior criminal specialization (violent crime, sexual crime, or burglary/theft) and subsequent homicide crime scene type (exploit, control, distance) in 77 U.S. cases of single-offender/single-victim homicides. Specialists as compared to those with no prior criminal history were significantly more likely to engage in goal directed behaviors such as controlling the victim, controlling the outcome, and exploitative behaviors (sex and theft). Sexual crime specialists specifically were the more distinct subtype. The findings indicated differences in how first-time homicide offenders approach the crime scene and are discussed in line with the usefulness to homicide investigators.

Intellectual Disability

November 23, 2018October 11, 2017 by admin

Intellectua Disability

Email this page to a friend Print Facebook Twitter Intellectual disability is a condition diagnosed before age 18 that includes below-average intellectual function and a lack of skills necessary for daily living.

In the past, the term mental retardation was used to describe this condition. This term is no longer used.

Causes Intellectual disability affects about 1% to 3% of the population. There are many causes of intellectual disability, but doctors find a specific reason in only 25% of cases.

Risk factors are related to the causes. Causes of intellectual disability can include:

• Infections (present at birth or occurring after birth) • Chromosomal abnormalities (such as Down syndrome) • Environmental • Metabolic (such as hyperbilirubinemia, or very high bilirubin levels in babies) • Nutritional (such as malnutrition) • Toxic (intrauterine exposure to alcohol, cocaine, amphetamines, and other drugs) •Trauma (before and after birth) • Unexplained (doctors do not know the reason for the person's intellectual disability)

Substance-Induced Disorders

November 23, 2018October 11, 2017 by admin

The toxic effects of substances can mimic mental illness in ways that can be difficult to distinguish from mental illness. This chapter focuses on symptoms of mental illness that are the result of substance abuse—a condition referred to as “substance-induced mental disorders.”

Overview Description Alcohol Caffeine Cocaine and Amphetamines Hallucinogens Nicotine Opioids Sedatives Diagnostic Considerations Case Studies: Identifying Disorders

Description As defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (American Psychiatric Association [APA] 2000) (DSM-IV-TR), substance-induced disorders include:

Substance-induced delirium Substance-induced persisting dementia Substance-induced persisting amnestic disorder Substance-induced psychotic disorder Substance-induced mood disorder Substance-induced anxiety disorder Hallucinogen persisting perceptual disorder Substance-induced sexual dysfunction Substance-induced sleep disorder

Substance-induced disorders are distinct from independent cooccurring mental disorders in that all or most of the psychiatric symptoms are the direct result of substance use. This is not to state that substance-induced disorders preclude co-occurring mental disorders, only that...

Psychosis (Schizophrenia And Bipolar Disorder) And Substance Use

February 21, 2019October 11, 2017 by admin

7 Psychosis (schizophrenia and bipolar disorder) and substance use

7.1 Psychosis

Psychosis is characterised by a loss of connectedness with reality. A person may develop false ideas or beliefs about reality (delusions) which in themselves may be based on false perceptions (hallucinations). People experiencing psychosis also have characteristic flaws in the ways they think. These are termed ‘thought disorders’. Examples are tangential thinking, loose associations between ideas, and incoherence. Psychosis significantly impairs work, family and social functioning. People with psychoses often experience poorer physical health. The worse the psychotic symptoms are, the higher the associated level nof impairment(251). Psychotic symptoms can occur in response to physical conditions, e.g. acute delirium with septicaemia. Alternatively, psychoses can be functional. There are two broad classes of functional psychotic disorders: schizophrenia and bipolar disorder. Generally, schizophrenia is a chronic condition with exacerbations, but always with some background symptoms. Bipolar disorder is ...

Bias in Mental Health Assessment and Intervention: Theory and Evidence

November 23, 2018October 11, 2017 by admin

Abstract

A recent surgeon general’s report and various studies document racial and ethnic disparities in mental health care, including gaps in access, questionable diagnostic practices, and limited provision of optimum treatments. Bias is a little studied but viable explanation for these disparities.

It is important to isolate bias from other barriers to high-quality mental health care and to understand bias at several levels (practitioner, practice network or program, and community). More research is needed that directly evaluates the contribution of particular forms of bias to disparities in the area of mental health care. RACIAL AND ETHNIC DISPARITIES are as widespread in the diagnosis and treatment of mental illness as they are in other areas of health. In 2001, then–Surgeon General David Satcher issued the report Race, Culture, and Ethnicity and Mental Health,1 in which he convincingly documented disparities in access and treatment that leave too many minority individuals...

Central Nervous System Stimulants And Sport Practice

November 23, 2018October 11, 2017 by admin

Abstract

Background and objectives

Central nervous system (CNS) stimulants may be used to reduce tiredness and increase alertness, competitiveness, and aggression. They are more likely to be used in competition but may be used during training to increase the intensity of the training session. There are several potential dangers involving their misuse in contact sports. This paper reviews the three main CNS stimulants, ephedrine, amfetamine, and cocaine, in relation to misuse in sport.

Methods

Description of the pharmacology, actions, and side effects of amfetamine, cocaine, and ephedrine.

Results

CNS stimulants have psychotropic effects that may be perceived to be ergogenic. Some are prescription drugs, such as Ephedra alkaloids, and there are issues regarding their appropriate therapeutic use. Recently attention has been given to their widespread use by athletes, despite the lack of evidence regarding any ergogenic or real performance benefit, and their potentially serious side effects. Recreational drugs, some of which are illegal (cocaine, amfetamines), are commonly...

Learned Helplessness: Theory and Evidence

November 23, 2018October 11, 2017 by admin

Abstract

Reviews the literature which examined the effects of exposing organisms to aversive events which they cannot control. Motivational, cognitive, and emotional effects of uncontrollability are examined. It is hypothesized that when events are uncontrollable the organism learns that its behavior and outcomes are independent, and this learning produces the motivational, cognitive, and emotional effects of uncontrollability. Research hich supports this learned helplessness hypothesis is described along with alternative hypotheses which have been offered as explanations of the learned helplessness effect. The application of this hypothesis to rats and man is examined...

Noise, Noise Sensitivity And Psychiatric Disorder: Epidemiological And Psychophysiological Studies.

November 24, 2018October 11, 2017 by admin

Abstract

Noise, a prototypical environmental stressor, has clear health effects in causing hearing loss but other health effects are less evident. Noise exposure may lead to minor emotional symptoms but the evidence of elevated levels of aircraft noise leading to psychiatric hospital admissions and psychiatric disorder in the community is contradictory. Despite this there are well documented associations between noise exposure and changes in performance, sleep disturbance and emotional reactions such as annoyance. Moreover, annoyance is associated with both environmental noise level and psychological and physical symptoms, psychiatric disorder and use of health services. It seems likely that existing psychiatric disorder contributes to high levels of annoyance. However, there is also the possibility that tendency to annoyance may be a risk factor for psychiatric morbidity. Although noise level explains a significant proportion of the variance in annoyance, the other major factor, confirmed in many studies,..

Understanding and Managing Compulsive Sexual Behaviors

November 24, 2018October 11, 2017 by admin

Abstract

Compulsive sexual behavior, otherwise known as sexual addiction, is an emerging psychiatric disorder that has significant medical and psychiatric consequences. Until recently, very little empirical data existed to explain the biological, psychological, and social risk factors that contribute to this condition. In addition, clinical issues, such as the natural course and best practices on treating sexual addictions, have not been formalized. Despite this absence, the number of patients and communities requesting assistance with this problem remains significant. This article will review the clinical features of compulsive sexual behavior and will summarize the current evidence for psychological and pharmacological treatment.

Introduction

Sexuality in the United States has never been more socially acceptable. Sex has become part of mainstream culture as reflected through the explicit coverage of sexual behaviors in the media, movies, newspapers, and magazines. In many ways, sexual expression has become a form of accepted entertainment similar to gambling, attending sporting events,..

The Dangerousness of Persons with Delusional Jealousy

February 21, 2019October 10, 2017 by admin

Delusional jealousy has received increasing recent attention from the psychiatric community and the public.5 This renewed interest is related to a greater appreciation of the linkage between delusional jealousy and subsequent aggression, especially aggression associated with domestic violence. Delusional jealousy may thus be one of the important variables to be studied when addressing violence prevention or setting social policy in domestic or similar dyads. Despite renewed interest in the study of delusional jealousy, relatively little systematic work has been done to investigate it from the perspective of a forensic psyhiatrist. Even less work has been done to develop a comprehensive bio psychosocial perspective of delusional jealousy by integrating neurobiological, psychological, ecological. and cultural parameters. The objectives of this article are as follows: (1) to report important psychiatric and psychosocial characteristics in a sample of 20 cases of delusional jealousy; (2) to explore the degree o...f

Pulmonary Edema And Hemorrhage As Complications Of Acute Airway Obstruction Following Anesthesia.

November 24, 2018October 10, 2017 by admin

Abstract

Airway obstruction is a quite common complication while its conditioned pulmonary edema--rare. Causes associated with anesthesia are various. Forced inspiratory efforts against an obstructed upper airway generate peak negative intrathoracic pressure. This may cause pulmonary edema and in some cases pulmonary hemorrhage. Last-mentioned is extremely rare. Pulmonary edema may arise soon after airway obstruction as well as later, after some hours. Damage of bronchi is found seldom during bronchoscopy in case of pulmonary hemorrhage, while more often alveolar damage is observed due to alveolar membrane damage. Hemorrhage is conditioned by hydrostatic pressure level, level of hypoxia, damage to bronchi or alveoli (disruption of alveolar membrane). Early diagnosis of negative-pressure pulmonary edema or pulmonary hemorrhage is very important, because this affects postoperative morbidity and mortality of the patients. Two cases of pulmonary edema and hemorrhage after upper airway obstruction as well as literature overview are presented in this article. Pulmonary hemorrhage developed during anesthesia...

Crisis Management During Anaesthesia: Pulmonary Oedema

November 24, 2018October 10, 2017 by admin

Abstract

Background: Pulmonary oedema may complicate the perioperative period and the aetiology may be different from non-operative patients. Diagnosis may be difficult during anaesthesia and consequently management may be delayed.

Objectives: To examine the role of a previously described core algorithm “COVER ABCD–A SWIFT CHECK”, supplemented by a specific sub-algorithm for pulmonary oedema, in its management occurring in association with anaesthesia.

Methods: The potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved.

Results: Pulmonary oedema was identified in 35 (<1%) of the first 4000 reports to AIMS. The most frequent presenting sign was hypoxia (46%) and the most specific sign was the presence of frothy sputum (23%). The core algorithm, although successful in the management of the initial physiological upset,...

The Surgical Hypertensive Patient

November 24, 2018October 10, 2017 by admin

Abstract

We reviewed the pathophysiology and treatment of hypertension in a recent edition of this journal (see key references). In this article, we discuss the management of the hypertensive patient presenting for surgery and anaesthesia.

Key points

Arterial hypertension is a risk factor for cardiovascular complications after anaesthesia and surgery.

Ideally, all hypertensive patients should be treated before elective surgery; in practice only patients with stage 3 (systolic >180 mm Hg; diastolic >110 mm Hg) are regarded as needing preoperative treatment.

The importance of isolated systolic hypertension in the surgical patient is not well defined.

Patients with moderate hypertension (stage 2) but significant target organ involvement should be considered for preoperative treatment.

Most antihypertensive agents do not have adverse interactions with anaesthetic agents and should be continued throughout the perioperative period except for ACE inhibitors and angiotensin II receptor antagonists where the evidence for continuation or cessation is unclear..

Fluoxetine Delayed Release Capsules

November 24, 2018October 10, 2017 by admin

WARNING: SUICIDAL THOUGHTS AND BEHAVIOR

Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older [see Warnings and Precautions (5.1)]. psy

In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber [see Warnings and Precautions (5.1).

Fluoxetine is not approved for use in children less than 7 years of age [see Warnings and Precautions (5.1) and Use in Specific Populations (8.4)]. Indications and Usage for Fluoxetine Delayed Release Capsules

Fluoxetine delayed-release capsules are indicated for the treatment of: ...

Extended Release Drug Delivery Strategies in Psychiatry

November 24, 2018October 10, 2017 by admin

Abstract

Objective: An overview of the emerging field of long-term delivery strategies for improved convenience and adherence with psychiatric medications is provided. This review is motivated by the hypothesis that adherence to treatment is an important determinant of clinical outcomes in a wide range of settings and is particularly important in psychiatry practice where patients require treatment for months or years and premature discontinuation can have serious consequences for patient health and quality of life.

Design: The author reviews the relevant literature and highlights several approaches to providing improved access to continuous medication through new and innovative delivery strategies ranging from days to annual intervals.

Benefits and Disadvantages: Several solutions to the problem of discontinuous access to pharmacotherapy are being developed in the form of new, long-acting drug-delivery systems, which gradually release medication over a period of several days or weeks with a single application. Long-acting formulations of psychiatric medications offer...

Is Succinylcholine Really Superior for RSI?

November 24, 2018October 10, 2017 by admin

Background:

Intubation is arguably the most important procedure performed by Emergency Physicians (EPs). Ideally, it would be performed successfully on the first attempt each and every time, but this of course cannot always be the case. Rapid Sequence Intubation (RSI) has become the preferred method for emergency intubations, as it improves visualization of the vocal cords, and decreases complications such as aspiration and increased intracranial pressure. Succinylcholine, a depolarizing agent, is the most widely utilized paralytic due to its rapid onset and short half-life. However, there are certain circumstances in which succinylcholine is contraindicated, including suspected hyperkalemia, known prior adverse reactions, concern for head injury, neuromuscular disease, or spinal cord injury. Rocuronium, a non-depolarizing agent with a considerably longer half-life, is frequently used in these situations.

Prior studies evaluated by the Cochrane review suggest succinylcholine produces superior intubation conditions when compared to rocuronium.[1]However, there is concern that succinylcholine's advantage...