Violence and crime among male inpatients with severe mental illness: attempting to explain ethnic differences

Background

Studies report that in the UK, among men with severe mental illness (SMI), those of black Caribbean ethnicity display increased risk of aggressive behaviour, criminal convictions, and schizophrenia. The study aimed to compare aggressive behaviour and criminal convictions among men with SMI of white British, black Caribbean and black African ethnicity, and to explore factors associated with differences across ethnicities.

Method

Sample 1 included 1,104 male inpatients with SMI. Sample 2 included a representative sub-sample of 165 who completed interviews, and authorized access to medical and criminal files. Ethnicity was self-ascribed.

Results

Staff-rated violence prior to admission, self-reported aggressive behaviour, and convictions for non-violent and violent crimes differed among men with SMI of different ethnicities. Relative to men with SMI of white British ethnicity, those of black African ethnicity showed decreased risk of aggressive behaviour, and those of black Caribbean ethnicity showed elevated risk of convictions for non-violent, and marginally, for violent crimes. Relative to men with SMI of black African ethnicity, those of black Caribbean ethnicity showed elevated risk of aggressive behaviour and criminal convictions. Proportionately more of the men of both black African and black Caribbean ethnicity, than those of white British ethnicity, presented schizophrenia spectrum disorders. Multivariate analyses failed to identify factors that would explain differences in aggressive behaviour, and criminal convictions across ethnic groups.

Conclusions

Differences in four different measures of aggressive and antisocial behaviour among men with SMI of different ethnicities were observed but factors associated with these differences were not found.     

The effects of strength,aerobic, and concurrent exercise on skeletal muscle damage in rats

Introduction: In this study we examined oxidative stress and skeletal muscle damage resulting from acute strength, aerobic, or concurrent exercise in rats. Methods: The animals were divided into control (C), strength (SE), aerobic (AE), and combined (CE) exercise groups. They were euthanized at 3 different time‐points (6, 24, and 48 h) after acute exercise. Results: SE exercise rats had increased dichlorofluorescein oxidation at 6 h post‐exercise and decreased superoxide dismutase activity at all time‐points. Glutathione peroxidase activity and sulfhydryl levels were increased in the AE group at 48 h post‐exercise. Serum lactate dehydrogenase activity was increased in the SE and CE groups at 24 h and in the AE group at 48 h. Echo intensity was elevated at 24 h for all groups. Conclusions: Forty‐eight hours was sufficient for complete recovery from oxidative stress and muscle damage in the SE and CE groups, but not in the AE group. Muscle Nerve 50 : 79–86, 2014     

The effects of micro-implant assisted rapid palatal expansion (MARPE) on the nasomaxillary complex—a finite element method (FEM) analysis

Background

Orthodontic palatal expansion appliances have been widely used with satisfactory and, most often, predictable clinical results. Recently, clinicians have successfully utilized micro-implants with palatal expander designs to work as anchors to the palate to achieve more efficient skeletal expansion and to decrease undesired dental effects. The purpose of the study was to use finite element method (FEM) to determine the stress distribution and displacement within the craniofacial complex when simulated conventional and micro-implant-assisted rapid palatal expansion (MARPE) expansion forces are applied to the maxilla. The simulated stress distribution produced within the palate and maxillary buttresses in addition to the displacement and rotation of the maxilla could then be analyzed to determine if micro-implants aid in skeletal expansion.

Methods

A three-dimensional (3D) mesh model of the cranium with associated maxillary sutures was developed using computed tomography (CT) images and Mimics modeling software. To compare transverse expansion stresses in rapid palatal expansion (RPE) and MARPE, expansion forces were distributed to differing points on the maxilla and evaluated with ANSYS simulation software.

Results

The stresses distributed from forces applied to the maxillary teeth are distributed mainly along the trajectories of the three maxillary buttresses. In comparison, the MARPE showed tension and compression directed to the palate, while showing less rotation, and tipping of the maxillary complex. In addition, the conventional hyrax displayed a rotation of the maxilla around the teeth as opposed to the midpalatal suture of the MARPE. This data suggests that the MARPE causes the maxilla to bend laterally, while preventing unwanted rotation of the complex.

Conclusions

In conclusion, the MARPE may be beneficial for hyperdivergent patients, or those that have already experienced closure of the midpalatal suture, who require palatal expansion and would worsen from buccal tipping of the teeth or maxillary complex.     

Review: Power of big data to improve patient care in gastroenterology

Big data is defined as being large, varied or frequently updated, and usually generated from real-world interaction. With the unprecedented availability of big data, comes an obligation to maximise its potential for healthcare improvements in treatment effectiveness, disease prevention and healthcare delivery. We review the opportunities and challenges that big data brings to gastroenterology. We review its sources for healthcare improvement in gastroenterology, including electronic medical records, patient registries and patient-generated data. Big data can complement traditional research methods in hypothesis generation, supporting studies and disseminating findings; and in some cases holds distinct advantages where traditional trials are unfeasible. There is great potential power in patient-level linkage of datasets to help quantify inequalities, identify best practice and improve patient outcomes. We exemplify this with the UK colorectal cancer repository and the potential of linkage using the National Endoscopy Database, the inflammatory bowel disease registry and the National Health Service bowel cancer screening programme. Artificial intelligence and machine learning are increasingly being used to improve diagnostics in gastroenterology, with image analysis entering clinical practice, and the potential of machine learning to improve outcome prediction and diagnostics in other clinical areas. Big data brings issues with large sample sizes, real-world biases, data curation, keeping clinical context at analysis and General Data Protection Regulation compliance. There is a tension between our obligation to use data for the common good and protecting individual patient’s data. We emphasise the importance of engaging with our patients to enable them to understand their data usage as fully as they wish.