bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anxiety Disorders among Offenders with Antisocial Personality Disorders: A Distinct Subtype?
Authors: Hodgins Sheilagh , De Brito Stephane A , Chhabra Preeti , Côté Gilles 
Published: January 2017

Objectives: About 50% of men with antisocial personality disorder (APD) present a comorbid anxiety disorder. Historically, it was thought that anxiety limited criminal activity and the development of APD, but recent evidence suggests that heightened responsiveness to threat may lead to persistent violent behaviour. Our study aimed to determine the prevalence of APD comorbid with anxiety disorders among offenders and the association of these comorbid disorders with violent offending. Method: A random sample of 495 male penitentiary inmates completed an interview using the Diagnostic Interview Schedule. After excluding men with psychotic disorders, 279 with APD were retained. All authorized access to their criminal records. Results: Two-thirds of the prisoners with APD presented a lifetime anxiety disorder. Among them, one-half had the onset of their anxiety disorder before they were aged 16 years. Among the offenders with APD, those with, compared with those without, anxiety disorders presented significantly more symptoms of APD, were more likely to have begun their criminal careers before they were aged 15 years, to have diagnoses of alcohol and (or) drug abuse and (or) dependence, and to have experienced suicidal ideas and attempts. While there were no differences in the mean number of convictions for violent offences between APD prisoners with and without anxiety disorders, more of those with anxiety disorders had been convicted of serious crimes involving interpersonal violence. Conclusions: Among men with APD, a substantial subgroup present life-long anxiety disorders. This pattern of comorbidity may reflect a distinct mechanism underlying violent behaviour and signalling the need for specific treatments.
Risk Factors for Depression in Older Adults in Beijing
Authors: Li Ning , Pang Lihua , Chen Gong , Song Xinming , Zhang Jun , Zheng Xiaoying 
Published: January 2017

Objective: Depression is a common mental disorder in older adults. We examined the prevalence and risk factors for depression in older adults in the Beijing area. Method: We used data from a cross-sectional survey conducted in July 2006 in Beijing. As part of the national survey for older Chinese adults, 2002 older adults were interviewed. The 15-item Geriatric Depression Scale was used to assess depression. Demographics as well as other personal information were also collected. Results: Among Beijing older adults, 13.01% were categorized as depressed. Prevalence rates of depression in rural and urban older adults were 26.63% and 10.79%, respectively. Poor economic status, high activities of daily living (ADL) score, poor physical health, impious offspring, and feeling old were important predictors of depression in older adults in Beijing. For the urban sample, poor economic status, poor physical health, high ADL score, and impious offspring were risk factors for depression. For the rural sample, depression was significantly associated with poor economic status and poor physical health. Conclusions: Depression is a common mood disorder among older adults in the Beijing area. Filial piety is a unique predictor for depression in older Chinese adults, compared with findings in Western cultures.
Which Students Will Choose a Career in Psychiatry?
Authors: Gowans Margot C , Epi Grad Dip Clin , Wright Bruce J , Brenneis Fraser R , Scott Ian M 
Published: January 2017

Objective: In Canada, availability of and access to mental health professionals is limited. Only 6.6% of practising physicians are psychiatrists, a situation unlikely to improve in the foreseeable future. Identifying student characteristics present at medical school entry that predict a subsequent psychiatry residency choice could allow targeted recruiting or support to students early on in their careers, in turn creating a supply of psychiatry-oriented residency applicants. Method: Between 2002 and 2004, data were collected from students in 15 Canadian medical school classes within 2 weeks of commencement of their medical studies. Surveys included questions on career preferences, attitudes, and demographics. Students were followed through to graduation and entry data linked anonymously with residency choice data. Logistic regression was used to identify early predictors of a psychiatry residency choice. Results: Students ( n = 1502) (77.4% of those eligible) contributed to the final analysis, with 5.3% naming psychiatry as their preferred residency career. When stated career interest in psychiatry at medical school entry was not included in a regression model, an exit career choice in psychiatry was predicted by a student's desire for prestige, lesser interest in medical compared with social problems, low hospital orientation, and not volunteering in sports. When an entry career interest in psychiatry was included in the model, this variable became the only predictor of an exit career choice in psychiatry. Conclusion: While experience and attitudes at medical school entry can predict whether students will chose a psychiatry career, the strongest predictor is an early career interest in psychiatry.
Trends in Psychotropic Use in Saskatchewan from 1983 to 2007
Authors: Meng Xiangfei , D'Arcy Carl , Tempier Raymond 
Published: January 2017

Objective: There has been little research reported on trends in the use of a full spectrum of psychotropics in a general population. We provide an overview of trends in psychotropic use over a 24-year period for Saskatchewan. Methods: Data were drawn from the Saskatchewan Ministry of Health administrative data files. It covers antidepressants (ADs), antipsychotics, mood stabilizers, anxiolytics, stimulants, and cholinesterase inhibitors in outpatient settings. We analyzed data from 9 triennial years from 1983 to 2007. Descriptive statistics were used. Results: Among the Saskatchewan population in our study, 8.38% were prescribed at least 1 psychotropic in 1983. The prevalence decreased to 7.44% in 1989, then gradually increased to 12.90% in 2007. We found a continuous increase in the number of psychotropic prescriptions for both males and females. The trend became more marked during the 1990s. Females used more psychotropics. Family physicians were the major prescribers, and their prescriptions dramatically increased over the period. There was an increase in the prescribing of all psychotropics except for anxiolytics. AD prescriptions dramatically increased, especially from 1995 onward. The proportion of patients with 8 to 11 and 12 or more prescriptions per year also gradually increased, whereas the proportion of patients with less than 3 prescriptions per year decreased. Conclusions: AD prescriptions are the major reason for the increasing trend of psychotropic use. Given the major role of family physicians in the use of psychotropics, the need for appropriate training and continuing education is reinforced.
A Surveillance System to Monitor Excess Mortality of People with Mental Illness in Canada
Authors: Lesage Alain , Rochette Louis , Émond Valérie , Pelletier Éric , St-Laurent Danielle , Diallo Fatoumata Binta , Kisely Stephen 
Published: January 2017

Objective: Outcome measures are rarely available for surveillance and system performance monitoring for mental disorders and addictions. Our study aims to demonstrate the feasibility and face validity of routinely measuring the mortality gap in the Canadian context at the provincial and regional levels using the methods and data available to the Canadian Chronic Disease Surveillance System (CCDSS) of the Public Health Agency of Canada. Methods: We used longitudinal data from the Quebec Integrated Chronic Disease Surveillance System, which also provides aggregated data to the CCDSS. This includes data from the health insurance registry physician claims and the hospital discharge abstract for all mental disorder diagnoses (International Classification of Diseases [ICD]-9 290–319 or ICD-10 F00–F99). Patients were defined as having had received a mental disorder diagnosis at least once during the year. Life expectancy was measured using Chiang's method for abridged life tables, complemented by the Hsieh method for adjustment of the last age interval. Results: We found a lower life expectancy among psychiatric patients of 8 years for men and 5 years for women. For patients with schizophrenia, life expectancy was lowered by 12 years for men and 8 years for women. Cardiovascular disease and cancer were the most common causes of premature death. Findings were consistent across time and regions of the province. Lower estimates of the mortality gap, compared with literature, could be explained by the inclusion of primary care patients and methods. Conclusions: Our study demonstrates the feasibility of using administrative data to measure the impact of current and future mental health plans in Canada provided the techniques can be replicated in other Canadian provinces.
A Clinical and Academic Outcome Study of Children Attending a Day Treatment Program
Authors: Kotsopoulos Sotiris , Walker Selena , Beggs Karyn , Jones Barbara 
Published: January 2017

Objective: To assess the behavioural and academic improvement of children who attended a day treatment program during a defined period of time. Method: Forty-six children admitted consecutively to the project were assessed on admission and discharge using behavioural and academic measures. They also had intelligence and language assessments. The subjects attended the program for one academic year, on the average. The large majority presented with disruptive behaviour disorders and low academic achievement levels. Results: There was a significant improvement reported by the parents in externalizing (P < 0.001) and internalizing (P < 0.05) behaviour. The subjects also gained one academic year, but their levels continued to be low in terms of percentiles. Measures of academic improvement showed significant associations with cognitive measures only (subscales of Wechsler Intelligence Scale for Children-Revised [WISC-R] and Clinical Evaluation of Language Fundamentals-Revised [CELF-R]). Conclusion: A day treatment and school program is an effective modality for treatment and remediation of children with severe psychiatric disorders. The academic underachievement may be resistant to remediation within the limited period of attendance in such a program.
Fitness to Stand Trial: Characteristics of Remands since the 1992 Criminal Code Amendments
Authors: Zapf Patricia A , Roesch Ronald 
Published: January 2017

Objective: To examine the characteristics of a sample of remands after the introduction of the 1992 Criminal Code amendments, to compare those deemed fit with those deemed unfit as the result of an institution-based evaluation of fitness, and to determine the impact of the Code changes on one's detention period by investigating the length of time that individuals were held on remand. Method: File information was collected and analyzed for 180 males who were remanded for inpatient evaluations of their fitness to stand trial between October 1994 and July 1995. Results: The results indicated that remanded defendants are more likely to be single, unemployed, and living alone and that unfit defendants are significantly more likely to have never been married. As well, individuals who were found to be unfit to stand trial were significantly less likely to have been diagnosed with a drug- or alcohol-use disorder and were 4 times more likely to have been diagnosed with a psychotic disorder. The results also indicated that while the 1992 Criminal Code revisions called for a 5-day evaluation period, it appears that this is rarely accomplished, and, in fact, the average length of time for an assessment of fitness is 23 days. Finally, the majority of remanded individuals are certified and treated with psychotropic medications while on remand. Conclusion: The results of this study suggest that the fitness remand period is being used for purposes other than assessing fitness.
The Treatment of Acne Scarring Using a Wire Scalpel
Authors: Ant Jeffrey G. , Branman Rhys L. 
Published: January 2017

Introduction: Treatment of acne scarring is a staged and time-consuming procedure. Needle subcision is used to raise rolling scars that are attached below the level of the dermis. This article describes a modification of that technique to treat a “field” of acne scars with a commercially available wire scalpel. This technique treats rolling scars and has some benefit to clusters of deep boxcar scars. A patient example is demonstrated. Materials and Methods: After local infiltration with 1% lidocaine with 1:100 000 epinephrine in a volume sufficient to blanch the operative sites, the areas are divided into narrow triangular or oval sections approximately 5 mm at the widest point. A straight needle swedged on a wire scalpel is used to guide the wire from the apex through the 3 sides of the triangle and back out the apex. The desired level is just subdermal. The needle should exit and re-enter through the same hole at the 3 corners. The wire is then grasped firmly and pulled beneath the dermis with a sawlike motion, allowing the wire to severe the dermal attachments. This process is repeated in slightly overlapping sections to avoid depressions from untreated areas until every identified scar is treated. Patient Presentation: In the case presented, some acne scarring remained visible; however, the authors noted an overall improvement, and the patient stated he was pleased with the results. Bleeding is usually minimal, and pressure dressings are normally not necessary. Discussion: The technique of wire subcision is an extension of a proven technique of needle subcision in the treatment of acne scarring. Although it is not useful in the treatment of all types of acne scarring, it is very effective when treating rolling scars that have dermal attachments. Each pass of the wire treats a wider area than the needle technique and is therefore better designed to completely undermine an area with fewer dermal attachments left untreated. Lacerations can be avoided by carefully exiting and entering through the same needle holes. Conclusions: The wire subcision technique treats rolling scars and may benefit clusters of deep boxcar scars. It may also be used to treat wider areas than needle subcision. The technique is simple and the complication rates are low. The authors believe this is a useful addition to the pantheon of acne scarring treatment techniques.
The Cosmetic Umbilicus: A Review of Aesthetic Features and Surgical Methods
Authors: Nelson Kristin , Borsand Marvin 
Published: January 2017

Introduction: The umbilicus (commonly called the belly button or navel) is an important part of the appearance of the abdomen. It must be carefully reconstructed during abdominoplasty to achieve the best cosmetic result. Features important to aesthetic appearance of the umbilicus include size, shape, depth, and position on the anterior abdomen. A variety of techniques, from simple to complicated, are available to attempt to achieve umbilical beauty. The objective of this review is to describe the characteristics of the ideal umbilicus and several available techniques surgeons can use to obtain ideal results when resetting or reconstructing the umbilicus. Methods: The literature was reviewed for umbilical reconstruction and umbilicoplasty procedures in abdominoplasty with additional emphasis on what features are important to the aesthetic appearance of the umbilicus. The surgical procedures and aesthetic preferences are summarized in this article. Results: Eight surgical procedures are illustrated here. The best surgical techniques allow a procedure to be performed in a timely fashion as well as to produce the best short-term and long-term results. Three of the procedures illustrated are unusual, complex, and time consuming, and are recommended only for cases when the umbilicus must be completely reconstructed because the original umbilicus is too malformed to be of use in reconstruction. Discussion: Suggestions taken from the various surgical techniques are emphasized, including striving for proper umbilical depth; defatting the new periumbilical region of the abdominal fat; tacking the stalk to the abdominal aponeurosis or attaching the superficial abdominal fascia to the edges of the abdominal flap incision; recognizing the importance of shape, size, and positioning of the final result; and avoiding large incisions. Conclusion: There are many acceptable methods for resetting the umbilicus available to cosmetic surgeons, and each surgeon must determine his or her favorite procedure. The best technique for a particular case may include ideas from several of the surgical approaches. The final result should strive for a moderately small, vertically shaped umbilicus with superior hooding. The new umbilicus should not have any protrusion or distortion.
Autologous Fat Transfer: Eliminating the Centrifuge, Decreasing Lipocyte Trauma and Establishing Standardization for Scientific Study
Authors: Shippert Ron D. 
Published: January 2017

Introduction: The autologous fat transfer procedure has undergone a renewal of interest because of the need for larger quantities of economical filler (face, buttocks, hands, and breasts). Commercial fillers are cost prohibitive when large quantities are needed. Present instruments on the market are not specialized enough to perform well during the autologous fat transfer procedure. As a result, multiple techniques have evolved that produce extremely varied results that are not scientifically verifiable. The objectives of this paper are to (1) review the events that are traumatic for the lipocyte and review how those events can be improved through new instrumentation; (2) review the use of the centrifuge and consider replacement of the centrifuge with an effective filter system; (3) establish instrument standards that will encourage scientific technique verification; and (4) introduce a standardized autologous fat transfer instrument that will save time, reduce significant trauma, and have standardized features to promote accurate scientific study. Methods: Information was obtained via a questionnaire, internet investigation, trade show information, personal discussions with surgeons, and the author's experience. Information from the questionnaire was used in the design of a new, improved standardized instrument. Results: During this study, an instrument was designed that would reduce operating room time considerably. Most of the time reduction was secondary to keeping the fat in the harvest syringe without transferring or centrifuging. This change in procedure would also considerably reduce lipocyte trauma in all 12 of the commonly accepted lipocyte trauma categories. In addition, the instrument could be standardized with multiple features that would give the surgeon confidence that the surgical results would not change because of the instruments. Conclusions: The Tissu-Trans™ device that was designed during this study significantly saves time, simplifies the procedure, and has standardized features that allow for scientific studies that are more accurate. The equipment offers simplicity and “feature latitude,” allowing the surgeon to perform all of the major steps (harvest, filter, irrigate, treatment, and reinjection) from a single harvest syringe. Although all 12 of the traumatic events for lipocytes were reduced in intensity, one should not leap to the conclusion that this correlates with increased lipocyte survival. To date, this has not been proven. Further clinical testing will be necessary to obtain this information.
Monitored Anesthesia Care vs. General Anesthesia: A Comparison of 100 Aesthetic Surgeries Performed in an Office-Based Surgical Center
Authors: Constantine Steven T. , Kennedy Brent D. , Jones Trenton C. , Pifer Matthew A. 
Published: January 2017

Introduction: The demand for and growth of elective aesthetic procedures have exploded over the past decade. This growth in an era of cost containment has led many physicians to seek a more judicious use of medical resources. Outpatient and office-based surgical centers have risen dramatically throughout the country, in part as a means to achieve such a goal. However, there has been significant debate over the most appropriate, cost-effective, and safe anesthetic techniques for such procedures. The objective of this study was to provide supporting evidence for the safety and efficacy of office-based surgical procedures as well as to evaluate and compare various anesthetic techniques in an era of cost containment. Materials and Methods: We retrospectively analyzed data from 100 consecutive aesthetic surgical cases performed by 2 surgeons who utilized markedly different anesthetic techniques, namely monitored anesthesia care or general anesthesia, in an office-based surgical center. Retrospective data included patient demographics, medical history, type of procedure, vital signs, duration of procedure, duration of recovery, medication dosages, incidence of intraoperative and immediate postoperative complications, and incidence of immediate postoperative nausea, vomiting, and pain. In addition, an operating cost analysis of both anesthetic techniques was performed. Results: There were no deaths or major complications in either group of patients. The average recovery time for the monitored anesthesia care group was 1.0 hour as compared to 1.8 hours in the general anesthesia group. There was a slightly higher incidence of immediate postoperative nausea and/or vomiting as well as immediate postoperative discomfort in the general anesthesia group. In addition, at our facility it was much more cost-effective to provide monitored anesthesia care, at $210.03 per patient as compared to $527.68 per patient undergoing a general anesthetic. Discussion: It is reasonable to conclude from our retrospective data that both monitored anesthesia care and general anesthesia are relatively safe methods for providing anesthesia for elective aesthetic procedures. From a cost perspective, it is clear that monitored anesthesia care offers a more cost-effective means for providing anesthesia; however, the decision to utilize one technique versus the other should be based upon surgeon comfort level, the type of procedure performed, and the patient's desires, if reasonable.