Mentally abnormal prisoners on remand: I—Rejected or accepted by the NHS?

Increasing numbers of mentally abnormal offenders are sentenced to prison. The decision to treat or imprison them is influenced by the attitudes of consultant psychiatrists and their staff. The process whereby those decisions were made and the willingness of consultants to offer treatment were investigated. A retrospective survey of all (362) mentally abnormal men remanded to Winchester prison for psychiatric reports over the five years 1979-83 showed that one in five were rejected for treatment by the NHS consultant psychiatrist responsible for their care. Those with mental handicaps, organic brain damage, or a chronic psychotic illness rendering them unable to cope independently in the community were the most likely to be rejected. They posed the least threat to the community in terms of their criminal behaviour yet were more likely to be sentenced to imprisonment. Such subjects were commonly described by consultants as too disturbed or potentially dangerous to be admitted to hospital or as criminals and unsuitable for treatment. Consultants in mental hospitals were most likely and those in district general hospitals and academic units least likely to accept prisoners.The fact that many mentally ill and mentally handicapped patients can receive adequate care and treatment only on reception into prison raises serious questions about the adequacy of current management policies and the range of facilities provided by regional health authorities.     

Mentally abnormal prisoners on remand: II—Comparison of services provided by Oxford and Wessex regions

Most regional health authorities have or plan to have secure units for treating mentally abnormal offenders. A retrospective study was carried out to compare the effectiveness of the health care services for men remanded to Winchester prison from Oxford and Wessex regions over the five years 1979-83. Thirty seven (30%) of 124 prisoners from Oxford region were rejected for treatment compared with 36 (16%) of the 220 men from Wessex region. Men from Oxford region were significantly more likely to be recommended for admission to a special hospital than those from Wessex (13/124 (10%) v 9/220 (4%), respectively) and significantly less likely to be recommended for admission to a hospital in the catchment area (35/124 (28%) v 94/220 (43%)). Men on remand from Oxford region were significantly more often perceived as being disruptive or aggressive by hospital staff and more likely to be labelled as having psychopathic or personality disorders. These differences may have reflected different attitudes towards mentally abnormal offenders and the allowances in the services available in the two regions; in particular, Oxford region did not have a secure unit or a forensic psychiatrist.If mentally ill prisoners do not receive the treatment that they need they run the risk of being criminalised. Most such men are best treated in general psychiatric units; only a few require secure conditions and staff with specialised psychiatric skills.     

The comparison of forensic-psychiatric traits between female and male perpetrators of murder or attempted murder

The aim of this investigation was to define more clearly specific forensic-psychiatric characteristics of female murder or attempted murder perpetrators. The retrospective method applied was based on the comparison of the data from forensic-psychiatric assessments carried out in the Center for Forensic Psychiatry, Psychiatric Hospital Vrapce, Zagreb, from 1983 to 1997 (including 70 female and 70 male subjects--who committed murder or attempted murder). Compared with men, female offenders were most often in some way emotionally related to their victims, and they were more often victimized themselves before committing the crime. In men alcoholism was a more significant circumstantial factor in the assessment of their accountability. Psychiatric security measures were more often given to male offenders. The intensity of aggression was lower in females than in males. This investigation reveals that there are some sex specific forensic-psychiatric traits of murder or attempted murder perpetrators. The obtained results could be of help in everyday forensic-psychiatric practice, both in assessments and treatment.     

Course of blood pressure in mild hypertensives after withdrawal of long term antihypertensive treatment. Medical Research Council Working Party on Mild Hypertension.

A series of 1418 men and 1,347 women with mild hypertension (diastolic phase V 90-109 mm Hg) aged 35-64 who had either had long term antihypertensive treatment with bendrofluazide or propranolol or taken placebo tablets for a similar period were randomly allocated to groups in which their tablets were either stopped or continued. The course of blood pressure and of biochemical variables was followed up for two years. Mean blood pressures rose rapidly after the withdrawal of active treatment, and between nine months and one year after stopping treatment the antihypertensive effect had almost disappeared. The effect persisting longer than this, and possibly due to resetting of the baroreceptors or of other blood pressure control mechanisms, was very small, and as the rise in mean pressure was due to an upward movement in general distribution there was no evidence of a subgroup in whom these mechanisms had been permanently reset to a clinically important extent. After withdrawal of propranolol the rise in pressure was more rapid in younger than in older people. After stopping bendrofluazide pressure rose more rapidly in men who had had higher pressures before and during treatment; this effect was not seen in women. Disturbances in biochemical variables associated with drug treatment had largely resolved by the end of two years after withdrawal. Stopping placebo tablets made no consistent difference to blood pressure.     

Neural correlates of sexual arousal in heterosexual and homosexual women and men

Most men have a category-specific pattern of genital and subjective sexual arousal, responding much more strongly to erotic stimuli depicting their preferred sex than to erotic stimuli depicting their nonpreferred sex. In contrast, women tend to have a less specific arousal pattern. To better understand this sex difference, we used neuroimaging to explore its neural correlates. Heterosexual and homosexual women viewed erotic photographs of either men or women. Evoked neural activity was monitored via fMRI and compared with responses to the same stimuli in heterosexual and homosexual men. Overall, a network of limbic (as well as the anterior cingulate) and visual processing regions showed significantly less category-specific activity in women than men. This was primarily driven by weaker overall activations to preferred-sex stimuli in women, though there was also some evidence of stronger limbic activations to nonpreferred-sex stimuli in women. Primary results were similar for heterosexual and homosexual participants. Women did show some evidence of category-specific responses in the visual processing regions, although even in these regions they exhibited less differential activity than men. In the anterior cingulate, a region with high concentrations of sex-hormone receptors, subjective and neural category specificity measures correlated positively for women but negatively for men, suggesting a possible sex difference in the role of the anterior cingulate. Overall, results suggest that men tend to show more differentiated neural responses than do women to erotic photographs of one sex compared to the other sex, though women may not be entirely indifferent to which sex is depicted.     

Low Socioeconomic Status and Female-Biased Parental Investment: The Mukogodo Example

Hierarchies of wealth and ethnic prestige among East African herders present an opportunity to test the Trivers-Willard hypothesis that low socioeconomic status should correlate with female biases in parental investment. The Mukogodo are at the bottom of such a regional hierarchy due to their poverty and low status as former hunters. As a result of these factors, Mukogodo men have lower polygyny rates than their neighbors, and Mukogodo women have higher mean reproductive success than Mukogodo men. The data fulfill the prediction that there should be a bias in parental investment in favor of daughters. The sex ratio of the 0–4 age group and the reported sex ratio at birth are both female-biased. Although there is no evidence of infanticide, sons may be neglected in favor of daughters. Evidence from a dispensary and from a clinic run by a Catholic mission both show that the Mukogodo take daughters for treatment more often than they take sons. Also, daughters may be nursed longer than sons.     

Area security unit in a psychiatric hospital.

Since 1974 a psychiatric hospital security unit, designed to serve the whole catchment area, has cared for mentally ill (mostly psychotic) patients with disturbed behaviour that cannot be managed in open wards. There are a few long-term dangerous patients but most stay only briefly. The admission of women to the unit was not followed by the expected reduction in violence. The unit has facilities for occupational therapy, physical recreation, work, and study, which are particularly important for those who are too dangerous to leave it. The unit''s calming influence depends as much on the supportive effect of the high staff ratio as on the use of tranquillisers. This type of unit is not suitable for patients with personality disturbances who "act out" or for mentally abnormal offenders; but it functions well as a crisis centre for the disturbed mentally ill, and there is an increasing demand for its services.     

Assessment of X bends in patients with atypical X chromosome phenotypes.

Several patients with X chromosome structural abnormalities have been more severely affected clinically than expected. Since bends at Xq13-21 have been associated with inactivation, the authors scored bends retrospectively in 62 patients with X chromosome aneuploidy and 21 cases with structural abnormalities of the X chromosome. They found that patients with 2 X inactivation sites where one X was structurally abnormal had significantly fewer cells with X bends than normal 46,XX. In addition, these patients also showed X bends on the normal X more often than would be expected if non-random X inactivation of the abnormal X chromosome was occurring. Five of the 6 patients with a short or long arm deletion or paracentric inversion of Xq were mentally retarded or had other congenital anomalies not usually associated with Turner syndrome. This suggests to them that these clinical findings may be related to interference with X inactivation patterns in cells with a structurally abnormal X chromosome.     

Nominal kinship cues facilitate altruism.

We investigated whether names in common promote altruistic behaviour, predicting that this would be especially so for relatively uncommon names, for surnames (which are better kinship cues than first names), and among women (who, although less willing than men to help strangers, according to prior research, are also the primary "kin keepers"). We solicited help from 2960 email addressees, with the request ostensibly coming from a same-sex person sharing both, either, or neither of the addressee''s first and last names. As anticipated, addressees were most likely to respond helpfully when senders shared both their names (12.3%) and least likely when they shared neither (2.0%), and this was especially true for relatively uncommon names. A shared surname was more effective than a shared first name only if it was relatively uncommon. Women were substantially more likely to reply than men. These results indicate that names elicit altruism because they function as salient cues of kinship.     

Diet and heart: a postscript.

During 1956-66, 337 healthy middle-aged men in London and south-east England participated in a seven-day individual weighed dietary survey. By the end of 1976, 45 of them had developed clinical coronary heart disease (CHD) which showed two main relationships with diet. Men with a high energy intake had a lower rate of disease than the rest, and, independently of this, so did men with a high intake of dietary fibre from cereals. Energy intake reflects physical activity, but the advantage of a diet high in cereal fibre cannot be explained; there was no evidence that the disease was associated with consumption of refined carbohydrates. Fewer cases of CHD developed among men with a relatively high ratio of polyunsaturated to saturated fatty acids in their diet, but the difference was not statistically significant.     

Attitudes and sterotypes of supporting fields towards the persons with disabilities

The aim of this research was to establish the attitudes, the views and reactions of the helping fields (which include social workers and medical nurses) and those who aren't the part of that cathegory, towards the mentally ill people. One hundred and twenty persons questioned have taken part in this research where in the group of supporting fields consisted of social workers and medical nurses (N = 40). The questionnaire was used in examining the attitudes of those questioned persons, the questionnaire that was used in Joki?-Begi?'s research (2005) and it turned out to be a really good one in defining the attitudes and stereotypes towards the mentally ill persons. The questionnaire consisted of several parts in which different things have been examined such as stereotypes, knowledge, attitudes, level of acceptance and social- demographic information. The research has shown the differences among the attitudes and the level of acceptance of the mentally ill as well as the level of knowledge which the examinees had. All the examinees that have been the part of this research mentioned "ill" as a dominant trait of the mentally disturbed person. Furthermore, the characteristics such as instability, insecurity, nervousness and inclination to suicide, indicate that all of these three groups of examinees have sterotypes about unstable emotional condition and state of mind of the sick. The examinees that don't belong to this group of supporting fields have enough knowledge neither about the emergence of the disease nor about its development and preventive measures. However, the social workers have a bit more negative attitude towards the mentally ill if compared to medical nurses which could be explained by insufficient working experience with the mentioned group of patients. It's important to say that all of the three groups of examinees don't have extremely negative attitudes towards the people with mental disorder. We shouldn't ignore the fact that these three groups have noticable social restraint towards the mentally ill and they cannot easily accept them in their own environment. Considering the fact there is a low number of researches that deal with this problem of labelling or in other words- stigmatization of the mentally ill, this research gives a great stimulus for writeup this very important problem area, especially if we take into consideration that the attitude of the community may help to bring about the feeling of marginalization and unacceptability with the mentally ill.     

Race and the Concept of Progress in Nineteenth Century American Ethnology

While nineteenth century American ethnologists relied on the word "evolution" more than the word "progress" to define their theory of culture, their theory of evolution nonetheless implied a teleological projection that was no more than a paeon for Anglo-Saxon race achievement. Believing that failures in earlier stages of evolution had limited brain size and quality of the "inferior races," they suggested that, for all practical purposes, the Caucasian was the lone man in evolution. While the Caucasian maintained an active, progressive role in modifying the environment, the lower races broke into the modern world as mere "survivals" from the past, mentally and physiologically unable to shoulder the burdens of complex civilization. Ethnology became a means through which both scientists and social scientists sought to estimate the relative value of the races, delineate social categories, and help justify the dynamics of race legislation.     

Éjaculation provoquée par le vibromassage ou l’électrostimulation endorectale chez le blessé médullaire: injection intracytoplasmique de spermatozoïdes obtenus par stimulation endorectale chez neuf couples

800 to 1,000 cases of traumatic spinal cord injury (S.C.I.) are observed in France each year. At present time, there are more than 35,000 survivors of S.C.I. in France. Studies show that 80% of injuries occur in men and 82% occur in individuals between the ages of 16 and 45 years. It is well known that more than 80% of men with S.C.I. suffer from ejaculation dysfunction. Since most of these couples are young, many desire a family and seek help to remedy their infertility. Two methods are mainly used to retrieve sperm from S.C.I. men: penile vibratory stimulation and rectal electrostimulation. Penile vibratory stimulation to induce ejaculation is recommended as first-line treatment, and S.C.I. men should only be referred for electroejaculation after failure of this technique. More than 70% of patients respond to penile vibratory stimulation with anterograde ejaculation. Patients who fail to ejaculate by penile vibratory stimulation are treated by electroejaculation. Their ejaculates often have normal sperm counts, but with a higher proportion of immotile sperm than in men without S.C.I. The authors report the pregnancy outcome of a series of 9 couples undergoing combined electroejaculation and in vitro fertilization with intracytoplasmic sperm injection: 25% pregnancies per cycle and 33% pregnancies per couple.     

Beliefs About Weight Gain and Attitudes Toward Relapse in a Sample of Women and Men with Obesity

Objective : The purpose of this study was to examine beliefs regarding reasons for weight gain, likely responses to weight loss relapse, notions of reasonable weight loss, and correlations between beliefs and attitudes in a large nonclinical sample of men and women with obesity. Research Methods and Procedures : Participants were 3,394 white women (n= 1,674) and men (n = 1,720) with obesity who had responded to a survey about body image and eating behaviors conducted by Consumer Reports magazine. Results : Women and men indicated that the most important reasons for their weight gain were lack of exercise and enjoying eating; the least important reason was a need to avoid social or sexual situations. Both groups reported that their most likely response to relapse is to start watching food intake, whereas their least likely response is to ask a friend, spouse, or family member for help. Women rated depression, stress, low self-esteem, and need to avoid situations as more important reasons for their weight gain than did men, and women were more likely to feel terrible and regain as a response to relapse. There was no relationship between an individual's beliefs about weight gain, responses to relapse, or notions of reasonable weight loss. Discussion : Implications of these findings for the treatment of obesity are discussed.     

Who pays for community care? The same old question.

Trends in mental health service funding over the past 40 years show that the programme of hospital closures has not resulted in a significant release of resources to fund community based services. Far from being excessive, the current provision of residential services (both NHS and non-NHS) for mentally ill people is now below levels recommended as sufficient by the government, the Royal College of Psychiatrists, and the National Schizophrenia Fellowship. What clinical research evidence there is suggests that more rather than fewer residential places are required. This situation is likely to be compounded by the recent transfer of responsibility for funding private and voluntary residential care from the Department of Social Security to local authority social services departments.     

Core groups and the transmission of HIV: learning from male sex workers

A growing and substantial body of research suggests that female sex workers play a disproportionately large role in the transmission of HIV in many parts of the world, and they are often referred to as core groups by epidemiologists, mathematical modellers, clinicians and policymakers. Male sex workers, by contrast, have received little attention and it is not known whether it is helpful to conceptualize them as a core group. This paper draws upon ethnographic research documenting social and sexual networks in London and looks at the position of five male sex workers within a network comprising 193 men and seven women (as well as 1378 anonymous sexual contacts and 780 commercial contacts). In so doing, it suggests that there is no evidence to show that male sex workers are more or less likely to acquire or transmit HIV in the course of commercial sex compared with other types of sexual relationships. In addition, men engaging in non-commercial sex all reported having unprotected sex in a variety of contexts and relationships and there is no evidence to suggest that men who are not sex workers play less of a role in the transmission of HIV. In short, these data suggest that it would be inappropriate to conceptualize male sex workers as a core group. This is not to suggest that public policy should continue to overlook male sex workers. New and inventive approaches are required to reach out to a vulnerable but diverse group of men, selling sex for a variety of reasons; even if these men are no more vulnerable to acquiring and/or transmitting HIV than other men and women that form part of their network.     

High income men have high value as long-term mates in the U.S.: personal income and the probability of marriage,divorce, and childbearing in the U.S.

Using data from the first Census data set that includes complete measures of male biological fertility for a large-scale probability sample of the U.S. population (the 2014 wave of the Study of Income and Program Participation-N = 55,281), this study shows that high income men are more likely to marry, are less likely to divorce, if divorced are more likely to remarry, and are less likely to be childless than low income men. Men who remarry marry relatively younger women than other men, on average, although this does not vary by personal income. For men who divorce who have children, high income is not associated with an increased probability of having children with new partners. Income is not associated with the probability of marriage for women and is positively associated with the probability of divorce. High income women are less likely to remarry after divorce and more likely to be childless than low income women. For women who divorce who have children, high income is associated with a lower chance of having children with new partners, although the relationship is curvilinear. These results are behavioral evidence that women are more likely than men to prioritize earning capabilities in a long-term mate and suggest that high income men have high value as long-term mates in the U.S.     

Mentally abnormal offenders: manner of death.

A 23 year follow up of deaths in a population of mentally disordered patients was carried out, and a typical case history is reported. A quarter (71) of the deaths reported were unnatural, verdicts of suicide or accidental death or open verdicts having been recorded. For men in most age groups the proportion of deaths by suicide was two to three times greater than in the general population in 1982; the rate among those aged 25-29 was five times that in the general population. Differences in the rate of unnatural death among diagnostic categories of mental illness were not significant, but the proportion of unnatural deaths among the mentally handicapped will probably eventually be lower than that among psychotic offenders or those with personality disorders. Violent death occurs at an older age in those with affective disorders. Social isolation and alienation add to the handicap of mental disorder in this group of people, and these sometimes difficult but always vulnerable patients must continue to be offered asylum other than prison.