Mortality in young offenders: retrospective cohort study

Objectives To estimate overall and cause specific standardised mortality ratios in young offenders.Design Comparison of mortality data in cohort of young offenders.Settings State of Victoria, Australia.Subjects Cohort of young offenders aged 10-20 years with a first custodial sentence from 1 January 1988 to 31 December 1999.Main outcome measures Deaths ascertained by matching with the national death index, a database containing records of all deaths in Australia since 1980. Death rates in the reference Victorian population used to calculate standardised mortality ratios.Results The offender cohort comprised 2621 men and 228 women with 11 333 person years of observation. The median age of first detention was 17.9 years for men and 18.4 years for women. Median follow up was 3.3 years for men and 1.4 years for women. Overall standardised mortality ratio adjusted for age (expressed as a ratio) was 9.4 (95% confidence interval 7.4 to 11.9) for men and 41.3 (20.2 to 84.7) for women. Cause specific standardised mortality ratios for men were 25.7 (17.9 to 36.9) for drug related causes, 9.2 (5.8 to 15) for suicide, and 5.7 (3.6 to 9.2) for non-intentional injury. A quarter of drug related deaths in men aged 15-19 years were in offenders.Conclusions Social policies for young offenders should address both the prevalent drug and mental health problems as well the high levels of social disadvantage.     

Does "afternoon diabetes" predict diabetes?

Twenty-eight men were given morning and afternoon oral glucose tolerance tests in 1969 and again in 1975. According to British Diabetic Association criteria all 28 had normal morning values in 1969 but seven had "afternoon diabetes". Four men had diabetic values in the morning in 1975 but only two of these had had afternoon diabetes in 1969. Better prediction of subsequent diabetes was obtained by calculating the area under the morning glucose tolerance curve in 1969. All four men who progressed to diabetes had areas exceeding 1000 units, which distinguished them absolutely from the other 24. They also tended to be more obese, but this was less predictive of subsequent diabetes.     

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.     

Are problem drinkers dangerous drivers? An investigation of arrest for drinking and driving,serum gamma glutamyltranspeptidase activities,blood alcohol concentrations,and road traffic accidents: the Tayside Safe Driving Project.

Serum gamma glutamyltranspeptidase activity was measured in 440 drivers at the time of arrest for driving under the influence of alcohol. The results were compared with information gathered by the arresting police officer. One third of drivers over the age of 30 had abnormal gamma glutamyltranspeptidase activities at the time of arrest. Among drivers who required a driving license for their work, and older drivers, a disproportionately high number had raised gamma glutamyltranspeptidase activities indicating problem drinking. In drivers over the age of 30 a strong association was found between gamma glutamyltranspeptidase activities and road traffic accidents but not alcohol concentrations or previous convictions. These findings argue against the Department of Transport''s criteria for high risk offenders and indicate a clear need for new measures against problem drinkers among drinking and driving offenders.     

Social Factors Influencing Russian Male Alcohol Use over the Life Course: A Qualitative Study Investigating Age Based Social Norms,Masculinity, and Workplace Context

The massive fluctuations occurring in Russian alcohol-related mortality since the mid-1980s cannot be seen outside of the context of great social and economic change. There is a dearth of qualitative studies about Russian male drinking and especially needed are those that address social processes and individual changes in drinking. Conducted as part of a longitudinal study on men’s alcohol consumption in Izhevsk, this qualitative study uses 25 semi-structured biographical interviews with men aged 33–60 years to explore life course variation in drinking. The dominant pattern was decreasing binge and frequent drinking as men reached middle age which was precipitated by family building, reductions in drinking with work colleagues, and health concerns. A minority of men described chaotic drinking histories with periods of abstinence and heavy drinking. The results highlight the importance of the blue-collar work environment for conditioning male heavy drinking in young adulthood through a variety of social, normative and structural mechanisms. Post-Soviet changes had a structural influence on the propensity for workplace drinking but the important social function of male drinking sessions remained. Bonding with workmates through heavy drinking was seen as an unavoidable and essential part of young men’s social life. With age peer pressure to drink decreased and the need to perform the role of responsible breadwinner put different behavioural demands on men. For some resisting social pressure to drink became an important site of self-determination and a mark of masculine maturity. Over the lifetime the place where masculine identity was asserted shifted from the workplace to the home, which commonly resulted in a reduction in drinking. We contribute to existing theories of Russian male drinking by showing that the performance of age-related social roles influences Russian men’s drinking patterns, drinking contexts and their attitudes. Further research should be conducted investigating drinking trajectories in Russian men.     

Mental Health Aspects of Shoplifting

A ten-year follow-up of 886 shoplifters showed clear differences between women and men. Men tended to have previous convictions and to steal books (unknown in women). Of the 532 women nearly one third were foreign-born, and this group comprised 46% of offenders aged 17-30. The peak age among British women was 51-60.First offenders accounted for 80% of the women, and their reconviction rate was 11%; among those with any kind of previous conviction the rate was 50%. The rate of admission to hospital for women shoplifters is three times higher than average.     

Increased lymphocyte DNA strand breaks in rubber workers

OBJECTIVE: To study the effect of occupational exposure to rubber processing, smoking, and alcohol drinking on lymphocyte DNA damage. SUBJECTS AND METHODS: Of 371 employees (197 men and 174 women) from a rubber factory in Guangzhou, 281 were rubber processing workers from five production sections and 90 were managerial workers. Information on occupational exposure, smoking, and drinking was collected by interviews. Blood samples were taken in the morning by venipuncture. DNA damages were measured by the Comet assay. Possible DNA-protein crosslinks were broken down by proteinase K. Tail moment, measured by Komet 4.0 image analysis software, was the measure of DNA damage. RESULTS: The rubber processing workers had larger tail moment than the managerial workers (Geometric mean, 95%CI) [1. 77microm (1.64-1.90) versus 1.52microm (1.36-1.71), P=0.04]. Both smoking [1.93microm (1.74-2.13) versus 1.59microm (1.47-1.71), P=0. 003] and alcohol drinking [2.21microm (1.87-2.62) versus 1.63microm (1.53-1.74), P<0.001] increased tail moment. Tail moment differed significantly among job categories (F=3.21, P=0.008), the largest was observed in mixers. In the non-smoking and non-drinking workers, rubber processing workers had larger tail moment than managerial workers after adjusting for age (P=0.033). General linear model analysis showed that after adjusting for each other, occupational exposure (P=0.027), smoking (P=0.012), and alcohol drinking (P=0. 013) was associated with larger tail moment, whereas age and gender had no effect. CONCLUSIONS: Occupational exposure to rubber processing, smoking, and alcohol drinking can cause DNA damage.     

Ecological analysis of collectivity of alcohol consumption in England: importance of average drinker.

OBJECTIVE: To assess whether the average consumption of alcohol is associated with the prevalence of heavy drinking, problem drinking, and abstention in England. DESIGN: Ecological analysis using data from a cross sectional household based survey of English adults. SUBJECTS: Random sample of 32,333 adults from the English population who participated in the 1993 and 1994 health surveys for England. MAIN OUTCOME MEASURES: Association, expressed as the correlation coefficient, between the regional mean and median alcohol consumption and the regional prevalence of heavy drinking, problem drinking, and abstention. RESULTS: Mean consumption of alcohol in light to moderate drinkers was strongly positively associated with the prevalence of heavy drinking (r = 0.75 in men and r = 0.62 in women for drinking more than 21 and 14 units per week respectively). A similar association was found between median consumption and prevalence of heavy drinking. Abstention was not significantly associated with mean consumption in drinkers (r = 0.08 for men and r = -0.29 for women). Both the median and mean consumption in drinkers were positively associated with the prevalence of problem drinking as defined by the CAGE questionnaire on alcohol use (r = 0.53 for men and r = 0.42 for women for the association with mean consumption). CONCLUSION: Factors that increase the average consumption of alcohol in the population may result in an increase in the prevalence of heavy drinking and related problems.     

Probation linked supervised disulfiram in the treatment of habitual drunken offenders: results of a pilot study.

Sixteen habitual drunken offenders agreed to take disulfiram in liquid form under supervision as a condition of a probation order. They knew that failure to take medication, as with failure to observe any other condition of probation, could result in their being returned to court. Three defaulted but only two of the remainder committed further offences. Nine were entirely successful. At the end of the study the average period of abstinence for the whole group was 30 weeks compared with six weeks during the previous two years. Nine risked drinking alcohol but none suffered any serious consequences or side effects. This technique may be a judicially acceptable and more hopeful alternative to prison for these offenders.     

Drinking among medical students: a questionnaire survey.

To assess the prevalence of drinking among medical students a questionnaire on smoking, exercise, drinking, and weight was distributed among the students available. A total of 260 replies were received from an estimated available population of 350 students (134 men and 126 women). The mean alcohol consumption obtained by a quantity-frequency measure was 20.5 units/week for male students and 14.6 units/week for female students. Retrospective diary reports showed mean (SE) consumptions of 18 (2) units/week for men (n = 134) and 11 (1) units/week for women (n = 126). Consumption among the men closely matched consumption among men matched for age in the general population. Women, however, drank more than women matched for age. Male and female medical students exceeded the suggested maximum for their sex in equal proportions. Quantity-frequency data showed that 31 (23%) men drank over 35 units/week and 28 (22%) women drank over 21 units/week. Of the 59 students exceeding these limits, 51 responded positively to a standard screening questionnaire for alcohol abuse. Forty students reported that they might have a drinking problem, and 138 reported that alcohol had affected their academic performance at some time; 17 of these were affected frequently. The students suggested sensible maximum consumption figures for health education. Smoking was associated with heavy drinking, especially among the women. These results suggest that some medical students are compromising their future health and their academic performance through excessive drinking.     

Diurnal variation of metabolites in three individual participants

The circadian system influences virtually all biological functions. Understanding the impact of circadian variation on metabolism may provide insight into mechanisms of circadian-associated disorders and guide the implementation of chrono-therapy. Previous research has reported circadian variation in 7–20% of metabolites in human blood. In this study, untargeted metabolomics profiles were measured using blood of two healthy men and one healthy woman, collected every 2 h for up to 48 h under carefully controlled conditions. The pattern of variation of each metabolite over time was examined on each participant separately, using both one- and two-order harmonic models. A total of 100 of 663 metabolites, representing all metabolite categories, showed diurnal rhythmic concentrations that exceeded the Bonferroni threshold (P < 2.5 × 10^?5). Overall, peak times of many metabolites were clustered during the afternoon-midnight, including the majority of amino acids, all peptides, all lysolipids and all phospholipids, whereas the majority of steroids peaked in the morning. We observed substantial inter-individual variation for both peak times and amplitudes in these three subjects. In conclusion, at least 15% of blood metabolites, representing a broad group of biological pathways, exhibit diurnal variation in three participants. The average peak times of most of these metabolites are clustered in morning or afternoon-midnight. Further work is needed to validate and extend this work in more individuals.     

Cancer,coronary artery disease and smoking: a preliminary report on differences in incidence between Seventh-day Adventists and others

A study was made of the incidence of certain types of disease among Seventh-day Adventists, a religious group of special interest because they refrain from smoking and drinking. Epidermoid cancer of the lung, previously shown to be related to smoking, was 10 times less common among Seventh-day Adventists than among the general population, even among those Seventh-day Adventists living in the Los Angeles area where all are exposed to smog. Similarly, cancers of the mouth, larynx, and esophagus, previously shown to be related not only to smoking but also to heavy drinking, were at least 10 times less common among Seventh-day Adventist men than among men of the general population. All other types of cancer, with the exception of cancer of the bladder and cervix, occurred among Seventh-day Adventists with the same frequency as in the general population. The latter occurred slightly less than in the general population. Myocardial infarction in Seventh-day Adventist males was less frequent and occurred at a later age than among males in the general population; while the age distribution of the disease among the Seventh-day Adventist females was similar to that of females in the general population.     

Collegiate rowing crew performance varies by morningness-eveningness

During adolescence and early adulthood, most humans are predisposed developmentally, both biologically and socially, toward evening/night activity. The morningness-eveningness (M-E) tendency to be an evening-preferring (E-type) rather than a morning-preferring (M-type) or intermediate/neither (N-type) "chronotype" may affect athletic performance at various times of day. This study evaluated M-E effects on rowing performance of an intact, experienced, university club crew with near-daily early morning (0500-0700 hours) and late afternoon (1630-1800 hours) training schedules. The hypothesis tested was that chronotype would modify circadian effects during morning and afternoon performances. Eight men and eight women (mean age 19.6 +/- 1.5 years) were tested in a randomized, counterbalanced design. A standard qualifying 2000-m ergometer rowing sprint and a nonroutine standing broad jump task were measured during early morning and late afternoon, separated by 3 days of rest. Each subject's chronotype was determined using two standard self-rating M-E scales, resulting in eight E-type (three women/five men), four M-type (two women/two men), and four N-type (three women/one man) subjects. The rowing results show that E-type and N-type subjects did not differ between morning and afternoon rowing performances, whereas M-type subjects rowed significantly faster in the morning. In contrast, the standing broad jump showed no consistent time-of-day or chronotype effect. These findings suggest that basic performance timing in young athletes is determined to some extent by naturally occurring M-E predispositions. Further, modification of time-of-day influences may be possible by routine practice at the same time each day, as was suggested here by the absence of evening superiority in performances. Understanding their personal M-E tendencies could allow young athletes to arrange training schedules at specific times of day to help counteract any natural circadian influences that might work against their performance.     

CANCER,CORONARY ARTERY DISEASE AND SMOKING—A Preliminary Report on Differences in Incidence Between Seventh-day Adventists and Others

A study was made of the incidence of certain types of disease among Seventh-day Adventists, a religious group of special interest because they refrain from smoking and drinking.Epidermoid cancer of the lung, previously shown to be related to smoking, was 10 times less common among Seventh-day Adventists than among the general population, even among those Seventh-day Adventists living in the Los Angeles area where all are exposed to smog. Similarly, cancers of the mouth, larynx, and esophagus, previously shown to be related not only to smoking but also to heavy drinking, were at least 10 times less common among Seventh-day Adventist men than among men of the general population. All other types of cancer, with the exception of cancer of the bladder and cervix, occurred among Seventh-day Adventists with the same frequency as in the general population. The latter occurred slightly less than in the general population.Myocardial infarction in Seventh-day Adventist males was less frequent and occurred at a later age than among males in the general population; while the age distribution of the disease among the Seventh-day Adventist females was similar to that of females in the general population.     

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.     

Doctors' drinking habits and consumption of alcohol.

Alcohol consumption and drinking habits among Finnish doctors were studied as part of a survey of stress and burnout. A questionnaire containing 99 questions or groups of questions was sent to all 3496 practising doctors aged under 66 randomly selected from the registry of the Finnish Medical Association. Altogether 2671 doctors (76%) responded; this sample was representative of the Finnish medical profession. The average weekly consumption of alcohol during the past year and various aspects of drinking behaviour were assessed, and the presence or absence of symptoms and diseases often encountered among heavy drinkers and addicts was determined. The data were analysed separately for men and women, for those aged less than or equal to 40 and greater than 40, and for the men with high and low alcohol consumption and with high and low scores on the index of drinking habits. Selected variables related to work, stress, and coping were correlated with alcohol consumption and drinking behaviour. The median consumption of alcohol among male doctors was 4876 g (6.2 litres) and among female doctors 2226 g (2.8 litres) of absolute alcohol per person per year and was higher in those aged over 40. Beer was most commonly drunk by men and wine by women. Increased alcohol consumption was associated with older age, disappointment with career, heavy smoking, use of benzodiazepines, stress and burnout symptoms, suicidal thoughts, general dissatisfaction, and diseases related to alcohol. Drinking habits were heavier among doctors working in community health centres, those taking long sick leaves, younger doctors disappointed with their careers or the atmosphere at work, and older doctors immersed in their work. Alcohol consumption among doctors seems to be higher than that of the general population in Finland, and heavy drinking seems to be associated with stress and burnout.     

Associations of White Matter Microstructure with Clinical and Demographic Characteristics in Heavy Drinkers

Damage to the brain’s white matter is a signature injury of alcohol use disorders (AUDs), yet understanding of risks associated with clinical and demographic characteristics is incomplete. This study investigated alcohol problem severity, recent drinking behavior, and demographic factors in relation to white matter microstructure in heavy drinkers. Magnetic resonance imaging (MRI) scans, including diffusion tensor imaging (DTI), were collected from 324 participants (mean age = 30.9 ± 9.1 years; 30% female) who reported five or more heavy drinking episodes in the past 30 days. Drinking history and alcohol problem severity were assessed. A common white matter factor was created from fractional anisotropy (FA) values of five white matter tracts: body of corpus callosum, fornix, external capsule, superior longitudinal fasciculus, and cingulate gyrus. Previous research has implicated these tracts in heavy drinking. Structural equation modeling (SEM) analyses tested the hypothesis that, after controlling for duration of alcohol exposure, clinical and behavioral measures of alcohol use severity would be associated with lower white matter factor scores. Potential interactions with smoking status, gender, age, treatment-seeking status, and depression or anxiety symptoms also were tested. Controlling for number of years drinking, greater alcohol problem severity and recent drinking frequency were significantly associated with lower white matter factor scores. The effect of drinking frequency differed significantly for men and women, such that higher drinking frequency was linked to lower white matter factor scores in women but not in men. In conclusion, alcohol problem severity was a significant predictor of lower white matter FA in heavy drinkers, after controlling for duration of alcohol exposure. In addition, more frequent drinking contributed to lower FA in women but not men, suggesting gender-specific vulnerability to alcohol neurotoxicity.     

Monitoring of behavior using a video-recording system for recognition of Salmonella infection in experimentally infected growing pigs

Behavior is one of the most commonly used indicators of illness; however, few studies have investigated how different common diseases affect animal behavior. This experiment was conducted to investigate behavioral and clinical alterations in growing pigs experimentally infected with Salmonella spp. during a 4-week post-infection period. A total of 48 growing pigs were divided into one of the three treatment groups (1) control, (2) infection with Salmonella Typhimurium or (3) infection with Salmonella Enteritidis. Individual pigs’ behavior was recorded daily (0900 to 1100 and 1600 to 1800 h) using a video-recording system. Pigs in both infected groups had lower weight gain and feed intake during week 0 to 2 and 0 to 4 experimental period. Bacteriological data revealed that pigs in both infected groups persistently shed bacteria throughout the period of study. Oral infection of growing pigs with S. Typhimurium and S. Enteritidis significantly reduced the frequency of morning large (except week 1) and small movement throughout the study period. In the evening, significantly lowest frequency of movements were observed in the S. Enteritidis-infected group compared with the control. The standing and sitting frequency were significantly lower in both infected groups only at the morning of week 4. Infection with Salmonella spp. led to a significant reduction in the frequency and duration of morning eating and drinking throughout the experimental period, with the exception of 4^th week drinking duration. The lowest frequency of evening eating during week 1 and 4 was recorded in both infected groups; whereas, the duration differed only at week 1. The evening drinking frequency only tended to decrease in response to S. Typhimurium infection at week 1. This study shows that, pigs infected with Salmonella spp. had poor performance, shedding high levels of Salmonella with their feces and reduced feeding and drinking activity, which are adaptive responses to infection and may help caretakers to detect ill health.