A Narrative Review of Flutamide in Juvenile Nasopharyngeal Angiofibroma.

The detection of androgen receptors within Juvenile Nasopharyngeal Angiofibroma (JNA) has prompted investigation of the role of Flutamide. The aim of this review is to evaluate Flutamide as a possible neo-adjuvant treatment for JNA. Literature searches were conducted using MEDLINE, EMBASE and Web of Science. The Joanna Briggs Institute (JBI) checklist was used to assess risk of bias. The Oxford Centre of Evidence-Based Medicine (OCEBM) Levels of Evidence was used to stratify the evidence level. Literature searches were conducted using MEDLINE, EMBASE and Web of Science. Flutamide as neo-adjuvant treatment potentially causes a reduction in JNA tumor volume by ≥ 25%. Based on the current limited evidence, Flutamide has a limited role in JNA management and further research is required. Its utilization should only follow discussion with the patient, their families, and within the multidisciplinary team.

An Economic Evaluation of the Impact of Using Rapport-Based Interviewing Approaches With Child Sexual Abuse Suspects.

Two studies examined whether rapport-based interviewing with child sexual abuse (CSA) suspects provides greater interview yield that could result in overall cost-savings to the investigation. First, multi-level modelling was applied to 35 naturalistic CSA suspect interviews to establish whether rapport-based interviewing techniques increase "yield" - defined as information of investigative value. The Observing Rapport Based Interviewing Technique (ORBIT coding manual was used to code interviews; it includes an assessment of both interpersonal adaptive and maladaptive rapport-based interviewer engagement as well as motivational interviewing (MI) strategies. The impact of these two strands (interpersonal and MI) on extracting information of investigative value (including strengthening a case for court and safeguarding) were examined. Adaptive interpersonal strategies increased case strengthening and safeguarding yield, with motivational interviewing having the largest impact on safeguarding yield. Both strategies increase the likelihood of gaining additional types of economic yield. Maladaptive interviewer strategies reduced case strengthening and different types of economic yield. In study two, literature-based economic estimates were applied to establish the potential cost benefits from following national ORBIT rapport training. Further training in adaptive and motivational interviewing could contribute cost savings between £19 and £78 million (annual unit costs) increasing to £238-£972 million (lifetime costs) for online CSA across England and Wales; and £157-£639 million (annual unit costs) increasing to £2-£8 billion (lifetime costs) for all CSA. Failure to commit training resource to this, or an alternative strategy, could mean the cost burden attributable to maladaptive interviewing (between £1 and £6 million for online CSA and £12 and £48 million for all CSA) is not successfully averted.

The right to silence and the permission to talk: Motivational interviewing and high-value detainees.

Motivational interviewing (MI) is an evidence-based intervention that has proved effective across diverse clinical contexts with clients ambivalent about and resistant to behavioral change. This article argues that the principles of MI can be successfully applied to law enforcement (LE) interviews with high-value detainees (HVDs; i.e., terrorist suspects). Although the forms of ambivalence and resistance may differ from those in clinical contexts, HVDs must make the decision whether to talk or not when they are interviewed. We argue there is likely ambivalence regarding this. We theorized that 4 MI-consistent (MI) skills may be useful for LE interviewers: reflective listening, summaries, rolling with resistance, and developing discrepancies. Using the Observing Rapport Based Interpersonal Techniques coding manual (Alison, Alison, Elntib, & Noone, 2012), we analyzed 804 tapes of LE interviews with 75 terrorism suspects in the United Kingdom. Multilevel structural equation modeling revealed that MI skills encouraged detainee engagement and subsequent information gain. It also revealed that any approach antithetical to MI had a profoundly negative impact on detainee engagement and subsequent information gain-potentially through creating reactance (a form of resistance based on motivations to regain a freedom when it is threatened). Overall, this research provides unique evidence for the use of specific skills and approaches that can increase or decrease HVD engagement and information provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Revenge versus rapport: Interrogation, terrorism, and torture.

This review begins with the historical context of harsh interrogation methods that have been used repeatedly since the Second World War. This is despite the legal, ethical and moral sanctions against them and the lack of evidence for their efficacy. Revenge-motivated interrogations (Carlsmith & Sood, 2009) regularly occur in high conflict, high uncertainty situations and where there is dehumanization of the enemy. These methods are diametrically opposed to the humanization process required for adopting rapport-based methods-for which there is an increasing corpus of studies evidencing their efficacy. We review this emerging field of study and show how rapport-based methods rely on building alliances and involve a specific set of interpersonal skills on the part of the interrogator. We conclude with 2 key propositions: (a) for psychologists to firmly maintain the Hippocratic Oath of "first do no harm," irrespective of perceived threat and uncertainty, and (b) for wider recognition of the empirical evidence that rapport-based approaches work and revenge tactics do not. Proposition (a) is directly in line with fundamental ethical principles of practice for anyone in a caring profession. Proposition (b) is based on the requirement for psychology to protect and promote human welfare and to base conclusions on objective evidence. (PsycINFO Database Record