Adverse Childhood Experiences and Forensic Typologies: Getting Specific about Trauma among Institutionalized Youth.

Adverse childhood experiences (ACEs) are linked to various conduct and behavior problems within juvenile delinquents, but fewer studies focused on these associations among specific forensic typologies of offending. Utilizing data from 3382 institutionalized delinquents in Texas, logistic regression models indicated multiple associations between ACEs and forensic typologies in both adjusted and unadjusted models, with sexual abuse and physical abuse emerging as the most consistent and robust predictors. Supplemental sensitivity models confirmed the associations between sexual abuse and physical abuse among youth who fit multiple forensic typologies. Models fared poorly at identifying youth who are engaged in fire setting. Implications for total and singular ACEs are discussed, along with how those relate to more clinically meaningful, forensic forms of juvenile delinquency.

Working on local time: Testing the job-demand-control-support model of stress with jail officers.

PURPOSE: The demands and consequences of the correctional workplace are well-documented, but researchers have yet to examine the correlates of work stress among a large multi-facility sample of jail officers. We framed our inquiry within the Job Demand-Control-Support model that has guided researchers in parallel studies of work stress among prison officers. METHOD: Data on officers' background characteristics, job demands, work-related control or autonomy, support from coworkers or family members, safety risks, and work-related stress were examined across 1380 officers working in 19 jails. RESULTS: Unreasonable workloads, perceptions of insufficient staff, role problems, less control or autonomy, a lack of support at work or home, and exposure to violence were associated with greater stress among jail officers. Jails with characteristics that threatened order and security-having more inmates per officer and greater levels of inmate violence-had higher levels of stress among officer workforces. CONCLUSIONS: Findings largely support research on work stress among prison officers and may inform efforts to reduce stress and improve quality of life among jail and prison personnel. Delegating appropriate workloads, the maintenance of control, social supports, and the reduction of safety risks are all important for reducing work stress among jail officers.

Come and Knock on Our Door: Offenders' Perspectives on Home Visits Through Ecological Theory.

The use of home visits has a long and storied history in the United States from different disciplines, such as nursing, prenatal mothers, young families, health promotion, and community corrections. Ecological theory explains how formal actors play a role in the promotion in the health field through home visits, but does not address community corrections home visits. Through the use of 30 semi-structured interviews, this research seeks to expand the understanding of ecological theory by capturing the perceptions of offenders sentenced to home visits conducted by a sheriff's office. The findings suggest the participants supported the home visits by formal agents and, in general, the home visits created an atmosphere of respect between the participants and sheriff's office personnel. This study creates the context for future research to understand the role of formal agents in recidivism and evaluate the efficacy of home visits by community corrections agencies.

Adverse Childhood Experiences, Commitment Offense, and Race/Ethnicity: Are the Effects Crime-, Race-, and Ethnicity-Specific?

Adverse childhood experiences are associated with an array of health, psychiatric, and behavioral problems including antisocial behavior. Criminologists have recently utilized adverse childhood experiences as an organizing research framework and shown that adverse childhood experiences are associated with delinquency, violence, and more chronic/severe criminal careers. However, much less is known about adverse childhood experiences vis-à-vis specific forms of crime and whether the effects vary across race and ethnicity. Using a sample of 2520 male confined juvenile delinquents, the current study used epidemiological tables of odds (both unadjusted and adjusted for onset, total adjudications, and total out of home placements) to evaluate the significance of the number of adverse childhood experiences on commitment for homicide, sexual assault, and serious persons/property offending. The effects of adverse childhood experiences vary considerably across racial and ethnic groups and across offense types. Adverse childhood experiences are strongly and positively associated with sexual offending, but negatively associated with homicide and serious person/property offending. Differential effects of adverse childhood experiences were also seen among African Americans, Hispanics, and whites. Suggestions for future research to clarify the mechanisms by which adverse childhood experiences manifest in specific forms of criminal behavior are offered.

Does childhood sexual abuse victimization translate into juvenile sexual offending? New evidence.

The cycle of violence thesis posits that early exposure to maltreatment increases the likelihood of later maladaptive and antisocial behaviors. Childhood sexual abuse (CSA) specifically has been shown to increase the likelihood of sexual offending, although less is known about its linkages to other forms of crime. Based on data from 2,520 incarcerated male juvenile offenders from a large southern state, hierarchical logistic regression models suggested that CSA increased the likelihood of later sexual offending nearly sixfold (467% increase). However, CSA was associated with an 83% reduced likelihood of homicide offending and 68% reduced likelihood of serious person/property offending. These findings suggest further support for the cycle of violence where CSA promotes sexual offending but novel findings regarding the linkages between CSA and other forms of crime.

Not my fault: blame externalization is the psychopathic feature most associated with pathological delinquency among confined delinquents.

The association between psychopathy and crime is established, but the specific components of the personality disorders that most contribute to crime are largely unknown. Drawing on data from 723 confined delinquents in Missouri, the present study delved into the eight subscales of the Psychopathic Personality Inventory-Short Form to empirically assess the specific aspects of the disorder that are most responsible for explaining variation in career delinquency. Blame externalization emerged as the strongest predictor of career delinquency in ordinary least squares regression, logistic regression, and t-test models. Fearlessness and carefree nonplanfulness were also significant in all models. Other features of psychopathy, such as stress immunity, social potency, and coldheartedness were weakly and inconsistently predictive of career delinquency. Implications of these findings for the study of psychopathy and delinquent careers are discussed in this article.

A role for radiotherapy in the management of advanced medullary thyroid carcinoma: the mayo clinic experience.

Outcomes of external beam radiotherapy (EBRT) in advanced medullary thyroid carcinoma (MTC) are largely unknown. Retrospective review of data from patients with MTC, diagnosed from June 1, 1970, through December 31, 2007. Overall survival and locoregional tumor control rates were calculated. Seventeen patients had adjuvant or palliative EBRT delivered to 41 sites. Six patients initially had adjuvant EBRT (median, 60.80 Gy); none had relapse in the treated area. Five patients with locoregional recurrence after surgery were treated (median, 59.40 Gy), and durable disease control was achieved in 3. Twelve patients received palliative EBRT to 29 sites of metastatic disease (median, 30.00 Gy), which provided sustained symptom relief at 45% of sites. Five- and ten-year overall survival rates were 44% and 19%, respectively. Adjuvant EBRT may be most effective for prevention of locoregional recurrence. EBRT may provide sustained control of advanced, metastatic disease in select patients.

Alias: lying to the police and pathological criminal behavior.

The use of aliases has been shown to be associated with antisocial behavior, but the empirical research on this topic is modest. The current study employs a multiple analytical approach to explore the association between aliases and career criminality in two large samples of adult offenders. We hypothesized that the use of aliases would not only be strongly associated with arrest history but this singular behavior would accurately classify a large proportion of habitual criminals. Results show that alias usage is robustly associated with career arrests net the effects of arrest onset, age, and sex in negative binomial regression models and was an excellent classifier (AUC = .82) of habitual criminality. Implications of the findings for forensic and criminal justice practitioners are offered.

Iron insufficiency and hypovitaminosis D in adolescents with chronic fatigue and orthostatic intolerance.

OBJECTIVES: More than 10% of adolescents suffer from severe fatigue and/or orthostatic intolerance. Adult studies show correlations between iron insufficiency and fatigue as well as between hypovitaminosis D and non-specific pain. We sought to determine whether there were correlations between nutritional factors (iron status, and serum vitamin D levels) and chronic ill health. METHODS: We reviewed records of 188 adolescents with symptoms of fatigue and/or orthostatic intolerance and who underwent autonomic reflex screening. RESULTS: Of the 188 patients, 130 patients (69%) had excessive postural tachycardia (PT) with a heart rate (HR) change of ≥30 bpm. 62 patients (47%, n = 131) had iron insufficiency with low iron stores, and 29 patients (22%, n = 131) were iron deficient. HR change did not correlate to ferritin level (P = 0.15). 21 patients (22%, n = 95) had hypovitaminosis D (25-hydroxyvitamin D ≤20 ng/mL). There was a significant association with hypovitaminosis D and orthostatic intolerance (P = 0.024). CONCLUSION: In patients presenting with chronic fatigue and/or orthostatic intolerance, low ferritin levels and hypovitaminosis D are common, especially in patients with PT.

Selective serotonin reuptake inhibitors, glioblastoma multiforme, and impact on toxicities and overall survival: the mayo clinic experience.

PURPOSE: The diagnoses of glioblastoma multiforme (GBM) and depression are often found to coexist. The impact of selective serotonin reuptake inhibitors (SSRI) on treatment-related toxicity and outcome in patients with GBM is unclear. METHODS AND MATERIALS: We retrospectively reviewed 160 patients with GBM who received treatment at our institution between 1999 and 2008. Those taking an SSRI during treatment for GBM were identified and toxicities were assessed. RESULTS: Median survival for the entire cohort was 1.05 years. A total of 35 patients (21.8%) took an SSRI during initial treatment for GBM. There was no statistical difference in the rate of ≥grade 3 toxicity in patients taking an SSRI when compared with those who were not (11.4% vs. 13.6%, respectively; P = 1.00). Two-year survival in the cohort of patients taking an SSRI was 32% versus 17% in those who were not (P = 0.18). After making adjustment for age, recursive partitioning analysis class, and extent of surgery, absence of an SSRI during treatment was associated with a hazard risk of 1.5 (95% confidence interval = 1.00-2.42; P = 0.05). CONCLUSIONS: This retrospective review suggests that concomitant use of an SSRI during treatment does not adversely affect survival. There was no increased toxicity with the use of SSRI concurrent with treatment of newly-diagnosed GBM.

Comparison of coagulation factor XIII content and concentration in cryoprecipitate and fresh-frozen plasma.

BACKGROUND: For patients with plasma coagulation factor XIII (pFXIII) deficiency, recommended means of replacement include infusions of fresh-frozen plasma (FFP), cryoprecipitate, or (where available) factor (F)XIII concentrates. Quantitative differences in pFXIII concentration in FFP and cryoprecipitate are not well defined and were, therefore, the subject of this study. STUDY DESIGN AND METHODS: FFP and cryoprecipitate (10 bags each from blood group O donors) were analyzed to quantify pFXIII activity and antigen. Coagulation FVIII, fibrinogen, and von Willebrand factor (VWF) were also quantitated. RESULTS: Mean (+/-SD) pFXIII activity in cryoprecipitate and FFP bags was 60 +/- 30 and 288 +/- 77 U per bag, respectively, and pFXIII antigen and activity levels were concordant. Other comparisons (mean +/- SD) between cryoprecipitate and FFP, respectively, were as follows: coagulation FVIII activity, 133 +/- 37 and 265 +/- 83 U per bag; fibrinogen content (Clauss kinetic assay), 183 +/- 44 and 725 +/- 199 mg per bag; VWF antigen content, 181 +/- 53 and 218 +/- 70 U per bag; VWF ristocetin cofactor activity, 168 +/- 34 and 221 +/- 65 U per bag; VWF collagen-binding activity, 164 +/- 40 and 208 +/- 71 U per bag; and fluid (plasma) volumes per bag, 21.3 +/- 2.7 and 245 +/- 29 mL. CONCLUSION: In contrast to other cryoprecipitable coagulation proteins, pFXIII is only mildly enriched in cryoprecipitate when compared with FFP (approx. two- to threefold). Although both products can provide effective pFXIII replacement, FFP may be preferred when infusion volume is not a major consideration and pFXIII concentrates are not available. VWF is substantially enriched in cryoprecipitate (approx. ninefold compared with its concentration in FFP), with VWF activity content exceeding that of FVIII by approximately 26 percent on average.

Aberrant pre-mRNA splicing of a highly conserved cell cycle regulator, CDC25C, in myelodysplastic syndromes.

Alternative pre-mRNA splicing alters gene expression and protein function, and aberrant splicing patterns can be associated with neoplasia. The potential role of disordered RNA splicing in myelodysplastic syndrome (MDS) is unexplored. We analysed the splicing repertoire of CDC25C- a gene localised to chromosome 5q31 and encoding a cyclin/cyclin-dependent-kinase regulatory phosphatase critical for cell cycle checkpoint control - in MDS, acute myeloid leukemia, chronic lymphocytic leukemia and healthy tissues. Five novel splicing isoforms were detected, and the splicing patterns were generally distinct in neoplastic samples compared with healthy controls. One of the novel isoforms, which we have termed CDC25C-6, occurred in 58% of the samples in our cohort. The results of this study suggest the possibility of aberrant splicing contributing to the phenotype in MDS and other haematologic malignancies.

Diagnosis and management of bone malignancy in adolescence.

Approximately 6% of all childhood malignancies are malignant bone tumors, of which the 2 most frequently encountered are osteosarcoma and Ewing sarcoma. In the United States, the annual incidence in children under 20 years of age is 8.7 per million. In this article we provide an overview of the clinical manifestations, diagnosis, treatment, and prognosis of both osteosarcoma and Ewing sarcoma. Survivorship issues in children and adolescents treated for these malignancies are discussed.

MPL W515 and JAK2 V617 mutation analysis in patients with refractory anemia with ringed sideroblasts and an elevated platelet count.

Discovery of a constitutively activating point mutation of the Janus kinase 2 (JAK2) receptor-associated tyrosine kinase in patients with polycythemia vera (PV) and other BCR/ABL-negative myeloproliferative disorders prompted many groups around the world to examine diverse subsets of patients with myeloid diseases for the prevalence of the JAK2 V617F mutation and its clinical and pathological associations.

C-terminal nucleophosmin mutations are uncommon in chronic myeloid disorders.

C-terminal somatic mutations in nucleophosmin (NPM), a nucleolar shuttling protein that binds p53 and p19(Arf), were recently described in karyotypically normal acute myeloid leukaemia (AML). We analysed primary marrow samples from 150 patients with various chronic myeloid disorders for mutations in the NPM1 gene encoding NPM. NPM1 mutations (tetranucleotide duplication) were detected in three patients, all of whom had chronic myelomonocytic leukaemia (CMML) and a short (<1 year) survival, with rapid progression to overt AML. All other patients were NPM1-wild type in the region analysed. In conclusion, C-terminal NPM mutations are uncommon in chronic myeloid neoplasia, but if present may represent an evolving leukaemic clone.

Recurrent neuroblastoma with gastric invasion.

The authors present an unusual manifestation of neuroblastoma in a young child: upper gastrointestinal bleeding due to erosion of the tumor into the stomach. Included are reviews of gastrointestinal manifestations of neuroblastoma and gastric tumors in children.