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Biomedical subjects

C Pritchard

Publications and source records attributed to C Pritchard.

At least 37 records · Page 2Linked to original sources
PubMed2000

Multi-criminal and violent groups among child sex offenders: a heuristic typology in a 2-year cohort of 374 men in two English counties.

OBJECTIVE: To determine the lifetime criminality of men charged with a sexual offence against a child and to identify any heuristic typologies. METHOD: The police files of a 2-year cohort of 462 men charged with a sexual offence against a minor (<17) in two English counties were analyzed; 374 were convicted. The patterns of their convictions produced a typology based upon judicially substantiated parameters. RESULTS: Half the guilty men had prior convictions for non-sexual crimes, including 24% with convictions for violent offences. Three heuristic groups emerged: "Sex-Only" offenders (S.O., n = 186); "Sex And Other" offenders (S.A.O., n = 97); and "Sex and Violent" offenders (S.V., n = 91), averaging three sex convictions each. However, the S.A.O. and S.V. men had more non-sexual than sex convictions, averaging 5.1 versus 10.5, justifying the designation of "multi-criminal" child sex abusers. However, the patterns of these men's sexual offending did not differ, except that the S.O. men's victims were significantly more often intra-family, 36%, 31%, and 13%, respectively; indicating that the majority of these men's victims were extra-familial (71%). Significantly, 19% of the convicted men had at least one "not guilty" verdict for a sex charge, as opposed to 4% for non-sexual crimes. CONCLUSIONS: While the S.O. group appear to consist of traditional types of fixated and regressed offenders, in men charged with offences, they are atypical of most sex abusers since their victims are mainly extra-familial. These "multi-criminal" men present particular challenges for custodial and therapeutic settings, and the potential dangerousness of these offenders should not be underestimated.

Adult↗
PubMed2000

Bilateral idiopathic Brown's syndrome with delayed onset in the second eye.

PURPOSE: We describe 6 cases of a previously unreported variation of bilateral Brown's syndrome that presented in congenital form in one eye and developed later in the fellow eye with no underlying cause. METHODS: We reviewed the clinical records of 6 patients from 6 separate practices to determine whether there were any common clinical features on presentation or in their clinical courses. RESULTS: All 6 patients were diagnosed with unilateral congenital Brown's syndrome at the first ophthalmologic assessment but showed no evidence of the syndrome in the fellow eye. In 5 cases the contralateral syndrome developed in the second eye after surgery was performed on the first eye, and in 1 case it developed before any surgery was done. The ages at onset of the syndrome in the second eye ranged from 2 to 8 years. None of the children had any evidence of systemic illness or local orbital disease to explain an acquired Brown's syndrome. CONCLUSION: To our knowledge, this is the first reported series of cases of bilateral Brown's syndrome that manifested sequentially in the eyes with no known causes for an acquired syndrome in the second eye. This finding supports the premise that congenital and acquired Brown's syndrome are on a continuum with a common pathophysiology of restriction of free movement of the superior oblique tendon in the trochlea.

Child↗
PubMed1998

The criminality of former "special educational provision" permanently "excluded from school" adolescents as young adults (16-23): costs and practical implications.

An analysis of police records of the criminal "careers" of a complete cohort (1990-95) of 227 "excluded from school" adolescents who had been in "special educational provision" found that 63% had a criminal conviction as young adults (16-23 years). However there was evidence of "missed opportunities" as 26% of the offenders were not convicted until over 18-years-old. Averaging 7.4 offences each, 29% had a conviction for violence, 29% had been to prison and a further 27% are currently on bail for alleged offences. Home Office-based predictions show that 42% are highly likely to re-commit their most serious offence within 2 years. Based upon Audit Commission and Department of Health estimates, these 143 young adults cost a minimum of pound 4.16 million pounds. However, 10% of excluded adolescents who were also "ex child care" had a significantly lower crime rate than the others (41% vs. 70%), which suggests that with targeted support, such as under the 1989 Children Act, effective intervention is possible in a significant number of cases.

Adolescent↗
PubMed1998

Quality improvement in the diagnosis and treatment of heart failure by participating Indiana and Kentucky hospitals.

Acute-care hospitals in Kentucky and Indiana collaborated with Health Care Excel, the Medicare peer review organization, to improve the care of patients admitted with heart failure. Current guidelines for the treatment of heart failure support a focus on quality indicators including confirmation of diagnosis, choice of therapeutic agents, education of patients and their caregivers, and discharge planning. Significant improvement occurred in use of diagnostic tests to confirm diagnosis and in patient education and discharge planing. Improvement in use of therapeutic agents was minimal or lacking in most hospitals. This project demonstrated an opportunity and need for continued improvement efforts in the care of heart failure patients.

Chi-Square Distribution↗
PubMed1998

Validity of a self-completed questionnaire measuring the physical demands of work.

OBJECTIVES: This study determined the accuracy of workers in quantifying occupational physical demands on a self-administered questionnaire. METHODS: First, a self-administered questionnaire on work postures, manual materials-handling, and repetitive upper-limb movements was validated using direct simultaneous observations for 123 randomly selected employees from 6 occupational settings. Second, weight estimation accuracy was assessed on visual analogue scales for 6 manual materials-handling activities using 20 randomly selected employees from 1 occupational setting. RESULTS: At a dichotomous level (ever-never), the accuracy of most of the self-reported physical demands was good (sensitivity 60-100%; specificity 56-100%). A more-detailed analysis of the dimensions studied (frequency, duration and amplitude) also showed that the accuracy of the self-reported estimates was satisfactory. Full agreement between the estimated and observed frequency was >60% for most of the manual materials-handling activities. In addition the average difference between the estimated and observed duration of the physical demands was found to be small. Finally the average difference between the self-reported and actual weights of various loads was found to be modest. CONCLUSIONS: The self-reported questionnaire used in this study would provide a useful instrument for estimating occupational physical demands and the frequency, duration, and amplitude of these demands in future epidemiologic studies associated with musculoskeletal pain.

Adult↗
PubMed1997

Population density and cancer mortality by gender and age in England and Wales and the Western World 1963-93.

The aetiology of malignant disease is multi-factorial, including contributory environmental factors. Based upon the premise that increases in the density of population will be coterminous with a worsening of the environment, it is hypothesised that such changes should be reflected in an increase in cancer mortality in general and in elderly populations. By focusing upon changes in the elderly (+75) deaths between two time periods, the study corrects for age factors related to cancer mortality. The study tests this hypothesis via correlations between population density and malignancy death rates in general and elderly age bands over a thirty year period. It was found that there were positive and significant correlations between population density and malignancy mortality rates in the Western World, especially amongst men, but all correlations strengthened in the direction hypothesised. The findings were not an artefact of longevity, further research is required to give a better understanding of these findings.

Adult↗
PubMed1997

Suicide and 'violent' death in a six-year cohort of male probationers compared with pattern of mortality in the general population: evidence of accumulative socio-psychiatric vulnerability.

The 'Health of the Nation' (Department of Health, 1992) suicide targets focus upon the mentally ill, but virtually ignore the mentally abnormal offender. Whilst forensic services deal with the severely disturbed, the majority of offenders remain in the community, despite long-standing psychosocial difficulties. This study explores the mortality rates of a six-year cohort of male probationers (1990-1995) with males in the general population. Male offenders (aged 17-54) had double the death rate, five times the 'external death' rate and nine times the suicide rate of the general population. This paper highlights the need to further improve the health-psychiatric-criminal justice collaboration.

Adolescent↗
PubMed1996

New patterns of suicide by age and gender in the United Kingdom and the Western World 1974-1992; an indicator of social change?

Between 1974 and 1992 male suicide increased in the United Kingdom and in most countries of the Western World. At the same time there were substantial reductions in female suicide in many countries. However, these results mask significant changes related to age in both genders. In most countries there was a disproportionate rise in younger male suicides (< 35 years); with two disproportionate peaks in younger (25-34 years) and elderly (75 + years) female suicides. The implications of these changes are briefly discussed within the context of changing socio-economic expectations.

Adult↗
PubMed1996

Comparison of cancer deaths in England and Wales and the developed world by age and gender 1973-92, and, new malignancies in England and Wales 1971-88.

Cancer deaths in England and Wales and the developed world were examined by age and gender between 1973-1992. Whilst over-all mortality levels increased, this was mainly linked to extended longevity, as the rate fell substantially for people under 55 in the majority of countries, possibly as a result of improved treatment and prevention outcomes. Whilst England and Wales had above average reductions in cancer deaths, especially for children, there were considerable rises in new malignancies, 1971-88, particularly amongst women under 35 years, and in certain selected sites. These over-all changes do not appear to be the result of improved diagnosis, thus, despite evidence of more effective therapeutic and preventative measures the incidence of new malignancies is increasing. The possible implications are briefly discussed, in the context of "medical audit', which increasing uses mortality rates as "indicators of effectiveness'.

Adolescent↗
PubMed1996

Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide.

Throughout the developed world suicide is predominantly associated with psychiatric disorders and substance misuse. The main social factors are age, as suicide increases with each decade, and gender, as suicide is more frequent among men than women, and proportionately more young men die than their female peers. An analysis of suicide in the People's Republic of China found that the profile was the opposite to that reported in the rest of the world, as more female subjects kill themselves than males, particularly younger women. Also, unlike the situation in other countries, suicide occurred more often in rural than in urban areas. It is argued that the Chinese data provide evidence of a greater cultural influence upon suicide rates than had previously been realized.

Adolescent↗
PubMed1996

An international comparison of characteristics of the sensation of nasal obstruction between Canadian and Japanese patients.

To determine differences in perception of nasal obstruction in Canadians and Japanese, we assessed subjective and objective nasal patency of 48 patients in Canada and 43 patients in Japan. Mean severity of the sensation of nasal obstruction in Canadian patients was significantly higher than in Japanese patients, while no significant differences in nasal resistances were found. Complaints of nasal obstruction in Canadian patients were directly concerned with nasal breathing, while Japanese patients complained of indirect matters, such as "unable to concentrate on job or study" or "nasal obstruction or nasal speech pointed out by other persons." The differences might be due to national characteristics.

Adult↗
PubMed1995

Psychiatric targets in 'health of the nation': regional suicide 1974-1990 and employment prospects in 1990-1994 in Britain: precursors of failure?

The psychiatric targets set in 'The Health of the Nation' reflect a fundamental change in auditing the psychiatric and social services, and it is argued that suicide levels have become 'Paradoxical indicators' of effectiveness. Based upon mortality rates between 1974-1990, inter-regional comparative league tables are presented. Changes in age and gender patterns, and the accumulative impact of unemployment 1990-1994, especially in the more affluent regions, suggest that the suicide targets may not be feasible. The implications for the community and psychiatric services are briefly discussed.

Adolescent↗