PubMed · 16335692
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Julie St-Arnaud, Marie P Beaudet, Patricia Tully. 2005. Life expectancy.. https://pubmed.ncbi.nlm.nih.gov/16335692/
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In northeastern Iran, there is an area of high incidence of esophageal cancer, which is populated by residents of Turkmen ancestry. Several environmental risk factors for esophageal cancer have been proposed, but the roles of familial and genetic factors have not been studied extensively in the Turkmen population. We evaluated the importance of familial risk factors for esophageal cancer by performing a case-control study of 167 cases of esophageal squamous cell carcinoma and 200 controls of Turkmen ethnicity. Detailed family pedigrees of the cases and controls were constructed, which documented all cancers in first- and second-degree relatives. The actuarial risk of cancer was then estimated in 2,097 first-degree relatives of cases and 2,783 first-degree relatives of the controls. A hazard ratio was constructed, based on a comparison of the 2 cumulative incidence curves. The risk to age 75 of esophageal cancer in the first-degree relatives of Turkmen patients with esophageal cancer was 34% versus 14% for the first-degree relatives of the controls (hazard ratio = 2.3; p = 3 x 10(-8)). Cases (9.6%) reported that their parents were related, versus 2.5% of the controls who reported this. (odds ratio = 4.1; p value = 0.006). Familial factors are important in the etiology of esophageal cancer among the Turkmen residents of Iran. The hazard ratio of 2.3 for cancer among first-degree relatives is consistent with an important contribution of heritable factors. It will be of interest to perform marker studies to establish which genes are responsible.
Unlike many other countries, for many years, Germany disregarded structured instruments for assessing the risk of criminal reoffence. However, this negative attitude now seems to be gradually changing. An increasing number of contributions regarding structured instruments have been published in the German literature in the last years, and some instruments have already found their way into practice. However, studies that systematically examine the applicability of the mostly Anglo-American instruments to German criminals are still lacking. Therefore, the major objective of the current study was to test some internationally established procedures in a larger unselected sample from the German penal system. The following were included in the study: the Level of Service Inventory - Revised (LSI-R), the HCR-20 Scheme, and the Psychopathy Checklist - Revised (PCL-R). On the whole, the instruments proved to be applicable to German criminals with only a few adaptations to the German situation, and they achieved a predictive accuracy comparable to the values reported internationally. However, there were only minor differences in the predictive performance between the measures. Moreover, some basic limitations became apparent. Firstly, we found quite high percentages of criminals with medium scores and a correspondingly ambiguous prognosis. Furthermore, the predictive accuracy seemed to be dependent on demographic, criminological and psychopathological characteristics of the offenders. Finally, the instruments appeared to only partially utilize the empirical store of knowledge available regarding factors influencing the recidivism of criminals, since even a simple predictive model that only added a few further aspects besides the tested instruments (e. g. treatment yes or no) achieved systematically better predictions than the instruments alone. Altogether, the tested measures turned out to be useful instruments for risk assessments and may be conducive for a more systemized practice. However, due to the limitations inherent, they should be seen as a complement to a careful and clinically informed appraisal and not a substitute.
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