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PubMed2004

Using civil representation to reduce delinquency among troubled youth.

Team Child is designed to provide civil legal representation for very troubled delinquent youth to improve their access to needed education programs, mental health services, and family services. Better provision of these services is intended to reduce delinquency and potentially avoid the long-term incarceration of these youth. This article uses an incidental truncation model to evaluate two Team Child programs in Florida. The authors find the programs not to be effective in reducing recidivism among the youth but to be effective in reducing the arrest rate of the recidivating juveniles. The results indicate a reduction of 11% to 23% of arrests after treatment for the Team Child group.

Adolescent↗
PubMed1979

Civil commitment practices in 1977: troubled semantics and/or troubled psychiatry.

This paper examines the practice of involuntary mental hospitalization through examination of criteria used for committment in a sample of 200 civil commitment certificates. Special reference is made, following previous research, to criteria used to describe the person deemed dangerous to himself or to others. The relevance of the findings of present practices in mental health is discussed. New procedures which facilitate presentation of factual evidence, and which eliminate gratuitous information, are required without delay.

Commitment of Persons with Psychiatric Disorders↗
PubMed1991

The dangerousness criterion for civil commitment: the problem and a possible solution.

The dangerousness criterion for civil commitment fails to specify which mental disorders justify commitment. This ambiguity is highlighted by the fact that there are patients with personality disorders or substance abuse who may be dangerous but for whom we have few effective treatments. A possible solution might be provided by adopting the American Psychiatric Association guidelines which consider severity of mental disorder and treatability in its criteria.

Commitment of Persons with Psychiatric Disorders↗
PubMed1990

Premature deaths among men in a Swedish municipality--civil status and primary health care utilization prior to death.

Causes of premature deaths among men in relation to civil status and primary health care utilization were studied in a Swedish municipality. Alcoholism, suicide and accidents (psycho-social deaths and accidents) were of special concern (40% of all deaths). When principal and contributing causes of death were considered, alcoholism was registered in 21% of all men. Including information from primary health care records, the Social Services and the local outpatient alcohol clinic, the proportion of men with alcohol abuse was 40%. Half of the men with psychosocial deaths and accidents were divorced at the time of death. The time elapse between divorce and death was especially short for those who committed suicide, 1.4 years, compared to 9.5 years when death was due to alcohol. Half of the men who visited the primary health care centre six months before death were single, and the problem of the final antemortem visit anticipated the cause of death in the majority of these men.

Adult↗
PubMed2006

The effect of a worksite based walking programme on cardiovascular risk in previously sedentary civil servants [NCT00284479].

BACKGROUND: A significant proportion of Europeans do not meet the recommendations for 30 mins of physical activity 5 times per week. Whether lower frequency, moderate intensity exercise alters cardiovascular disease (CVD) risk has received little attention. This study examined the effects of 45 minutes self-paced walking, 2 d. wk(-1) on aerobic fitness, blood pressure (BP), body composition, lipids and C-Reactive Protein (CRP) in previously sedentary civil servants. METHODS: 37 subjects (24 women) aged 41.5 +/- 9.3 years were randomly assigned to either two 45 minute walks per week (walking group) or no training (control group). Aerobic fitness, body composition, blood pressure (BP), CRP and lipoprotein variables were measured at baseline and following 8 weeks. Steps counts were measured at baseline and during weeks 4 and 8 of the intervention. RESULTS: Compared to the control group, the walking group showed a significant reduction in systolic BP and maintained body fat levels (P < 0.05). There were no changes other risk factors. Subjects took significantly more steps on the days when prescribed walking was performed (9303 +/- 2665) compared to rest days (5803 +/- 2749; P < 0.001). CONCLUSION: These findings suggest that walking twice per week for 45 minutes at approximately 62% HRmax, improves activity levels, reduces systolic BP and prevents an increase in body fat in previously sedentary adults. This walking prescription, however, failed to induce significant improvements in other markers of cardiovascular disease risk following eight weeks of training.

Adult↗
PubMed2004

Testimony method to ameliorate post-traumatic stress symptoms. Community-based intervention study with Mozambican civil war survivors.

BACKGROUND: The effectiveness of the testimony method has not been established in rural communities with survivors of prolonged civil war. AIMS: To examine the effectiveness and feasibility of a testimony method to ameliorate post-traumatic stress symptoms. METHOD: Participants (n=206) belonged to former war zones in Mozambique. They were divided into a case (n=137) and a non-case group (n=69). The case group was randomly divided into an intervention (n=66) and a control group (n=71). Symptoms were measured during baseline assessment, post-intervention and at an 11-month follow-up. RESULTS: Post-intervention measurements demonstrated significant symptom reduction in both the intervention and the control group. No significant differences were found between the intervention and the control group. Follow-up measurements showed sustained lower levels of symptoms in both groups, and some indications of a positive intervention effect in women. CONCLUSIONS: A remarkable drop in symptoms could not be linked directly to the intervention. Feasibility of the intervention was good, but controlling the intervention in a small rural community appeared to be a difficult task to accomplish.

Adult↗
PubMed1987

Suicide and civil commitment.

The contemporary approach to suicide prevention relies primarily on involuntary commitment of the suicidal individual. While there is generally widespread acceptance of the principle of society's right, even its moral obligation, to intervene to prevent a suicide, there is much less agreement concerning the conditions under which such an action should proceed. Most of the debate centers on the widely applied commitment criteria of mental illness and dangerousness to self and others. Questions have also been raised regarding the efficacy of commitment as a preventive measure. In this paper, these controversies are placed in a broader historical context. We examine empirical evidence concerning prevailing commitment criteria and the prophylactic value of involuntary hospitalization, and discuss the appropriateness of our current approach to civil commitment in light of existing data.

Commitment of Persons with Psychiatric Disorders↗
PubMed1981

Civil commitment as a "street-level" bureaucracy: case-load, professionalization and administration.

This article applies street-level bureaucracy theories to "coping" patterns of behavior that developed in an involuntary commitment system. Daily procedures and routines of five Nebraska county boards of mental health and the attitudes of their members were studied. The results showed that the urban, high case-load, professionally-oriented board informally modified statutory procedures significantly to reduce face-to-face client contact, limit the scope of its decisions, and displace responsibility for the most ambiguous decisions to the treatment facility and board psychiatrist. Rural, low case-load, less professionally-specialized boards also modified the statutory procedures, but conducted the commitment process in a far more ambiguous, open-ended, and tense system with substantial face-to-face client contact. Both urban and rural boards had multifaceted role definitions; rural boards, however, had a more open-ended perception of their functions, and attempted more actively to modify antisocial behavior and redirect board subjects to sources of social counseling. Therefore, understanding street-level "coping" behavior in an actual commitment context is important to develop realistic changes in civil commitment systems and to preclude informal procedures that reduce a commitment system's effectiveness or undermine a proposed patient' s rights.

Administrative Personnel↗
PubMed1985

Wounded by bayonet, ball, and bacteria: medicine and neurosurgery in the American Civil War.

The American Civil War was a holocaust that illustrated the mid-19th century's unpreparedness for the delivery of medical care to the mass casualties due to both wounds and disease. Several major considerations are offered to explain the soldiers' morbidity. Incomplete understanding of pathophysiology and its management is exemplified by the treatment of the battlefield head injury. Accepting these concepts and the extent of the knowledge of the time, that higher mortality did not occur is in part testimony to the admirable care that was rendered and human resilience in an effort to survive.

Brain Injuries↗
PubMed2002

Genetic structure of the Ards Peninsula, Northern Ireland: evidence from civil registers of marriage 1840-1911.

This paper uses marital migration data transcribed from the Civil Registers of Marriage 1840-1911 to estimate kinship from migration matrices and isonymy in the Ards Peninsula, Northern Ireland. The distribution of religious denominations (Presbyterian, Episcopalian, and Roman Catholic) varies systematically throughout the region, with up to 77% Roman Catholic in the south and 81% Presbyterian in the north. Portavogie, a fishing village on the east coast, is exclusively Protestant, with a population 93% Presbyterian. Comparison of migration and isonymy with geographical distance by multidimensional scaling and the MATFIT procedure show Portavogie to be an outlier, more distantly related to other areas than its geographical position would predict. We suggest that this discrepancy is due to settlement history and occupational and religious isolation. Mantel tests show that marital migration is significantly related to geographical distance (rMG = 0.4257), as is the distribution of religious denominations (rRG = 0.5548) through settlement history. Migration is dependent on religion (rMR = 0.3674), and isonymy is dependent on migration (rIM= 0.2531) but not on geography or religion. With Portavogie omitted from the analysis, the dependence of migration on geography and on religion increases (rMG = 0.5583, rMR = 0.5646), as does the correlation between religion and geography (rRG = 0.7213). The dependence of isonymy on migration increases (rIM = 0.5103), and significant correlations between isonymy and religion (rIR = 0.4135) and isonymy and geography (rIG = 0.4660) appear. We argue that a full explanation of population structure requires geographical distance, settlement history, and the influence of religion and occupation to be taken into account.

Christianity↗
PubMed1996

Dental fillings in Civil War skulls: what do they tell us?

This article discusses the dental techniques, methods and materials used in the South during the Civil War based on the dental restorations found in the skulls of four confederate soldiers. The skulls display a variety of dental filling materials, including thorium, lead, tin and tin amalgam. These materials were used at a time when more valuable materials, such as gold and silver, were not readily available in the South.

Dental Amalgam↗
PubMedDate not supplied

[Work and alcoholism: study with civil servants].

This investigation was carried out with civil servants, and it aimed at analyzing the influence of labor in the production/ reproduction and transformation of alcoholic behavior. Methodologically, this study is characterized as exploratory and qualitative. Data collection was done by means of documental analysis and participatory observation. Interviews were performed if needed to complement the information. The identification of nexuses of production and reproduction of alcoholic behavior in an institutional context provided proposals for changing it, as well as showed the need to carry out an integrated job among the services that provide care for alcoholics by seeking other investments for gradually changing this behavior.

Alcoholism↗
PubMed1996

Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study.

OBJECTIVES: This study sought to examine the association between the psychosocial work environment and subsequent rates of sickness absence. METHODS: The analyses were based on a cohort of male and female British civil servants (n=9072). Rates of short spells ( 7 days) of sickness absence were calculated for different aspects of the psychosocial work environment, as measured by self-reports and personnel managers' ratings (external assessments). RESULTS: Low levels of work demands, control, and support were associated with higher rates of short and long spells of absence in men and, to a lesser extent, in women. The differences were similar for the self-reports and external assessments. After adjustment for grade of employment, the differences were diminished but generally remained significant for short spells. The combination of high demands and low control was only associated with higher rates of short spells in the lower grades. CONCLUSIONS: The psychosocial work environment predicts rates of sickness absence. Increased levels of control and support at work could have beneficial effects in terms of both improving the health and well-being of employees and increasing productivity.

Absenteeism↗
PubMed2002

Job strain does not relate to morning level vanilmandelic acid in Japanese civil servants.

Epidemiologic and clinical studies have related acute and, less frequently, chronic life stress to cardiovascular diseases. In addition, animal models suggest that chronic psychological stress could cause atherosclerosis, probably by increasing sympathetic activation. In this cross-sectional study we evaluated the association between job strain, as one of the markers of workplace stress, and the urinary excretion of Vanilmandelic acid (VMA) upon awakening as a sympathoadrenal activity marker in the morning. Subjects were 936 male and 823 female civil servants working in departments related to the municipality of a city in Toyama Prefecture, Japan, in the spring of 2001. VMA was measured by high-performance liquid chromatography. We found that there was an age dependent increase in the level of VMA and females had higher VMA levels than males. Males who were current smokers had significantly lower VMA levels than nonsmokers after adjusting for age. Job strain level did not relate to VMA concentration in urine after adjusting for age and smoking status both in men and women. In addition, working and sleeping hours as predictor variables were also not associated with urinary VMA levels upon awakening in the morning. In conclusion, it seems that job strain does not independently relate to the sympathoadrenal activity, but the interaction between job strain and other variables such as personal characteristics and environmental factors and their relation with sympathoadrenal activity should further be explored.

Chromatography, High Pressure Liquid↗
PubMed2003

Gender and age differences in lifestyle factors related to hypertension in middle-aged civil service employees.

The aim of this study is to identify lifestyle factors related to hypertension in man and woman workers, and to investigate age and gender differences in the relationships of the factors. From 6,000 civil service employees (4,937 men and 1,063 women) aged 40-69 years, information on lifestyle-related factors such as stress, exercise habits, preference for salty taste, alcohol drinking and smoking habits, and body mass index, as well as age and family history of hypertension was obtained through self-administered questionnaires in 1997. Hypertension was defined as either a systolic blood pressure > or = 140 mmHg, a diastolic blood pressure > or = 90 mmHg, or undergoing treatment for hypertension, and was present by 37.0% in men and 19.6% in women. Only body mass index was a significant lifestyle-related risk factor common to both genders with an odds ratio and its 95% confidence interval in parentheses of 2.2 (2.0-2.5) for men and 3.2 (2.3-4.6) for women. Men and women who preferred salty taste showed multivariate adjusted odds ratios of 0.9 (0.8-1.1) and 1.5 (1.1-2.2) for hypertension, respectively. In the stratified subanalysis, women aged 50 years and over had a significant odds ratio of 2.7 (1.5-4.9), whereas women aged 40-49 years and men of all age classes failed to show significant relationships. Salt intake was suggested to be a key factor for hypertension particularly for women after menopause.

Adult↗
PubMed1989

The role of Addington v Texas on involuntary civil commitment.

The United States Supreme Court in 1979 set the standard for involuntary commitment. This decision, styled Addington v Texas, raised the burden of proof required to commit persons from the usual civil burden of proof of "preponderance of the evidence" to "clear and convincing" evidence. There was no reduction in the rates of commitment as a result of the decision. The proportion of patients committed in Texas grew in almost linear fashion during the years 1972-1986. Various economic, sociological, and treatment factors may have more influence on commitment of patients than does a court decision.

Commitment of Persons with Psychiatric Disorders↗