Incidence Of Recidivism Research Articles

Outcomes of Endoscopic Congenital Cholesteatoma Removal in South Korea

Transcanal endoscopic ear surgery (TEES) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility during cholesteatoma resection. However, the literature on outcomes following TEES alone for the removal of congenital cholesteatoma (CC) is lacking and limited to small series. To assess outcomes of TEES for CC limited to the middle ear and/or mastoid antrum and to explore the risk factors associated with recidivism (ie, recurrent and/or residual cholesteatoma). This cohort study evaluated retrospective, multicenter data for 271 children with CC who underwent TEES at 9 tertiary referral hospitals in South Korea between January 1, 2013, and December 31, 2021, and had a follow-up of at least 6 months after surgery. Outcomes included the incidence of residual cholesteatoma and audiometric data after TEES. A multivariable analysis using Cox proportional hazards regression models was used to assess associations between cholesteatoma characteristics and recidivism, with hazard ratios (HRs) and 95% CIs reported. Of the 271 patients (mean [SD] age, 3.5 [2.9] years; 194 [71.6%] boys, 77 [28.4%] girls), 190 had Potsic stage I CC (70.1%), 21 (7.7%) had stage II, 57 (21.0%) had stage III, and 3 (1.1%) had stage IV. Thirty-six patients (13.3%) with residual cholesteatoma were found, including 15 (7.9%) with Potsic stage I, 3 (14.3%) with stage II, and 18 (31.6%) with stage III. In the multivariable analysis, invasion of the malleus (HR, 2.257; 95% CI, 1.074-4.743) and posterosuperior quadrant location (HR, 3.078; 95% CI, 1.540-6.151) were associated with the incidence of recidivism. Overall, hearing loss (>25 dB on auditory behavioral test or >30 dB of auditory evoked responses) decreased from 24.4% to 17.7% after TEES. This cohort study involved the largest known population to date of CC removed by TEES. The findings suggest that TEES may be feasible and effective for the removal of CC limited to the middle ear and/or mastoid antrum in children.

The Effect of Horticultural Community Service Programs on Recidivism

The average cost of housing a single inmate in the United States is roughly $31,286 per year, bringing the total average cost states spend on corrections to more than $50 billion per year. Statistics show 1 in every 34 adults in the United States is under some form of correctional supervision; and after 3 years, more than 4 in 10 prisoners return to custody. The purpose of this study was to determine the availability of opportunities for horticultural community service and whether there were differences in incidences of recurrences of offenses/recidivism of offenders completing community service in horticultural vs. nonhorticultural settings. Data were collected through obtaining offender profile probation revocation reports, agency records, and community service supervision reports for one county in Texas. The sample included both violent and nonviolent and misdemeanor and felony offenders. Offenders who completed their community service in horticultural or nonhorticultural outdoor environments showed lower rates of recidivism compared with offenders who completed their community service in nonhorticultural indoor environments and those who had no community service. Demographic comparisons found no difference in incidence of recidivism in comparisons of offenders based on gender, age, and the environment in which community service was served. In addition, no difference was shown in incidence of recidivism in comparisons based on offenders with misdemeanor vs. felony charges. The results and information gathered support the continued notion that horticultural activities can play an important role in influencing an offender’s successful reentry into society.

Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis

BackgroundThe laparoscopic sleeve gastrectomy is now the most common bariatric operation in the United States and has become an established procedure in the armamentarium of the bariatric surgeon. However, this has happened without the strong support of long-term outcomes data, namely the rate of revision and durability of the weight loss. Newly published data from around the world are starting to show alarming trends in these 2 areas. This paper will examine the published and presented data with at least a 7-year follow-up. ObjectivesThis is a meta-analysis on published data with at least 7 years of follow-up from the laparoscopic sleeve gastrectomy. SettingOnline published articles. MethodsWe performed a meta-analysis of publications with at least 7 years of follow-up with the keywords “laparoscopic, bariatric, sleeve gastrectomy, sleeve, long-term, long, term, results, follow-up, follow up, conversion, 7 years, 8 years, 9 years, 10 years, 11 years.” We queried the PubMed, MEDLINE, and ClinicalKey search engines, which included abstracts as well. The I2 statistic was used to determine the heterogeneity across the studies. In presence of heterogeneity, a random effect model using the Dersimonian and Laird method was used to estimate the pooled estimates. The results were summarized using effect size along with a 95% confidence interval (CI). Meta-regression was also used to assess the effect of body mass index and follow-up years on the incidence of recidivism at ≥7 years. ResultsNine cohort studies met the inclusion criteria, with a total of 2280 patients included initially. Only 652 patients had completed ≥7 years of follow-up. At ≥7 years, the long-term weight recidivism rate was estimated to be 27.8% (I2 = .60%; 95% CI: 22.8%–32.7%) with a range of 14% to 37%. The overall revision rate was estimated to be 19.9% (I2 = 93.8%; 95% CI: 11.3%–28.5%). This was broken down into 13.1% (I2 = 93.8%; 95% CI: 5.6%–20.6%) due to weight regain (5 studies) and 2.9% (I2 = 60.8%; 95% CI: 1%–4.9%) due to gastroesophageal reflux disease (5 studies). ConclusionsBased on available data up to the beginning of 2017, bariatric surgeons should be aware of the long-term outcomes of the sleeve gastrectomy, especially regarding revisions and weight regain. It is incumbent on the surgeon to make sure that bariatric patients are truly informed regarding the long-term results of the sleeve gastrectomy.

Predictors of pulmonary critical care recidivism

BackgroundMany patients need readmission to intensive care unit (recidivism) which make ICU moderation burdensome. Readmitted patients mostly carry poor prognosis compared to newly admitted ones, in addition to the bad psychological impact for both patient and his family. Study designIn this retrospective study data of the admitted patients to the pulmonary critical care unit, Mansoura University Hospital included: demographic, clinical, laboratory, and ventilatory data in addition time of discharge and readmission were collected, analyzed and interpreted. AimThe aim of this work is to study the predictors of pulmonary critical care recidivism. Patients and methodsIn this retrospective study 1562 pulmonary critical care unit patients admitted to pulmonary critical care unit, Mansoura University Hospital from August 2009 till the end of December 2013 were subjected to: recording of demographic data, body mass index, admission severity scoring, type of respiratory failure, presence of co morbidity, need for pressors, presence of acute kidney injury at the time of admission, duration of mechanical ventilation, protocolized versus non protocolized weaning, need for tracheostomy, time of discharge, and discharging oxygen saturation using pulse oxymetry. ResultsOf the total number was 1562 patients 69 patients were transferred to other ICUs. From the remaining 1493 patients, 327 died within the first 24h of ICU admission and 1166 survived, 395 patients needed readmission and 771 were non readmission. The incidence of recidivism was more in: patients with type II respiratory failure (66.8%), age above 50years (69.9%), BMI above 35 (70.4%), non recovered acute kidney injury (53.2%), pressor receivers (87.6%), who underwent tracheostomy (67.8%), had longer duration of mechanical ventilation (17±7days vs. 9±4days in non readmitted) and patients who were discharged between 8pm and 8am (72.4%) on hot days (82.1%), in all the p value was <0.005. On the other hand, there was no statistically significant difference in both readmitted and non readmitted patients as regards: sex and weaning method (protocolized 49.4% or non protocolized 50.6%), in all the p value was >0.005. ConclusionAge above 50years, obesity, non recovered AKI, presence of type II respiratory failure, nocturnal and hot day discharge, need for pressors and tracheostomy are considered to be predictors of recidivism to pulmonary critical care unit.

Recidivism in EU Antitrust Enforcement: A Legal and Economic Analysis

Recidivism has, in the last few years, attracted much attention and controversy in the context of EU antitrust enforcement. The treatment of recidivism by the European Commission and the EU Courts has often been criticized, and the observed incidence of recidivism has led to some questioning of the overall effectiveness of EU antitrust enforcement. This article first clarifies the concept of recidivism and then analyses the treatment of recidivism as an aggravating circumstance in setting the amount of fines, the interplay between recidivism and leniency, and the difficulty of drawing conclusions as to the overall effectiveness of EU antitrust enforcement from the observed incidence of recidivism.

Examining the incidence of and time to recidivism within the risk contingency framework: A 20-year follow up study.

This study examined the extent to which the contingencies risk framework (consisting of dispositional, historical, contextual, and clinical domains) predicted detected recidivism (i.e., arrest or conviction). Secondary data were extracted on 413 prisoners who underwent a psychiatric evaluation, were assessed on the risk domains, and followed up over 20 years. There were 273 (66.1%) cases of recidivism for serious offenses (e.g., assaults). Criminal career outcomes examined included: years to and the incidence of recidivism. Statistics showed that chance classification of the incidence of recidivism was 21% more accurate for the recursive partitioning than the bilinear model. These results are consistent with the contingencies risk framework, support its use over linear models, and highlight its predictive utility.

The Impacts of Community-based Foreclosure Prevention Programs

This paper examines the impact of community-based foreclosure prevention interventions using two proxy measures: time to resolution and rate of recidivism. These issues are examined with data from over 4200 borrowers who received intense case-management, post-purchase counseling and/or assistance loans through the Mortgage Foreclosure Prevention Program in Minnesota. Overall, the findings suggest that these interventions have a positive impact. With regard to time to resolution, the time to outcome for borrowers served by the program was on average 10.5 months (315 days). With regard to the rate of recidivism, about one-quarter of borrowers who avoided foreclosure reported being delinquent again 12 months after program intervention, and about one-third were delinquent again after 36 months. Households that did not receive an assistance loan as part of the intervention had a higher incidence of recidivism over time, about 45 per cent. Both time to resolution and recidivism among program participants compared favorably with those reported elsewhere for the industry.

Age as a Differential Characteristic of Rapists, Pedophiles, and Sexual Sadists

In this study, we investigated the role of age in three categories of 168 sex offenders, including 53 rapists, 62 pedophiles, and 53 sadists. On the basis of the match between requisites of completing each type of sexual offense, we hypothesized that rapists would be less represented in the older age group, whereas pedophilic and sexually sadistic offenders would show a more muted decline with age. This hypothesis was supported by the data, clearly a showing smaller number of rapists in the over 40 group relative to the number of pedophiles and sadists ( p = 0.0009.) Further examination of the files eliminated the alternate explanation ascribing this pattern to lack of opportunity in older rapists because of incarceration. These results suggest that age over 40 may mitigate incidence of recidivism in rapists, but not in pedophiles or sexual sadists. Approximately one third of the sexual sadists had committed either first- or second-degree murder, whereas none of the nonsadistic rapists or pedophiles had these crimes on their records. The data further justify categorization of sex offenders into nonsadistic rapist, sadistic rapist, and pedophilic offenders in future research to enhance precision in delineating demographic characteristics and putative causal explanations for sexual offending.

Long-Term Rearrest Rates in a Sample of Adjudicated Delinquents: Evaluating the Impact of Alternative Programs

The authors assess the impact of training school versus alternative program placements for a 12-year period on 266 youths remanded to the Texas Youth Commission in 1983. A proportional-hazards model is used to predict time until recidivism as a function of individual characteristics, criminal history, family environment, program placement, and delinquency risk. Being male, of younger age at the time of commitment, and in an institutional program prior to parole are found to significantly increase the hazard of recidivism. Although program experience does not affect the overall incidence of recidivism, it does affect the timing of subsequent criminal acts. Youth placed in alternative programs have significantly longer survival time until recidivism compared to youth who have been in institutions. In addition, these effects are greatest for the youngest offenders. An important benefit of alternative programs may be to lengthen a window of opportunity for additional rehabilitative efforts and interventions during parole.

Pediatric cholesteatoma: An individualized, single-stage approach

We report our experience with a one-stage surgery for pediatric cholesteatoma in 216 ears. Our technique is based on three main principles: (1) the surgery is individualized; (2) the goal of surgery is to completely remove cholesteatoma and related disease in one operation; and (3) the reconstruction is performed to provide both good hearing and a dry, trouble-free ear. The incidence of recidivism was 10.2%, and the rate achieved was 13.3% at 5 years and 24% at 10 years. Canal wall down surgery was the predominant procedure used. The incidence of intraoperative neurosensory hearing loss, vertigo, and facial nerve injury was extremely low. The postoperative cavity problems encountered were minimal. (Otolaryngol Head Neck Surg 1996;115:107-14.)

Pharmacotherapy of Sexual Offenders

To review the definition, sociology, pathogenesis, diagnosis, medicolegal aspects, and pharmacologic treatment of sexual offenders, with emphasis on the antiandrogens, the luteinizing hormone-releasing hormone (LHRH) antagonists, and the serotonergics. An English-language literature search using MEDLINE (1966-1991) yielded clinical trials, case reports, editorials, and review articles. Emphasis was placed on comparative trials and case reports discussing pedophilia, rape, and exhibitionism. Data from controlled human studies were evaluated. The trials were assessed for sample size, duration of therapy, therapeutic response, and incidence of recidivism. The pharmacologic management of sexual offenders is controversial, and treatment is presently focused on psychotherapy and the use of antiandrogenic medications. Few well-controlled, blinded, efficacy trials with adequate sample sizes have been conducted. The populations studied are heterogeneous, and the subjects enrolled present with different sexually coercive behaviors. Consequently, the results of these studies are difficult to extrapolate to the treatment of other sexual offenders. No convincing evidence exists that pharmacologic treatment decreases the recidivism rate. Case reports describing the use of serotonergic drugs and LHRH antagonists hopefully will promote controlled clinical trials. A social consensus must be reached concerning the ethics of using these agents as a part of the treatment of sexual offenders.

INVITED REVIEW: ALCOHOLIC LIVER DISEASE: TO TRANSPLANT OR NOT TO TRANSPLANT?

Liver transplantation for patients with alcoholic liver disease remains very controversial. We review recent data which suggest that, contrary to earlier reports, many alcoholic patients with end-stage liver disease are able to meet stringent selection criteria and that these selected alcoholics achieve a good result from a liver transplant. Conversely, non-selected alcoholics have a significantly poorer survival. This raises the question as to what is the most appropriate method to select alcoholic patients for liver transplantation. We advocate a selection process which considers the potential recipients' medical, surgical and psychiatric suitability rather than their diagnosis. We outline how we have arrived at this approach in part because of the heterogeneity of patients who carry the diagnosis 'alcoholic liver disease'. We describe how we try to estimate prognosis for future abstinence, which is based on a profile of historical features rather than a fixed period of sobriety. Using this approach, the incidence of recidivism in the first 2 years after transplantation has been low. Prospective longitudinal studies are needed to improve methods of selection for the management of alcoholic patients undergoing liver transplantation.

Management of labyrinthine fistulas caused by cholesteatoma

The surgical management of labyrinthine fistulas caused by cholesteatoma remains controversial. Forty cases (41 ears) of labyrinthine fistulas were reviewed. This represented 10% of our total series of cholesteatomas in adults and children (426 ears). Clinical presentation, extent of disease, results of fistula testing and audiometric studies, and radiographic findings were analyzed. A canal wall-down procedure was performed in all but one patient. Generally an attempt was made to completely remove the cholesteatoma, to graft the fistulous area, and to reconstruct the middle ear mechanism in one stage. The matrix was preserved in patients with large fistulas where the involved ear was the only hearing one, when the matrix was adherent to the underlying optic duct, and in selected elderly persons. Long-term followup did not reveal a significant difference in hearing, degree of vertigo, or incidence of recidivism when those patients in whom the matrix was removed were compared with those in whom the matrix was preserved. The importance of recognizing the presence of a labyrinthine fistula preoperatively is stressed, along with the need to be prepared for an unexpected fistula. Operative management is described.

Juvenile procedures in the Swiss Canton of Vaud

The author is an Inspector in the Metropolitan Police and, as a result of being awarded a bursary, she spent three months in Switzerland in the Canton of Vaud. She made a study of their policing methods and, more specifically, their methods of dealing with juvenile crime and juveniles at risk. The legal system in Vaud is inquisitorial and the police work under examining magistrates who decide in each case whether a person should appear before a court. Figures indicate that proportionately fewer juveniles commit offences in Vaud than in London. The incidence of recidivism is lower. This is probably because Vaud is less urban than London with stronger community ties. The principles used in sentencing are similar but there is less cautioning and more use of community service orders. The emphasis is on education and on ensuring that juveniles are employable