309 research outputs found
Phase II study to evaluate combining gemcitabine with flutamide in advanced pancreatic cancer patients
A phase II study was undertaken to determine the safety of combining flutamide with gemcitabine, with response rate being the primary end point. Twenty-seven patients with histologically proven, previously untreated, unresectable pancreatic adenocarcinoma received gemcitabine, 1âgâmâ2 intravenously on days 1, 8 and 15 of a 28 day cycle, and flutamide 250âmg given orally three times daily. Treatment was halted if there was unacceptable toxicity, or evidence of disease progression. Toxicity was documented every cycle. Tumour assessment was undertaken after cycles 2 and 4, and thereafter at least every additional four cycles. One hundred and seventeen cycles of treatment were administered, median four cycles per patient (range 1â18). Gemcitabine combined with flutamide was well tolerated, with most toxicities being recorded as grade 1 or 2 and only nine treatment cycles associated with grade 3 toxicity. The most frequent toxicity was myelosuppression. One case of transient jaundice was recorded. The commonest symptomatic toxicity was nausea and vomiting. The response rate was 15% (four partial responses), median survival 6 months and 22% of patients were alive at 1 year. These results suggest antitumour activity of the combination therapy to be equivalent to single agent gemcitabine
"A different world" exploring and understanding the climate of a recently re-rolled sexual offender prison
Understanding how sexual offenders experience prison and its environment is important because such experiences can impact on rehabilitation outcomes. The purpose of this research investigation was to explore the rehabilitative and therapeutic climate of a recently re-rolled sexual offender prison. The research took a mixed methods approach and consisted of quantitative and qualitative phases. There were differences between prisoners and staff on their perception of the prison climate and for prisoner and staff relationships. The qualitative results helped to explain the quantitative findings and added a more nuanced understanding of the experience of the prison, the nature of prisoner and staff relationships and the opportunities for personal growth within the prison. The study has important implications for prisons that co-locate sexual offenders and want to provide an environment conducive to rehabilitation
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Resist not desist: a retrospective exploration of viable prevention strategies helping individuals to avoid committing their first sexual offence against a child
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Resist not desist: the need for a prevention project: an exploration of convicted sexual offender and practitioner perspectives
"Itâs sort of reaffirmed to me that I'm not a monster, I'm not a terrible person": sex offendersâ movements toward desistance via peer-support roles in prison
Individuals incarcerated in prisons across the United Kingdom and abroad are able to volunteer for a variety of peer-support roles, which are characterized by prisoner-to-prisoner helping. Some research has found that such roles can represent turning points in the lives of those who have offended and encourage movements toward desistance. This proposed redemptive influence is argued to result from the prosocial behaviors that such roles appear to elicit in their holders. The present study aims to explore the mechanics of this claimed influence. While a limited amount of research has attempted this on a general offending population, no research has done so with a sample of sexual offenders. Given the intensive treatment programs involved in such contexts, and the requirements for sexual offenders to demonstrate reduced risk, the authors believe those serving time for sexual offenses represent an important sample on which to explore the potentially redemptive properties of peer-support roles. To this end, 13 peer supporters participated in semistructured interviews. Transcripts were analyzed using a phenomenologically oriented thematic analysis. Results suggest that sexual offenders who adopt peer-support roles are able to live up to desired selves by âdoing goodâ in prison, âgiving back,â and consequently resisting negative labels. These benefits have been theoretically linked with better reintegration outcomes for sexual offenders, who are publicly denigrated in the extreme and find it especially difficult to (re)integrate. Suggestions regarding the future utility of such schemes are offered
"The resurrection after the old has gone and the new has come": understanding narratives of forgiveness, redemption and resurrection in Christian individuals serving time in custody for a sexual offence
Research has shown how religion is associated with numerous positive effects including enhanced mood, increased feelings of hope, increased altruistic behaviour, improved ability to cope and also reducing peopleâs involvement in delinquent and criminal behaviour. However, this has also been contested with some arguing that religion can have criminogenic effects. Whilst there is a growing body of research concerning the effect (criminogenic or positive) of religion on offending, there is currently a paucity of research focusing on sexual offending and religion. The aim of this study was to explore and understand the effects that religious beliefs have on individuals with sexual convictionsâ sense of self, identity, their thoughts about the future and on their daily lives in prison. The results focus on a centrally important superordinate theme related to forgiveness and redemption. The analysis unpacks participantsâ narratives of forgiveness and the impact such narratives have on participants. A key finding from the data in this study was that religious beliefs and being forgiven by a higher power appeared to facilitate redemptive selves and the enacting of these selves. Implications for practice and limitations are discussed
âI Despise Myself for Thinking about Them.â A Thematic Analysis of the Mental Health Implications and Employed Coping Mechanisms of Self-Reported Non-Offending Minor Attracted Persons
âNon-offending pedophilesâ or âminor attracted personsâ are individuals who suppress an attraction to children. Previous analyses of this populationâs mental illness employed overt self-report methods, limited by social desirability. Additionally, studies assessing the coping mechanisms employed to remain offense-free are underpowered; understanding of these would facilitate the rehabilitation of prior offenders. A thematic analysis of coping mechanisms and mental illness was conducted on 5,210 posts on the âVirtuous Pedophilesâ forum. Four themes emerged for coping mechanisms: Managing risk and attraction to children, Managing mood, Managing preferences prosocially and Friends, family and relationships, with 13 subthemes. Five themes emerged for mental ill-health, including: Addiction, Anxiety, Depression, Self-hatred/Self-harm/Suicide and Other. Self-hatred/Self-harm/Suicide accounted for almost a third of discussed mental ill-health. These results highlight the severity of mental ill-health amongst this population and the coping mechanisms employed to remain offense-free
A phase Ib dose-finding, pharmacokinetic study of the focal adhesion kinase inhibitor GSK2256098 and trametinib in patients with advanced solid tumours
BACKGROUND: Combined focal adhesion kinase (FAK) and MEK inhibition may provide greater anticancer effect than FAK monotherapy. METHODS: This dose-finding phase Ib study (adaptive 3â+â3 design) determined the maximum tolerated dose (MTD) of trametinib and the FAK inhibitor GSK2256098 in combination. Eligible patients had mesothelioma or other solid tumours with probable mitogen activated protein kinase pathway activation. Adverse events (AEs), dose-limiting toxicities, disease progression and pharmacokinetics/pharmacodynamics were analysed. RESULTS: Thirty-four subjects were enrolled. The GSK2256098/trametinib MTDs were 500âmg twice daily (BID)/0.375âmg once daily (QD) (high/low) and 250âmg BID/0.5âmg QD (low/high). The most common AEs were nausea, diarrhoea, decreased appetite, pruritus, fatigue and rash; none were grade 4. Systemic exposure to trametinib increased when co-administered with GSK2256098, versus trametinib monotherapy; GSK2256098 pharmacokinetics were unaffected by concomitant trametinib. Median progression-free survival (PFS) was 11.8 weeks (95% CI: 6.1-24.1) in subjects with mesothelioma and was longer with Merlin-negative versus Merlin-positive tumours (15.0 vs 7.3 weeks). CONCLUSIONS: Trametinib exposure increased when co-administered with GSK2256098, but not vice versa. Mesothelioma patients with loss of Merlin had longer PFS than subjects with wild-type, although support for efficacy with this combination was limited. Safety profiles were acceptable up to the MTD
âItâs not something I chose you knowâ: making sense of pedophilesâ sexual interest in children and the impact on their psychosexual identity
Sexual interest in children is one of the most strongly predictive of the known risk factors for sexual reconviction. It is an important aspect of risk assessment to identify the presence of such interest, and an important task for treatment providers to address such a sexual interest where it is present. It has been argued that understanding pedophilesâ deviant sexual interest in children can enhance risk assessment, management, and treatment planning. This research study aims to explore the phenomenology of deviant sexual interest in children, the impact it has on pedophilic offendersâ identities, and their views on the treatability of that interest. The study used semistructured interviews and repertory grids to make sense of participantsâ experiences. The results revealed three superordinate themes: ââlivingâ with a deviant sexual interest,â ârelational sexual self,â and âpossible and feared sexual self.â The analysis unpacks these themes and repertory grid analysis is used to explore a subset of participantsâ identities in more detail. The results reveal that there needs to be an acceptance from both client and therapist that their sexual interest in children may never go away. Through this acceptance, clients could work on enhancing sexual self-regulation, recognizing their triggers, and so managing their sexual thoughts, feelings, and behavior. Implications for treatment are also discussed
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