A new medication-based prediction score for postoperative delirium in surgical patients: development and proof of feasibility in a retrospective patient cohort

Structured risk screening for postoperative delirium (POD) considering prehospital medication is not established. We aimed to develop a POD-risk prediction score based on known risk factors and delirium-risk increasing drugs to be used by pharmacists during medication reconciliation at hospital admission, and to test for feasibility in a retrospective cohort of surgical patients. Therefore, established POD-risk factors and drugs were extracted from the literature and a score was generated. Following this, the score was tested for feasibility in a retrospective 3-month-cohort of surgical patients. For patients with higher scores suggesting higher probability of POD, patient charts were screened for documentation of POD. For development of the score, the following POD-risk factors were defined and points assigned for score calculation: age (≥65 years=1 point/≥75 years=2), male sex (1), renal insufficiency (RI; 1), hepatic impairment (HI; Model-of-endstage-liver-disease (MELD) 10-14=1/≥15=2), delirium-risk increasing drugs (1 point per drug class), anticholinergic drug burden (ACB; ≥3=1). In the retrospective test cohort of 1174 surgical patients these factors concerned: age ≥65 years 567 patients (48%)/≥75 years 303 (26%), male 652 (55%), RI 238 (20%), MELD 10-14 106 (9%)/≥15 65 (5%), ≥ 1 delirium-risk increasing drug 418 (36%), ACB ≥3 106 (9%). The median POD-risk prediction score was 2 (range 0-9). Of 146 patients (12%) with a score ≥ 5, POD was documented for 43 (30%), no evidence for POD for 91 (62%) and data inconclusive for 12 (8%). For scores of ≥ 7, POD was documented for 50% of the patients with sufficient POD documentation. Overall, POD documentation was poor. To summarize, we developed and successfully tested the feasibility of a POD-prediction-score assessable by pharmacists at medication reconciliation at hospital admission

Area and individual differences in personal crime victimization incidence: The role of individual, lifestyle/routine activities and contextual predictors

This article examines how personal crime differences between areas and between individuals are predicted by area and population heterogeneity and their synergies. It draws on lifestyle/routine activities and social disorganization theories to model the number of personal victimization incidents over individuals including routine activities and area characteristics, respectively, as well as their (cross-cluster) interactions. The methodology employs multilevel or hierarchical negative binomial regression with extra binomial variation using data from the British Crime Survey and the UK Census. Personal crime rates differ substantially across areas, reflecting to a large degree the clustering of individuals with measured vulnerability factors in the same areas. Most factors suggested by theory and previous research are conducive to frequent personal victimization except the following new results. Pensioners living alone in densely populated areas face disproportionally high numbers of personal crimes. Frequent club and pub visits are associated with more personal crimes only for males and adults living with young children, respectively. Ethnic minority individuals experience fewer personal crimes than whites. The findings suggest integrating social disorganization and lifestyle theories and prioritizing resources to the most vulnerable, rather than all, residents of poor and densely populated areas to prevent personal crimes

Online dating applications and risk of youth victimization : A lifestyle exposure perspective

Based on lifestyle exposure theory (LET), this study examined online dating application (ODA) use and victimization experiences among adolescents using large cross-national samples of Finnish, American, Spanish, and South Korean young people between ages 15 and 18. According to logistic regression analyses in two substudies, ODA use was associated with more likely victimization to online harassment, online sexual harassment, and other cybercrimes and sexual victimization by adults and peers. According to mediation analyses, this relationship was mainly accounted for by the fact that ODA users engage in more risky activities in online communication and information sharing. Attention should be paid to the risks ODAs pose to vulnerable groups, such as young people, with insufficient skills to regulate their social relationships online.Peer reviewe

Doing ‘dangerous’ autoethnography on Islamophobic victimization

This article draws on our different experiences of employing autoethnography when researching Islamophobia, using two independent research projects. In particular, we reflect upon our experiences of Islamophobic victimization as a result of being ‘visibly’ Muslim in public spaces in the UK. We discuss our motivation for employing autoethnography and the role of our insider/outsider status in adopting the role of the Muslim ‘other’ in public spaces. Additionally, we consider the nature, extent and impact of Islamophobic victimization upon ourselves, and the coping mechanisms we employed to deal with it. The article concludes by reflecting upon the advantages, ethical challenges and limitations of using autoethnography when researching Islamophobic victimization

How victim age affects the context and timing of child sexual abuse: applying the routine activities approach to the first sexual abuse incident

The aim of this study was to examine from the routine activities approach how victim age might help to explain the timing, context and nature of offenders’ first known contact sexual abuse incident. One-hundred adult male child sexual abusers (M = 45.8 years, SD = 12.2; range = 20–84) were surveyed about the first time they had sexual contact with a child. Afternoon and early evening (between 3 pm and 9 pm) was the most common time in which sexual contact first occurred. Most incidents occurred in a home. Two-thirds of incidents occurred when another person was in close proximity, usually elsewhere in the home. Older victims were more likely to be sexually abused by someone outside their families and in the later hours of the day compared to younger victims. Proximity of another person (adult and/or child) appeared to have little effect on offenders’ decisions to abuse, although it had some impact on the level of intrusion and duration of these incidents. Overall, the findings lend support to the application of the routine activities approach for considering how contextual risk factors (i.e., the timing and relationship context) change as children age, and raise questions about how to best conceptualize guardianship in the context of child sexual abuse. These factors should be key considerations when devising and implementing sexual abuse prevention strategies and for informing theory development

Gender differences in developmental links between antisocial behavior, friends' antisocial behavior and peer rejection in childhood: Results in two cultures

This study addressed gender differences in the developmental links among antisocial behavior, friends' anti-social behavior, and peer rejection. High and increasing, moderate, and low antisocial developmental trajectories were identified among 289 Dutch children, ages 7 to 10, and 445 French-Canadian children, ages 9 to 12. Only boys followed the high trajectory. These boys had more deviant friends and were more often rejected than other children. A minority of girls followed the moderate antisocial behavior trajectory. These girls had fewer deviant friends than moderate antisocial boys, but moderate antisocial boys and girls were equally likely to be rejected. The influence of friends and poor peer relations plays a crucial but different role in the development of antisocial behavior among boys and girls. © 2005 by the Society for Research in Child Development, Inc. All rights reserved

On ethically solvent leaders : the roles of pride and moral identity in predicting leader ethical behavior.

The popular media has repeatedly pointed to pride as one of the key factors motivating leaders to behave unethically. However, given the devastating consequences that leader unethical behavior may have, a more scientific account of the role of pride is warranted. The present study differentiates between authentic and hubristic pride and assesses its impact on leader ethical behavior, while taking into consideration the extent to which leaders find it important to their self-concept to be a moral person. In two experiments we found that with higher levels of moral identity, authentically proud leaders are more likely to engage in ethical behavior than hubristically proud leaders, and that this effect is mediated by leaders’ motivation to act selflessly. A field survey among organizational leaders corroborated that moral identity may bring the positive effect of authentic pride and the negative effect of hubristic pride on leader ethical behavior to the forefront

Developmental links between trajectories of physical violence, vandalism, theft, and alcohol-drug use from childhood to adolescence

Differences in developmental trajectories of physical violence, vandalism, theft, and alcohol-drug use from ages 10 to 15 were studied. For females and for males, three trajectories of theft and of alcohol-drug use increased from 10 years to 15 years, while only the high trajectory of vandalism increased from ten to 14. All trajectories of physical violence decreased. Children who engaged in the high trajectories of vandalism, theft, and alcohol-drug use had a high probability of also being high in physical violence. Compared to males, females were less likely to be on the high trajectory of physical violence, and their trajectories of other antisocial behaviors were less strongly associated with high levels of physical violence. The results suggest that physical violence during pre-adolescence and adolescence has a different developmental pattern than other forms of antisocial behavior, and that its relation to these other forms of antisocial behavior differs by se