Predicting Domestic Homicide and Serious Violence in Leicestershire with Intelligence Records of Suicidal Ideation or Self-Harm Warnings: a Retrospective Analysis

$\textit{Research Question}$ Does prior information retained in police intelligence records about an offender’s suicidal tendencies help to predict a future domestic homicide or attempted homicide? $\textit{Data}$ Records on 158,379 arrestees in 1997–2015 were examined for suicidal or selfharm warnings by date of entry and compared to 620 offenders identified in cases of domestic homicides or serious violence over the same time period. $\textit{Methods}$ The percentage of offenders in domestic homicide and serious violence cases who were known to have reported suicidal ideation prior to those crimes was compared to the overall percentage of arrested persons who had such reports. $\textit{Findings}$ Of the total 620 deadly violence offenders, 125 had a marker for suicide or self-harm, of which 35 (5.6%) were posted prior to the deadly domestic violence. Of the 80 homicide cases (excluding grievous bodily harm), 7 had suicide or self-harm markers prior to the homicidal offence, for a rate of 8.75%. These rates compare to an overall marker rate among the 158,379 arrestees in the time period studied, of whom 7,241 were identified as holding a warning marker at the point of data collection for this study in 2016, which equated to only 5% of the group, of which an estimated 38% would have occurred prior to a crime (2,752 cases), or 1.7% of the 158,379. By that metric, it is three times more likely that offenders charged with an act of deadly domestic violence had prior suicidal warning markers than offenders not charged with such crimes (5.6/1.7 = 3.3), and 5.2 times more likely for homicide offenders to have a prior marker than for all arrestees. $\textit{Conclusions}$ Police intelligence system markers for suicide or self-harm can provide valuable information for building more accurate prediction models for domestic homicide and serious assaults

I’m going to tell you a little about myself: Illness centrality, self-image and identity in cystic fibrosis

This study assessed the illness centrality of adolescents with CF and the specific ways that CF may affect adolescents’ identities, through the qualitative analysis of video narratives. Adolescents with CF were loaned video cameras and asked to “show us your life outside the hospital” and to “teach your healthcare team about your CF.” Four major themes were identified related to illness centrality: CF is Central, CF is Compartmentalized, CF is Integrated into Self Image, CF is Denied. Integration and compartmentalization often co-existed. Four themes emerged related to the role of CF in self-image and identity: (1) Valence (positive or negative); (2) Control (no control or some control); (3) Difference/Normalcy (different, normal, normal except for CF); (4) Acceptance/adaptation (acknowledgement of CF, reworking life to accommodate CF). Adolescents did not have just one feeling about CF but felt differently at different times. Younger and/or healthier adolescents were less likely to focus on CF as central to their self-image. When not dealing directly with treatments or clinic visits, these adolescents had identities comprised largely of “typical” adolescent interests such as school, friends, hobbies, and family. CF played a more prominent role in the identities of older and sicker adolescents. Adolescents also found ways to adapt or alter their lives and their CF-related activities to make them feel more like “normal” adolescents. Implications for treatment are provided

Hearing the patient voice: Using video intervention/prevention assessment to understand teens with cystic fibrosis

This qualitative study asked two questions: 1) How do teens with cystic fibrosis (CF) feel about their treatments; and 2) What factors lead teens to adhere, or not adhere, to treatments. To answer these questions we used an innovative approach (Video Intervention/Prevention Assessment or VIA), to learn about the experiences of teens with CF. We loaned video camcorders to teens with CF and asked them to create visual narratives of their lives. Researchers logged and coded videotapes, identifying themes that arose from the material. A primary theme was “Doctors don’t understand.” Participants also highlighted the value of routines and parental support in consistently doing treatments. We identify and discuss themes that emerged and discuss how findings can be used to help providers improve care, develop partnerships with patients and increase adherence

Healthy Corner Store Network Heart Smarts Program

Objectives: 1. Identify corner stores for nutrition education and health screenings based on criteria presented. 2. Identify education strategies appropriate for a corner store setting when integrating health screenings, nutrition education and food access. 3. List at least two store owner training topics for use in a corner store setting that reinforce nutrition education and disease prevention in the store. 4. Understand methods for evaluating outcomes of an integrated educational effort. Presented at APHA in Chicago, Illinois

A Longitudinal Assessment of Change in Blood Pressure Among Participants in the Heart Smarts Program

Many low-income areas of the United States are considered food deserts because people living in those communities have limited access to fresh fruits and vegetables (FFV); lack of FFV is tied to numerous health issues, including cardiovascular disease and obesity. The Heart Smarts Program (HSP) provides increased access to FFV in food deserts, as well as providing participants with nutrition education courses and health screenings, including blood pressure. The purpose of this study is to examine HSP participants who have been with the program for differing lengths of time in order to determine if length of participation has an impact on magnitude of change in blood pressure. Participants are self-selected members of the community who frequent the corner stores in which the HSP operates and who have chosen to participate in health screenings. The blood pressure readings of participants who had two or more screenings with the HSP were analyzed to determine the longitudinal impact of participation in the HSP on change in blood pressure. Analysis of the average change in both systolic and diastolic blood pressures between four groups of participants who had taken part in the HSP for differing lengths of time showed no significant difference (p=0.625, p=0.259). This indicates that increased length of participation in the HSP is not associated with a larger drop in blood pressure when compared to those who have participated for a shorter time. However, this study does not examine changes in weight, eating habits, and level of nutrition education, and therefore it is unable to determine the longitudinal effects of the HSP as a whole

Munchausen by internet: current research and future directions.

The Internet has revolutionized the health world, enabling self-diagnosis and online support to take place irrespective of time or location. Alongside the positive aspects for an individual's health from making use of the Internet, debate has intensified on how the increasing use of Web technology might have a negative impact on patients, caregivers, and practitioners. One such negative health-related behavior is Munchausen by Internet

Assessing Peer Mentor Skill Development in Participating in a Novel Medical Student Mentoring Initiative

BackgroundLearning communities in medical schools create a bridge for senior students to engage with junior peers, providing advice and support as mentors. In this process, mentors are likely to gain skills in communication, empathy, and leadership - well received traits for residency. Methods We aim to elucidate an objective measure of mentor growth and development during the mentorship program. We will evaluate opinions on the program\u27s ability to foster professional attributes including leadership, communication, and empathy; determining features that benefit them while assessing for paradigms of improvement. We will survey 24 M2-students through self-rated queries on a Likert scale. This survey will be administered to mentors at two time-points: half-way and at the end of the program. Results From the mid-point survey, 22 out of 24 total mentors responded. Most mentors feel satisfied with the support that they receive from the program, specifically with the time commitment while not feeling overwhelmed with their duties. Finally, mentors find an importance in building mentee confidence and helping mentees to meet their goals, but most do not feel skilled at this. Conclusion The survey results provide valuable insight regarding mentors’ personal and professional development. We identified mentors’ needs for increased support. In a follow-up study, we will assess how the program can develop educational interventions to aid mentors in developing abilities to communicate, lead, and mentor. We additionally hope to establish a rigorous quality-assessment tool to be used year-over-year in assessing program development while also defining avenues to improve mentors’ professional development

Learning Community Student-Resident Physician Mentorship

Wayne State University School of Medicine (WSUSOM) in 2018 formed Learning Communities (LCs), that facilitate student engagement, comradery, and mentoring. These programs include medical student-premed, near-peer, and faculty/attending mentorships. There has been an identified gap in mentorship between near-peer and faculty/attending mentorship, and that is near-peer mentors at WSUSOM have yet to complete the residency process to guide other students through it. Moreover, faculty/attending mentors are more removed from residency and may not have relevant advice for students. As resident physicians are recent graduates, they are more likely to provide relevant insight about residency applications, academic challenges, and efficiency than attendings. We aim to assess the extent of the gap between faculty/attending and peer mentorships. MS4 at WSUSOM (N=33) self-reported their: confidence in transitioning to residency; the gaps they believe such mentorship will fill; and whether they, themselves, would participate in an MS-resident fellowship program. Results indicated that MS4s feel somewhat confident in their abilities to transition to residency. They believe that a resident-MS mentorship would help in the interview and application process, as well as, the residency program choosing process. Furthermore, if given the opportunity, all the students would consider joining the program. We hope to implement a student-resident mentorship program, to reassure students on their journey to residency

Trapped lipopolysaccharide and LptD intermediates reveal lipopolysaccharide translocation steps across the Escherichia coli outer membrane

Lipopolysaccharide (LPS) is a main component of the outer membrane of Gram-negative bacteria, which is essential for the vitality of most Gram-negative bacteria and plays a critical role for drug resistance. LptD/E complex forms a N-terminal LPS transport slide, a hydrophobic intramembrane hole and the hydrophilic channel of the barrel, for LPS transport, lipid A insertion and core oligosaccharide and O-antigen polysaccharide translocation, respectively. However, there is no direct evidence to confirm that LptD/E transports LPS from the periplasm to the external leaflet of the outer membrane. By replacing LptD residues with an unnatural amino acid p-benzoyl-L-phenyalanine (pBPA) and UV-photo-cross-linking in E.coli, the translocon and LPS intermediates were obtained at the N-terminal domain, the intramembrane hole, the lumenal gate, the lumen of LptD channel, and the extracellular loop 1 and 4, providing the first direct evidence and “snapshots” to reveal LPS translocation steps across the outer membrane

Making optical atomic clocks more stable with 10−1610^{-16} level laser stabilization

The superb precision of an atomic clock is derived from its stability. Atomic clocks based on optical (rather than microwave) frequencies are attractive because of their potential for high stability, which scales with operational frequency. Nevertheless, optical clocks have not yet realized this vast potential, due in large part to limitations of the laser used to excite the atomic resonance. To address this problem, we demonstrate a cavity-stabilized laser system with a reduced thermal noise floor, exhibiting a fractional frequency instability of $2 \times 10^{-16}$. We use this laser as a stable optical source in a Yb optical lattice clock to resolve an ultranarrow 1 Hz transition linewidth. With the stable laser source and the signal to noise ratio (S/N) afforded by the Yb optical clock, we dramatically reduce key stability limitations of the clock, and make measurements consistent with a clock instability of $5 \times 10^{-16} / \sqrt{\tau}$