The impact on staff of working with personality disordered offenders: A systematic review

© 2015 Freestone et al. Background: Personality disordered offenders (PDOs) are generally considered difficult to manage and to have a negative impact on staff working with them. Aims: This study aimed to provide an overview of studies examining the impact on staff of working with PDOs, identify impact areas associated with working with PDOs, identify gaps in existing research,and direct future research efforts. Methods: The authors conducted a systematic review of the English-language literature from 1964-2014 across 20 databases in the medical and social sciences. Results: 27 papers were included in the review. Studies identified negative impacts upon staff including: negative attitudes, burnout, stress, negative counter-transferential experiences; two studies found positive impacts of job excitement and satisfaction, and the evidence related to perceived risk of violence from PDOs was equivocal. Studies demonstrated considerable heterogeneity and meta-analysis was not possible. The overall level of identified evidence was low: 23 studies (85%) were descriptive only, and only one adequately powered cohort study was found. Conclusions: The review identified a significant amount of descriptive literature, but only one cohort study and no trials or previous systematic reviews of literatures. Clinicians and managers working with PDOs should be aware of the potential impacts identified, but there is an urgent need for further research focusing on the robust evaluation of interventions to minimise harm to staff working with offenders who suffer from personality disorder Copyright

Risk factors associated with short-term complications in mandibular fractures: the MANTRA study—a Maxillofacial Trainee Research Collaborative (MTReC)

Abstract Introduction Complications following mandibular fractures occur in 9–23% of patients. Identifying those at risk is key to prevention. Previous studies highlighted smoking, age and time from injury to presentation as risk factors but rarely recorded other possible confounders. In this paper, we use a collaborative snapshot audit to document novel risk factors and confirm established risks for complications following the treatment of mandibular fractures. Methods The audit was carried out by 122 OMFS trainees across the UK and Ireland (49 centres) over 6 months, coordinated by the Maxillofacial Surgery Trainees Research Collaborative. Variables recorded included basic demography, medical and social history, injury mechanism and type, management and 30-day outcome. Results Nine hundred and forty-seven (947) patients with fractured mandibles were recorded. Surgical management was carried out in 76.3%. Complications at 30 days occurred 65 (9%) of those who were managed surgically. Risk factors for complications included male sex, increasing age, any medical history, increasing number of cigarettes smoked per week, increasing alcohol use per week, worse oral hygiene and increased time from injury to presentation. Discussion We have used a large prospective snapshot audit to confirm established risk factors and identify novel risk factors. We demonstrate that time from injury to presentation is confounded by other indicators of poor health behaviour. These results are important in designing trial protocols for management of mandibular fractures and in targeting health interventions to patients at highest risk of complications. </jats:sec

Isothermal crystallization and effect of soak time on phase evolution, microstructure and ionic conductivity of Li2O-Al2O3-TiO2-P2O5 glass-ceramic

Glass-ceramics derived from Li2O-Al2O3-TiO2-P2O5 vitreous system were obtained by isothermal heat treatment at 700 degrees C, for different soak times ranging from 0 to 60 h. Phase analysis revealed mixture of amorphous and crystalline phases for short soak times (<1 h). By 1 h of soak time, crystallization was complete and phases were ascribed to dominant Li1+xAlxTi2-x(PO4)(3) (LATP) along with secondary AlPO4 and TiO2, previously reported. Microstructural evolution with soak time was imaged using high resolution scanning electron microscope (SEM). Crystalline volume fraction in glass-ceramics was estimated from image analysis and it followed Kolmogorov-Johnson-Mehl-Avrami (KNA) equation. Conductivity of glass-ceramics was derived using impedance spectroscopy data for all soak times and correlated to the crystalline volume content After attaining a critical volume of crystalline phase/s, conductivity increased significantly and was observed to follow the scaling equation sigma(dc) similar to (V - V-c)(beta), where sigma(dc) is dc conductivity, V is crystalline volume content, V-c is threshold value of crystalline volume content above which sudden increase in conductivity was observed and beta is scaling exponent V-c approximate to 30% was in accordance with percolation scaling law and is attributed to formation of 3D conducting channel network in the glass-ceramics microstructure. (C) 2016 Elsevier B.V. All rights reserved