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Journal articles on the topic 'Aggressive episodes'

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Published: 30 August 2021
Last updated: 9 February 2022

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1

Bjørkly, Stål. "Report Form for Aggressive Episodes: Preliminary Report." Perceptual and Motor Skills 83, no. 3_suppl (December 1996): 1139–52. http://dx.doi.org/10.2466/pms.1996.83.3f.1139.

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This paper gives a description of the development and initial empirical testing of the Report Form for Aggressive Episodes, a behavioural rating scale used to measure displayed aggressive behaviour and the situational determinant(s) according to a list of 30 potential precipitants to aggression. Findings from a one-year study in a special secure unit for the long-term treatment of dangerous patients show very high rates of underreporting of aggressive episodes in ward journals and patient files compared to this scale. Illustrations of the clinical use of the scale are provided by scoring examples and two case vignettes.
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2

Mellesdal, Liv. "Aggression on a Psychiatric Acute Ward: A Three-Year Prospective Study." Psychological Reports 92, no. 3_suppl (June 2003): 1229–48. http://dx.doi.org/10.2466/pr0.2003.92.3c.1229.

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The objectives of this 3-yr. prospective study of aggression on a Norwegian psychiatric acute ward serving a population of 170,000 were to monitor the rate and characteristics of aggressive behaviour, to identify possible interactional and situational precipitants to aggression, and to explore possible differences between aggressive and nonaggressive patients in terms of diagnosis, sex, age, numbers of admissions, admission type, and length of stay. Aggressive incidents were recorded on the Report Form for Aggressive Episodes (REFA). Severity of injuries was scored according to Fottrell's severity scale. Of the total 934 patients admitted, 98 (10.5%) accounted for a total of 981 aggressive episodes. About 55% of the aggressive incidents were assaults that resulted in 85 minor and 21 severe physical injuries. There was no evidence that diagnosis might be used to predict aggression in the clinical setting. Mean rate of admission per patient and length of stay was significantly higher in the aggressive group than in the nonaggressive group. However, several patients in the aggressive group also had admissions without being aggressive. About 13% of the aggressive patients accounted for nearly 50% of the aggressive incidents. There was no significant sex difference by total rate of aggression, but female patients tended to have higher rates of assaults and contributed to significantly more injuries than male patients. Nearly 20% of the aggressive episodes occurred during the first 24 hours of a stay and 54% during the first week. Limit setting, problems in communication, and physical contact, separately or in combinations, preceded nearly 90% of the aggressive episodes.
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3

Muncer, Steven J., Bernard Gorman, and Anne Campbell. "Sorting out aggression: Dimensional and categorical perceptions of aggressive episodes." Aggressive Behavior 12, no. 5 (1986): 327–36. http://dx.doi.org/10.1002/1098-2337(1986)12:5<327::aid-ab2480120503>3.0.co;2-j.

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4

Testa, Maria, Brian M. Quigley, and Kenneth E. Leonard. "Does Alcohol Make a Difference?" Journal of Interpersonal Violence 18, no. 7 (July 2003): 735–43. http://dx.doi.org/10.1177/0886260503253232.

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Episodes of husband-to-wife violence in which the husband consumed alcohol were compared with episodes of husband-to-wife violence, reported by the same individuals, in which the husband was not drinking. Among this community sample of newly-weds, wife reports, but not husband reports, indicated that violent episodes in which the husband was drinking included more acts of violence and were more likely to involve severe violence. Both wife and husband reports indicated that wives were more likely to be physically aggressive in husband drinking episodes compared to sober episodes. However, whereas wives reported that their aggressive behavior was a response to husband aggression, husbands reported that wives were more likely to initiate violence in these episodes. Violent episodes that include alcohol may be more severe and more mutually violent than sober episodes. Discrepancies between husband and wife reports may reflect differences in recall or self-serving biases.
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Aparicio Reinoso, T., and S. Gonzalez Parra. "Predictors of aggressive behavior among acute psychiatric patients: 5 years clinical study." European Psychiatry 33, S1 (March 2016): S626—S627. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2350.

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IntroductionThe problem of violence and aggressive behaviour among patients with psychiatric disorders need careful assessment to improve the quality of psychiatric care.ObjectiveThe aim of this paper is to describe the characteristics of repeated episodes of violence among patients admitted to a Psychiatric Ward, which is a total of 66 beds at Doctor Rodriguez Lafora Hospital from January 2009 to December 2014.MethodsWe designed a retrospective, longitudinal and observational study over a 5-year period in two brief hospitalization units of Doctor Rodriguez Lafora Hospital in Madrid. The main variables studied were: type of admission, diagnosis, age, trigger and shift.ResultsIn our study, we analyzed the prototypical person who carries out these episodes of aggression: a male between 31–40 years, diagnosed with psychotic disorder or personality disorder, involuntary admitted. This episode is associated as a main trigger to mood disturbances, lack of acceptance of standards and psychotic symptoms. These episodes occur more frequently in the afternoon shift one business day and often processed without injuries or minor bruises to other patients and/or nursing assistants. In our practice, we have observed that in most cases adequate verbal restraint in the beginning is sufficient to prevent the episode of aggression.ConclusionsUnderstand the aggressive factors can influence the production of violent behavior and the use of appropriate containment techniques may be considered a therapeutic option to prevent and address violent behavior in psychiatric patients hospitalized in brief hospitalization units.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Testa, Maria, Laura T. Petrocelli, Cory A. Crane, Audrey Kubiak, and Kenneth E. Leonard. "A Qualitative Analysis of Physically Aggressive Conflict Episodes Among a Community Sample." Journal of Interpersonal Violence 35, no. 21-22 (June 21, 2017): 4393–418. http://dx.doi.org/10.1177/0886260517715023.

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Intimate partner aggression among community couples has been conceptualized as representing an occasional, situationally provoked response to a conflict. Yet, relatively few studies have considered the situational factors that contribute to the occurrence of an aggressive episode. The present study used thematic analysis to understand how episodes of physical aggression come about from the participant’s perspective. We examined narrative descriptions of relationship conflicts that included physical aggression to gain insight into the types of aggressive incidents experienced, the reasons and motives behind the aggression, and the meaning of these events. Married and cohabiting couples (ages 18-45 at baseline) were recruited from the community to participate in a longitudinal study of relationships. Heavy drinking couples were oversampled. At Wave 3, participants were asked to describe the most severe conflict they had experienced over the past year and to answer questions about severity and impact. Narratives that described use of partner physical aggression by one or both partners were subject to thematic analysis. Using narratives provided by 27 male and 29 female respondents (representing 51 different couples), we identified three primary motives or reasons for aggression: Expressive, Instrumental, and Punishment. Narratives suggested as a primary theme that participants view partner violence as unusual, undesirable, and hence, meaningful. This was particularly true for male-to-female violence, which appeared objectively and subjectively different from female-to-male violence. Findings provide unique insight into the function and meaning of partner violence, including its gendered nature, within a community sample. Implications for measurement of partner aggression are also discussed.
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7

van Elst, L. T. "Dual Brain Pathology in Patients With Affective Aggressive Episodes." Archives of General Psychiatry 58, no. 12 (December 1, 2001): 1187. http://dx.doi.org/10.1001/archpsyc.58.12.1187.

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8

Bambauer, Kara Zivin, and Daniel F. Connor. "Characteristics of Aggression in Clinically Referred Children." CNS Spectrums 10, no. 9 (September 2005): 709–18. http://dx.doi.org/10.1017/s1092852900019702.

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AbstractObjectiveWe investigated the phenomenology of aggression in a group of psychiatrically referred children and in a comparison group of children.IntroductionChildren (N=275) were evaluated at a pediatric psychopharmacology clinic in an academic medical center and compared with 100 non-referred children from the community. To assess the influence of several predictors on the child's level of clinical impairment we conducted stepwise regression analyses.ResultsAggression occurred across many different psychiatric diagnoses in psychiatrically referred children. Aggression in referred children was more frequent, physical, intense, lasted for a longer duration per episode, was more resistant to intervention, and occurred at an earlier age of onset in contrast with comparison children. Controlling for psychiatric diagnosis and demographic variables, family income and number of aggressive episodes in the last 6 months were the only significant predictors of child impairment.DiscussionPhenomenologically, aggression may be more maladaptive in children with a psychiatric disorder compared with non-referred youths. These phenomenological differences in characteristics of aggression support the concept of an aggressive syndrome in psychiatrically referred children.ConclusionResults support the need for development of specific treatment interventions for excessive maladaptive aggression independent of psychiatric diagnosis in referred children and adolescents.
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Creaby, Mary, Mary Warner, Nahla Jamil, and Sudad Jawad. "Ictal aggression in severely mentally handicapped people." Irish Journal of Psychological Medicine 10, no. 1 (February 1993): 12–15. http://dx.doi.org/10.1017/s0790966700013227.

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AbstractObjective: To study the relationship between epilepsy and aggression in a population of severely mentally handicapped people. Methods: Comparing epilepsy and aggression variables in people with epilepsy without aggression, people with aggression without epilepsy, and people with both. The epilepsy variables were: seizure frequency, classification, anticonvulsant drugs, therapeutic drug monitoring, and neuroleptic drugs. Aggression variables were: frequency, direction, type, and neuroleptic drugs. Results: Prevalence of aggressive behaviour was similar in people with and without epilepsy (36%). Partial seizures were less prevalent in people with epilepsy and aggression. People with epilepsy were more likely to manifest unprovoked aggression directed against property. Conclusion: Some episodes of aggressive behaviour in people with epilepsy may be ictal in origin.
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10

Craft, M., I. A. Ismail, D. Krishnamurti, J. Mathews, A. Regan, R. V. Seth, and P. M. North. "Lithium in the Treatment of Aggression in Mentally Handicapped Patients." British Journal of Psychiatry 150, no. 5 (May 1987): 685–89. http://dx.doi.org/10.1192/bjp.150.5.685.

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In a double-blind trial lasting 4 months in 42 mentally handicapped patients, the effect of lithium on aggression was assessed in comparison with placebo. In the lithium-treated group, 73% of patients showed a reduction in aggression during treatment. There were significant differences in mean weekly aggression scores and in the frequency of aggressive episodes between the lithium and placebo groups. Side-effects were noted in 36% of the lithium group (and 20% of the placebo group), but were mainly transitory. There were no episodes of toxicity, and no patients had to be withdrawn from the trial. Lithium appears to be worth a 2-month trial in such patients, where repeated aggression has not been relieved by more appropriate placement, occupation or company.
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11

BJØRKLY, STÅL. "The Scale for the Prediction of Aggression and Dangerousness in Psychotic Patients (PAD):." Criminal Justice and Behavior 21, no. 3 (September 1994): 341–56. http://dx.doi.org/10.1177/0093854894021003004.

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The Scale for the Prediction of Aggression and Dangerousness in Psychotic Patients (PAD) is a rating scale constructed for the assessment of psychotic patients in relation to 29 situations or interactions. The instrument is used to rate the potential of these situations/interactions for precipitating aggressive behavior in psychotic patients. These assessments result in a profile of situational vulnerability that describes a patient's potential for aggressive behavior in relation to the 29 situations or interactions. In this pilot study, 10 psychotic patients at a special secure unit were assessed by means of this scale. After the completion of the PAD ratings, systematic observations of episodes involving verbal, threatened, and physical aggression were made throughout a 2-year follow-up period. The results indicate that the PAD was able to predict the patients' potential for aggression and, to some extent, the situations that were the most potent precipitants of aggressive behavior.
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12

Stubbs, Brendon. "Physical intervention in older adult psychiatry: an audit of physical ailments identified by physiotherapists and the implications for managing aggressive behavior." International Psychogeriatrics 21, no. 6 (June 4, 2009): 1196–97. http://dx.doi.org/10.1017/s1041610209990019.

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Aggression and violence are frequent events in healthcare settings across the globe, with mental health and old age settings often frequenting top spot in incidence lists (Hodgson et al., 2004, Behar et al., 2008). Some may underestimate the challenging nature of older age psychiatric patients, but the reality is that this population can display high levels of aggressive and violent behavior (Stewart et al., 2008). The potentially challenging nature of this population was revealed in a recent study in the U.K., which reported 2753 episodes of aggressive behavior over a three month period (Stewart et al., 2008). Over half of these aggressive displays were in the form of physical aggression, and displays of this type of behavior increase the likelihood of healthcare staff having to employ physical intervention (Stewart et al., 2008). Physical intervention is a form of hands-on physical restraint that involves trained staff employing physical holding techniques to move and restrict the movement of the aggressive patient.
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13

Ng, Yi Shiau, Laurence A. Bindoff, Gráinne S. Gorman, Rita Horvath, Thomas Klopstock, Michelangelo Mancuso, Mika H. Martikainen, et al. "Consensus-based statements for the management of mitochondrial stroke-like episodes." Wellcome Open Research 4 (December 13, 2019): 201. http://dx.doi.org/10.12688/wellcomeopenres.15599.1.

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Background: Focal-onset seizures and encephalopathy are prominent features of a stroke-like episode, which is a severe neurological manifestation associated with subtypes of mitochondrial disease. Despite more than 30 years of research, the acute treatment of stroke-like episodes remains controversial. Methods: We used the modified Delphi process to harness the clinical expertise of a group of mitochondrial disease specialists from five European countries to produce consensus guidance for the acute management of stroke-like episodes and commonly associated complications. Results: Consensus on a new definition of mitochondrial stroke-like episodes was achieved and enabled the group to develop diagnostic criteria based on clinical features, neuroimaging and/or electroencephalogram findings. Guidelines for the management of strokelike episodes were agreed with aggressive seizure management strongly recommended at the outset of stroke-like episodes. Conclusions: Our consensus statement defines stroke-like episodes in terms of an epileptic encephalopathy and we have used this to revise both diagnostic criteria and guidelines for management. A prospective, multi-centre, randomised controlled trial is required for evaluating the efficacy of any compound on modifying the trajectory of stroke-like episodes.
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14

Calegaro, Vitor Crestani, Amanda Bolson Dotto, Denise Freitas, Anderson Barcellos Brum, Andrei Garziera Valerio, Christina Chitolina Schetinger, and Angelo B. M. Cunha. "Aggressive behavior during the first 24 hours of psychiatric admission." Trends in Psychiatry and Psychotherapy 36, no. 3 (September 2014): 152–59. http://dx.doi.org/10.1590/2237-6089-2014-0016.

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OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients.METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS) form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS). The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive.RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002) and individual component scores, and their results showed more activation (p < 0.001) and thinking disorders (p = 0.009), but less anxious-depression (p = 0.008). Violent patients had more severe psychomotor agitation (p = 0.027), hallucinations (p = 0.017) and unusual thought content (p = 0.020). Additionally, self-aggressive patients had more disorientation (p = 0.011) and conceptual disorganization (p = 0.007).CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.
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Notari, Lorella, Simona Cannas, Ylenia Agata Di Sotto, and Clara Palestrini. "A Retrospective Analysis of Dog–Dog and Dog–Human Cases of Aggression in Northern Italy." Animals 10, no. 9 (September 16, 2020): 1662. http://dx.doi.org/10.3390/ani10091662.

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In this survey, a caseload of aggressive dogs (n = 170) was analysed to increase the available information about biting dog characteristics, contribute to risk evaluation and improve bite prevention tools. All dog data were collected from questionnaires completed by veterinary behaviourists in Northern Italy. All dogs were referred to them by public authorities to be evaluated and treated due to the incidence of one or more episodes of aggression. Between the two groups of human-directed and dog-directed aggressive dogs, significant associations were found: the dog-directed aggressive group inflicted significantly more severe bites (p < 0.01) and offensive aggression (p < 0.01), whereas defensive aggression was significantly more numerous in the human-directed aggression group (p < 0.01) and more significantly located in private homes (p < 0.01). No significant associations were found between the severity of bites and one or more specific breeds in either group. The prevalence of defensive bites in private homes in human-directed aggression indicate that owners’ understanding of their dogs’ behaviour and communication is fundamental to preventing aggression, and that owner education programmes are fundamental tools to reduce aggression risk factors and prevent aggression.
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Tornatzky, Walter, Jonathan C. Cole, and Klaus A. Miczek. "Recurrent Aggressive Episodes Entrain Ultradian Heart Rate and Core Temperature Rhythms." Physiology & Behavior 63, no. 5 (March 1998): 845–53. http://dx.doi.org/10.1016/s0031-9384(98)00008-0.

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17

Arseneau-Robar, T. Jean Marie, Anouk Lisa Taucher, Eliane Müller, Carel van Schaik, Redouan Bshary, and Erik P. Willems. "Female monkeys use both the carrot and the stick to promote male participation in intergroup fights." Proceedings of the Royal Society B: Biological Sciences 283, no. 1843 (November 30, 2016): 20161817. http://dx.doi.org/10.1098/rspb.2016.1817.

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Group-level cooperation often poses a social dilemma in which joint action may be difficult to achieve. Theoretical models and experimental work on humans show that social incentives, such as punishment of defectors and rewarding of cooperators, can promote cooperation in groups of unrelated individuals. Here, we demonstrate that these processes can operate in a non-human animal species, and be used to effectively promote the production of a public good. We took advantage of the fact that intergroup fights in vervet monkeys ( Chlorocebus aethiops pygerythrus ) are characterized by episodes of intergroup aggression with pauses in-between. During pauses, females selectively groomed males that had participated in the previous aggressive episode, but aggressed male group members that had not. In subsequent (i.e. future) episodes, males who had received either aggression or grooming participated above their personal base-line level. Therefore, female–male aggression and grooming both appear to function as social incentives that effectively promote male participation in intergroup fights. Importantly, females stood to gain much from recruiting males as the probability of winning intergroup fights was dependent on the number of active participants, relative to the number of fighters in the opposing group. Furthermore, females appear to maximize the benefits gained from recruiting males as they primarily used social incentives where and when high-quality food resources, which are the resources primarily limiting to female fitness, were at stake.
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Bjørkly, Stål. "Interrater Reliability of the Report Form for Aggressive Episodes in Group Ratings." Perceptual and Motor Skills 87, no. 3_suppl (December 1998): 1405–6. http://dx.doi.org/10.2466/pms.1998.87.3f.1405.

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19

Abright, A. Reese. "Editorial: Reducing Aggressive Episodes in Psychiatrically Hospitalized Children: Does Behavior Modification Work?" Journal of the American Academy of Child & Adolescent Psychiatry 59, no. 5 (May 2020): 590–91. http://dx.doi.org/10.1016/j.jaac.2019.10.009.

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20

Hilzenrat, Nir, Esther Lamoureux, Averell Sherker, and Albert Cohen. "Cholestasis in Crohn's Disease: A Diagnostic Challenge." Canadian Journal of Gastroenterology 11, no. 1 (1997): 35–37. http://dx.doi.org/10.1155/1997/203843.

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A 24-year-old male with Crohn's disease who developed three independent episodes of cholestatic liver disease over an eight-year period is described. The first episode was related to an idiosyncratic drug reaction while on sulfasalazine. The second episode, at the time of an exacerbation of his colitis, was characterized by moderate portal inflammation on liver biopsy and resolved quickly while he was on corticosteroid therapy. The most recent episode, occurring when the bowel disease was quiescent, was due to granulomatous hepatitis and resolved clinically with no specific therapy. Because numerous potentially serious hepatobiliary complications have been associated with inflammatory bowel disease, prompt and aggressive investigation in these instances is recommended.
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21

GILL, KATHRYN L., and SUSAN D. CALKINS. "Do aggressive/destructive toddlers lack concern for others? Behavioral and physiological indicators of empathic responding in 2-year-old children." Development and Psychopathology 15, no. 1 (March 2003): 55–71. http://dx.doi.org/10.1017/s095457940300004x.

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Ninety-nine 2-year-olds, out of a larger sample of 474 children, were classified as high (n = 49) or low (n = 50) in externalizing (aggressive/destructive) behaviors based on maternal reports assessed twice across a 2-month period. During a laboratory assessment, these toddlers participated in two empathy-eliciting tasks, from which affective, behavioral, and physiological measures were derived. Relations among measures of empathy were examined both within and across episodes and aggression groups. Analyses indicated that different indices of empathy were related to each other, both within and across empathy situations. In addition, aggressive children displayed more behaviors indicative of empathy than did nonaggressive children. Finally, a pattern of physiological responding to another's distress was evident across both groups of children, and some results indicated that greater physiological regulation was related to less empathy-related behavior. Results are discussed in terms of the developing nature of empathy and its changing association with both self-regulation and aggression.
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22

EARLS, CHRISTOPHER M., and JEAN PROULX. "The Differentiation of Francophone Rapists and Nonrapists Using Penile Circumferential Measures." Criminal Justice and Behavior 13, no. 4 (December 1986): 419–29. http://dx.doi.org/10.1177/0093854886013004004.

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A group of ten French-speaking rapists and ten French-speaking nonrapists were exposed to four classes of audiotaped stimuli: mutually consenting, rape, aggressive, and sexually neutral episodes. Penile circumference changes were recorded during stimulus presentation. Although rapists and nonrapists did not respond differentially to mutually consenting stimulus episodes, the two groups were distinguished by their responses to rape episodes. The discrimination was even more marked when the results were individually analyzed using the rape index. Thus we were able to replicate, in French, the differentiation between rapists and non-rapists using penile measures.
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23

Agarwal, Meena, and Mark Roberts. "Violence among Psychiatric In-Patients at an Interim Secure Unit: Changes in Pattern over a Two-Year Period." Medicine, Science and the Law 36, no. 1 (January 1996): 31–36. http://dx.doi.org/10.1177/002580249603600107.

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A retrospective study of recordings of all violent episodes among in-patients requiring restraint was undertaken over a two-year period during which the nature of admissions to the unit changed to an increase in mentally abnormal offenders (those admitted through the criminal justice system and detained under criminal sections of the Mental Health Act). It was found that those detained under criminal sections were less likely to be aggressive, were of relatively older age and less likely to repeat the violence than their mentally ill counterparts detained under civil sections. In addition to the past history of violence, verbally abusive behaviour was the best predictor of subsequent physical aggression though only a minority of patients displaying serious physical assault showed verbally abusive behaviour. Deterioration in mental health and staff-patient interaction were seen as major contributory factors to aggression which will also explain a greater degree of aggression directed towards the staff. Further comparative analysis of aggressive behaviour of mentally ill patients detained under civil sections and mentally abnormal offenders is warranted.
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24

Lundgren, Pia, Linnea Lundberg, Gunnel Hellgren, Gerd Holmström, Anna-Lena Hård, Lois E. Smith, Agneta Wallin, Boubou Hallberg, and Ann Hellström. "Aggressive Posterior Retinopathy of Prematurity Is Associated with Multiple Infectious Episodes and Thrombocytopenia." Neonatology 111, no. 1 (September 16, 2016): 79–85. http://dx.doi.org/10.1159/000448161.

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25

Richard, Christian M., James L. Brown, Randolph Atkins, and Gautam Divekar. "Using Naturalistic Driving Data to Develop a Typology of Speeding Episodes." Transportation Research Record: Journal of the Transportation Research Board 2659, no. 1 (January 2017): 91–97. http://dx.doi.org/10.3141/2659-10.

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Speeding-related crashes continue to be a serious problem in the United States. A recently completed NHTSA project, Motivations for Speeding, collected data to address questions about driver speeding behavior. This naturalistic driving study used 1-Hz GPS units to collect data from 88 drivers in Seattle, Washington, to record how fast vehicles traveled on different roadways. The current project further developed this data set to redefine speeding in terms of speeding episodes, which were continuous periods in which drivers exceeded the posted speed limit by at least 10 mph. More than half of all study participants averaged less than one speeding episode per trip taken. Various characteristics of speeding episodes representing aspects such as duration, magnitude, variability, and overall form of speeding were examined. Cluster analyses conducted using these characteristics of speeding episodes identified six types of speeding. These included two types of speeding that occurred around speed-zone transitions (speeding up and slowing down), incidental speeding, casual speeding, cruising speeding, and aggressive speeding. Qualitative examination of the speeding types indicated that these types also differed in terms of the prevalence of additional risky situational characteristics.
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Rudd, Jill E., Gary Pettey, Patricia Burant, and Sharon Snyder-Suhy. "The Correlation between Trait Verbal Aggression and Reports of Viewing Others' Conflict Interactions: A Survey." Psychological Reports 101, no. 3_suppl (December 2007): 1095–98. http://dx.doi.org/10.2466/pr0.101.4.1095-1098.

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Perceptions of others' use of verbally aggressive messages during conflicts were examined in family and organizational as well as in interactions among strangers. Additionally, trait verbal aggressiveness and its correlation with the perception of others' use of aggressive messages were examined. 266 participants answered a brief telephone survey completing the Trait Verbal Aggressiveness Scale and rating how often they observed others using verbally aggresive messages. Participants reported observing more verbally aggressive messages in conflict episodes with strangers than with family members or coworkers. Trait verbal aggressiveness and frequency of observed verbally aggressive messages were significantly correlated in the family and organizational settings but not in the context with a stranger.
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Palmer, Amanda M., Robert C. Schlauch, and Jack Darkes. "Treatment of Violent and Sexual Obsessions Using Exposure and Response Prevention During a Concurrent Depressive Episode." Clinical Case Studies 18, no. 3 (March 24, 2019): 220–34. http://dx.doi.org/10.1177/1534650119838628.

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Obsessive-compulsive disorder (OCD) frequently co-occurs during a major depressive episode (i.e., Major depressive disorder, MDD). Concurrent depressive episodes may present additional challenges and barriers in OCD treatment; therefore, clinicians should address both symptom domains simultaneously. The present case study illustrates an example of an individual presenting with OCD symptoms falling under aggressive and sexual domains. The treatment utilized was exposure and response prevention (ERP), which is empirically supported to address OCD symptoms. Additional treatment elements, such as behavioral activation, building self-concept through mastery, and emotional processing were incorporated to specifically address depression symptoms, which enhanced the efficacy of ERP. The current case presentation provides evidence that the utilized combination of treatment modalities is feasible to implement and may effectively reduce OCD symptoms during a depressive episode.
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Hershorn, Michael, and Alan Rosenbaum. "Over- vs. Undercontrolled Hostility: Application of the Construct to the Classification of Maritally Violent Men." Violence and Victims 6, no. 2 (January 1991): 151–58. http://dx.doi.org/10.1891/0886-6708.6.2.151.

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The purpose of the present investigation was to evaluate the applicability of Megargee’s (1967) distinction between over- and undercontrolled hostility to maritally aggressive men. Subjects were 41 men who were referred for treatment for physical marital violence. Data were derived from a written battery of self-report measures. Overcontrolled hostile men showed patterns of abuse in which violent episodes were more severe but less frequent and in which the wife was the sole target of the aggressive behavior. Undercontrolled hostile husbands were more generally aggressive and more frequently aggressive. Additionally, undercontrolled husbands were more likely than overcontrolled husbands to have witnessed violence in their families of origin and to have had rejecting mothers. Implications for the assessment and treatment of marital violence are discussed.
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Citrome, Leslie, and Jan Volavka. "The psychopharmacology of violence: making sensible decisions." CNS Spectrums 19, no. 5 (February 26, 2014): 411–18. http://dx.doi.org/10.1017/s1092852914000054.

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Violent behavior associated with mental disorders is a common reason for admission to a psychiatric inpatient unit. Once hospitalized, patients may continue to be intermittently agitated and have persistent aggressive behaviors, preventing their discharge back into the community. Managing agitation quickly with effective pharmacological agents can avoid further escalation to aggression and violence. In the acute setting, this usually involves the parenteral use of antipsychotics, with or without benzodiazepines. Within the past decade, short-acting intramuscular formulations of second-generation antipsychotics have become available and provide a means to induce calm with a substantially lower risk of acute dystonia or akathisia compared with haloperidol. New alternative formulations that avoid injections include inhalation and sublingual administration. Longer-term management of persistent aggressive behavior by reducing the frequency and intensity of future episodes of agitation is more complex. In contrast to agitation associated with schizophrenia or bipolar mania, no agents have yet been approved by regulatory agencies for the treatment of persistent aggressive behavior. The strongest evidence supports the use of clozapine as an antihostility agent, followed by olanzapine. Adjunctive strategies with anticonvulsants and beta-adrenergic agents may also be worthwhile to consider.
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Unadkat, Anish, Su Subasinghe, Richard J. Harvey, and David J. Castle. "Methamphetamine use in patients presenting to emergency departments and psychiatric inpatient facilities: what are the service implications?" Australasian Psychiatry 27, no. 1 (November 1, 2018): 14–17. http://dx.doi.org/10.1177/1039856218810155.

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Objectives: The aim of this study is to understand better the service implications of patients presenting to an inner city Australian Emergency Department (ED) and Acute Psychiatric Inpatient Service (AIS) with a history of recent crystal methamphetamine use. Methods: An audit was taken of all patients with recent crystal methamphetamine use presenting to St Vincent’s Hospital Melbourne ED and AIS over the month of September 2017. Recorded information included patient demographics, diagnosis, aggressive episodes, restrictive interventions and other risk incidents. Results: Methamphetamine was related to 21.7% of AIS admissions. Of these individuals, half were involved in aggression towards staff. In the ED, 65.7% of patients with amphetamine use were aggressive to staff and 50% were aggressive towards other patients. There were high rates of physical (69.2%) and mechanical restraint (61.5%) in the ED setting. Methamphetamine use in the AIS was commonly associated with enduring psychotic disorders, whilst those managed exclusively in the ED were most commonly in an acute intoxicated state. Conclusions: Methamphetamine use presents a significant challenge to EDs and acute mental health services. Additional resources are required to manage these patients and their impact on the health system needs to be factored into future service planning.
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&NA;. "Episodes of acute severe asthma require aggressive treatment with bronchodilators, corticosteroids and other agents." Drugs & Therapy Perspectives 26, no. 8 (August 2010): 9–13. http://dx.doi.org/10.2165/11205320-000000000-00000.

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Liddell, Christine, Jane Kvalsvig, Pumla Qotyana, and Agnes Shabalala. "Community Violence and Young South African Children's Involvement in Aggression." International Journal of Behavioral Development 17, no. 4 (December 1994): 613–28. http://dx.doi.org/10.1177/016502549401700403.

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Five-year-old children from four different communities in South Africa were observed during their everyday patterns of play and social participation. The communities differed in terms of the levels of community violence that researchers encountered during two years of data collection. The results indicated that children from more violent communities were significantly more likely to be involved in aggressive episodes, and that this was particularly so in cases where children had more contact with older boys and men. The predictive model for involvement in aggression, as developed in this study, illustrates the importance of combining demographic variables with variables pertaining to children's actual behaviour. The results are also discussed in terms of their implications for young South African children; although growing up in violent communities is associated with greater involvement in aggressive behaviour, the degree to which this can be considered seriously pathological is called into question by some of the results.
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Borker, Anupama S., Sabrina Hutchins, Robin Grant, Nobuko Hijiya, John T. Sandlund, Monika L. Metzger, Sima Jeha, et al. "Syndrome of Inappropriate Secretion of Anti-Diuretic Hormone in Children with Acute Lymphoblastic Leukemia." Blood 108, no. 11 (November 16, 2006): 4474. http://dx.doi.org/10.1182/blood.v108.11.4474.4474.

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Abstract Background: The syndrome of inappropriate secretion of anti diuretic hormone (SIADH) is a well known complication of vincristine. Available literature on SIADH in pediatric acute lymphoblastic leukemia (ALL) focuses on patients with severe manifestations. We performed this study to determine the clinical consequences of SIADH that occurred during ALL therapy. Patients and Methods: We studied all episodes of hyponatremia in patients with ALL diagnosed from December 1991 to October 2002 at St Jude Children’s Research Hospital who had not relapsed or undergone stem cell transplantation. SIADH was defined as sodium ≤ 130 meq/L in a euvolemic patient with increased urinary sodium excretion, decreased serum osmolarity and increased urine osmolarity with creatinine normal for sex and age. For each episode, we reviewed demographic features, treatment phase, predisposing factors, presenting features, duration, severity, treatment and outcome. Results: Of 605 patients studied, 68 patients had 79 episodes of SIADH. Fifty-nine patients (87%) had only 1 episode while 9 patients (13%) had recurrences. The mean lowest serum sodium was 128.3 mEq/L (range, 121–130 mEq/L) and the mean duration of hyponatremia was 1.9 days (range, 1–14 days). Ninety-six percent of episodes were associated with the administration of 1 (n=29) or 2 (n=43) doses of vincristine in the preceding 2 weeks. Episodes were associated with infection in 51 cases and central nervous system pathology in 3 cases. Only 6 (8 %) patients had serum sodium 125 mEq/L or lower; 50% of these had altered mental status, compared to 7% whose sodium never fell below 125 mEq/L. Treatment included fluid restriction (46%), change or cessation of intravenous fluids (6%), diuretics (2%), or observation (46%). All symptomatic patients had complete neurological recovery. Conclusions: SIADH is common during treatment for ALL but is rarely severe or symptomatic. The risk is greatest within 14 days of vincristine administration. Most episodes are self limited and need neither extensive investigation nor aggressive therapy.
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Cairo, M. S., S. Spooner, L. Sowden, G. A. Bennetts, B. Towne, and F. Hodder. "Long-term use of indwelling multipurpose silastic catheters in pediatric cancer patients treated with aggressive chemotherapy." Journal of Clinical Oncology 4, no. 5 (May 1986): 784–88. http://dx.doi.org/10.1200/jco.1986.4.5.784.

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We studied the complications related to the use of 53 multipurpose silastic catheters (MSC) placed in 46 pediatric cancer patients over a 1-year period. We documented the longest duration of catheter placement in the pediatric oncology literature. There were 7,650 Broviac days (range, 9 to 365 days; mean, 163 days) with 255 patient months of catheter use and a mean of 5.5 months per catheter. Of the 53 MSCs, 90% were Broviacs (72% adult size, 18% pediatric size) and 10% Hickman. There were 23 episodes of bacteremias or 0.31 episodes per 100 days of catheter use. Coagulase-negative staphylococci were isolated in 20% of the episodes of bacteremia. Only 34% had an absolute granulocyte count (AGC) (Polymorphonuclear cells [PMN] + band cells) less than 500 in the 23 MSCs with bacteremia. Ten percent were removed: 4% for mechanical problems, 6% for bacteremia unresponsive to appropriate antibiotic therapy. There were no deaths related to bacteremia, embolism, or vascular damage. This study demonstrated that despite the recent use of more aggressive immunosuppressive therapy, the incidence of MSC bacteremias was 43%, similar to earlier National Cancer Institute studies (39%) American Society of Clinical Oncology, (abstract C-219, 1982). Based on these findings, we have currently modified our MSC care and have recently throughout the past 6 months reduced our infectious complication rate by 50%.
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Wettstein, Alexander, and Marion Scherzinger. "Using camera-glasses for the assessment of aggressive behaviour among adolescents in residential correctional care: a small-scale study." Journal of Aggression, Conflict and Peace Research 7, no. 1 (January 12, 2015): 33–46. http://dx.doi.org/10.1108/jacpr-04-2014-0117.

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Purpose – The purpose of this paper is to examine naturally occurring episodes of aggressive interaction among adolescents in residential correctional programmes. The aims of our study were twofold. First, the development of a new camera-glasses method, and second, the method's applicability in the study of aggressive adolescents in residential care. Design/methodology/approach – Based on a mobile assessment strategy, the paper developed a new methodology for in-the-field recording of environmental conditions in which aggressive behaviour arises. The authors used glasses with an inbuilt camera worn by research subjects to record observational data. In the particular study presented here the authors used camera-glasses to observe the material and social environments of eight aggressive adolescents in a residential treatment programme and of a contrast group of four non-aggressive adolescents living at home. Findings – The crucial methodological findings are that camera-glasses successfully record the social and physical environments of aggressive adolescents from their perspective in relation to their environment and interlocutors, and that the camera-glasses method does not generate high reactivity. The results show that aggressive adolescents in residential care use direct and reactive forms of aggression, and that their aggressive behaviours occur predominantly in settings with limited adult supervision. In residential care aggressive behaviour is, paradoxically, an effective strategy for individuals to gain regard and social status among peers and to push their interests among staff. Research limitations/implications – An obvious limitation is the reliance on a small sample which limits the generalisation of the results. Practical implications – For residential facilities it is crucial to reduce the occurrence of low supervised social situations in order to minimise peer contagion. Furthermore, staff and educators need to be trained to use deescalating response strategies when dealing with adolescents’ aggressive behaviour, precisely deescalating strategies which neither involve acquiescence nor surrender to pressure. Originality/value – Our investigations demonstrate that the camera-glasses method is a promising new assessment technique which has applicability in various fields of adolescent research.
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Haivas, Claudia-Denise, and Isaac Teitelbaum. "Eradication of Repeated Episodes of Coagulase-Negative Staphylococcus Peritonitis: A Multipronged Approach." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 39, no. 6 (November 2019): 568–70. http://dx.doi.org/10.3747/pdi.2019.00247.

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Bacterial peritonitis continues to be a significant cause of morbidity and mortality in patients undergoing peritoneal dialysis. Episodes of peritonitis due to coagulase-negative staphylococci (CNS) are especially prone to relapse or repeat, often culminating in catheter removal and technique failure. This pattern is thought to be associated with the production of a biofilm that offers protection against antimicrobials and the host defense systems. We report the successful eradication of repeated episodes of CNS peritonitis using an aggressive multipronged therapeutic approach combining several antibiotics and a thrombolytic agent.
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Tudor, Megan E., Karim Ibrahim, Emilie Bertschinger, Justyna Piasecka, and Denis G. Sukhodolsky. "Cognitive-Behavioral Therapy for a 9-Year-Old Girl With Disruptive Mood Dysregulation Disorder." Clinical Case Studies 15, no. 6 (September 23, 2016): 459–75. http://dx.doi.org/10.1177/1534650116669431.

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Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnosis in the field of childhood onset disorders. Characterized by both behavior and mood disruption, DMDD is a purportedly unique clinical presentation with few relevant treatment studies to date. The current case study presents the application of cognitive-behavioral therapy (CBT) for anger and aggression in a 9-year-old girl with DMDD, co-occurring attention deficit hyperactivity disorder (ADHD), and a history of unspecified anxiety disorder. At the time of intake evaluation, she demonstrated three to four temper outbursts and two to three episodes of aggressive behavior per week, in addition to prolonged displays of non-episodic irritability lasting hours or days at a time. A total of 12 CBT sessions were conducted over 12 weeks and 5 follow-up booster sessions were completed over a subsequent 3-month period. Irritability-related material was specially designed to target the DMDD clinical presentation. Post-treatment and 3-month follow-up assessments, including independent evaluation, demonstrated significant decreases in the target symptoms of anger, aggression, and irritability. Although the complexities of diagnosing and treating DMDD warrant extensive research inquiry, the current case study suggests CBT for anger and aggression as a viable treatment for affected youth.
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Lin, Ping-I., Carl Bonander, Kathryn Harmeyer, Patrick Kennedy, Michael Sorter, Alexander Osborn, and Drew Barzman. "Predicting the time trend of first episodes of aggressive behaviors in pediatric psychiatric inpatient units." Journal of Psychiatric Research 140 (August 2021): 117–23. http://dx.doi.org/10.1016/j.jpsychires.2021.05.058.

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Mesquida, Christian G., and Neil I. Wiener. "Male Age Composition and Severity of Conflicts." Politics and the Life Sciences 18, no. 2 (September 1999): 181–89. http://dx.doi.org/10.1017/s0730938400021158.

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From a behavioral ecology perspective, all forms of warfare are instances of collective aggression perpetrated predominantly by coalitions of young men. Such coalitions are manifestations of cross-cultural sex differences in aggressive behavior and may be conceptualized as a form of intrasexual competition, occasionally to obtain mates, but more often to acquire resources for the attraction and retention of mates. All societies have young males, yet wars are discrete events that can take place even after long periods of peace. Therefore, an additional factor is needed to explain the episodic nature of the phenomenon. We have proposed (Mesquida and Wiener, 1996) that the most reliable factor in explaining episodes of coalitional aggression is the relative abundance of young males. In this article, we present additional evidence to that effect. The ratio of the number of men ages 15 to 29 years of age versus men 30 and older in a population appears to be associated with the occurrence and severity of conflicts as measured by the number of war casualties. A series of analyses of demographic and war casualty data indicates that the relative prevalence of young men consistently accounts for more than one third of the variance in severity of conflicts.
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Kuester, Jutta, and Andreas Paul. "Female-Female Competition and Male Mate Choice in Barbary Macaques (Macaca Sylvanus)." Behaviour 133, no. 9-10 (1996): 763–90. http://dx.doi.org/10.1163/156853996x00468.

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AbstractDue to a strong breeding synchronization, the Barbary macaque is a likely candidate for female competition for access to mates, female reproductive suppression, and male mate choice. The present study evaluated the significance of these factors for the mating system of this species. Female competition was analysed from focal observations of 19 out of 59 potentially reproductive females in their conception period. Ad libitum recorded sexual interactions of all animals were used for an analysis of male mate choice. The focal females were aggressive towards females once per 6.1 h and received aggression from females once per 3.8 h. However, they were three times more frequently the target of male aggression (once per 1.2 h), whereby the aggressor was often the momentary sexual partner. Rate of aggression received from males and females was not related with female rank. Females of all cycle stages disturbed sexual contacts, whereby the intruder was dominant to the target in most episodes (86 out of 100). Intruders more attractive than their targets were most successful in terminating the sexual association of their target, but success of intrusions was low and not related with female rank. The intruder copulated with the former partner of her target in only 5 intrusion episodes. Rate and date of conception and infant survival was not related with female rank, indicating that aggression against females during the conception period and intrusions into sexual contacts did not impair reproduction. Therefore, female
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Fortes, Paula Madeira, Lucas Albrechet-Souza, Mailton Vasconcelos, Bruna Maria Ascoli, Ana Paula Menegolla, and Rosa Maria M. de Almeida. "Social instigation and repeated aggressive confrontations in male Swiss mice: analysis of plasma corticosterone, CRF and BDNF levels in limbic brain areas." Trends in Psychiatry and Psychotherapy 39, no. 2 (June 12, 2017): 98–105. http://dx.doi.org/10.1590/2237-6089-2016-0075.

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Abstract Introduction: Agonistic behaviors help to ensure survival, provide advantage in competition, and communicate social status. The resident-intruder paradigm, an animal model based on male intraspecific confrontations, can be an ethologically relevant tool to investigate the neurobiology of aggressive behavior. Objectives: To examine behavioral and neurobiological mechanisms of aggressive behavior in male Swiss mice exposed to repeated confrontations in the resident intruder paradigm. Methods: Behavioral analysis was performed in association with measurements of plasma corticosterone of mice repeatedly exposed to a potential rival nearby, but inaccessible (social instigation), or to 10 sessions of social instigation followed by direct aggressive encounters. Moreover, corticotropin-releasing factor (CRF) and brain-derived neurotrophic factor (BNDF) were measured in the brain of these animals. Control mice were exposed to neither social instigation nor aggressive confrontations. Results: Mice exposed to aggressive confrontations exhibited a similar pattern of species-typical aggressive and non-aggressive behaviors on the first and the last session. Moreover, in contrast to social instigation only, repeated aggressive confrontations promoted an increase in plasma corticosterone. After 10 aggressive confrontation sessions, mice presented a non-significant trend toward reducing hippocampal levels of CRF, which inversely correlated with plasma corticosterone levels. Conversely, repeated sessions of social instigation or aggressive confrontation did not alter BDNF concentrations at the prefrontal cortex and hippocampus. Conclusion: Exposure to repeated episodes of aggressive encounters did not promote habituation over time. Additionally, CRF seems to be involved in physiological responses to social stressors.
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Monks, Claire P., Peter K. Smith, and Kat Kucaba. "Peer Victimisation in Early Childhood; Observations of Participant Roles and Sex Differences." International Journal of Environmental Research and Public Health 18, no. 2 (January 7, 2021): 415. http://dx.doi.org/10.3390/ijerph18020415.

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During middle childhood and adolescence, victimisation appears to be a group process involving different participant roles. However, peer reports with younger children (four to six years old) have failed to identify the participant roles of assistant (to the bully) reinforcers or defenders with much reliability. This may be because peer victimisation is a more dyadic process among younger children (behavioural reality), or because of limitations in young children’s cognitive capacity to identify these behaviours (cognitive limitations). The findings of an observational study which examined the group nature of peer victimisation among young children are presented. Observations were made of 56 children aged four and five years using time sampling during free play at school (totalling 43.5 h of observation). Records were made of their behaviour when an onlooker witnessed aggression by others, and also of others’ behaviour when they were being aggressive or being victimised. Although children other than the aggressor and target were present in nearly two thirds of the episodes of peer victimisation observed, few exhibited behavioural responses in line with the assistant, reinforcer or defender roles. This supports the behavioural reality rather than the cognitive limitations explanation. Sex differences were observed in types of aggression displayed by children, with boys more likely than girls to be physically aggressive. Children were less likely to be aggressive to other-sex peers and were most likely to be victimised by children of the same sex as them. There were also sex differences in children’s onlooker behaviour. The implications for our understanding of the development of peer victimisation and bullying in children are discussed.
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Monks, Claire P., Peter K. Smith, and Kat Kucaba. "Peer Victimisation in Early Childhood; Observations of Participant Roles and Sex Differences." International Journal of Environmental Research and Public Health 18, no. 2 (January 7, 2021): 415. http://dx.doi.org/10.3390/ijerph18020415.

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During middle childhood and adolescence, victimisation appears to be a group process involving different participant roles. However, peer reports with younger children (four to six years old) have failed to identify the participant roles of assistant (to the bully) reinforcers or defenders with much reliability. This may be because peer victimisation is a more dyadic process among younger children (behavioural reality), or because of limitations in young children’s cognitive capacity to identify these behaviours (cognitive limitations). The findings of an observational study which examined the group nature of peer victimisation among young children are presented. Observations were made of 56 children aged four and five years using time sampling during free play at school (totalling 43.5 h of observation). Records were made of their behaviour when an onlooker witnessed aggression by others, and also of others’ behaviour when they were being aggressive or being victimised. Although children other than the aggressor and target were present in nearly two thirds of the episodes of peer victimisation observed, few exhibited behavioural responses in line with the assistant, reinforcer or defender roles. This supports the behavioural reality rather than the cognitive limitations explanation. Sex differences were observed in types of aggression displayed by children, with boys more likely than girls to be physically aggressive. Children were less likely to be aggressive to other-sex peers and were most likely to be victimised by children of the same sex as them. There were also sex differences in children’s onlooker behaviour. The implications for our understanding of the development of peer victimisation and bullying in children are discussed.
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44

Theodorakis, J., H. Schneeberger, W. D. Illner, M. Stangl, B. Zanker, and W. Land. "Aggressive treatment of the first acute rejection episode using first-line anti-lymphocytic preparation reduces further acute rejection episodes after human kidney transplantation." Transplant International 11, s1 (June 1998): S86—S89. http://dx.doi.org/10.1111/j.1432-2277.1998.tb01203.x.

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Theodorakis, J., H. Schneeberger, W. D. Illner, M. Stangl, B. Zanker, and W. Land. "Aggressive treatment of the first acute rejection episode using first-line anti-lymphocytic preparation reduces further acute rejection episodes after human kidney transplantation." Transplant International 11 (June 5, 1998): S86—S89. http://dx.doi.org/10.1007/s001470050433.

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46

Stiell, Ian G., Catherine M. Clement, Jeffrey J. Perry, Christian Vaillancourt, Cheryl Symington, Garth Dickinson, David Birnie, and Martin S. Green. "Association of the Ottawa Aggressive Protocol with rapid discharge of emergency department patients with recent-onset atrial fibrillation or flutter." CJEM 12, no. 03 (May 2010): 181–91. http://dx.doi.org/10.1017/s1481803500012227.

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ABSTRACTObjective:There is no consensus on the optimal management of recent-onset episodes of atrial fibrillation or flutter. The approach to these conditions is particularly relevant in the current era of emergency department (ED) overcrowding. We sought to examine the effectiveness and safety of the Ottawa Aggressive Protocol to perform rapid cardioversion and discharge patients with these arrhythmias.Methods:This cohort study enrolled consecutive patient visits to an adult university hospital ED for recent-onset atrial fibrillation or flutter managed with the Ottawa Aggressive Protocol. The protocol includes intravenous chemical cardioversion, electrical cardioversion if necessary and discharge home from the ED.Results:A total of 660 patient visits were included, 95.2% involving atrial fibrillation and 4.9% involving atrial flutter. The mean age of patients enrolled was 64.5 years. In total, 96.8% were discharged home and, of those, 93.3% were in sinus rhythm. All patients were initially administered intravenous procaïnamide, with a 58.3% conversion rate. A total of 243 patients underwent subsequent electrical cardioversion with a 91.7% success rate. Adverse events occurred in 7.6% of cases: hypotension 6.7%, bradycardia 0.3% and 7-day relapse 8.6%. There were no cases of torsades de pointes, stroke or death. The median lengths of stay in the ED were as follows: 4.9 hours overall, 3.9 hours for those undergoing conversion with procaïnamide and 6.5 hours for those requiring electrical conversion.Conclusion:This is the largest study to date to evaluate the Ottawa Aggressive Protocol, a unique approach to cardioversion for ED patients with recent-onset episodes of atrial fibrillation and flutter. Our data demonstrate that the Ottawa Aggressive Protocol is effective, safe and rapid, and has the potential to significantly reduce hospital admissions and expedite ED care.
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Talukdar, R., M. Ludlam, L. Pout, and N. P. Lekka. "Ensuring patient safety: Physical health monitoring in rapid tranquillisation for aggression and violence of adult acute inpatients." European Psychiatry 33, S1 (March 2016): S170—S171. http://dx.doi.org/10.1016/j.eurpsy.2016.01.352.

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IntroductionIntramuscular (IM) medications used in rapid tranquillisation (RT) to manage violent/aggressive behaviour can cause serious physical side effects including sudden death, therefore comprehensive physical health monitoring is advised.ObjectivesTo assess whether physical health monitoring of patients who received IM medication for RT was completed as per the Aggression/Violence NICE-guideline based local Policy.MethodsAll patients that received IM benzodiazepines or antipsychotics for RT were identified amongst 822 discharges from February 2014 to February 2015. Demographics, diagnoses, non-pharmacological interventions, types/doses of medication, and associated seclusion/restraint episodes were recorded. Notes were examined to determine whether physical health monitoring protocols involving blood pressure, pulse, temperature, oxygen saturation, respiratory rate and level of consciousness were followed.ResultsThere were a total of 218 episodes where these medications were used, in which only 19 (8.8%) had any physical observations completed; only one case (0.5%) was completed fully as per the protocol. Of the cases that did not have observations taken, in 12 (5.5%) cases observations were attempted but the patient was too agitated/aggressive. A doctor was contacted in only 53 (24.3%) cases and an ECG was completed in 120 (55%) cases, of which only 11 were completed within 24 hours.ConclusionsThe results show poor compliance (or at least recording) with the guidance, demonstrating the need for further education of nursing and medical staff on the potential dangers of RT and for better physical health monitoring of patients on RT. To improve patient safety, staff training and well-timed recording of physical observations on electronic tablets will commence.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mehta, Sudhir. "Recurrent Afebrile Episodes of Spontaneous Pneumothorax in a Child with Well Controlled Systemic Lupus Erythematosus Disease." Journal of Nepal Paediatric Society 36, no. 1 (October 22, 2016): 94–96. http://dx.doi.org/10.3126/jnps.v36i1.12419.

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Systemic Lupus Erythematosus is an autoimmune disorder with multiple system involvement. Despite its pleuro-pulmonary involvement, recurrent spontaneous pneumothoraces are rare complication of childhood SLE. We report a 12 year old girl having SLE with nephritis, who developed recurrent episodes of spontaneous pneumothoraces. Surgical management with prolonged evacuation and aggressive immunosuppressive therapy improves the outcome for these patients. J Nepal Paediatr Soc 2016;36(1):94-96.
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Chen, Chen, Weixing Zhu, Juan Steibel, Janice Siegford, Kaitlin Wurtz, Junjie Han, and Tomas Norton. "Recognition of aggressive episodes of pigs based on convolutional neural network and long short-term memory." Computers and Electronics in Agriculture 169 (February 2020): 105166. http://dx.doi.org/10.1016/j.compag.2019.105166.

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50

Isaacs, J. D., L. J. Stearns, W. H. Poling, D. Milton, J. Nasternak, and C. Romano. "Intrathecal drug delivery versus comprehensive medical management as it may impact inpatient length of stay, readmission, and inpatient cost of care." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 18520. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.18520.

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18520 Background: Long lengths of stay (LOS) and high readmission rates partly explain the high medical costs of treating cancer patients. Uncontrolled pain is the number two reason for hospital readmission. Aggressive measures and treatment strategies for relieving intractable cancer pain can require the implantation and management of intrathecal (IT) drug delivery systems. The objective was to examine LOS, episodes of readmission, intensive care (ICU) stays, and discharge status among patients treated with IT versus comprehensive medical management (CMM) for pain. Methods: Retrospective case-control medical record review methods were employed. Sixty-three randomly selected cancer patients who received an IT were matched on gender, age group, and primary diagnosis to 63 who did not. Results: The total LOS for the 63 non-IT patients was 567 days. The total LOS for the 63 IT patients was 301 days. The mean LOS among the non-IT patients was 9 days. The mean LOS among the IT patients was 4.7 days. Total LOS for the non-IT patients was statistically significantly higher. Among the 63 non-IT patients 94 total inpatient episodes were experienced. Among the 63 IT patients 68 total inpatient episodes were experienced. The likelihood of a non-IT patient readmitting was nine-fold higher than the IT patients and statistically significantly different. The total Intensive Care Unit (ICU) days for the 63 non-IT patients were 60 days. The total ICU days for the 63 IT patients were 30 days. The total ICU for the non-IT patients was not statistically significantly higher. The likelihood of a non-IT patient expiring while an inpatient was fourteen-fold higher than the IT patients and was statistically significantly different. The average cost per episode was 22% higher among the IT group versus the non-IT group. Conclusions: The implantable IT system for pain management among cancer patients experiencing intractable pain may be a significant influence on patient LOS, readmission, and ICU episodes even though it represents a 22% increase in average inpatient costs per episode. Controlled studies examining these hospital indicators as primary outcomes for these patients by evaluating the IT drug delivery system as compared to CMM are warranted. No significant financial relationships to disclose.
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