This meta-analysis is the first to our knowledge to evaluate the predictive properties of dynamic sex offender risk assessment instruments, which are designed to assess factors associated with recidivism that are amenable to change. Based on 52 studies (N = 13,446), we found that dynamic risk assessment instruments have small-to-moderate predictive properties, with Cohen's ranging between 0.71 for sexual recidivism (41 studies, 22 unique samples, N = 5,699) and 0.43 for violent (including sexual) recidivism (27 studies, 14 unique samples, N = 10,368). Incremental predictive validity of dynamic over static risk assessment instruments was significant but modest; Cox hazard ratios varied between 1.08 for sexual recidivism (19 studies, 13 unique samples, N = 3,747) and 1.05 for any recidivism (11 studies, 8 unique samples, N = 2,511). Cox hazard ratios for the predictive validity of change scores on dynamic risk assessment instruments, controlling for static and initial dynamic scores, varied between 0.91 for sexual recidivism (6 studies, 6 unique samples, n = 1,980) and 0.95 for any recidivism (3 studies, 3 unique samples, n = 1,172). These findings indicate that dynamic risk assessment instruments can, in terms of Andrews and Bonta's (2010) risk and need principles, be a useful tool for improving sex offender treatment. They have the potential to contribute to the selection of appropriate, more individually tailored treatment approaches (focusing on individually relevant criminogenic need factors) and can assist in the evaluation of treatment effects. Considering this, further development of dynamic risk assessment instruments is warranted. (PsycINFO Database Record
IMPORTANCEThe optimal staging for gastric cancer remains a matter of debate.OBJECTIVE To evaluate the value of 18 F-fludeoxyglucose-positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL) in addition to initial staging by means of gastroscopy and CT in patients with locally advanced gastric cancer. DESIGN, SETTING, AND PARTICIPANTSThis multicenter prospective, observational cohort study included 394 patients with locally advanced, clinically curable gastric adenocarcinoma (ՆcT3 and/or N+, M0 category based on CT) between August 1, 2017, and February 1, 2020.EXPOSURES All patients underwent an FDG-PET/CT and/or SL in addition to initial staging. MAIN OUTCOMES AND MEASURESThe primary outcome was the number of patients in whom the intent of treatment changed based on the results of these 2 investigations. Secondary outcomes included diagnostic performance, number of incidental findings on FDG-PET/CT, morbidity and mortality after SL, and diagnostic delay. RESULTSOf the 394 patients included, 256 (65%) were men and mean (SD) age was 67.6 (10.7) years. A total of 382 patients underwent FDG-PET/CT and 357 underwent SL. Treatment intent changed from curative to palliative in 65 patients (16%) based on the additional FDG-PET/CT and SL findings. FDG-PET/CT detected distant metastases in 12 patients (3%), and SL detected peritoneal or locally nonresectable disease in 73 patients (19%), with an overlap of 7 patients (2%). FDG-PET/CT had a sensitivity of 33% (95% CI, 17%-53%) and specificity of 97% (95% CI, 94%-99%) in detecting distant metastases. Secondary findings on FDG/PET were found in 83 of 382 patients (22%), which led to additional examinations in 65 of 394 patients (16%). Staging laparoscopy resulted in a complication requiring reintervention in 3 patients (0.8%) without postoperative mortality. The mean (SD) diagnostic delay was 19 (14) days.CONCLUSIONS AND RELEVANCE This study's findings suggest an apparently limited additional value of FDG-PET/CT; however, SL added considerably to the staging process of locally advanced gastric cancer by detection of peritoneal and nonresectable disease. Therefore, it may be useful to include SL in guidelines for staging advanced gastric cancer, but not FDG-PET/CT.
Although dynamic risk factors are considered important in the assessment and treatment of adult male sex offenders, little is known about their interrelationships. We apply network analysis to assess their associations and to provide an analysis of their shortest pathways to sexual and violent (including sexual contact) recidivism. Analyses revealed a central position for general rejection/loneliness (in all networks), poor cognitive problem solving (in networks containing sexual or violent—including sexual contact—recidivism), and impulsive acts (only in the network including sexual recidivism). These variables represented links between clusters of dynamic risk factors composed of factors relating to sexual self-regulation, emotionally intimate relationships, antisocial traits, and self-management. Impulsive acts showed the strongest independent association with sexual and violent (including sexual contact) recidivism.
This study shows that small oligopeptides related to the primary structure of beta-hCG, especially AQGV, are promising potential drugs for preventing the development of renal ischaemia-reperfusion injury.
The article applies an incentive-motivation model to sexual violence. It suggests that insights can be gained by looking at the biopsychological processes that underlie 'conventional behavior'. It argues that sexual violence, as in rape, arises from a fusion between (i) sexual motivation and (ii) sensation-seeking and varying strengths of dominance/aggression motivations. The excitatory part of the motivational system is rooted in brain dopamine and sexual violence is expressed in behavior when excitation exceeds inhibition. The assumptions are framed within the principle of the hierarchical control of behavior. The incentive-motivation and hierarchical framework can yield insights into such phenomena as planning and impulsivity, future discounting, habituation and escalation, violence as addiction, the role of fetishes, sexual fantasy, stress, drugs and brain development.
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