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The 1% of the population accountable for 63% of all violent crime convictions.

https://arctichealth.org/en/permalink/ahliterature259131
Source
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):559-71
Publication Type
Article
Date
Apr-2014
Author
Falk, O
Wallinius, M
Lundström, S
Frisell, T
Anckarsäter, H
Kerekes, N
Source
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):559-71
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aggression - psychology
Criminals - psychology - statistics & numerical data
Female
Humans
Male
Mental Disorders - epidemiology - psychology
Middle Aged
Registries
Risk factors
Substance-Related Disorders - epidemiology
Sweden
Violence - psychology - statistics & numerical data
Abstract
Population-based studies on violent crime and background factors may provide an understanding of the relationships between susceptibility factors and crime. We aimed to determine the distribution of violent crime convictions in the Swedish population 1973-2004 and to identify criminal, academic, parental, and psychiatric risk factors for persistence in violent crime.
The nationwide multi-generation register was used with many other linked nationwide registers to select participants. All individuals born in 1958-1980 (2,393,765 individuals) were included. Persistent violent offenders (those with a lifetime history of three or more violent crime convictions) were compared with individuals having one or two such convictions, and to matched non-offenders. Independent variables were gender, age of first conviction for a violent crime, nonviolent crime convictions, and diagnoses for major mental disorders, personality disorders, and substance use disorders.
A total of 93,642 individuals (3.9%) had at least one violent conviction. The distribution of convictions was highly skewed; 24,342 persistent violent offenders (1.0% of the total population) accounted for 63.2% of all convictions. Persistence in violence was associated with male sex (OR 2.5), personality disorder (OR 2.3), violent crime conviction before age 19 (OR 2.0), drug-related offenses (OR 1.9), nonviolent criminality (OR 1.9), substance use disorder (OR 1.9), and major mental disorder (OR 1.3).
The majority of violent crimes are perpetrated by a small number of persistent violent offenders, typically males, characterized by early onset of violent criminality, substance abuse, personality disorders, and nonviolent criminality.
Notes
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PubMed ID
24173408 View in PubMed
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A 5-year follow-up study of adolescents who sought treatment for substance misuse in Sweden.

https://arctichealth.org/en/permalink/ahliterature107628
Source
Eur Child Adolesc Psychiatry. 2014 May;23(5):347-60
Publication Type
Article
Date
May-2014
Author
Sheilagh Hodgins
Sara Lövenhag
Mattias Rehn
Kent W Nilsson
Author Affiliation
Maria-Ungdom Research Centre, Stockholm, Sweden.
Source
Eur Child Adolesc Psychiatry. 2014 May;23(5):347-60
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Antisocial Personality Disorder - diagnosis - epidemiology
Comorbidity
Crime - psychology
Female
Follow-Up Studies
Humans
Interviews as Topic
Male
Mental Disorders - epidemiology
Outcome Assessment (Health Care)
Parents
Patient Acceptance of Health Care - statistics & numerical data
Poverty - statistics & numerical data
Prevalence
Residence Characteristics
Risk factors
Socioeconomic Factors
Substance Abuse Treatment Centers
Substance-Related Disorders - epidemiology - psychology - therapy
Sweden - epidemiology
Urban Population
Violence - psychology - statistics & numerical data
Abstract
Previous studies have shown that substance misuse in adolescence is associated with increased risks of hospitalizations for mental and physical disorders, convictions for crimes, poverty, and premature death from age 21 to 50. The present study examined 180 adolescent boys and girls who sought treatment for substance misuse in Sweden. The adolescents and their parents were assessed independently when the adolescents first contacted the clinic to diagnose mental disorders and collect information on maltreatment and antisocial behavior. Official criminal files were obtained. Five years later, 147 of the ex-clients again completed similar assessments. The objectives were (1) to document the prevalence of alcohol use disorders (AUD) and drug use disorders (DUD) in early adulthood; and (2) to identify family and individual factors measured in adolescence that predicted these disorders, after taking account of AUD and DUD in adolescence and treatment. Results showed that AUD, DUD, and AUD + DUD present in mid-adolescence were in most cases also present in early adulthood. Prediction models detected no positive effect of treatment in limiting persistence of these disorders. Thus, treatment-as-usual provided by the only psychiatric service for adolescents with substance misuse in a large urban center in Sweden failed to prevent the persistence of substance misuse. Despite extensive clinical assessments of the ex-clients and their parents, few factors assessed in mid-adolescence were associated with substance misuse disorders 5 years later. It may be that family and individual factors in early life promote the mental disorders that precede adolescent substance misuse.
PubMed ID
23989597 View in PubMed
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A 5-year follow-up study of users of benzodiazepine: starting with diazepam versus oxazepam.

https://arctichealth.org/en/permalink/ahliterature282849
Source
Br J Gen Pract. 2016 Apr;66(645):e241-7
Publication Type
Article
Date
Apr-2016
Author
Ingunn Fride Tvete
Trine Bjørner
Tor Skomedal
Source
Br J Gen Pract. 2016 Apr;66(645):e241-7
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Anti-Anxiety Agents - therapeutic use
Anxiety - drug therapy - epidemiology
Depression - drug therapy - epidemiology
Diazepam - therapeutic use
Dose-Response Relationship, Drug
Drug Prescriptions - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway - epidemiology
Oxazepam - therapeutic use
Prescription Drug Misuse - statistics & numerical data
Prevalence
Proportional Hazards Models
Risk factors
Substance-Related Disorders - epidemiology
Abstract
Drug dependency may develop during long-term benzodiazepine use, indicated, for example, by dose escalation. The first benzodiazepine chosen may affect the risk of dose escalation.
To detect possible differences in benzodiazepine use between new users of diazepam and oxazepam over time.
This 5-year prescription database study included 19 747 new benzodiazepine users, inhabitants of Norway, aged 30-60 years, with first redemption for diazepam or oxazepam.
Individuals starting on diazepam versus oxazepam were analysed by logistic regression with sex, age, other drug redemptions, prescriber's specialty, household income, education level, type of work, and vocational rehabilitation support as background variables. Time to reach a daily average intake of =1 defined daily doses (DDD) over a 3-month period was analysed using a Cox proportional hazard regression model.
New users of oxazepam had a higher risk for dose escalation compared with new users of diazepam. This was true even when accounting for differences in sociodemographic status and previous drug use (hazard ratio [HR] 1.33, 95% confidence interval = 1.17 to 1.51).
Most doctors prescribed, according to recommendations, oxazepam to individuals they may have regarded as prone to and at risk of dependency. However, these individuals were at higher risk for dose escalation even when accounting for differences in sociodemographic status and previous drug use. Differences between the two user groups could be explained by different preferences for starting drug, DDD for oxazepam being possibly too low, and some unaccounted differences in illness.
Notes
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Cites: Addiction. 2011 Dec;106(12):2086-10921714826
PubMed ID
26965028 View in PubMed
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A 6-year experience with urine drug testing by family service agencies in Nova Scotia, Canada.

https://arctichealth.org/en/permalink/ahliterature193186
Source
Forensic Sci Int. 2001 Oct 1;121(3):151-6
Publication Type
Article
Date
Oct-1-2001
Author
A D Fraser
Author Affiliation
Clinical & Forensic Toxicologist, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 1278 Tower Road, Halifax, NS, Canada B3H 2Y9. adfraser@is.dal.ca
Source
Forensic Sci Int. 2001 Oct 1;121(3):151-6
Date
Oct-1-2001
Language
English
Publication Type
Article
Keywords
Adult
Child
Child Custody
Chromatography, High Pressure Liquid
Humans
Nova Scotia - epidemiology
Questionnaires
Social Work
Substance-Related Disorders - epidemiology - urine
Abstract
The objective of this study is to describe a urine drug-testing program implemented for parents with a history of substance abuse by family service agencies in the province of Nova Scotia, Canada. Nurse collectors went to the parents' home to obtain urine specimens under direct observation and then delivered the specimens to the toxicology laboratory or arranged shipment by courier under chain of custody. Each urine specimen was screened for cannabinoids, cocaine metabolite, opiates, amphetamines and benzodiazepines, ethyl alcohol and creatinine. All positive screening tests were confirmed by another method such as gas chromatography-mass spectrometry (GC-MS). In 15,979 urine specimens collected from 1994 to 1999, the percent positive rate for one (or more) drugs/metabolites ranged from 45.6% (1994-1996) to 30.0% (1998, 1999). A total of 575 specimens (3.7%) were dilute (urine creatinine
PubMed ID
11566417 View in PubMed
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The 2015 National Canadian Homeless Youth Survey: Mental Health and Addiction Findings.

https://arctichealth.org/en/permalink/ahliterature291013
Source
Can J Psychiatry. 2017 07; 62(7):493-500
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
07-2017
Author
Sean A Kidd
Stephen Gaetz
Bill O'Grady
Author Affiliation
1 Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario.
Source
Can J Psychiatry. 2017 07; 62(7):493-500
Date
07-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Canada - epidemiology
Female
Homeless Youth - statistics & numerical data
Humans
Male
Mental Health - statistics & numerical data
Sex Factors
Sexual and Gender Minorities - statistics & numerical data
Stress, Psychological - epidemiology
Substance-Related Disorders - epidemiology
Suicide, Attempted - statistics & numerical data
Young Adult
Abstract
This study was designed to provide a representative description of the mental health of youth accessing homelessness services in Canada. It is the most extensive survey in this area to date and is intended to inform the development of mental health and addiction service and policy for this marginalized population.
This study reports mental health-related data from the 2015 "Leaving Home" national youth homelessness survey, which was administered through 57 agencies serving homeless youth in 42 communities across the country. This self-reported, point-in-time survey assessed a broad range of demographic information, pre-homelessness and homelessness variables, and mental health indicators.
Survey data were obtained from 1103 youth accessing Canadian homelessness services in the Nunavut territory and all Canadian provinces except for Prince Edward Island. Forty-two per cent of participants reported 1 or more suicide attempts, 85.4% fell in a high range of psychological distress, and key indicators of risk included an earlier age of the first episode of homelessness, female gender, and identifying as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer, and 2 spirit [LGBTQ2S]).
This study provides clear and compelling evidence of a need for mental health support for these youth, particularly LGBTQ2S youth and female youth. The mental health concerns observed here, however, must be considered in the light of the tremendous adversity in all social determinants faced by these youth, with population-level interventions best leveraged in prevention and rapid response.
Notes
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PubMed ID
28372467 View in PubMed
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Absolute risk of suicide after first hospital contact in mental disorder.

https://arctichealth.org/en/permalink/ahliterature130761
Source
Arch Gen Psychiatry. 2011 Oct;68(10):1058-64
Publication Type
Article
Date
Oct-2011
Author
Merete Nordentoft
Preben Bo Mortensen
Carsten Bøcker Pedersen
Author Affiliation
Psychiatric Centre Copenhagen, Denmark. mn@dadlnet.dk
Source
Arch Gen Psychiatry. 2011 Oct;68(10):1058-64
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Bipolar Disorder - epidemiology - psychology
Comorbidity
Denmark - epidemiology
Female
Humans
Incidence
Male
Mental Disorders - epidemiology - psychology
Middle Aged
Mood Disorders - epidemiology - psychology
Prospective Studies
Risk factors
Schizophrenia - epidemiology
Schizophrenic Psychology
Sex Factors
Substance-Related Disorders - epidemiology - psychology
Suicide - psychology - statistics & numerical data
Young Adult
Abstract
Estimates of lifetime risk of suicide in mental disorders were based on selected samples with incomplete follow-up.
To estimate, in a national cohort, the absolute risk of suicide within 36 years after the first psychiatric contact.
Prospective study of incident cases followed up for as long as 36 years. Median follow-up was 18 years.
Individual data drawn from Danish longitudinal registers.
A total of 176,347 persons born from January 1, 1955, through December 31, 1991, were followed up from their first contact with secondary mental health services after 15 years of age until death, emigration, disappearance, or the end of 2006. For each participant, 5 matched control individuals were included.
Absolute risk of suicide in percentage of individuals up to 36 years after the first contact.
Among men, the absolute risk of suicide (95% confidence interval [CI]) was highest for bipolar disorder, (7.77%; 6.01%-10.05%), followed by unipolar affective disorder (6.67%; 5.72%-7.78%) and schizophrenia (6.55%; 5.85%-7.34%). Among women, the highest risk was found among women with schizophrenia (4.91%; 95% CI, 4.03%-5.98%), followed by bipolar disorder (4.78%; 3.48%-6.56%). In the nonpsychiatric population, the risk was 0.72% (95% CI, 0.61%-0.86%) for men and 0.26% (0.20%-0.35%) for women. Comorbid substance abuse and comorbid unipolar affective disorder significantly increased the risk. The co-occurrence of deliberate self-harm increased the risk approximately 2-fold. Men with bipolar disorder and deliberate self-harm had the highest risk (17.08%; 95% CI, 11.19%-26.07%).
This is the first analysis of the absolute risk of suicide in a total national cohort of individuals followed up from the first psychiatric contact, and it represents, to our knowledge, the hitherto largest sample with the longest and most complete follow-up. Our estimates are lower than those most often cited, but they are still substantial and indicate the continuous need for prevention of suicide among people with mental disorders.
PubMed ID
21969462 View in PubMed
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Access and utilization of HIV treatment and services among women sex workers in Vancouver's Downtown Eastside.

https://arctichealth.org/en/permalink/ahliterature174373
Source
J Urban Health. 2005 Sep;82(3):488-97
Publication Type
Article
Date
Sep-2005
Author
Kate Shannon
Vicki Bright
Janice Duddy
Mark W Tyndall
Author Affiliation
BC Centre for Excellence in HIV AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6.
Source
J Urban Health. 2005 Sep;82(3):488-97
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active - utilization
Canada - epidemiology
Community Health Services - supply & distribution - utilization
Female
HIV Infections - epidemiology - therapy
Health Services Accessibility
Hepatitis C - epidemiology
Humans
Middle Aged
Poverty Areas
Prostitution
Substance-Related Disorders - epidemiology
Urban Population
Abstract
Many HIV-infected women are not realizing the benefits of highly active antiretroviral therapy (HAART) despite significant advancements in treatment. Women in Vancouver's Downtown Eastside (DTES) are highly marginalized and struggle with multiple morbidities, unstable housing, addiction, survival sex, and elevated risk of sexual and drug-related harms, including HIV infection. Although recent studies have identified the heightened risk of HIV infection among women engaged in sex work and injection drug use, the uptake of HIV care among this population has received little attention. The objectives of this study are to evaluate the needs of women engaged in survival sex work and to assess utilization and acceptance of HAART. During November 2003, a baseline needs assessment was conducted among 159 women through a low-threshold drop-in centre servicing street-level sex workers in Vancouver. Cross-sectional data were used to describe the sociodemographic characteristics, drug use patterns, HIV/hepatitis C virus (HCV) testing and status, and attitudes towards HAART. High rates of cocaine injection, heroin injection, and smokeable crack cocaine use reflect the vulnerable and chaotic nature of this population. Although preliminary findings suggest an overall high uptake of health and social services, there was limited attention to HIV care with only 9% of the women on HAART. Self-reported barriers to accessing treatment were largely attributed to misinformation and misconceptions about treatment. Given the acceptability of accessing HAART through community interventions and women specific services, this study highlights the potential to reach this highly marginalized group and provides valuable baseline information on a population that has remained largely outside consistent HIV care.
Notes
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PubMed ID
15944404 View in PubMed
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Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

https://arctichealth.org/en/permalink/ahliterature131318
Source
Open Med. 2011;5(2):e94-e103
Publication Type
Article
Date
2011
Author
Erika Khandor
Kate Mason
Catharine Chambers
Kate Rossiter
Laura Cowan
Stephen W Hwang
Author Affiliation
Toronto Public Health, Toronto, Ontario, Canada.
Source
Open Med. 2011;5(2):e94-e103
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chronic Disease - epidemiology
Communication Barriers
Cost of Illness
Family Practice - statistics & numerical data
Female
Health Care Costs
Health Services Accessibility - economics - statistics & numerical data
Health Status Disparities
Health Surveys
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Primary Health Care - economics - statistics & numerical data
Risk factors
Sexual Behavior - statistics & numerical data
Substance-Related Disorders - epidemiology
Abstract
Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada.
Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics.
Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53).
Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of homelessness, lack of proof of health insurance coverage and having a chronic medical condition. Increased efforts are needed to address the barriers to appropriate health care and good health that persist in this population despite the provision of health insurance.
Notes
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PubMed ID
21915240 View in PubMed
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Accidental deaths caused by electricity in Sweden, 1975-2000.

https://arctichealth.org/en/permalink/ahliterature79263
Source
J Forensic Sci. 2006 Nov;51(6):1383-8
Publication Type
Article
Date
Nov-2006
Author
Lindström Richard
Bylund Per-Olof
Eriksson Anders
Author Affiliation
Section of Forensic Medicine, Department of Community Health and Rehabilitation, Umeå University, PO Box 7616, SE-907 12 Umeå, Sweden.
Source
J Forensic Sci. 2006 Nov;51(6):1383-8
Date
Nov-2006
Language
English
Publication Type
Article
Keywords
Accidents - mortality
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Arrhythmia - etiology - mortality
Central Nervous System Depressants - blood - urine
Child
Child, Preschool
Electric Injuries - mortality
Ethanol - blood - urine
Female
Humans
Infant
Male
Middle Aged
Registries
Risk factors
Substance-Related Disorders - epidemiology
Sweden - epidemiology
Abstract
This study analyzes accidental fatalities caused by electricity--at work and during leisure time--to evaluate risk factors, the role of alcohol, and to identify possible preventive strategies. In Sweden, data on fatalities by electrocution from 1975 through 2000 were collected from the National Cause-of-Death Register. Additional cases were found in the archives of The Swedish National Electrical Safety Board. Suicides and deaths by lightning were excluded. Two hundred and eighty-five deaths were found, including occupational (n=132), leisure time (n=151), and unknown (n=2). Most deaths were caused by aerial power lines, and the most common place for an electrical injury was a railway area or residential property. Postmortem blood from 20% (n=47) of the tested cases was found positive for alcohol, and these persons were killed mainly during leisure time. During the study period, the overall incidence of electricity-related fatalities has decreased, in spite of increased use of electricity. This indicates that safety improvements have been successful.
PubMed ID
17199625 View in PubMed
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