Jail suicide risk despite denial (or: when actions speak louder than words).
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Biomedical subjects
Publications and source records attributed to L M Hayes.
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BACKGROUND: Recent findings point to an association between allergic asthma in adults and increased responsiveness of myeloid progenitor cells to certain hemopoietic growth factors. However, it is not clear at what age these changes in progenitor cells first become manifest, although increasing evidence suggests that the allergic phenotype may begin to emerge in very early life. OBJECTIVE: We sought to compare expression of hemopoietic cytokine receptors on CD34(+) progenitor cells in cord blood from normal infants ("low risk" for subsequent atopy) and infants with at least one atopic first degree relative ("at risk" for subsequent atopy). METHODS: Cord blood was obtained from 21 neonates. Nonadherent mononuclear cells were stained with mAbs directed against CD45, CD34, and the alpha-chains of the GM-CSF, IL-3, and IL-5 receptors and analyzed by flow cytometry. RESULTS: No differences in absolute CD34(+) numbers were observed between the 2 groups. However, expression of GM-CSF receptor on CD34(+) cells was reduced in the "at-risk" compared with the "low- risk" group (P =.021), although no significant differences were noted between the 2 groups with respect to IL-3 and IL-5 receptor expression. CONCLUSION: The functional sequelae of reduced GM-CSF receptor expression on CD34(+) cells remain to be determined. Nonetheless, these findings show an association between genetic risk for atopy and changes in the expression of hemopoietic cytokine receptors on cord blood progenitor cells and support the notion that the allergic phenotype may begin to evolve in the perinatal period.
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Author notes that inmate suicide continues to pose a serious public health problem within correctional facilities. He reviews the problem, the key components to comprehensive suicide prevention programming, and the obstacles to prevention.
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This article profiles the suicide prevention practices at a large metropolitan jail, a facility that experienced nine inmate suicides in a recent 24-month period. The suicide rate in this facility was found to far exceed the rate for jails of comparable size as well as the national rate of jail suicides. The nine suicides are summarized and common features (including the issue of protective custody) of the deaths and systemic jail deficiencies are discussed. The process by which the jail system developed a suicide prevention program based upon the principles of staff training, identification/screening, communication, levels of supervision, housing, and intervention is offered.
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Although first introduced more than 15 years ago, Critical Incident Stress Debriefing (CISD) has not been frequently utilized within the correctional community. As a structured protocol designed to prevent or mitigate traumatic stress, CISD has two main goals: (1) to lessen the impact of distressing critical incidents on the personnel exposed to them; (2) to accelerate recovery from those events before harmful stress reactions have a chance to damage the performance, careers, health, and families of personnel responding to emergencies. The need for debriefing remains acute. Whenever I conduct a jail-suicide prevention training seminar and explain the importance of the CISD process, correctional officers invariably approach me at the end of the workshop and begin to explain their experience with an inmate's suicide. Their voices are always characterized by frustration. This is one officer's story.
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