A survey of North American plethysmographic assessment centers was undertaken to examine the extent to which variability exists among them. Results clearly revealed a field in which there is abundant inconsistency in both plethysmographic assessment procedures and data interpretation. A critical need for standardization was identified if plethysmographic assessment is to develop further its potential to assist in the clinical assessment and treatment of sex offenders.
Phallometric testing is a procedure that has enjoyed considerable popularity as an objective component in the assessment of sexual offenders. The value of this procedure may be most notably compromised in the realm of interpretation, and problems in interpretation are particularly acute for those participants where full arousal is not obtained during testing. The calculation of Percent Full Erection (PFE) scores has of necessity involved a speculative component in such cases. Eliminating this speculation through empirical investigation was the purpose of the current research. Circumferential change scores (from flaccidity to full erection) were obtained for 724 respondents at nine North American correctional facilities, allowing for the calculation of descriptive statistics and a determination of the distribution characteristics of these scores. The results provide an empirical basis for calculating PFE scores and interpreting phallometric data in those cases where full arousal is not obtained, and specific confidence levels associated with interpretation are offered. It is suggested that only through a more rigorous application of the principles of science will the procedure of phallometric assessment fulfill its true potential.
Plethysmographic testing was completed on 100 research participants from the same medium-security prison population, 50 of whom were incarcerated for nonsexual offenses. In order to strengthen the validity of the research, only participants who achieved full arousal were included in the sample, and the percentage of full erection scores, as well as the Rape Index, were examined. The resulting sexual arousal profiles revealed striking similarities between rapists and control participants, indicating that deviant arousal alone did not distinguish these sexual offenders from nonsexual offenders. The only marked difference between the two groups was in the almost-perfect ability of control participants to inhibit deviant arousal and the weak ability of sexual offenders to accomplish this. The suggestion was advanced that a determination of an offender's ability to inhibit deviant arousal may be the only aspect of plethysmographic testing which has practical application in the assessment of rapists.
ObjectiveTo compare the mortality and morbidity of traumatically injured patients who received additional prehospital care by a doctor and critical care paramedic enhanced care team (ECT), with those solely treated by a paramedic non-ECT.MethodsA retrospective analysis of Trauma Audit and Research Network (TARN) data and case note review of all severe trauma cases (Injury Severity Score ≥9) in North East England from 1 January 2014 to 1 December 2017 who were treated by the North East Ambulance Service, the Great North Air Ambulance Service or both. TARN methods were used to calculate the number of unexpected survivors or deaths in each group (W score (Ws)). The Glasgow Outcome Scores were contrasted to evaluate morbidity.ResultsThe ECT group treated 531 patients: there were 17 unexpected survivors and no unexpected deaths. The non-ECT group treated 1202 patients independently: there were no unexpected survivors and 31 unexpected deaths. The proportion of patients requiring critical care interventions differed between the two groups 49% versus 33% (CI for difference 12% to 20%). In the ECT group, the Ws was 3.22 (95% CI 0.79 to 5.64). In the non-ECT group, the Ws was −2.97 (95% CI −1.22 to −4.71). The difference between the Ws was 6.18 (95% CI 3.19 to 9.17). There was no evidence of worse morbidity in the ECT group.ConclusionThis is the first UK ECT service to demonstrate a risk-adjusted mortality benefit in trauma patients with no detriment in morbidity: our results demonstrate an additional 3.22 survivors per 100 severe trauma casualties when treated by an ECT. The authors encourage other ECT services to conduct similar research.
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