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A qualitative analysis of interview data with 41 rapists determined that five implicit theories (ITs) underlie rapists' offense supportive beliefs/feelings/motives: (a) dangerous world (DW)--where men have feelings of generalized anger and/or resentment toward others; (b) women are dangerous--where men hold a set of attitudes that are hostile toward women; (c) women as sexual objects (WSO)--where women are seen as primarily sexual objects; (d) male sex drive is uncontrollable--where sexual urges are seen all consuming; (e) entitlement--where men feel that they can do exactly what they want. Consideration of whether DW or WSO ITs were present or absent indicated that three main groups could be identified: Group 1: violently motivated--presence of DW and/or absence of WSO; Group 2: sexually motivated--presence of WSO and/or absence of DW; Group 3: sadistically motivated--presence of DW and WSO. These results are discussed in terms of treatment needs of rapists. (Contains 3 tables and 1 note.)

Interviews with 28 sexual murderers were subjected to grounded theory analysis. Five implicit theories (ITs) were identified: dangerous world, male sex drive is uncontrollable, entitlement, women as sexual objects, and women as unknowable. These ITs were found to be identical to those identified in the literature as being present in rapists. The presence of dangerous world and male sex drive is uncontrollable were present, or absent, such that three groups could be identified: (a) dangerous world plus male sex drive is uncontrollable; (b) dangerous world, in the absence of male sex drive is uncontrollable; (c) male sex drive is uncontrollable in the absence of dangerous world. These three groups were found to differ in motivation: (a) were motivated by urges to rape and murder; (b) were motivated by grievance, resentment and/or anger toward women; (c) were motivated to sexually offend but were prepared to kill to avoid detection, or secure compliance.

Introduction: Continuous renal replacement therapy (CRRT) has become a primary treatment of severe acute kidney injury in children admitted to the intensive care unit. CRRT "downtime" (when the circuit is not active) can represent a significant portion of the prescribed treatment time and adversely affects clearance. The objective of this study was to evaluate factors associated with CRRT "downtime" and to determine whether instituting a tandem therapeutic plasma exchange (TPE) protocol could significantly and robustly decrease circuit downtime in patients receiving both therapies. Methods: This is a retrospective cohort study of 116 patients undergoing CRRT in the pediatric, neonatal, or cardiac ICU at UPMC Children's Hospital of Pittsburgh from January 2014 to July 2020. We performed multivariable logistic regression to determine factors associated with CRRT downtime. We instituted a tandem TPE protocol whereby TPE and CRRT could run in parallel without pausing CRRT in April 2018. We analyzed the effect of the protocol change by plotting downtime for patients undergoing CRRT and TPE on a run chart. The effect of initiating tandem TPE on downtime was assessed by special cause variation. Results: For 108/139 (77.7%) sessions with downtime data available, the median (IQR) percentage of downtime was 6.2% (1.7–12.7%). Multivariable logistic regression showed that TPE was significantly associated with CRRT downtime (p = 0.003), and that age, sex, race, catheter size, and anticoagulation were not. For patients undergoing TPE, the median (IQR) percentage of downtime was 14.7% (10.5–26%) and 3.4% (1.3–4.9%) before and after initiation of tandem TPE, respectively (p < 0.001). The difference in downtime percentage met criteria for special cause variation. Conclusions: Interruptions for TPE increase CRRT downtime. Tandem TPE significantly reduces CRRT downtime in patients undergoing both procedures concomitantly. [ABSTRACT FROM AUTHOR]

A qualitative analysis of interview data with 41 rapists determined that five implicit theories (ITs) underlie rapists' offense supportive beliefs/feelings/motives: (a) dangerous world (DW)--where men have feelings of generalized anger and/or resentment toward others; (b) women are dangerous--where men hold a set of attitudes that are hostile toward women; (c) women as sexual objects (WSO)--where women are seen as primarily sexual objects; (d) male sex drive is uncontrollable--where sexual urges are seen all consuming; (e) entitlement--where men feel that they can do exactly what they want. Consideration of whether DW or WSO ITs were present or absent indicated that three main groups could be identified: Group 1: violently motivated--presence of DW and/or absence of WSO; Group 2: sexually motivated--presence of WSO and/or absence of DW; Group 3: sadistically motivated--presence of DW and WSO. These results are discussed in terms of treatment needs of rapists. Keywords: rapists; rape; implicit theories; motivation; treatment implications

Interviews with 28 sexual murderers were subjected to grounded theory analysis. Five implicit theories (ITs) were identified: dangerous world, male sex drive is uncontrollable, entitlement, women as sexual objects, and women as unknowable. These ITs were found to be identical to those identified in the literature as being present in rapists. The presence of dangerous world and male sex drive is uncontrollable were present, or absent, such that three groups could be identified: (a) dangerous world plus male sex drive is uncontrollable; (b) dangerous world, in the absence of male sex drive is uncontrollable; (c) male sex drive is uncontrollable in the absence of dangerous world. These three groups were found to differ in motivation: (a) were motivated by urges to rape and murder; (b) were motivated by grievance, resentment and/or anger toward women; (c) were motivated to sexually offend but were prepared to kill to avoid detection, or secure compliance. Keywords: sexual murder, implicit theories, ITs, motivation, treatment

What is needed to carry out a thorough risk assessment of an ex-offender? This article describes four major components: (a) a functional analysis of the offense process in order to determine how the offenders' problems contributed to their offending and to identify the modus operandi used in their offense(s); (b) the application of a suitable actuarial risk predictor to assess the offender's global level of risk; (c) identification of stable dynamic risk factors that make potential treatment targets; and (d) monitoring of acute dynamic factors that indicate offending is imminent.