Reliability statistics.
\r\n\t
\r\n\tRecently in 2019, International Council on Systems Engineering (INCOSE) has released the latest version of the “Guidelines for the Utilization of ISO/IEC/IEEE 15288 in the Context of System of Systems (SoS) Engineering” to industry for review and comments. The document was developed under the Partner Standards Development Organization cooperation agreement between ISO and IEEE, as it was approved by Council Resolution 49/2007. This document provides guidance for the utilization of ISO/IEC/IEEE 15288 in the context of SoS in many domains, including healthcare, transportation, energy, defense, corporations, cities, and governments. This document treats an SoS as a system whose elements are managerially and/or operationally independent systems, and which together usually produce results that cannot be achieved by the individual systems alone. This INCOSE guide book perceives that SoS engineering demands a balance between linear procedural procedures for systematic activity and holistic nonlinear procedures due to additional complexity from SoS perspectives.
\r\n\tThe objective of this book is to provide a comprehensive reference on Systems-of-Systems Engineering, Modeling, Simulation and Analysis (MS&A) for engineers and researchers in both system engineering and advanced mathematical modeling fields.
\r\n\tThe book is organized in two parts, namely Part I and Part II. Part I presents an overview of SOS, SOS Engineering, SOS Enterprise Architecture (SOSEA) and SOS Enterprise (SOSE) Concept of Operations (CONOPS). Part II discusses SOSE MS&A approaches for assessing SOS Enterprise CONOPS (SOSE-CONOPS) and characterizing SOSE performance behavior. Part II focuses on advanced mathematical application concepts to address future complex space SOS challenges that require interdisciplinary research involving game theory, probability and statistics, non-linear programming and mathematical modeling components.
\r\n\tPart I should include topics related to the following areas:
\r\n\t- SOS and SOS Engineering Introduction
\r\n\t- Taxonomy of SOS
\r\n\t- SOS Enterprise (SOSE), SOSE CONOPS, Architecture Frameworks and Decision Support Tools
\r\n\tPart II should address the following research areas:
\r\n\t- SOS Modeling, Simulation & Analysis (SOS M&SA) Methods
\r\n\t- SOS Enterprise Architecture Design Frameworks and Decision Support Tools
\r\n\t- SOS Enterprise CONOPS Assessment Frameworks and Decision Support Tools.
X-ray computed tomography (CT) was first invented in 1972 and its ability to obtain cross sectional images has proven to be a major advance in the field of medicine, garnering the Nobel Prize in medicine for Sir Godfrey Newbold Hounsfield and Allan McLeod Cormack in 1979. Since then, numerous advances have been made with the introduction of high quality scanners and new imaging protocols to enhance the quality of the images and reduce the amount of radiation. Inherent drawbacks of conventional CT imaging for cardiac imaging, such as low temporal resolution and the need for ECG gating, prompted the development of electron beam CT (EBCT). Further advances in the scanners have led to the introduction of multi detector CT (MDCT) scanners, which have increased spatial resolution and now utilize sequential imaging acquisition modes and other features to minimize radiation exposure. MDCT scanners for coronary imaging utilize a minimum of 16 slice, and now 64 - 320 slice scanners are widely used to get excellent, high-resolution images of the heart and the coronary arteries.
\n\t\tThe coronary CT angiogram (CCTA) is a relatively fast and simple procedure. Adequate patient preparation and co-operation are essential for good image acquisition. Beta-blockers are routinely given to slow the heart rate (Bluemke et al. 2008) in order to eliminate or reduce artifact from motion of the coronary arteries. This chapter deals primarily with the use of coronary CTA as an alternative to invasive angiography and another chapter describes the technical features in more detail. However, in brief, temporal resolution is an important limitation and is determined by the speed of the X-ray gantry(Kapoor and Thompson 2009). MDCT scanners improve this temporal resolution by acquiring a full CT slice in only half a rotation, and recent advances in scanner design have improved the speed of rotation and even added second tube sources in order to improve temporal resolution even more. The 64-slice MSCT instruments are now considered the minimum standard for CT scanners intended for coronary artery imaging. Images are most commonly acquired using prospective gating and only during diastole (for example at 70-80% of the R-R interval) in order to reduce the radiation dosage (Earls et al. 2008). Both spatial resolution and temporal resolution are less with CCTA than conventional invasive coronary angiography and these limitations must be kept in mind when deciding which test to order. The maximum spatial resolution of MSCT is 0.4 mm, and is determined by the size of the picture elements of the CT detector. Smaller coronary segments frequently are not evaluable with CTA and coronary CTA may be unable to distinguish moderate from severe flow limiting stenosis, because of these limitations of resolution(Kapoor and Thompson 2009).
\n\t\tNon-contrast CT scanning of the coronary arteries is a widely used technique for risk stratification and prognosis for individuals without know coronary artery disease. With this technique, calcium in the form of calcium hydroxyapatite in the artery wall is imaged and quantified in order to provide a rough measure of the presence of coronary atherosclerosis. There is a linear relationship between the amount of coronary calcium and coronary atherosclerosis, that is, the more coronary calcium the higher the likelihood of coronary stenosis(Rumberger et al. 1995), and proportionally prognostic – the higher the calcium score the greater the likelihood of coronary events(O\'Rourke et al. 2000). Moehlenkamp and colleagues recently demonstrated that coronary calcium scoring not only adds prognostic value to the Framingham risk model, but also that it’s value is greater than hsCRP (Mohlenkamp et al. 2003). Also the recent randomized Eisner Trial demonstrated that coronary calcium testing leads to better downstream control of coronary risk factors(Rozanski et al. 2011). Thus, the ability of coronary calcium scoring to non-invasively identify and quantify the amount of coronary calcium is invaluable to diagnose pre-clinical CAD and help to aggressively modify the risk factors. It should be emphasized that coronary CTA, while a very useful tool, is not a particularly appropriate test for patients with chest pain syndromes. CT coronary calcium scoring is performed without the use of iodinated x-ray contrast. In order to perform CT coronary angiography, the focus of this chapter, x-ray contrast is administered.
\n\t\tWhile CCTA can sometimes provide images of truly impressive quality, the spatial and temporal resolution are significantly inferior to invasive angiography, and CCTA images are sometimes degraded by artifacts. A recent prospective multicenter-blinded study evaluated the diagnostic performance of 64-multidetector row CCTA compared with invasive coronary angiography (ICA) in patients with chest pain without known CAD who were referred for non-emergent ICA. The data revealed high diagnostic performance at both 50% and 70% stenosis thresholds. In addition, the 99% negative predictive value (NPV) of CCTA at the patient and vessel levels establishes it as a highly effective noninvasive alternative to ICA for the exclusion of obstructive coronary artery stenosis(Budoff et al. 2008). The strength of the CCTA lies in its high negative predictive value. A good quality negative CCTA without artifacts can rule out the presence of CAD with a great level of confidence. The high negative predictive value has been consistently demonstrated(Gopalakrishnan et al. 2008; Mowatt et al. 2008; Stein et al. 2008) and it is this population where coronary CTA might well be a substitute for invasive angiography. Figure 1 demonstrates a normal high quality coronary CT angiogram and figure 2 demonstrates one in which the diagnosis of high - grade coronary artery disease was made. In general, coronary CTA is much less accurate in the presence of heavy coronary calcification and in patients with atrial fibrillation or other irregular cardiac rhythms. Figure 3 is an example of such a non-diagnostic study. Another chapter deals with the accuracy of CTA in greater detail.
\n\t\t\tCT coronary angiogram of a 39 year old male who complained of chest pain (maximum intensity image of the right coronary artery (A and B) and the left coronary artery (C) and reformatted image (D). The study was normal giving a high degree of confidence that coronary artery disease was not present.
Although coronary CTA has limitations, it is much less invasive than invasive coronary angiography and it is an appropriate alternative in selective cases. For example, according to the ACCF/SCCT/ACR/ASNC appropriate use criteria for diagnosing CAD, patients who present with non-acute symptoms and possibly representing an ischemic equivalent, CCTA is considered an appropriate test in those with a low to intermediate probability of CAD whose ECG is uninterpretable and who cannot exercise(Taylor et al. 2010). CCTA is also considered appropriate in patients with a low to intermediate pre-test probability with acute symptoms suggestive of acute coronary syndrome (ACS) with a normal ECG and cardiac biomarkers(Taylor et al. 2010). However, in patients who have obvious severe cardiac ischemia, coronary CTA is not an appropriate alternative to invasive angiography as it will simply delay interventional therapy and add to the x-ray contrast load prior to the needed invasive procedure(Taylor et al. 2010).
\n\t\t\tVolume rendered (A) and maximum intensity projection (B) CT angiogram images from a 48-year-old male demonstrating a high-grade stenosis in the mid segment of the left anterior descending coronary artery. The patient had presented with persistent, intermittent chest pain and a myocardial perfusion image had been equivocal.
Thin maximum intensity projection (MIP) coronary CT angiogram in a 65-year-old female patient showing the proximal left coronary artery branches. Heavy coronary calcium makes the study non-diagnostic. Image quality is also impaired by insufficient x-ray contrast in the aorta and coronary arteries at the time of acquisition.
Another category of patients in whom CCTA is used as an alternative to invasive angiography are those with an equivocal or low probability stress tests whose symptoms suggestive of angina persist despite low probability scans. These patients are often referred for cardiac catheterization, but CCTA is a less invasive test that can rule out obstructive CAD as a cause for their symptoms. The high negative predictive value of CCTA allows the clinician to confidently reassure the patient without invasive testing. This same rationale applies to those patients with suspected coronary artery disease who are scheduled to undergo non-cardiac surgeries. When applied to the appropriate subset of patients, i.e. those with relatively low pre-test probability of CAD, CCTA can prove to be the final test to confidently rule out the presence of CAD and these patients benefit from avoiding the higher cost and potential complications of invasive coronary angiography.
\n\t\t\tWhen patients present with a new diagnosis of heart failure / cardiomyopathy, further diagnostic evaluation is warranted. Coronary artery disease is the most common cause of cardiomyopathy and differentiating ischemic from non-ischemic etiology has important therapeutic and prognostic implications. In particular, since ischemic cardiomyopathy has the potential for improvement from revascularization, it is very important that the etiology be established. Treatment guidelines for patients with a new diagnosis of cardiomyopathy prominently feature the use of invasive coronary angiography, and it is considered the gold standard for establishing the diagnosis of cardiomyopathy of coronary artery disease. While myocardial perfusion imaging has some value in this population, there are important limitations in this group such as lower diagnostic accuracy and difficulty in performing stress in some of them. Also, while regional wall motion abnormalities identified by two dimensional echocardiography or radionuclide angiography have been proposed to be specific for coronary artery stenosis induced ischemia and infarction(Budoff et al. 1998), subsequent studies have shown similar abnormalities with dilated cardiomyopathies, not related to coronary artery disease(Andreini et al. 2007). With the use coronary CT angiogram, however, a diagnosis either in favor of or against coronary artery disease can be made fairly easily. Patients with acute congestive heart failure may not be suitable for CCTA immediately because of tachycardia and the need to avoid x-ray contrast. However, once the heart failure is compensated, coronary CTA can be performed and the accuracy in this setting has been established. One study that demonstrated excellent sensitivity (89%) and negative predictive value (99%), suggests that it could be used in patients with a cardiomyopathy to identify the etiology(Garcia et al. 2006). Also, a direct comparison with coronary angiography revealed excellent accuracy of the MDCT in correctly diagnosing the etiology of cardiomyopathy, ischemic or non-ischemic(Andreini et al. 2009). There are obvious advantages to non-invasively ruling in or out coronary artery disease in this group of patients. The ACC/ASNC/AHA consider it appropriate to evaluate for CAD in new onset HF and no prior diagnosis of CAD and reduced LVEF(Taylor et al. 2010).
\n\t\t\tAtrial fibrillation is a common arrhythmia and is associated with significant morbidity. The options available for the treatment of atrial fibrillation, especially in symptomatic individuals, include anti-arrhythmia drug therapy, surgery, and catheter based approaches. The use of radio frequency ablation to isolate the pulmonary veins is a growing therapy for atrial fibrillation and has emerged as an important alternative to conventional treatments. The majority of the atrial fibrillation foci appear to arise around the pulmonary veins and successful pulmonary vein isolation (PVI) can prove to be a permanent cure for atrial fibrillation. Coronary CT angiography is a key diagnostic tool in managing patients being considered for PVI(Cronin et al. 2004). For one, the presence of significant coronary artery disease has implications for adjunctive medical therapy since Vaughan-Williams class 1C drugs such as flecainide are contraindicated in patients with CAD. Coronary CTA can diagnose coronary artery disease in these patients. Essential components for a successful pulmonary vein isolation procedure include accurate anatomical mapping of the pulmonary veins. This is important because the pulmonary vein anatomy is variable, and common ostia and extra pulmonary veins are common. The knowledge of this anatomy is helpful to avoid pulmonary vein stenosis and necessary to avoid missing potential areas contributing to atrial fibrillation(Jongbloed et al. 2005). MDCT provides excellent visualization of the origins of the pulmonary veins, the diameter of the ostia, course of the pulmonary veins, presence of dual ostia and presence of additional supernumary veins(Schwartzman et al. 2003). The distance of the esophagus from the left atrium is also an important parameter that can also easily measured. Another important pre-requisite for the procedure is the absence of a left atrial appendage thrombus, a finding not uncommon in patients with atrial fibrillation. CT angiography allows for excellent visualization of the entire left atrium and the appendage and can be used to identify the presence or absence of a thrombus. Invasive angiography is not ordinarily needed in patients being evaluated for pulmonary vein isolation for treatment of atrial fibrillation; the exception being those with signs of ischemia who may need revascularization as part of the management strategy.
\n\t\t\tThe incidence of coronary anomalies in the general population is about 1%(Yamanaka and Hobbs 1990). A coronary anomaly can be defined as a pattern that is not routinely encountered in the general population. Coronary anomalies account for about 12% of the deaths in U.S high school and college athletes(Van Camp et al. 1995). The American Heart Association’s (AHA) committee on sudden death attributed 19% of the deaths in athletes to coronary anomalies. Invasive coronary angiography is often used to diagnose coronary anomalies and they are routinely found unexpectedly when angiograms are performed for other reason, but ICA has inherent limitations to accurately study coronary anomalies because of its two dimensional display and the non-visualization of adjacent vascular structures. Computed tomography angiography, however, is inherently three dimensional and is ideal for providing extensive information about the spatial anatomy of the coronary artery, including the origin, course, presence of an intra-myocardial path as well as the relationship to the surrounding structures. The sensitivity of the CCTA in diagnosing coronary anomalies is nearly 100%(Kacmaz et al. 2008). Figures 4 and 5 demonstrate the superb display of coronary anomalies by CT angiography. Since many patients in whom the diagnosis of a coronary anomaly are made young, it is important to pay particular attention to keeping the radiation dose low in this group. For example, diagnostic tests to rule out a coronary anomaly are frequently ordered in young athletes who have symptoms. The radiation dose with CCTA is heavily dependent on imaging technique and pristine image quality is not needed for this indication. Thus, lower than standard tube current and tube voltage along with other radiation sparing algorithms should be used for this group of patients. In fact, the origins of the coronary arteries can sometimes be seen quite well with a limited field-of-view, non-contrast CT at a very low radiation dose and such an exam should be considered.
\n\t\t\t\tCT angiogram maximum intensity projection (A), volume rendered (B) and reformatted image (C) from a 55 year old female with chest pain and problems during a coronary angiogram. The right coronary artery arises from the left coronary cusp (arrow) and courses between the aorta and the main pulmonary artery
The conventional treatment of left main coronary artery (LMCA) stenosis is coronary artery bypass graft surgery. However recent advances in percutaneous coronary intervention (PCI) have prompted utilization of stents to treat LMCA stenosis. The rate of angiographic restenosis on follow up studies varies from 22% to 40%(Silvestri et al. 2000; Park et al. 2003), although the use of drug eluting stents (DES) has markedly reduced the incidence of in-stent restenosis. However, because of the potential dire consequences of re-stenosis in the left main coronary artery, surveillance angiography is usually recommended 2-6 months after
\n\t\t\t\tComplex congenital heart disease in a 22-year-old male patient being considered for surgical intervention. The patient previously had a modified Fontan operation for a large ventricular septal defect and transposition of the great arteries. He developed a giant right atrium and very difficult atrial arrhythmia. Oblique maximum intensity projection (A) and volume rendered (B) CT coronary angiogram images also demonstrate anomalous coronary arteries (arrow) arising from the same coronary cusp to the right and posteriorly to the sternum.
intervention to this segment. Several studies have proposed CCTA as an alternative non-invasive modality to assess ISR in this patient group. Blooming artifacts caused by the stent struts are a major hindrance in the accurate CTA evaluation of ISR in other vessels(Mahnken et al. 2004), (Cademartiri et al. 2007). However LMCA stents tend to be large, usually with a diameter greater than 3.5mm. Also the left main segment is less prone to motion artifact on CT than other segments, and evaluation of stents in the LMCA is more accurate with CCTA than in other locations. One study prospectively evaluated the accuracy of stent patency in
\n\t\t\t\tThin MIP oblique projections from a coronary CT angiogram in a patient with a stent in the left main coronary artery (arrow). Although there is suboptimal image quality related to artifact from the metallic struts and coronary calcium in this case, the stent appears to be patent. Coronary CT angiography is considered to be accurate in determining the patency of large stents, which have been placed in the left main coronary artery segment.
the LMCA by CCTA and compared it to conventional coronary angiography and intravascular ultrasound(Van Mieghem et al. 2006). In this study of 70 patients the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of identifying ISR (defined as >50% narrowing) in LMCA stents was 100%, 97%, 98%, 86% and 100% respectively. The accuracy was lower (83%) for LMCA bifurcation stents. Conventional angiography identified 14% of the patients having ISR, which were also identified by CCTA. The 2010 appropriateness use criteria (AUC) consider it appropriate to use CCTA in asymptomatic patients for the assessment of left main coronary stent with a stent diameter greater than 3mm. The accuracy of CCTA in detecting in-stent restenosis depends on the type of stent and the complexity of the lesion and these should be taken into account before considering this modality for evaluating ISR (figure 6). Coronary CT angiography, and even non-contrast gated CT scans, can also be useful as an alternative or adjunct to invasive angiography if there is a question of mal-positioning of a left main stent (figure 7).
\n\t\t\t\tNon-contrast CT of the heart demonstrating a mal-positioned stent in the left main coronary artery (arrow) that extrudes approximately 5 mm into the aorta. Invasive coronary angiography had been planned, but was deferred because of concerns that the stent might become dislodged.
As discussed, coronary CT angiography is less invasive, although has lower resolution than invasive angiography. However, it is inherently three - dimensional and therefore provides diagnostic content which is different from and which can be complementary to the information derived from invasive angiography.
\n\t\t\tChronic total occlusions (CTOs) of coronary arteries are complex lesions present in approximately 30% of patients undergoing coronary angiography(Grantham et al. 2009). CTOs are defined, as lesions present for at least 3 months with grade 0 to 1 Thrombolysis in Myocardial Infraction (TIMI) flow on angiography. CCTA is being increasingly used as a non-invasive modality to accurately define the characteristics of the CTO to assist in the interventional procedure.
\n\t\t\t\tThere are several advantages to performing a CCTA prior to planned revascularization of a CTO. The length of the occluded segment, which is an important predictor of success of revascularization, can be easily obtained(Mollet et al. 2005). The course of the artery, occlusion length, collateral circulation, degree of calcium are important variables that can be obtained by CCTA, all of which assist in planning the procedure that translates into shorter procedure times. Foreshortening of the vessel and limited visualization of the distal vessel in the absence of collateral filling are important shortcomings of invasive coronary angiography, which are easily fixed by CCTA. It can also define bends and angles inside the occluded segment that prove to be extremely helpful to the operator to navigate the wire safely and successfully through the occlusion to the distal vessel. The degree of calcification also has an adverse effect on the success of the procedure. One study showed that the distribution of calcium within the lumen is an independent predictor of failed percutaneous revascularization of CTO(Soon et al. 2007). The ability of CCTA to characterize the distribution of calcium within the lesion is important in predicting the likelihood of PCI success. Cross-sectional calcification, which can only reliably be detected on CCTA, was noted to be more important than the length of calcium deposits in one study(Soon et al. 2007). CCTA information can be utilized to plan the strategy of CTO-PCI. In the evaluation of a CTO, the CT angiogram is able to provide complementary data to that of conventional angiography that may be relevant to the success of the CTO recanalization (figure 8).
\n\t\t\t\tChronic total occlusion (CTO) of the right coronary artery (arrows) is seen with measurements of the occlusion length on MIP images of a coronary CT angiogram. The patient subsequently underwent PCI of the CTO. Knowledge of the occlusion length and the morphology of the occluded segment were felt to have been helpful in planning the interventional procedure.
Many coronary bypass grafts ultimately fail and the standard of care for assessing patients post aorto - coronary bypass has been invasive coronary angiography. Traditionally, this method has been used somewhat liberally, as these patients already have known significant CAD and, in the presence of symptoms, a negative non-invasive functional study may not be completely reassuring. CCTA has been shown to be a useful alternative in evaluating by-pass grafts. The location and patency of grafts can be established with very high accuracy and the conduit can be visualized in a three dimensional fashion(Malagutti et al. 2007). Stenoses in the proximal anastamotic site and the body of vein grafts are accurately displayed with CCTA. However, distal anastomotic sites and especially the coronary artery just beyond the anastomosis are sometimes not easily discerned. Current CT technology is still limited in the presence of significant coronary calcifications and these patients often have heavy coronary calcifications. Metallic clips also sometimes obscure the distal anastomosis site. When patients are being considered for repeat coronary artery bypass surgery, potential injury to patent internal mammary artery bypass grafts can contribute to the hazard of the procedure. Sometimes this injury occurs during the median sternotomy if the bypass graft is adherent to the posterior sternum and inadvertently cut. This occurrence can lead to death or major morbidity. CT angiography can very effectively display the course of bypass grafts relative to the sternum and is considered highly appropriate in this patient population. It is considered to be a useful tool for planning these operations and helpful in avoiding this complication (figure 9).
\n\t\t\t\tModified lateral and axial views of coronary CT angiogram MIP images were obtained in a patient scheduled for repeat coronary bypass surgery. The previously placed left internal mammary artery graft (arrows) is patent and seen to be located immediately posterior and to the right of the midline of the sternum. Based on the results of the examination, the planned approach to the subsequent sternotomy was modified in order to avoid injury to the bypass
Coronary artery aneurysms and ectasia are characterized by an abnormal dilatation of a coronary artery. Morgagni in 1761 first described a coronary artery aneurysm(Falsetti and Carrol 1976). Coronary artery aneurysms are defined as coronary artery segments that have a diameter that exceeds the diameter of normal adjacent coronary segments or the diameter of the patient’s largest coronary vessel by 1.5 times and involves less than 50% of the total length of the vessel(Pahlavan and Niroomand 2006). The various etiologies of aneurysms include coronary atherosclerosis (50%), followed by congenital (17%) and infectious causes (10%)(Pahlavan and Niroomand 2006). The pathogenesis is related to the underlying cause, but a pre-requisite to aneurysm formation is the presence of an abnormal tunica media in the vessel wall that results in enlargement and remodeling of an arterial segment(Diaz-Zamudio et al. 2009). Percutaneous intervention, especially with stents, has also been shown to be a cause for the development of aneurysms(Aoki et al. 2008). The diagnostic approach to coronary aneurysms depends on the clinical scenario, and coronary CT angiography is a useful adjunct to diagnose, evaluate, and follow up these coronary artery abnormalities. Figures 10-12 demonstrate close agreement between invasive assessment and CT angiography in 3 patients with coronary aneurysms and figure 13 demonstrates it in one with a saphenous vein graft pseudoaneurysm. While the natural history of these conditions is not well described and follow up algorithms are not worked out, coronary aneurysms appear to be displayed in accurate detail using CT angiography.
\n\t\t\t\tAneurysmal dilation of the proximal segments of the left anterior descending artery in a male patient who had recurrent coronary emboli. The aneurysmal segment is seen on oblique maximum intensity projection (A) and volume rendered (B) CT angiogram as well as on intravascular ultrasound (C) and right anterior oblique projection invasive coronary angiogram (D). The appearance and diameter of the dilated segment agrees closely on the three modalities.
Huge right coronary artery aneurysm seen on axial view MIP coronary CT angiogram (A) and on invasive coronary angiogram (B).
Coronary CT angiogram MIP (A) and MPR (B) views and invasive coronary angiogram RAO projection showing aneurysmal dilation of the left anterior descending coronary artery.
Saphenous vein bypass graft which developed dissection and contained rupture / pseudoaneurysm post percutaneous intervention. The appearances on CT angiogram by volume rendered image (A), MPR (B), and oblique MIP (C) agreed closely with those on invasive coronary angiogram (D).
CCTA has proven to be an excellent technique to diagnose CAD and is increasingly being used as a first line modality in low risk populations. Several prior diagnostic techniques used in the detection of CAD have proven to provide important prognostic information. CCTA, although a relatively newer imaging technique, has also been shown in recent studies to provide important prognostic information(Ostrom et al. 2008). In a recent report by Gaemperli and colleagues, patients without coronary atherosclerosis on CTA had an excellent prognosis where as the risk for cardiac events increased significantly in the presence of coronary plaques or obstructive lesions. The event rates in the first year were reported to be 34% and 59%, respectively(Gaemperli et al. 2008). There was a strong positive correlation between the extent of coronary atherosclerosis (i.e., the number of segments with coronary plaques) and an adverse cardiac outcome. The presence of three or more coronary plaques was the cut-off providing the highest accuracy to predict future cardiac events. Another study revealed the 1st-year event rate for patients with abnormal coronary arteries to be 30% compared to 0% in patients with normal coronary arteries emphasizing the importance of evaluation of coronary plaque burden(Gaemperli et al. 2008). Recent angiographic and IVUS derived evidence suggests that assessing plaque phenotype is important in detecting vulnerable plaque(Stone et al. 2011). CCTA’s can be used to evaluate the coronary lumen and vessel wall and provide information on obstructive lesions as well as non-stenotic plaques. The burden of atherosclerotic disease determined by CCTA was associated with all-cause mortality among patients with suspected CAD referred for evaluation in an ambulatory setting(Ostrom et al. 2008). CTA demonstrating the presence of luminal obstruction or non- obstructive, non-calcified plaque is a useful noninvasive modality that accurately predicts all-cause mortality with incremental benefit over traditional risk factor assessment and CACS.
\n\t\tIn addition to the above common conditions, there are other, less frequent states when the relatively non-invasive nature of CTA makes it preferable to invasive angiography. For example, occasional patients have very challenging arterial access problems for direct angiography and noninvasively imaging the coronary arteries or bypass graft anatomy might be preferable, even if it would not otherwise be the approach of choice. Also, other patients in whom invasive angiography is risky, such as those with aortic valve endocarditis or heavy aortic atherosclerosis, might also benefit from the less invasive alternative. In these cases, the potential hazard of the invasive procedure is large enough to alter the decision.
\n\t\tCoronary CT angiography is an excellent non-invasive diagnostic modality that can be utilized to study in detail the coronary anatomy. It can sometimes supplant traditional invasive coronary angiography, especially in patients in whom the need for coronary intervention is felt to be unlikely. It’s excellent negative predictive value makes it a useful, less invasive tool for ruling out coronary artery disease in patients who are at the lower risk of the spectrum for the presence of coronary atherosclerosis. The inherently three dimensional nature also makes coronary CT angiography useful for patients with coronary anomalies and in selected patients who have already had coronary angiography, such as those scheduled to undergo repeat coronary bypass surgery intervention for chronic coronary total occlusions, or those with incomplete procedures. While there has been considerable improvement in the temporal and spatial resolution of the CCTA, it is still inferior to invasive coronary angiography in these aspects and direct invasive angiography is usually needed to make detailed revascularization decisions.
\n\t\tEmotions have attracted a greater level of attention as a critical element of public health in the 21st century. In St. Vincent and the Grenadines, the Caribbean and the wider world by extension, displaying emotions by males carries a stigma [1, 2, 3]. Emotions are also regarded as the cornerstones of our social worlds, which affect our interactions with others in varied ways [4]; and as such, this issue has prompted intellectual discussions surrounding the relation between emotions and the male population [5]; a focus that looms high, to the extent that it has become of national interest among health professionals and providers for the last ten years in St. Vincent and the Grenadines (SVG).
\nIn part, this hype can arguably be associated with the SVG Education Revolution of 2003, which – under the motto “no one left behind” – has opened countless opportunities for the general population to move on academically in every level of the educational system [6]. The influx of students to secondary schools on one hand, and the radical increase of the number of adults in quest of tertiary level studies on the other, unearthed troubling psychologically and emotionally generated behavioral problems to which both genders succumbed [7, 8]. It also surfaced the demand for counselors, career guidance officers, and psychologists, who were called to aid the breakdown of the gender barriers in the expression of feelings among the male population that existed in the Vincentian society for many years and put emotional issues on the front burner.
\nGeneral social observation in SGV has shown that males who have come to grips with their emotions and are willing to live a life that projects a more liberal way of behaving tend to excel academically, while being less likely to become troublemakers and less prone to having criminal intent. Nowadays, numerous young males have been incarcerated, are abandoning school, have taken to the hills to farm illegal marijuana plants, are seeking comfort in alcoholic beverages, are becoming abusive to their female counterparts, or are admitted to the mental health hospital due to emotional and psychological pressures [9, 10]. This is an escalating occurrence among the male population, while their counterparts (females) are far more willing to show their emotions and are thus, less susceptible to those troubling devices [11, 12, 13].This is particularly true among males incarcerated in SGV Her Majesty’s Prison, who would immediately take on the look of a “seasoned” criminal exhibit little or no remorse in deep contrast to the general empathy.
\nThis backdrop heightens the need for one’s exploration of men’s attitude towards their emotion. There has been a rationale for the choice of these incarcerated males, who “do” masculinity either as a survival technique and an adaptation to imprisonment [14, 15, 16, 17] or as an emotional response to interpersonal rejection [18, 19]. As in other countries, already captured male populations are often regarded as one of the most vulnerable groups in the Vincentian population [20, 21, 22]. This research springs from the co-opt preamble and delves into the stereotypical and tabooed issue of males and their emotions in the Vincentian setting. The present research endeavors to offer an understanding of the general male ethos where their emotions are concerned. It examines the issue from the perspectives of males who are confined or incarcerated seeking seeks to explore aspects related to the general issue of masculinity and emotions, namely: (a) emotions and abuse, (b) crying in relation to emotions (c) family and friends in relation to emotions and (d) suicidal thoughts and emotions.The main objective of this study is to analyze various factors that are associated with emotional and psychological issues relating to males at the correctional institution in St. Vincent and the Grenadines. More specifically, it sought to analyze the emotions males are encountering and ascertain the factors that lead to the emotions that males struggle with. As a means to achieve this, we firstly aimed at identifying emotional issues inmates are uncomfortable to talk about, and finding out levels of family impact on males’ lives in order to determine the coping strategies that have been used by inmates to deal with their emotional issues.
\nThis article intents to weave ideas in relation to the emotive reactions of incarcerated males at the Saint Vincent and the Grenadines Correctional Institution. The methodological tools utilized for data collection in this mixed-method study were mainly quantitative (questionnaires) combined with field observations. The particular method was not chosen randomly. Quantitative methodologies allow researchers to evaluate within a more controlled context [23]. The questionnaire covered demographics such as age, type of crime, recidivism, and religion [perceived as an emotion regulator [24]], as well as elements and associated factors aligned with the stated hypotheses that highlight males’ emotions and their behaviors. Finally, along with the collected quantitative data, observation was done based on a two-year pro bono service that the researcher carried out at the facilities and during the sample collection period, and anecdotes were noted.This research sought to generate measurable and testable data based on the aims and objectives, acting as a road map for the study, guiding the researcher to predetermined destinations, and thus gradually adding to the accumulation of human knowledge.
\nTo create a finite structure in line with the aims of the present research mentioned earlier, 4 hypotheses were created and embedded in the questionnaire. The hypotheses were:
Male inmates are struggling to deal with their emotions due to past abuse.
Male inmates who refrain from crying feel uncomfortable to talk about their emotional issues.
\nFamily can positively impact the lives of male inmates.
Male inmates have suicidal thoughts irrespective of any disparity between positive and negative emotions.
Her Majesty’s Prisons (Kingstown and Belle Isle) is the lone correctional institution in St. Vincent and the Grenadines build in 1872. Colonial in nature, the main structure is situated in the heart of Kingstown, in close proximity to the back of the building that houses the House of Assembly and the High Court. In the same premises, there is a library/classroom and a Chapel that has been converted into living quarters. The total population of the Kingston prison facility in December 17, 2018 stood at 472, accommodating mainly those who are on remand and few already sentenced.
\nThe Belle Isle Correctional Facility became operational in April 2012, when some 226 prisoners were transferred there from the Kingstown holding. This institution is built to house 288 inmates, but it is still under construction. It is home to less than 50% of the present total inmates and mainly houses those already been sentenced. It is a modern prison with a conference room, classrooms, and recreation room offering a variety of programmes which incorporate major activities such as art, anger restrain training, tailoring, culinary art, music, agriculture, and welding skills training. Most of these programmes are facilitated by community members, persons who are not particularly affiliated to the institution. The institution also boasts of a small soccer team which occasionally engages with community teams.
\nInmates in both institutions are classified in three categories: Unit A Under 21 years, Unit B First Offenders and Unit C Repeat Offenders. There is a rigid timetable and activities are tailored – breakfast is at 6:30 am; devotion at 8:15 am; lunch is at 11:30 am, recreational activities at 1:00 pm, and total lock down at 5:00 pm. As pertaining to the emotional aspects of inmates, they are served in a professional manner by a psychologist, a counselor, and a welfare officer. Accessible to the institution is also the Mental Health Hospital, which provides contracted consultants and a qualified counselor who visit the institutions once a week to meet with a pre-arranged clientele1.
\nThe inmates at Her Majesty’s Correctional Facilities in Kingstown and Belle Isle served as the sample for the study. An attempt was made in having the entire prison population involved in the data collection process skipping any randomization process; nonetheless, internal developments within the institution itself forced a reversal. Based on the feedback received by the prison administrators, there was always the fear that the support would not be there to complete all 428 inmates at the time. Indeed, half-way through, unforeseen factors, continuous postponements, and resource constrains made it impossible for the prison administration to facilitate my request for the entire prison population to be approached. Unfortunately, there were 7 blocks that were not given the opportunity participate in the research. However, the remaining 3 blocks were randomly selected drawn from an alphabetical labelling system. The stratified randomized sampling (proportional or quota sampling) strategy was adopted. This method of sampling divided the population into strata, and then samples from each stratum were randomly selected. The total number of 150 participants constituted our sample that was collected during the period March–July 2019.Assuming that the entire population could not be reached, this method also allowed for a randomized sampling of the respondents containing minimal systematic bias and therefore being relatively representative of the male population in SVG [25].
\nThe questionnaire was structured in two parts – (I) demographic data and (II) conceptual questions. The latter part was designed to focus on the hypotheses each of which consisted of four questions.
\nSocio-demographic: These questions included continuous variables like age (starting at age 18); length of current sentence (starting at less than 1 year); and recidivism (starting at 1 time, as well as categorical variables such as original household (coded with Nuclear – Single Parent – Extended – Reconstituted – and Sibling); religion (Christian – Muslim – Hindu – Other); and person being closest to (Mother – Father – Sibling – Friend – Nobody). In addition, the variable of type of criminal activity was treated as an open-ended question.
Abuse: Six binary abuse variables were constructed; two for each type of trauma: physical, sexual, and emotional. Dealing with negative emotions was measured by pre-determined categories (namely, “Blame others”, “Blame yourself/Self-hate”, “Avoiding what is happening by drinking, smoking”, and “Withdrawing from others”). Feeling comfortable to talk to other males in prison about emotional issues was constructed from the following experiences: “Most males here share the same struggles”, “We are all on the same level”, “As males we are not as tough and aggressive as we often show”, “There is a greater sense of bonding”, and “There are less chances of being labelled a homosexual”. Inmates were also asked to name whether mental health, relationships, sexual issues, money matters, and/or depression currently affect them the most.
Crying: Crying data, as a means of emotions’ expression, were collected from two types of questions; one focusing on sharing emotional issues and the other on reasons that prevent you from doing so. The frequency of crying was measured on a 1 to 5 Likert scale (with 1 being Never and 5 Always). The reasons that may discourage male prisoners to share their emotions varied from confidentiality and lack of trust to and feelings of embarrassment and people being too judgemental. The response options for males’ thoughts before talking about their emotions were: “Males are not supposed to talk about their emotions”, “Avoidance of acting like a woman”, “Males more focus on toughness and aggression”, “Self-reliance (a man is independent)”, and “Afraid of being labelled a homosexual”.
(Family) bonds: Two close-ended questions dealt with who do male prisoners trust the most and who (in their family) helped them with the emotional issues, when there were such. For both questions, the possible responses were included their mother, their father, their sibling(s), and other (being their uncle/aunt, girlfriend etc). The difficultness of talking about emotions to someone was measured from a 1–5 Likert scale with 1 being Very difficult and 5 being Very Easy. Dealing with their emotions, prisoners chose among the possible answers of “Pray”, “Seek counseling”, “Exercise/sport”, and “Use substances/alcohol”.
Suicidal thoughts: The suicidal thoughts data were collected from two question types: one with regard to the frequency of such thoughts and the other focusing on the “gap” between positive and negative emotions experienced by the male inmates. The frequency was calculated with a Likert scale, with 1 being Very difficult, 2 being Difficult, 3 being Neither difficult nor easy, 4 being Easy, and 5 being Very easy. The same scale was also used for the variable/question “How often do you visit a medical doctor?”. Both positive and negative emotions were also measured on a similar Likert scale (1 = Never, 2 = Almost never, 3 = Sometimes, 4 = Almost Always, and 5 = Always).
Permission from the prisons’ authorities was necessary. This process took months to complete and initially, it created many doubts that the prison officials would want to grant such access to conduct the research. Having received permission from the Superintendent of Prisons, a pilot study was carried out few months before the actual administration of the questionnaire. This preliminary study served as a means of refining the final instrument to be used for the survey testing its reliability and validity. The piloting stage also helped in identifying some of the problems that loomed on the horizon, namely the lack of cooperation from some prison officials and the full conceptualization of the content of the questionnaires by some prisoners. Applying the abovementioned sampling techniques, the questionnaires were distributed and collected personally by the researcher on the same day. Amidst many constraints, the collection process initially began to look fruitful. However, there were days visiting the institution realizing that only ten (or no) questionnaires had been completed amidst excuses of being short of staff or that too many other activities are taking place at the same time. Having completed 150 questionnaires after months visiting the institution it was obvious that completing the entire population was an impossible task; and having started collecting the data with that notion in mind, the data collection was ended.
\nThe statistical software SPSS (v.25) was used for all data analysis. In terms of methodology, I used multiple correspondence and regression analyses in order to describe the pattern of relationship between (categorical and binary) variables. Such analyses were meaningful given that a prior measurement of internal consistency (see\n2\nTable 1) provided an overall high-enough3reliability coefficient (α = .812). Multinomial logistic regressions and tests to assess the associated factors with our dependent variables were also run. These were feasible because, despite the relatively small sample (150), the assumptions about the scale of the variables, their linear – parametric (Pearson’s) and non-parametric (Spearman’s rho and Kendall’s tau-b) – correlations, and homogeneous, normal errors were reasonable. Generally, any related difficulty to discern or recognize possible relevant deviations from assumptions with small samples did not invalidate the test, which remained valid under these assumptions.
\nCronbach’s Alpha (α) | \nN of Items | \n
---|---|
.812 | \n41 | \n
Reliability statistics.
The sample of the present study consisted of 150 male inmates whose age varied from 18 to over 56 years old. Slightly more than half (n = 78, 51.9%) of the participants were 26–40 years old while only 6% of the sample (n = 9) where younger than 20 years old. Nineteen (13%) prisoners were either 21–25 or 41–45 years old and 24 (16%) were over 46 years old (Figure 1). Looking at the type of offense that resulted into their incarceration, the most popular crime was burglary/robbery/theft (n = 36, 24%) closely followed by rape (n = 33, 22%) and (attempted) murder / manslaughter (n = 29, 19.3%). A relatively common offense was assault and cause of physical damage committed by 22 males (14.7%). Other types of offense driving unlicensed car, damage of property, and issues related to child maintenance (n = 17, 11.3%) (Figure 2).
\nBar count of age.
Bar count of type of offense.
Regarding their religious affiliation, the vast majority of the sample (n = 132, 88%), considered themselves to be Christian, followed by those who had no religion (n = 11, 7.3%). Only 3 (2%) males identified themselves as non-Christian, two being Muslim and one in self-search. The length of the sentence they were already given followed the same pattern. 99 inmates (66%) were sentenced with up to 3 years of imprisonment and only 13 (8.7%) were serving sentences longer than 9 years (Figure 3). As far as recidivism is concerned, nearly 40% of the males (n = 57, 38%) admitted that they were incarcerated for the first time and almost all the remaining (n = 81, 54%) had been previously imprisoned 2–5 times (Figure 4).
\nPie chart count of length of current sentence.
Bar count of times of being in prison.
Focusing on the family background of the prisoners, almost 1/3 of them (n = 51, 34%) were coming from single-parent families, while most of the remaining respondents had grown up in either extended (n = 38, 25.3%) or nuclear (n = 22.7%) family environments. The few remaining males were raised either by their sibling(s) (n = 10, 6.7%) or by a guardian, girlfriend or foster parent (n = 6, 4%). Those results matched the males’ responses pertaining to who is being closest to them. Slightly more than half of the participants were feeling their mother as being closest to them (n = 77, 51.3%) whereas only 7 inmates (4.7%) had the same feelings for their father. Almost 10% of the sample (n = 14) expressed their loneliness replying that there is nobody who is emotionally close to them. Other people identified by the inmates as being the closest to them were their (girl)friends, grandparents, guardians or their therapists (Figure 5).
\nPopulation pyramid count person being closest to by original household.
Hypothesis 1 (confirmed): Male inmates are struggling to deal with their emotions due to past abuse.
\nInitially, looking at the abuse patterns among the incarcerated males, almost 79.3%4 (n = 119) males admitted of having at least one experience of physical, emotional, and/or sexual abuse in the past. Among those inmates, 15 (10%) also had strong feelings of abandonment and neglect. More specifically, the majority (n = 81, 54%) of males had suffered an emotional abuse in the past, followed by those who were physically (n = 70, 46.7%) or sexually (n = 46, 30.7%) traumatized. Therefore, it was not a coincidence that the participants were predominantly facing sexual or relationship issues (58.7%, n = 88), while 33 of them (22%) were having depression and other mental health problems. Taking into consideration that almost all males (n = 148, 98.7%) were facing negative emotions, in their effort to deal with them, prisoners gave a wide range of responses. The most common way used to deal with their negative emotions was to withdraw from others and seek isolation (n = 101, 67.3%) or try to avoid what is happening by drinking and smoking (n = 82, 54.7%). The second most popular way males used to face their emotional issues was through blaming either themselves (n = 70, 46.7%) or others (n = 38, 25.3%). Only 1 inmate (0.7%) expressed a positive way in dealing with his problems, which was through religion, and more specifically, by talking to Jesus.
\nFocusing on the openness and willingness of prisoners to express their emotional issues with others, the vast majority of them were feeling comfortable doing so, but only with their fellow inmates. The main reason was that males in prison share the same emotional struggles (n = 71, 47.3%), and because they are not as tough and aggressive as they often show (n = 86, 57.3%). In fact, males thought that prison creates a great sense of bonding (n = 59, 39.3%), being all on the same (prison) level (n = 69, 46%). Almost 1/3 of respondents also highlighted that having less chances of being labeled a homosexual (n = 54, 36%) makes it easier for them to talk about their emotions.
\nBased on both parametric and non-parametric correlations, the type of abuse that most participants had suffered was found overall to be significantly correlated with the way they were currently dealing with their negative emotions (p = .000) and whether or not these males were feeling comfortable to talk about their emotional issues to others (p = .000). Looking deeper at those relationships, participants who were struggling to deal with their negative emotions were 9.7 times more likely to blame others (p = .009) and 5.8 times to blame themselves (p = .004) than the minority of prisoners who were not facing any negative emotions. Marginally significant was also the correlation between abuse and avoidance (p = .043), where previously abused inmates were almost 3 times more likely to avoid facing the negative consequences of past experiences than their non-abused counterparts (see\nTable 2).
\nHave you ever been abused?\na\n\n | \nB | \nStd. Error | \nWald | \ndf | \nSig. | \nExp(B) | \n95% Confidence Interval for Exp(B) | \n|||
---|---|---|---|---|---|---|---|---|---|---|
Lower Bound | \nUpper Bound | \n|||||||||
Yes | \nFacing negative emotions | \n−.709 | \n1.635 | \n.188 | \n1 | \n.665 | \n.492 | \n.020 | \n12.128 | \n|
Dealing with negative emotions (ref. cat. is “No”) | \n\n | |||||||||
Blaming others | \n2.281 | \n.873 | \n6.825 | \n1 | \n.009 | \n9.790 | \n1.768 | \n54.216 | \n||
Blaming yourself | \n1.768 | \n.622 | \n8.071 | \n1 | \n.004 | \n5.859 | \n1.730 | \n19.839 | \n||
Avoiding what is happening | \n1.097 | \n.542 | \n4.093 | \n1 | \n.043 | \n2.995 | \n1.035 | \n8.667 | \n||
Withdrawing from others | \n.397 | \n.583 | \n.464 | \n1 | \n.496 | \n1.488 | \n.475 | \n4.664 | \n||
Talking to Jesus | \n16.088 | \n2590.495 | \n.000 | \n1 | \n.995 | \n9700534.344 | \n.000 | \n.\nb\n\n | \n||
Feeling comfortable talking to other males about emotional issues (ref. cat. is “No”) | \n\n | |||||||||
Most males here share the same emotional struggles like you | \n30.753 | \n3013.793 | \n.000 | \n1 | \n.992 | \n22697154630045.258 | \n.000 | \n.\nb\n\n | \n||
You’re all at the same level (in prison) | \n−.519 | \n.591 | \n.771 | \n1 | \n.380 | \n.595 | \n.187 | \n1.895 | \n||
Males are not as tough and aggressive as they often show they are | \n−.147 | \n.541 | \n.074 | \n1 | \n.785 | \n.863 | \n.299 | \n2.492 | \n||
There is a greater sense of bonding when you share your emotions | \n−1.106 | \n.590 | \n3.512 | \n1 | \n.061 | \n.331 | \n.104 | \n1.052 | \n||
There are less chances of being labeled a homosexual if you share your emotions | \n1.202 | \n.629 | \n3.647 | \n1 | \n.056 | \n3.327 | \n.969 | \n11.427 | \n||
“Soft spot” | \n0\nc\n\n | \n. | \n. | \n0 | \n. | \n. | \n. | \n. | \n
Parameter estimates.
The reference category is: No.
Floating point overflow occurred while computing this statistic. Its value is therefore set to system missing.
This parameter is set to zero because it is redundant.
Hypothesis 2 (partially confirmed): Male inmates who refrain from crying feel uncomfortable to talk about their emotional issues.
\nHow often do you cry? 1/3 of the prisoners responded that they (almost) never cry (n = 52, 34.4%), while almost half of the sample were doing so occasionally (n = 69, 46%). Only 3 males (2%) admitted of crying on a regular basis as a way of venting off their negative emotions (before their incarceration). Once again, these figures were not surprising as the largest segment of the respondents believed that males are not supposed to show or talk about their emotions (n = 98, 65.3%), as an avoidance of acting like a woman and being labeled a homosexual (n = 94, 62.7%). On the contrary, males should be self-reliant/independent (n = 74, 49.3%) and focused on toughness and aggression (n = 89, 59.3%).
\nDigging into the reasons why males refrain from sharing their emotions, the main issue that emerged was that of confidentiality and lack of trust (n = 125, 83.3%). Other, equally important issues were about persons being too judgemental (n = 88, 58.7%), and their subsequent feelings of embarrassment (n = 81, 54%). At the same time, the performance of multinomial regressions showed partial correlations between our dependent and independent variables. More specifically, inmates who were radically refraining from crying were more likely to avoid talking about their emotion issues to others believing that males should be more focussed on toughness and aggression than those prisoners who admitted of crying frequently (p = .027). In the same vein, both groups of participants who were almost never (p = .032) or occasionally (p = .020) expressing their emotions through crying were 3 times more likely not to do so for the same reasons of toughness and aggression as expressed by those who were never crying. An additional reason shared by the males who were almost never or almost always crying for not feeling comfortable to talk about their emotions (either to fellow inmates or to individuals outside of prison) was related to inner fears of being labeled as a homosexual (p = .032) or even perceived as acting like a woman (p = .020) (see\nTable 3).
\nHow often do you cry?\na\n\n | \nB | \nStd. Error | \nWald | \ndf | \nSig. | \nExp(B) | \n95% Confidence Interval for Exp(B) | \n|||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lower Bound | \nUpper Bound | \n|||||||||||
Never | \nThinking about certain things before talking about emotions (Ref. cat is “No”) | \n\n | ||||||||||
Males are not supposed to show or talk about their emotions | \n−.023 | \n1.394 | \n.000 | \n1 | \n.987 | \n.977 | \n.064 | \n15.014 | \n||||
Avoidance of not acting like a woman | \n−3.863 | \n2.287 | \n2.852 | \n1 | \n.091 | \n.021 | \n.000 | \n1.860 | \n||||
Males are more focused on toughness and aggression | \n−3.927 | \n1.770 | \n4.921 | \n1 | \n.027 | \n.020 | \n.001 | \n.633 | \n||||
Self-reliance (a man is independent) | \n−.191 | \n1.457 | \n.017 | \n1 | \n.895 | \n.826 | \n.048 | \n14.352 | \n||||
Afraid of being labeled as a homosexual | \n2.937 | \n1.750 | \n2.817 | \n1 | \n.093 | \n18.863 | \n.611 | \n582.486 | \n||||
Prefer being alone | \n.534 | \n35.730 | \n.000 | \n1 | \n.988 | \n1.705 | \n6.580E-31 | \n4419769202310835500000000000000.000 | \n||||
Almost never | \nThinking about certain things before talking about emotions (Ref. cat is “No”) | \n\n | ||||||||||
Males are not supposed to show or talk about their emotions | \n2.052 | \n.973 | \n4.447 | \n1 | \n.035 | \n7.780 | \n1.156 | \n52.368 | \n||||
Avoidance of not acting like a woman | \n−2.603 | \n1.122 | \n5.381 | \n1 | \n.020 | \n.074 | \n.008 | \n.668 | \n||||
Males are more focused on toughness and aggression | \n−2.914 | \n1.361 | \n4.583 | \n1 | \n.032 | \n.054 | \n.004 | \n.782 | \n||||
Self-reliance (a man is independent) | \n.078 | \n.949 | \n.007 | \n1 | \n.935 | \n1.081 | \n.168 | \n6.942 | \n||||
Afraid of being labeled as a homosexual | \n2.420 | \n1.349 | \n3.218 | \n1 | \n.073 | \n11.251 | \n.799 | \n158.362 | \n||||
Prefer being alone | \n3.267 | \n29.681 | \n.012 | \n1 | \n.912 | \n26.244 | \n1.427E-24 | \n482708551918159960000000000.000 | \n||||
Sometimes | \nThinking about certain things before talking about emotions (Ref. cat is “No”) | \n\n | ||||||||||
Males are not supposed to show or talk about their emotions | \n1.004 | \n.930 | \n1.166 | \n1 | \n.280 | \n2.728 | \n.441 | \n16.870 | \n||||
Avoidance of not acting like a woman | \n−1.979 | \n1.071 | \n3.416 | \n1 | \n.065 | \n.138 | \n.017 | \n1.127 | \n||||
Males are more focused on toughness and aggression | \n−3.100 | \n1.334 | \n5.405 | \n1 | \n.020 | \n.045 | \n.003 | \n.615 | \n||||
\n | \nSelf-reliance (a man is independent) | \n−.518 | \n.912 | \n.322 | \n1 | \n.570 | \n.596 | \n.100 | \n3.559 | \n|||
Afraid of being labeled as a homosexual | \n2.118 | \n1.330 | \n2.535 | \n1 | \n.111 | \n8.316 | \n.613 | \n112.800 | \n||||
Prefer being alone | \n−.802 | \n29.545 | \n.001 | \n1 | \n.978 | \n.448 | \n3.182E-26 | \n6320155164565928000000000.000 | \n||||
Almost always | \nThinking about certain things before talking about emotions (Ref. cat is “No”) | \n\n | ||||||||||
Males are not supposed to show or talk about their emotions | \n1.977 | \n1.087 | \n3.309 | \n1 | \n.069 | \n7.223 | \n.858 | \n60.817 | \n||||
Avoidance of not acting like a woman | \n−2.045 | \n1.191 | \n2.951 | \n1 | \n.086 | \n.129 | \n.013 | \n1.334 | \n||||
Males are more focused on toughness and aggression | \n−2.431 | \n1.430 | \n2.891 | \n1 | \n.089 | \n.088 | \n.005 | \n1.450 | \n||||
Self-reliance (a man is independent) | \n−.051 | \n1.022 | \n.003 | \n1 | \n.960 | \n.950 | \n.128 | \n7.033 | \n||||
Afraid of being labeled as a homosexual | \n3.014 | \n1.402 | \n4.624 | \n1 | \n.032 | \n20.367 | \n1.306 | \n317.669 | \n||||
Prefer being alone | \n2.374 | \n30.906 | \n.006 | \n1 | \n.939 | \n10.735 | \n5.287E-26 | \n2179683110155908300000000000.000 | \n
Parameter estimates.
The reference category is: Always.
This parameter is set to zero because it is redundant.
Floating point overflow occurred while computing this statistic. Its value is therefore set to system missing.
Hypothesis 3 (not confirmed): Family can positively impact the lives of male inmates.
\nExploring the impact of family on male prisoners, the participants were initially asked to identify who they trust the most. More than half of the sample responded their mother (n = 77, 51.3%). The second most common reply was “nobody” (n = 23, 15.3%), while the remaining responds were mainly scattered among their girlfriend (n = 5, 3.3%), their friends (n = 12, 8%), and eventually their father (n = 9, 6%). In continue, males were asked to mention who has helped them to deal with their emotional problems. Their replies followed to same trend. Again, 34% (n = 51) acknowledged that their mother had done so, but almost 50% of the sample (n = 65) now mentioned that nobody has ever assisted them with their emotional issues.
\nBefore sent to prison or at the beginning of their current sentence, all males operated various ways to deal with their emotions. Few of them (n = 2, 1.4%) were signing and reading, while the majority (n = 81, 54%) sought help from God through praying, and others from psychologists though counseling (n = 65, 43.3%). 66 people (44%) also found exercising or playing a sport helpful in dealing with emotions, while a good number of them (n = 58, 38.7%) used to smoke, drink, and use drugs. Overall, males found it (very) difficult to talk about their emotions (n = 90, 60%) and just 19 (12.7%) of them thought it was (very) easy.
\nLooking at the possible impact of other people on the inmates’ incapacity or unwillingness to share their emotions, no statistical significant correlation was given; hence, hypothesis 3 was not confirmed. As Table 4 shows below, neither family (both nuclear and extended) nor other members from prisoners’ social environment [eg. (girl)friends, therapist] seemed to influence, positively or negatively, the obstacles that males were facing in talking about their emotions to someone (average p = .913). Similarly, it was found that talking about emotions to other people was an insignificantly correlated factor in dealing with emotional issues (average p = .992).
\nTalking about emotions is…\na\n\n | \nB | \nStd. Error | \nWald | \ndf | \nSig. | \nExp(B) | \n95% Confidence Interval for Exp(B) | \n||
---|---|---|---|---|---|---|---|---|---|
Lower Bound | \nUpper Bound | \n||||||||
Very difficult | \nTrusting the most | \n\n | |||||||
Mother | \n−1.135 | \n10.356 | \n.012 | \n1 | \n.913 | \n.321 | \n4.922E-10 | \n209873396.257 | \n|
Father | \n−4.469 | \n10.466 | \n.182 | \n1 | \n.669 | \n.011 | \n1.414E-11 | \n9290209.914 | \n|
Friend(s) | \n−3.415 | \n10.396 | \n.108 | \n1 | \n.743 | \n.033 | \n4.653E-11 | \n23214069.590 | \n|
Girlfriend | \n3.211 | \n14.702 | \n.048 | \n1 | \n.827 | \n24.809 | \n7.589E-12 | \n81099178338468.190 | \n|
Wife | \n−4.942 | \n36.888 | \n.018 | \n1 | \n.893 | \n.007 | \n2.852E-34 | \n178885359362352800000000000000.000 | \n|
Cousin | \n8.241 | \n681.515 | \n.000 | \n1 | \n.990 | \n3794.900 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n−2.112 | \n10.398 | \n.041 | \n1 | \n.839 | \n.121 | \n1.707E-10 | \n85741671.419 | \n|
Grandmother | \n−2.561 | \n20.299 | \n.016 | \n1 | \n.900 | \n.077 | \n4.070E-19 | \n14663068979522668.000 | \n|
Therapist | \n−3.229 | \n36.897 | \n.008 | \n1 | \n.930 | \n.040 | \n1.553E-33 | \n1009363927852481700000000000000.000 | \n|
Aunt | \n4.003 | \n34.116 | \n.014 | \n1 | \n.907 | \n54.769 | \n4.997E-28 | \n6002842730305803000000000000000.000 | \n|
Guardian | \n3.198 | \n681.659 | \n.000 | \n1 | \n.996 | \n24.472 | \n.000 | \n.\nc\n\n | \n|
Helped you to deal with emotional issues | \n\n | ||||||||
Mother | \n4.557 | \n680.661 | \n.000 | \n1 | \n.995 | \n95.300 | \n.000 | \n.\nc\n\n | \n|
Father | \n1.904 | \n680.678 | \n.000 | \n1 | \n.998 | \n6.712 | \n.000 | \n.\nc\n\n | \n|
Sibling | \n2.219 | \n680.660 | \n.000 | \n1 | \n.997 | \n9.198 | \n.000 | \n.\nc\n\n | \n|
Esteemed person | \n.000 | \n681.576 | \n.000 | \n1 | \n1.000 | \n1.000 | \n.000 | \n.\nc\n\n | \n|
Girlfriend | \n5.513 | \n680.696 | \n.000 | \n1 | \n.994 | \n247.774 | \n.000 | \n.\nc\n\n | \n|
Wife | \n1.726 | \n680.964 | \n.000 | \n1 | \n.998 | \n5.618 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n6.202 | \n680.662 | \n.000 | \n1 | \n.993 | \n493.888 | \n.000 | \n.\nc\n\n | \n|
Difficult | \nTrusting the most | \n\n | |||||||
Mother | \n−.318 | \n10.328 | \n.001 | \n1 | \n.975 | \n.727 | \n1.177E-9 | \n449658085.645 | \n|
Father | \n−5.436 | \n10.464 | \n.270 | \n1 | \n.603 | \n.004 | \n5.393E-12 | \n3518236.928 | \n|
\n | \nFriend(s) | \n−1.408 | \n10.345 | \n.019 | \n1 | \n.892 | \n.245 | \n3.829E-10 | \n156250805.677 | \n
Girlfriend | \n−1.939 | \n14.887 | \n.017 | \n1 | \n.896 | \n.144 | \n3.065E-14 | \n674902371395.648 | \n|
Wife | \n−3.523 | \n35.657 | \n.010 | \n1 | \n.921 | \n.030 | \n1.315E-32 | \n66240196900202480000000000000.000 | \n|
Cousin | \n1.385 | \n657.098 | \n.000 | \n1 | \n.998 | \n3.994 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n−1.391 | \n10.364 | \n.018 | \n1 | \n.893 | \n.249 | \n3.751E-10 | \n165189695.174 | \n|
Grandmother | \n1.352 | \n19.093 | \n.005 | \n1 | \n.944 | \n3.867 | \n2.165E-16 | \n69078467018115992.000 | \n|
Therapist | \n−3.444 | \n35.663 | \n.009 | \n1 | \n.923 | \n.032 | \n1.405E-32 | \n72589450383962740000000000000.000 | \n|
Aunt | \n−1.366 | \n35.655 | \n.001 | \n1 | \n.969 | \n.255 | \n1.142E-31 | \n570455239289069950000000000000.000 | \n|
Guardian | \n2.592 | \n657.098 | \n.000 | \n1 | \n.997 | \n13.356 | \n.000 | \n.\nc\n\n | \n|
Helped you to deal with emotional issues | \n\n | ||||||||
Mother | \n3.443 | \n656.131 | \n.000 | \n1 | \n.996 | \n31.285 | \n.000 | \n.\nc\n\n | \n|
Father | \n4.196 | \n656.134 | \n.000 | \n1 | \n.995 | \n66.434 | \n.000 | \n.\nc\n\n | \n|
Sibling | \n2.190 | \n656.129 | \n.000 | \n1 | \n.997 | \n8.934 | \n.000 | \n.\nc\n\n | \n|
Esteemed person | \n.000 | \n657.012 | \n.000 | \n1 | \n1.000 | \n1.000 | \n.000 | \n.\nc\n\n | \n|
Girlfriend | \n6.558 | \n656.160 | \n.000 | \n1 | \n.992 | \n704.854 | \n.000 | \n.\nc\n\n | \n|
Wife | \n8.615 | \n656.414 | \n.000 | \n1 | \n.990 | \n5515.374 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n4.829 | \n656.131 | \n.000 | \n1 | \n.994 | \n125.096 | \n.000 | \n.\nc\n\n | \n|
Neither difficult nor easy | \nTrusting the most | \n\n | |||||||
Mother | \n2.686 | \n11.165 | \n.058 | \n1 | \n.810 | \n14.674 | \n4.603E-9 | \n46776121177.218 | \n|
Father | \n−1.399 | \n11.303 | \n.015 | \n1 | \n.902 | \n.247 | \n5.909E-11 | \n1031766470.631 | \n|
Friend(s) | \n.521 | \n11.194 | \n.002 | \n1 | \n.963 | \n1.684 | \n4.985E-10 | \n5687802612.665 | \n|
Girlfriend | \n.305 | \n15.712 | \n.000 | \n1 | \n.985 | \n1.356 | \n5.732E-14 | \n32086520315331.360 | \n|
Wife | \n4.894 | \n34.371 | \n.020 | \n1 | \n.887 | \n133.447 | \n7.384E-28 | \n24116473984118280000000000000000.000 | \n|
\n | \nCousin | \n5.741 | \n681.672 | \n.000 | \n1 | \n.993 | \n311.483 | \n.000 | \n.\nc\n\n | \n
Nobody | \n.685 | \n11.216 | \n.004 | \n1 | \n.951 | \n1.985 | \n5.631E-10 | \n6993814976.199 | \n|
Grandmother | \n1.098 | \n20.725 | \n.003 | \n1 | \n.958 | \n2.998 | \n6.845E-18 | \n1313386892053417730.000 | \n|
Therapist | \n5.181 | \n34.381 | \n.023 | \n1 | \n.880 | \n177.844 | \n9.654E-28 | \n32762855332909110000000000000000.000 | \n|
Aunt | \n1.729 | \n37.123 | \n.002 | \n1 | \n.963 | \n5.636 | \n1.419E-31 | \n223899845021578750000000000000000.000 | \n|
Guardian | \n11.587 | \n681.528 | \n.000 | \n1 | \n.986 | \n107636.035 | \n.000 | \n.\nc\n\n | \n|
Helped you to deal with emotional issues | \n\n | ||||||||
Mother | \n4.933 | \n680.661 | \n.000 | \n1 | \n.994 | \n138.858 | \n.000 | \n.\nc\n\n | \n|
Father | \n2.931 | \n680.673 | \n.000 | \n1 | \n.997 | \n18.754 | \n.000 | \n.\nc\n\n | \n|
Sibling | \n3.332 | \n680.660 | \n.000 | \n1 | \n.996 | \n28.005 | \n.000 | \n.\nc\n\n | \n|
Esteemed person | \n5.268 | \n681.432 | \n.000 | \n1 | \n.994 | \n194.075 | \n.000 | \n.\nc\n\n | \n|
Girlfriend | \n9.052 | \n680.690 | \n.000 | \n1 | \n.989 | \n8533.501 | \n.000 | \n.\nc\n\n | \n|
Wife | \n7.253 | \n680.974 | \n.000 | \n1 | \n.992 | \n1412.559 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n5.829 | \n680.662 | \n.000 | \n1 | \n.993 | \n339.912 | \n.000 | \n.\nc\n\n | \n|
Easy | \nTrusting the most | \n\n | |||||||
Mother | \n2.066 | \n11.804 | \n.031 | \n1 | \n.861 | \n7.894 | \n7.073E-10 | \n88101694713.661 | \n|
Father | \n−1.082 | \n11.942 | \n.008 | \n1 | \n.928 | \n.339 | \n2.319E-11 | \n4951929174.890 | \n|
Friend(s) | \n.446 | \n11.800 | \n.001 | \n1 | \n.970 | \n1.561 | \n1.411E-10 | \n17281209496.777 | \n|
Girlfriend | \n4.844 | \n15.803 | \n.094 | \n1 | \n.759 | \n126.971 | \n4.493E-12 | \n3588087231311329.500 | \n|
Wife | \n−.864 | \n41.011 | \n.000 | \n1 | \n.983 | \n.421 | \n5.202E-36 | \n34122402905359492000000000000000000.000 | \n|
Cousin | \n−7.420 | \n625.964 | \n.000 | \n1 | \n.991 | \n.001 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n−.643 | \n11.952 | \n.003 | \n1 | \n.957 | \n.526 | \n3.524E-11 | \n7836850545.453 | \n|
Grandmother | \n1.633 | \n22.685 | \n.005 | \n1 | \n.943 | \n5.122 | \n2.512E-19 | \n104402003260355310000.000 | \n|
\n | \nTherapist | \n1.715 | \n41.041 | \n.002 | \n1 | \n.967 | \n5.556 | \n6.470E-35 | \n477181474016070200000000000000000000.000 | \n
Aunt | \n2.401 | \n41.019 | \n.003 | \n1 | \n.953 | \n11.034 | \n1.341E-34 | \n908158071886049200000000000000000000.000 | \n|
Guardian | \n−7.950 | \n625.963 | \n.000 | \n1 | \n.990 | \n.000 | \n.000 | \n.\nc\n\n | \n|
Helped you to deal with emotional issues | \n\n | ||||||||
Mother | \n−9.734 | \n624.621 | \n.000 | \n1 | \n.988 | \n5.922E-5 | \n.000 | \n.\nc\n\n | \n|
Father | \n−8.542 | \n624.624 | \n.000 | \n1 | \n.989 | \n.000 | \n.000 | \n.\nc\n\n | \n|
Sibling | \n−13.428 | \n624.624 | \n.000 | \n1 | \n.983 | \n1.473E-6 | \n.000 | \n.\nc\n\n | \n|
Esteemed person | \n−12.101 | \n625.847 | \n.000 | \n1 | \n.985 | \n5.554E-6 | \n.000 | \n.\nc\n\n | \n|
Girlfriend | \n−8.820 | \n624.658 | \n.000 | \n1 | \n.989 | \n.000 | \n.000 | \n.\nc\n\n | \n|
Wife | \n−11.578 | \n625.008 | \n.000 | \n1 | \n.985 | \n9.366E-6 | \n.000 | \n.\nc\n\n | \n|
Nobody | \n−9.135 | \n624.621 | \n.000 | \n1 | \n.988 | \n.000 | \n.000 | \n.\nc\n\n | \n
Parameter estimates.
The reference category is: Very easy
This parameter is set to zero because it is redundant.
Floating point overflow occurred while computing this statistic. Its value is therefore set to system missing.
Hypothesis 4 (confirmed): Male inmates have suicidal thoughts irrespective of any disparity between positive and negative emotions.
\nSeeking to measure the frequency of suicidal thoughts among the male inmates, a Likert scale question was added. The responses showed that a relatively high proportion of the sample (n = 68, 45.3%) were thinking of committing suicide occasionally (“Sometimes”), and the second highest proportion was these who never had such thoughts (n = 31, 20.7%). Almost the same percentage of people responded that they “Almost always” (n = 21, 14%) or “Almost never” (n = 21, 14%) have suicidal thoughts and only 4.7% (n = 7) have them on regular basis (“Always”). While in prison, males had the opportunity to visit a medical doctor or a psychologist, when needed. Some of them (n = 57, 38%) were finding the access to their service (very) easy, while for others (n = 55, 36.7%) was (very) difficult.
\nMoving from the descriptive statistics to multivariate regressions as an attempt to provide answers to our research questions, the data analysis as shown in Table 5 confirms the initial hypothesis. Male inmates were, indeed, having suicidal thoughts irrespective of the similar frequency of positive or negative emotions they were experiencing. In other words, the frequent thoughts or intentions of male inmates in SVG to commit suicide were not related to the equally frequent positive (eg. joy, hope, kindness) or negative (eg. loneliness, depression, fear) they may have been experiencing.
\nHaving suicidal thoughts\na\n\n | \nB | \nStd. Error | \nWald | \ndf | \nSig. | \nExp(B) | \n95% Confidence Interval for Exp(B) | \n||
---|---|---|---|---|---|---|---|---|---|
Lower Bound | \nUpper Bound | \n||||||||
Never | \nNever experiencing … | \n\n | |||||||
Worry (−) | \n38.265 | \n42131.091 | \n.000 | \n1 | \n.999 | \n41512528905990320.000 | \n.000 | \n.\nb\n\n | \n|
Loneliness (−) | \n−5.139 | \n37807.382 | \n.000 | \n1 | \n1.000 | \n.006 | \n.000 | \n.\nb\n\n | \n|
Anger (−) | \n−17.882 | \n79534.322 | \n.000 | \n1 | \n1.000 | \n1.713E-8 | \n.000 | \n.\nb\n\n | \n|
Depression (−) | \n−14.205 | \n82741.329 | \n.000 | \n1 | \n1.000 | \n6.777E-7 | \n.000 | \n.\nb\n\n | \n|
Rejection (−) | \n24.921 | \n9436.227 | \n.000 | \n1 | \n.998 | \n66533189065.058 | \n.000 | \n.\nb\n\n | \n|
Frustration (−) | \n30.958 | \n24413.461 | \n.000 | \n1 | \n.999 | \n27847338461359.742 | \n.000 | \n.\nb\n\n | \n|
Jealousy (−) | \n21.971 | \n45327.033 | \n.000 | \n1 | \n1.000 | \n3483997796.992 | \n.000 | \n.\nb\n\n | \n|
Shame (−) | \n43.908 | \n15195.137 | \n.000 | \n1 | \n.998 | \n11719077213841310000.000 | \n.000 | \n.\nb\n\n | \n|
Fear (−) | \n−3.601 | \n44078.805 | \n.000 | \n1 | \n1.000 | \n.027 | \n.000 | \n.\nb\n\n | \n|
Sadness (−) | \n−32.828 | \n20159.582 | \n.000 | \n1 | \n.999 | \n5.531E-15 | \n.000 | \n.\nb\n\n | \n|
Joy (+) | \n44.629 | \n36308.886 | \n.000 | \n1 | \n.999 | \n24096244549266317000.000 | \n.000 | \n.\nb\n\n | \n|
Forgiveness (+) | \n29.357 | \n45828.959 | \n.000 | \n1 | \n.999 | \n5618462657828.428 | \n.000 | \n.\nb\n\n | \n|
Love (+) | \n28.429 | \n68809.244 | \n.000 | \n1 | \n1.000 | \n2221343412505.831 | \n.000 | \n.\nb\n\n | \n|
Thankfulness (+) | \n−46.389 | \n33238.126 | \n.000 | \n1 | \n.999 | \n7.139E-21 | \n.000 | \n.\nb\n\n | \n|
Pride (+) | \n51.398 | \n24718.421 | \n.000 | \n1 | \n.998 | \n20974296918467923000000.000 | \n.000 | \n.\nb\n\n | \n|
Gladness (+) | \n−72.392 | \n50294.937 | \n.000 | \n1 | \n.999 | \n3.635E-32 | \n.000 | \n.\nb\n\n | \n|
Inspiration (+) | \n−55.492 | \n85436.525 | \n.000 | \n1 | \n.999 | \n7.948E-25 | \n.000 | \n.\nb\n\n | \n|
Hope (+) | \n11.827 | \n63358.506 | \n.000 | \n1 | \n1.000 | \n136961.278 | \n.000 | \n.\nb\n\n | \n|
Kindness (+) | \n31.787 | \n.000 | \n. | \n1 | \n. | \n63787421138352.160 | \n63787421138352.160 | \n63787421138352.160 | \n|
Warmth (+) | \n8.409 | \n.000 | \n. | \n1 | \n. | \n4485.333 | \n4485.333 | \n4485.333 | \n|
Almost never | \nAlmost never experiencing… | \n\n | |||||||
Worry (−) | \n17.337 | \n62730.027 | \n.000 | \n1 | \n1.000 | \n33830667.954 | \n.000 | \n.\nb\n\n | \n|
\n | \nLoneliness (−) | \n−9.711 | \n34034.477 | \n.000 | \n1 | \n1.000 | \n6.059E-5 | \n.000 | \n.\nb\n\n | \n
Anger (−) | \n−1.924 | \n19347.725 | \n.000 | \n1 | \n1.000 | \n.146 | \n.000 | \n.\nb\n\n | \n|
Depression (−) | \n9.818 | \n23029.240 | \n.000 | \n1 | \n1.000 | \n18363.795 | \n.000 | \n.\nb\n\n | \n|
Rejection (−) | \n8.158 | \n34567.475 | \n.000 | \n1 | \n1.000 | \n3489.671 | \n.000 | \n.\nb\n\n | \n|
Frustration (−) | \n13.964 | \n16139.542 | \n.000 | \n1 | \n.999 | \n1160449.712 | \n.000 | \n.\nb\n\n | \n|
Jealousy (−) | \n22.533 | \n32665.601 | \n.000 | \n1 | \n.999 | \n6105775901.719 | \n.000 | \n.\nb\n\n | \n|
Shame (−) | \n35.521 | \n46428.161 | \n.000 | \n1 | \n.999 | \n2670030769720042.500 | \n.000 | \n.\nb\n\n | \n|
Fear (−) | \n35.521 | \n46428.161 | \n.000 | \n1 | \n.999 | \n2670030769720042.500 | \n.000 | \n.\nb\n\n | \n|
Sadness (−) | \n17.608 | \n42357.809 | \n.000 | \n1 | \n1.000 | \n44381092.351 | \n.000 | \n.\nb\n\n | \n|
Joy (+) | \n1.402 | \n63332.243 | \n.000 | \n1 | \n1.000 | \n4.064 | \n.000 | \n.\nb\n\n | \n|
Forgiveness (+) | \n−1.440 | \n57396.565 | \n.000 | \n1 | \n1.000 | \n.237 | \n.000 | \n.\nb\n\n | \n|
Love (+) | \n.313 | \n16938.360 | \n.000 | \n1 | \n1.000 | \n1.367 | \n.000 | \n.\nb\n\n | \n|
Thankfulness (+) | \n−3.646 | \n33406.056 | \n.000 | \n1 | \n1.000 | \n.026 | \n.000 | \n.\nb\n\n | \n|
Pride (+) | \n−4.300 | \n32548.244 | \n.000 | \n1 | \n1.000 | \n.014 | \n.000 | \n.\nb\n\n | \n|
Gladness (+) | \n−21.410 | \n32410.214 | \n.000 | \n1 | \n.999 | \n5.030E-10 | \n.000 | \n.\nb\n\n | \n|
Inspiration (+) | \n−15.599 | \n53537.876 | \n.000 | \n1 | \n1.000 | \n1.681E-7 | \n.000 | \n.\nb\n\n | \n|
Hope (+) | \n−4.277 | \n12318.961 | \n.000 | \n1 | \n1.000 | \n.014 | \n.000 | \n.\nb\n\n | \n|
Kindness (+) | \n21.446 | \n22120.485 | \n.000 | \n1 | \n.999 | \n2059283298.525 | \n.000 | \n.\nb\n\n | \n|
Warmth (+) | \n−14.930 | \n8827.409 | \n.000 | \n1 | \n.999 | \n3.280E-7 | \n.000 | \n.\nb\n\n | \n|
Sometimes | \nSometimes experiencing… | \n\n | |||||||
Worry (−) | \n25.756 | \n21842.662 | \n.000 | \n1 | \n.999 | \n153345818008.820 | \n.000 | \n.\nb\n\n | \n|
Loneliness (−) | \n−7.627 | \n23144.438 | \n.000 | \n1 | \n1.000 | \n.000 | \n.000 | \n.\nb\n\n | \n|
Anger (−) | \n−7.814 | \n20611.045 | \n.000 | \n1 | \n1.000 | \n.000 | \n.000 | \n.\nb\n\n | \n|
\n | \nDepression (−) | \n10.880 | \n19572.240 | \n.000 | \n1 | \n1.000 | \n53084.629 | \n.000 | \n.\nb\n\n | \n
Rejection (−) | \n2.386 | \n14377.750 | \n.000 | \n1 | \n1.000 | \n10.866 | \n.000 | \n.\nb\n\n | \n|
Frustration (−) | \n23.451 | \n6961.863 | \n.000 | \n1 | \n.997 | \n15305137329.349 | \n.000 | \n.\nb\n\n | \n|
Jealousy (−) | \n21.023 | \n35452.621 | \n.000 | \n1 | \n1.000 | \n1350132117.246 | \n.000 | \n.\nb\n\n | \n|
Shame (−) | \n46.349 | \n19147.919 | \n.000 | \n1 | \n.998 | \n134687881868218000000.000 | \n.000 | \n.\nb\n\n | \n|
Fear (−) | \n.464 | \n17216.104 | \n.000 | \n1 | \n1.000 | \n1.591 | \n.000 | \n.\nb\n\n | \n|
Sadness (−) | \n3.031 | \n13855.955 | \n.000 | \n1 | \n1.000 | \n20.726 | \n.000 | \n.\nb\n\n | \n|
Joy (+) | \n−.480 | \n19549.724 | \n.000 | \n1 | \n1.000 | \n.619 | \n.000 | \n.\nb\n\n | \n|
Forgiveness (+) | \n7.455 | \n24432.265 | \n.000 | \n1 | \n1.000 | \n1729.107 | \n.000 | \n.\nb\n\n | \n|
Love (+) | \n1.239 | \n26718.325 | \n.000 | \n1 | \n1.000 | \n3.452 | \n.000 | \n.\nb\n\n | \n|
Thankfulness (+) | \n9.055 | \n7536.983 | \n.000 | \n1 | \n.999 | \n8560.522 | \n.000 | \n.\nb\n\n | \n|
Pride (+) | \n1.837 | \n10838.583 | \n.000 | \n1 | \n1.000 | \n6.278 | \n.000 | \n.\nb\n\n | \n|
Gladness (+) | \n−33.519 | \n28558.496 | \n.000 | \n1 | \n.999 | \n2.772E-15 | \n.000 | \n.\nb\n\n | \n|
Inspiration (+) | \n−8.211 | \n43149.464 | \n.000 | \n1 | \n1.000 | \n.000 | \n.000 | \n.\nb\n\n | \n|
Hope (+) | \n−5.634 | \n11332.098 | \n.000 | \n1 | \n1.000 | \n.004 | \n.000 | \n.\nb\n\n | \n|
Kindness (+) | \n12.634 | \n.000 | \n. | \n1 | \n. | \n306728.293 | \n306728.293 | \n306728.293 | \n|
Warmth (+) | \n−16.876 | \n.000 | \n. | \n1 | \n. | \n4.686E-8 | \n4.686E-8 | \n4.686E-8 | \n|
Almost always | \nAlmost always experiencing… | \n\n | |||||||
Worry (−) | \n20.506 | \n17453.044 | \n.000 | \n1 | \n.999 | \n804770902.727 | \n.000 | \n.\nb\n\n | \n|
Loneliness (−) | \n−1.592 | \n17924.925 | \n.000 | \n1 | \n1.000 | \n.203 | \n.000 | \n.\nb\n\n | \n|
Anger (−) | \n−2.581 | \n17950.704 | \n.000 | \n1 | \n1.000 | \n.076 | \n.000 | \n.\nb\n\n | \n|
Depression (−) | \n13.616 | \n23382.990 | \n.000 | \n1 | \n1.000 | \n819226.292 | \n.000 | \n.\nb\n\n | \n|
Rejection (−) | \n3.583 | \n6386.837 | \n.000 | \n1 | \n1.000 | \n35.979 | \n.000 | \n.\nb\n\n | \n|
\n | \nFrustration (−) | \n18.653 | \n14439.424 | \n.000 | \n1 | \n.999 | \n126090251.289 | \n.000 | \n.\nb\n\n | \n
Jealousy (−) | \n14.808 | \n29716.579 | \n.000 | \n1 | \n1.000 | \n2699157.783 | \n.000 | \n.\nb\n\n | \n|
Shame (−) | \n45.466 | \n21327.045 | \n.000 | \n1 | \n.998 | \n55691661855071380000.000 | \n.000 | \n.\nb\n\n | \n|
Fear (−) | \n5.595 | \n14237.673 | \n.000 | \n1 | \n1.000 | \n269.191 | \n.000 | \n.\nb\n\n | \n|
Sadness (−) | \n1.510 | \n24004.762 | \n.000 | \n1 | \n1.000 | \n4.529 | \n.000 | \n.\nb\n\n | \n|
Joy (+) | \n.109 | \n9914.736 | \n.000 | \n1 | \n1.000 | \n1.115 | \n.000 | \n.\nb\n\n | \n|
Forgiveness (+) | \n5.222 | \n12493.560 | \n.000 | \n1 | \n1.000 | \n185.332 | \n.000 | \n.\nb\n\n | \n|
Love (+) | \n−3.497 | \n15974.687 | \n.000 | \n1 | \n1.000 | \n.030 | \n.000 | \n.\nb\n\n | \n|
Thankfulness (+) | \n7.421 | \n2682.184 | \n.000 | \n1 | \n.998 | \n1671.232 | \n.000 | \n.\nb\n\n | \n|
Pride (+) | \n−4.543 | \n7817.173 | \n.000 | \n1 | \n1.000 | \n.011 | \n.000 | \n.\nb\n\n | \n|
Gladness (+) | \n−33.649 | \n16456.088 | \n.000 | \n1 | \n.998 | \n2.436E-15 | \n.000 | \n.\nb\n\n | \n|
Inspiration (+) | \n−16.021 | \n38348.256 | \n.000 | \n1 | \n1.000 | \n1.102E-7 | \n.000 | \n.\nb\n\n | \n|
Hope (+) | \n−7.183 | \n6199.960 | \n.000 | \n1 | \n.999 | \n.001 | \n.000 | \n.\nb\n\n | \n|
Kindness (+) | \n19.455 | \n.000 | \n. | \n1 | \n. | \n281332174.318 | \n281332174.318 | \n281332174.318 | \n|
Warmth (+) | \n−6.874 | \n.000 | \n. | \n1 | \n. | \n.001 | \n.001 | \n.001 | \n
Parameter estimates.
The reference category is: Always.
Floating point overflow occurred while computing this statistic. Its value is therefore set to system missing.
This parameter is set to zero because it is redundant.
No empirical research is free of limitations; henceforth, such limitations should be acknowledged prior to any conceptualization of our hypotheses. Initially, it should be noted thatSt. Vincent and the Grenadines – as any given society or nation – has social norms and moral values that might be different or conflicting in another social sphere. It may be possible that some commonality still exists among institutionalized males or even among different nations within the Caribbean region. Though, these elements are not sufficient to ignore the issue of representativeness. Keeping in mind the exceptionally high percentage of the particular men who had experienced emotional and psychological distress in their lives linked to prevalent standards of manliness or masculinity taboos, as well as the regional cultural and ethnical diversity, it would have been scientifically imprecise to claim that the results are generalizable and that the present sample represents an area larger than SVG. In addition, given the relatively small – but randomized – size of the sample and population as well as the nature of the questions, conclusions were drawn with extreme caution. Due to conceptual and structural limitations related to constraints on generalizability, this study could not test complex theoretical models from the existing literature; yet, it helped us formulate more specific hypotheses for more definite future investigation.
\nResearch evidence consistently shows high rates of unresolved issues among incarcerated samples. Our study provided evidence that emotional problems among incarcerated men in SVG is associated with a wide range of relational issues such as refrain from crying, suppression of feelings, lack of strong family bonds, and exposure to past abuse. Although, many respondents had the idea of ending their lives, the intensity of such thoughts varied greatly. There was no clear demarcation between those who embrace positive emotions and those who experience a weaker pull in that direction and vice-versa. Inmates having strong positive emotions also displayed a propensity for negative emotions falling the “sometimes” vacuum. Based on the inmates’ responses, it was feasible to make a definitive statement that inmates find it hard to deal with their negative emotions due to past abuse. There is ample indication to show that sharing or dealing with negative emotions is very difficult for all inmates, either they had suffered an abuse or not. Due to intervening factors, with culture being the main one, crying accounted for one of the reasons why inmates may feel uncomfortable to talk about issues of emotional nature. By observation, those persons who were able to pick the issues that bothered them the most and talk about them were also not afraid of crying.
\nHistorically, research attention has focused on the emotional and psychological needs or problems of incarcerated women (e.g. [26, 27, 28, 29, 30]), not those of men. This study findings call for further action; action to screen for and treat emotion-related traumas among incarcerated men. Treatment for emotional problems and their consequences inside correctional settings is pivotal; especially for incarcerated men – a largely neglected but serially traumatized population [31, 32]. In St. Vincent and the Grenadines, a programme whose focus is to address the issue of recidivism, mental health and to overcome behavioral issues, helping inmates to regulate their emotions, develop social skills, and address thinking that can lead to violence and criminality, such as aggressive or antisocial behavior has just gotten under way. The more obvious understanding to stereotypical behaviors is that the society has predetermined the course of males’ emotional reactions. A conceptual “mold” has been created, which has gathered widespread acceptability. As Way [33] argues, the solution lies with exposing the inaccuracies of our gender stereotypes in which human needs and capabilities are given a sex and sexuality. The issue of males being able to reveal their emotions will remain a stigmatized issue unless academics and practitioners are willing to make the issue an urgent one.
\nIn the meantime, helping men to work their way out of the dilemma of having to succumb to “suck it up”, “man it up”, “stop acting like a baby”, “men don’t cry” and other derogative emotive clichés that men have grown to hear and feel and have unwillingly accepted as their mantra, should be society’s target. A viable solution might be recommending a shift in the outdated perception of “Man is Invincible” to “Man is Human Being” adapting the view that behavior that is shadowed by an unhealed wound as not being a gender specific issue, but more a human being issue. Man does not need more shame or stigmas attached to him, for that will certainly work to his disadvantage.
\nFamily environment could play a viable role in desisting such shaming and stigmatization processes. Respondents put high premium on family and family values, as their deep sense of neglect and the limited interaction with their family members acted as a springboard to their delinquency. They were able to talk about how their families’ aloofness and lack of caring created an emotional void inside them. A noticeable absence of family members’ contribution to relationship building is that of the fathers’. Fathers played little or no role in the lives of the respondents. Generally, fathers have played a limited role in the lives of most Caribbean males, due to the high single parent household that are featured [34]. The extent to which this affect males when dealing with situations that warrant much display of strong emotions is relatively unknown.
\nWe should also have a deeper look into the extent, complexity, and motives of those 120 male inmates who admitted of having some form of suicidal ideation in the past. Given the raising numbers of incarcerated men in SVG and the strength of these associations, targeted intervention is critical. To put this issue in context, the changing of our the local society’s beliefs about males social and emotional capacities would never happen overnight, but invariably rely on the combined skills of educators and parents to help cultivate the inert capacities males possess [35]. This study also unearthed stimulating information for more in-depth research. It allowed for the collection of information regarding imprisoned males and their emotions revealing the various components of those motions and their possible inter-relationships. In the meanwhile, it is anticipated that the present study would contribute in fostering a research culture in prisons and at the same time stimulate individuals to address the pressing issues of health and wellness among the male population in St. Vincent and the Grenadines.
\nThe authors declare that they have no conflict of interest.
\nInformed consent was obtained from all individual adult participants included in the study.
\nThe authors have no funding to disclose.
\nAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
\ncruel and violent treatment of a person
\npsychological dysfunction in an individual that is associated with distress or impairment and a reaction that is not culturally expected.
\nstrong feelings deriving from one’s circumstances, mood, or relationships with others.
\nIntechOpen aims to ensure that original material is published while at the same time giving significant freedom to our Authors. To that end we maintain a flexible Copyright Policy guaranteeing that there is no transfer of copyright to the publisher and Authors retain exclusive copyright to their Work.
',metaTitle:"Publication Agreement - Chapters",metaDescription:"IN TECH aims to guarantee that original material is published while at the same time giving significant freedom to our authors. For that matter, we uphold a flexible copyright policy meaning that there is no transfer of copyright to the publisher and authors retain exclusive copyright to their work.\n\nWhen submitting a manuscript the Corresponding Author is required to accept the terms and conditions set forth in our Publication Agreement as follows:",metaKeywords:null,canonicalURL:"/page/publication-agreement-chapters",contentRaw:'[{"type":"htmlEditorComponent","content":"The Corresponding Author (acting on behalf of all Authors) and INTECHOPEN LIMITED, incorporated and registered in England and Wales with company number 11086078 and a registered office at 5 Princes Gate Court, London, United Kingdom, SW7 2QJ conclude the following Agreement regarding the publication of a Book Chapter:
\\n\\n1. DEFINITIONS
\\n\\nCorresponding Author: The Author of the Chapter who serves as a Signatory to this Agreement. The Corresponding Author acts on behalf of any other Co-Author.
\\n\\nCo-Author: All other Authors of the Chapter besides the Corresponding Author.
\\n\\nIntechOpen: IntechOpen Ltd., the Publisher of the Book.
\\n\\nBook: The publication as a collection of chapters compiled by IntechOpen including the Chapter. Chapter: The original literary work created by Corresponding Author and any Co-Author that is the subject of this Agreement.
\\n\\n2. CORRESPONDING AUTHOR'S GRANT OF RIGHTS
\\n\\n2.1 Subject to the following Article, the Corresponding Author grants and shall ensure that each Co-Author grants, to IntechOpen, during the full term of copyright and any extensions or renewals of that term the following:
\\n\\nThe aforementioned licenses shall survive the expiry or termination of this Agreement for any reason.
\\n\\n2.2 The Corresponding Author (on their own behalf and on behalf of any Co-Author) reserves the following rights to the Chapter but agrees not to exercise them in such a way as to adversely affect IntechOpen's ability to utilize the full benefit of this Publication Agreement: (i) reprographic rights worldwide, other than those which subsist in the typographical arrangement of the Chapter as published by IntechOpen; and (ii) public lending rights arising under the Public Lending Right Act 1979, as amended from time to time, and any similar rights arising in any part of the world.
\\n\\nThe Corresponding Author confirms that they (and any Co-Author) are and will remain a member of any applicable licensing and collecting society and any successor to that body responsible for administering royalties for the reprographic reproduction of copyright works.
\\n\\nSubject to the license granted above, copyright in the Chapter and all versions of it created during IntechOpen's editing process (including the published version) is retained by the Corresponding Author and any Co-Author.
\\n\\nSubject to the license granted above, the Corresponding Author and any Co-Author retains patent, trademark and other intellectual property rights to the Chapter.
\\n\\n2.3 All rights granted to IntechOpen in this Article are assignable, sublicensable or otherwise transferrable to third parties without the Corresponding Author's or any Co-Author’s specific approval.
\\n\\n2.4 The Corresponding Author (on their own behalf and on behalf of each Co-Author) will not assert any rights under the Copyright, Designs and Patents Act 1988 to object to derogatory treatment of the Chapter as a consequence of IntechOpen's changes to the Chapter arising from translation of it, corrections and edits for house style, removal of problematic material and other reasonable edits.
\\n\\n3. CORRESPONDING AUTHOR'S DUTIES
\\n\\n3.1 When distributing or re-publishing the Chapter, the Corresponding Author agrees to credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen. The Corresponding Author warrants that each Co-Author will also credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen, when they are distributing or re-publishing the Chapter.
\\n\\n3.2 When submitting the Chapter, the Corresponding Author agrees to:
\\n\\nThe Corresponding Author will be held responsible for the payment of the Open Access Publishing Fees.
\\n\\nAll payments shall be due 30 days from the date of the issued invoice. The Corresponding Author or the payer on the Corresponding Author's and Co-Authors' behalf will bear all banking and similar charges incurred.
\\n\\n3.3 The Corresponding Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Chapter worldwide for the full term of the above licenses, and shall provide to IntechOpen upon request the original copies of such consents for inspection (at IntechOpen's option) or photocopies of such consents.
\\n\\nThe Corresponding Author shall obtain written informed consent for publication from people who might recognize themselves or be identified by others (e.g. from case reports or photographs).
\\n\\n3.4 The Corresponding Author and any Co-Author shall respect confidentiality rights during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Corresponding Author and any Co-Author are confidential and are intended only for the recipient. The contents may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
\\n\\n4. CORRESPONDING AUTHOR'S WARRANTY
\\n\\n4.1 The Corresponding Author represents and warrants that the Chapter does not and will not breach any applicable law or the rights of any third party and, specifically, that the Chapter contains no matter that is defamatory or that infringes any literary or proprietary rights, intellectual property rights, or any rights of privacy. The Corresponding Author warrants and represents that: (i) the Chapter is the original work of themselves and any Co-Author and is not copied wholly or substantially from any other work or material or any other source; (ii) the Chapter has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) they themselves and any Co-Author are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) they themselves and any Co-Author have not assigned and will not during the term of this Publication Agreement purport to assign any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\\n\\nThe Corresponding Author also warrants and represents that: (i) they have the full power to enter into this Publication Agreement on their own behalf and on behalf of each Co-Author; and (ii) they have the necessary rights and/or title in and to the Chapter to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licenses expressed to be granted in this Publication Agreement. If the Chapter was prepared jointly by the Corresponding Author and any Co-Author, the Corresponding Author warrants and represents that: (i) each Co-Author agrees to the submission, license and publication of the Chapter on the terms of this Publication Agreement; and (ii) they have the authority to enter into this Publication Agreement on behalf of and bind each Co-Author. The Corresponding Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each such Co-Author.
\\n\\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\\n\\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\\n\\n5. TERMINATION
\\n\\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
\\n\\nIn case of termination, IntechOpen will notify the Corresponding Author, in writing, of the decision.
\\n\\n6. INTECHOPEN’S DUTIES AND RIGHTS
\\n\\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\\n\\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\\n\\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\\n\\n7. MISCELLANEOUS
\\n\\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\\n\\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\\n\\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\\n\\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\\n\\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\\n\\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
\\n\\nAny modification to or deletion of a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\\n\\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\\n\\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\\n\\nLast updated: 2020-11-27
\\n\\n\\n\\n
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The Corresponding Author (acting on behalf of all Authors) and INTECHOPEN LIMITED, incorporated and registered in England and Wales with company number 11086078 and a registered office at 5 Princes Gate Court, London, United Kingdom, SW7 2QJ conclude the following Agreement regarding the publication of a Book Chapter:
\n\n1. DEFINITIONS
\n\nCorresponding Author: The Author of the Chapter who serves as a Signatory to this Agreement. The Corresponding Author acts on behalf of any other Co-Author.
\n\nCo-Author: All other Authors of the Chapter besides the Corresponding Author.
\n\nIntechOpen: IntechOpen Ltd., the Publisher of the Book.
\n\nBook: The publication as a collection of chapters compiled by IntechOpen including the Chapter. Chapter: The original literary work created by Corresponding Author and any Co-Author that is the subject of this Agreement.
\n\n2. CORRESPONDING AUTHOR'S GRANT OF RIGHTS
\n\n2.1 Subject to the following Article, the Corresponding Author grants and shall ensure that each Co-Author grants, to IntechOpen, during the full term of copyright and any extensions or renewals of that term the following:
\n\nThe aforementioned licenses shall survive the expiry or termination of this Agreement for any reason.
\n\n2.2 The Corresponding Author (on their own behalf and on behalf of any Co-Author) reserves the following rights to the Chapter but agrees not to exercise them in such a way as to adversely affect IntechOpen's ability to utilize the full benefit of this Publication Agreement: (i) reprographic rights worldwide, other than those which subsist in the typographical arrangement of the Chapter as published by IntechOpen; and (ii) public lending rights arising under the Public Lending Right Act 1979, as amended from time to time, and any similar rights arising in any part of the world.
\n\nThe Corresponding Author confirms that they (and any Co-Author) are and will remain a member of any applicable licensing and collecting society and any successor to that body responsible for administering royalties for the reprographic reproduction of copyright works.
\n\nSubject to the license granted above, copyright in the Chapter and all versions of it created during IntechOpen's editing process (including the published version) is retained by the Corresponding Author and any Co-Author.
\n\nSubject to the license granted above, the Corresponding Author and any Co-Author retains patent, trademark and other intellectual property rights to the Chapter.
\n\n2.3 All rights granted to IntechOpen in this Article are assignable, sublicensable or otherwise transferrable to third parties without the Corresponding Author's or any Co-Author’s specific approval.
\n\n2.4 The Corresponding Author (on their own behalf and on behalf of each Co-Author) will not assert any rights under the Copyright, Designs and Patents Act 1988 to object to derogatory treatment of the Chapter as a consequence of IntechOpen's changes to the Chapter arising from translation of it, corrections and edits for house style, removal of problematic material and other reasonable edits.
\n\n3. CORRESPONDING AUTHOR'S DUTIES
\n\n3.1 When distributing or re-publishing the Chapter, the Corresponding Author agrees to credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen. The Corresponding Author warrants that each Co-Author will also credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen, when they are distributing or re-publishing the Chapter.
\n\n3.2 When submitting the Chapter, the Corresponding Author agrees to:
\n\nThe Corresponding Author will be held responsible for the payment of the Open Access Publishing Fees.
\n\nAll payments shall be due 30 days from the date of the issued invoice. The Corresponding Author or the payer on the Corresponding Author's and Co-Authors' behalf will bear all banking and similar charges incurred.
\n\n3.3 The Corresponding Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Chapter worldwide for the full term of the above licenses, and shall provide to IntechOpen upon request the original copies of such consents for inspection (at IntechOpen's option) or photocopies of such consents.
\n\nThe Corresponding Author shall obtain written informed consent for publication from people who might recognize themselves or be identified by others (e.g. from case reports or photographs).
\n\n3.4 The Corresponding Author and any Co-Author shall respect confidentiality rights during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Corresponding Author and any Co-Author are confidential and are intended only for the recipient. The contents may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
\n\n4. CORRESPONDING AUTHOR'S WARRANTY
\n\n4.1 The Corresponding Author represents and warrants that the Chapter does not and will not breach any applicable law or the rights of any third party and, specifically, that the Chapter contains no matter that is defamatory or that infringes any literary or proprietary rights, intellectual property rights, or any rights of privacy. The Corresponding Author warrants and represents that: (i) the Chapter is the original work of themselves and any Co-Author and is not copied wholly or substantially from any other work or material or any other source; (ii) the Chapter has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) they themselves and any Co-Author are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) they themselves and any Co-Author have not assigned and will not during the term of this Publication Agreement purport to assign any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\n\nThe Corresponding Author also warrants and represents that: (i) they have the full power to enter into this Publication Agreement on their own behalf and on behalf of each Co-Author; and (ii) they have the necessary rights and/or title in and to the Chapter to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licenses expressed to be granted in this Publication Agreement. If the Chapter was prepared jointly by the Corresponding Author and any Co-Author, the Corresponding Author warrants and represents that: (i) each Co-Author agrees to the submission, license and publication of the Chapter on the terms of this Publication Agreement; and (ii) they have the authority to enter into this Publication Agreement on behalf of and bind each Co-Author. The Corresponding Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each such Co-Author.
\n\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\n\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\n\n5. TERMINATION
\n\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
\n\nIn case of termination, IntechOpen will notify the Corresponding Author, in writing, of the decision.
\n\n6. INTECHOPEN’S DUTIES AND RIGHTS
\n\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\n\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\n\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\n\n7. MISCELLANEOUS
\n\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\n\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\n\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\n\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\n\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\n\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
\n\nAny modification to or deletion of a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\n\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\n\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\n\nLast updated: 2020-11-27
\n\n\n\n
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