This constitutes a violation of human rights and includes physical, sexual, psychological, emotional; financial and material abuse; abandonment; neglect; and serious loss of dignity and respect.While there is little information regarding the extent of maltreatment in elderly populations, especially in developing countries, it is estimated that 4–6% of elderly people in high-income countries have experienced some form of maltreatment at home However, older people are often afraid to report cases of maltreatment to family, friends, or to the authorities. Data on the extent of the problem in institutions such as hospitals, nursing homes and other long-term care facilities are scarce. Elder maltreatment can lead to serious physical injuries and long-term psychological consequences. Elder maltreatment is predicted to increase as many countries are experiencing rapidly ageing populations. Many strategies have been implemented to prevent elder maltreatment and to take action against it and mitigate its consequences including public and professional awareness campaigns, screening (of potential victims and abusers), caregiver support interventions (e.g. stress management, respite care), adult protective services and self-help groups. Their effectiveness has, however, not so far been well-established. Targeted
Several rare but painful episodes of assassination, attempted assassination and school shootings at elementary, middle, high schools, as well as colleges and universities in the United States, led to a considerable body of research on ascertainable behaviors of persons who have planned or carried out such attacks.
Speech and memory test
Another use for etomidate is to determine speech lateralization in people prior to performing lobectomies to remove epileptogenic centres in the brain. This is called the etomidate speech and memory test, or eSAM, and is used at the Montreal Neurological Institute. However, only retrospective cohort studies support the use and safety of etomidate for this test. Steroidogenesis inhibitor
In addition to its action and use as an anesthetic, etomidate has also been found to directly inhibit the enzymatic biosynthesis of steroid hormones, including corticosteroids in the adrenal gland. As the only adrenal steroidogenesis inhibitor available for intravenous or parenteral administration, it is useful in situations in which rapid control of hypercortisolism is necessary or in which oral administration is unfeasible. Use in executions
The U.S. state of Florida used the drug in a death penalty procedure when Mark James Asay, 53, was executed on August 24, 2017. He became the first person in the U.S. to be executed with etomidate as one of the drugs. Etomidate replaces midazolam as the sedative. Drug companies have made it harder to buy midazolam for executions. The etomidate was followed by rocuronium bromide, a paralytic, and finally, potassium acetate in place of the commonly used potassium chloride injection to stop the heart. Potassium acetate was first used for this purpose inadvertently in a 2015 execution in Oklahoma. Adverse effects
Etomidate suppresses corticosteroid synthesis in the adrenal cortex by reversibly inhibiting 11β-hydroxylase, an enzyme important in adrenal steroid production; it leads to primary adrenal suppression.