The utility of the Historical Clinical Risk -20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security-A UK perspective

<p>Abstract</p> <p>Background</p> <p>Structured Professional Judgment (SPJ) approaches to violence risk assessment are increasingly being adopted into clinical practice in international forensic settings. The aim of this study was to examine the predictive validity of the Historical Clinical Risk -20 (HCR-20) violence risk assessment scale for outcome following transfers from high to medium security in a United Kingdom setting.</p> <p>Methods</p> <p>The sample was predominately male and mentally ill and the majority of cases were detained under the criminal section of the Mental Health Act (1986). The HCR-20 was rated based on detailed case file information on 72 cases transferred from high to medium security. Outcomes were examined, independent of risk score, and cases were classed as "success or failure" based on established criteria.</p> <p>Results</p> <p>The mean length of follow up was 6 years. The total HCR-20 score was a robust predictor of failure at lower levels of security and return to high security. The Clinical and Risk management items contributed most to predictive accuracy.</p> <p>Conclusions</p> <p>Although the HCR-20 was designed as a violence risk prediction tool our findings suggest it has potential utility in decisions to transfer patients from high to lower levels of security.</p

Einfluß geringer Silberkonzentrationen auf einige lebende Organismen der evolutionären Reihe

Untersucht wurde die sanitär-toxikologische Wirkung von Elektrlytsilberlösungen in Wasser auf Hydrobionten und den Organismus von Warmblütern in akuten, subakuten und chronischen Versuchen. Für die Algen (Sc. quadricauda), Wasserflöhe (Daphnia magna), Fische (Guppy), Mäuse, Ratten und Kaninchen waren Silberkonzentrationen im Bereich von 5,0 - 4,0 bis 0,5 - 0,4 mg/l aktiv. Für die Hydrobionten ist eine Konzentration von 0,05 mg/l toxisch, die sich aber nicht auf Warmblüter auswirkt. Unter maritimen und sonstigen Bedingungen, wo zur Versorgung Wasser verwendet wird, das mit Silberionen konserviert wurde, sollte man den Silbergehalt im Wasser auf 0,05 mg/l begrenzen, was ungefähr einer gerade noch inaktiven Dosis an Konservierungsmittel (0,0025 mg pro 1 kg Lebendgewicht) entspricht