The Criminal Responsibility of the Juvenile Murderer

Juvenile courts—special courts having jurisdiction over juvenile offenders—were created which professed as their objective an intense desire to consider the child\u27s welfare and provide for his redemption rather than punishment for his misconduct? Behind this apparent unity of purpose, contrary positions exist. The juvenile court jurisdiction may or may not affect incapacity. If it does, the effect is to change the common law age for complete incapacity and those ages between which there is a rebuttable presumption of incapacity. If juvenile court jurisdiction does not affect incapacity, then it may only postpone criminal prosecution and punishment until the offender passes beyond the juvenile court\u27s jurisdiction

Entwicklung und Validierung des Bedürfnisinventars bei Gedächtnisstörungen (BIG-65): Krankheitskorrelierte Bedürfnisse bei Menschen mit Hirnleistungsstörungen und Demenz

Zusammenfassung: Hintergrund: Der Bedarf an einer systematischen Erfassung krankheitskorrelierter Patientenbedürfnisse bei Hirnleistungsstörungen und Demenz zur Auswahl optimaler Behandlungsoptionen steigt zunehmend. Es fehlt jedoch an validen Messinstrumenten, die zur Erfassung krankheitskorrelierter Bedürfnisse auch bei Menschen mit Demenz eingesetzt werden können. Methode: Die Studie umfasst die Konstruktion und Validierung des Bedürfnisinventars bei Gedächtnisstörungen (BIG-65) zur Erfassung krankheitskorrelierter Bedürfnisse. Der BIG-65 wurde theoriegeleitet entwickelt und basiert auf einer systematischen Literaturrecherche. Er wurde in einer Abklärungsstation, nach umfassender Untersuchung und Diagnosestellung, hinsichtlich seiner psychometrischen Eigenschaften an einer Gelegenheitsstichprobe (n = 83) validiert. Ergebnisse: Der BIG-65 hat 66Items und bietet neben einer breiten Auswahl an biopsychosozialen und umweltbezogenen Bedürfnissen eine geeignete Struktur zur Erfassung krankheitskorrelierter Bedürfnisse bei Menschen mit Hirnleistungsstörungen. Er verfügt über eine besonders hohe Augenscheinvalidität und eine sehr hohe Test-Retest-Reliabilität (rtt = 0,916). Im Mittel wurden 3,5 (SD = 3,7) unabgedeckte Bedürfnisse angegeben. Am häufigsten genannt wurden: "weniger vergessen" (50%), "bessere Konzentration" (23,2%), "Informationen zur Krankheit" (20,7%), "Informationen über Behandlungen" (17,1%) sowie "sich weniger Sorgen machen", "weniger gereizt sein", "Verbesserung der Stimmung", "Verbesserung der Orientierung" (alle 13,4%). Bedürfnisprofile unterscheiden sich zwischen verschiedenen Patientengruppen mit präklinischen (subjektive und milde kognitive Beeinträchtigung) und klinischen (Demenz) Hirnleistungsstörungen. Schlussfolgerungen: Krankheitskorrelierte Bedürfnisse können mit dem BIG-65 bis zu einer mittelschweren Demenz reliabel erfasst werden. Mit zunehmendem Demenzschweregrad oder einem Mini-Mental-Status <20Punkten sollte die Erfassung, z.B. mit zusätzlichen Beobachtungsmethoden des emotionalen Ausdrucks, ergänzt werden. Die Ergebnisse zeigen, dass Menschen mit Hirnleistungsstörungen individuelle Strategien zur Stabilisierung von Lebensqualität verfolgen. Neben einem objektiven Assessment von Krankheitssymptomen kann die Priorisierung optimaler Behandlungsmaßnahmen von der systematischen Erfassung krankheitskorrelierter Patientenbedürfnisse profitiere

The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease

BACKGROUND: Interpretation of the Hospital Anxiety and Depression Scale (HADS), commonly used to assess anxiety and depression in COPD patients, is unclear. Since its minimal important difference has never been established, our aim was to determine it using several approaches. METHODS: 88 COPD patients with FEV1 /= 0.5 we performed linear regression analyses to predict the minimal important difference from the anchors. As distribution-based approach we used the Effect Size approach. RESULTS: Based on CRQ emotional function and mastery domain as well as on total scores, the minimal important difference was 1.41 (95% CI 1.18-1.63) and 1.57 (1.37-1.76) for the HADS anxiety score and 1.68 (1.48-1.87) and 1.60 (1.38-1.82) for the HADS total score. Correlations of the HADS depression score and CRQ domain and Feeling Thermometer scores were < 0.5. Based on the Effect Size approach the MID of the HADS anxiety and depression score was 1.32 and 1.40, respectively. CONCLUSION: The minimal important difference of the HADS is around 1.5 in COPD patients corresponding to a change from baseline of around 20%. It can be used for the planning and interpretation of trials

Recruitment barriers in a randomized controlled trial from the physicians' perspective – A postal survey

BACKGROUND: The feasibility of randomized trials often depends on successful patient recruitment. Although numerous recruitment barriers have been identified it is unclear which of them complicate recruitment most. Also, most surveys have focused on the patients' perspective of recruitment barriers whereas the perspective of recruiting physicians has received less attention. Therefore, our aim was to conduct a postal survey among recruiting physicians of a multi-center trial to weigh barriers according to their impact on recruitment. METHODS: We identified any potential recruitment barriers from the literature and from our own experience with a multi-center trial of respiratory rehabilitation in patients with chronic obstructive pulmonary disease. We developed and pilot-tested a self-administered questionnaire where recruiting physicians were asked to express their agreement with statements about recruitment barriers on a Likert-type scale from 1 (full agreement with statement = very substantial recruitment barrier) to 7 (no agreement with statement = no recruitment barrier). RESULTS: 38 of 55 recruiting physicians returned questionnaires (69% response rate), of which 35 could be analyzed (64% useable response rate). Recruiting physicians reported that "time constraints" (median agreement of 3, interquartile range 2-5) had the most negative impact on recruitment followed by "difficulties including identified eligible patients" (median agreement of 5, IQR 3-6). Other barriers such as "trial design barriers", "lack of access to treatment", "individual barriers of recruiting physicians" or "insufficient training of recruiting physicians" were perceived to have little or no impact on patient recruitment. CONCLUSION: Physicians perceived time constraints as the most relevant recruitment barrier in a randomized trial. To overcome recruitment barriers interventions, that are affordable for both industry- and investigator-driven trials, need to be developed and tested in randomized trials. TRIAL REGISTRATION: ISRCTN84612310

Cosmological Perturbations in Flux Compactifications

Kaluza-Klein compactifications with four-dimensional inflationary geometry combine the attractive idea of higher dimensional models with the attempt to incorporate four-dimensional early-time or late-time cosmology. We analyze the mass spectrum of cosmological perturbations around such compactifications, including the scalar, vector, and tensor sector. Whereas scalar perturbations were discussed before, the spectrum of vector and tensor perturbations is a new result of this article. Moreover, the complete analysis shows, that possible instabilities of such compactifications are restricted to the scalar sector. The mass squares of the vector and tensor perturbations are all non-negative. We discuss form fields with a non-trivial background flux in the extra space as matter degrees of freedom. They provide a source of scalar and vector perturbations in the effective four-dimensional theory. We analyze the perturbations in Freund-Rubin compactifications. Although it can only be considered as a toy model, we expect the results to qualitatively generalize to similar configurations. We find that there are two possible channels of instabilities in the scalar sector of perturbations, whose stabilization has to be addressed in any cosmological model that incorporates extra dimensions und form fields. One of the instabilities is associated with the perturbations of the form field.Comment: 16 pages, v2 figure and references added, accepted version for JCA

Canonical phase space approach to the noisy Burgers equation

Presenting a general phase approach to stochastic processes we analyze in particular the Fokker-Planck equation for the noisy Burgers equation and discuss the time dependent and stationary probability distributions. In one dimension we derive the long-time skew distribution approaching the symmetric stationary Gaussian distribution. In the short time regime we discuss heuristically the nonlinear soliton contributions and derive an expression for the distribution in accordance with the directed polymer-replica model and asymmetric exclusion model results.Comment: 4 pages, Revtex file, submitted to Phys. Rev. Lett. a reference has been added and a few typos correcte

Patterns in the Kardar-Parisi-Zhang equation

We review a recent asymptotic weak noise approach to the Kardar-Parisi-Zhang equation for the kinetic growth of an interface in higher dimensions. The weak noise approach provides a many body picture of a growing interface in terms of a network of localized growth modes. Scaling in 1d is associated with a gapless domain wall mode. The method also provides an independent argument for the existence of an upper critical dimension.Comment: 8 pages revtex, 4 eps figure