Spinal cystic echinococcosis - a systematic analysis and review of the literature : part 1. Epidemiology and anatomy

Bone involvement in human cystic echinococcosis (CE) is rare, but affects the spine in approximately 50% of cases. Despite significant advances in diagnostic imaging techniques as well as surgical and medical treatment of spinal CE, our basic understanding of the parasite's predilection for the spine remains incomplete. To fill this gap, we systematically reviewed the published literature of the last five decades to summarize and analyze the currently existing data on epidemiological and anatomical aspects of spinal CE

Methodological development: structured outcome assessment and community risk monitoring (SORM)

This paper describes an effort to develop a clinical tool for the continuous monitoring of risk for violence in forensic mental health clients who have left their institutions and who are dwelling in the community on a conditional release basis. The model is called Structured Outcome Assessment and Community Risk Monitoring (SORM). The SORM consists of 30 dynamic factors and each factor in SORM is assessed in two ways: The current absence, presence or partial och intermittent presence of the factors, which is an actuarial (systematized and 'objective') assessment. Secondly, the risk effect, i.e. whether the presence/absence of factors currently increases, decreases or is perceived as unrelated to violence risk, is a clinical (or impressionistic) assessment. Thus, the factors considered via the SORM can be coded as risk factors or protective factors (or as factors unimportant to risk of violence) depending on circumstances that apply in the individual case. Further, the SORM has a built-in module for gathering idiographical information about risk-affecting contextual factors. The use of the SORM and its potential as a risk monitoring instrument is illustrated via preliminary data and case vignettes from an ongoing multicenter project. In this research project, patients leaving any of the 9 participating forensic hospitals in Sweden is assessed at release on a variety of static background factors, and the SORM is then administered every 30 days for 2 years. © 2005 Elsevier Inc. All rights reserved

Violent behaviour in forensic psychiatric patients: Risk assessment and different risk-management levels using the HCR-2o

There has been a growing optimism regarding the accuracy of structured instruments for violence risk assessment in mentally disordered offenders. However, several issues pertaining to forensic assessments of risk remains unsolved, one of which is the relationship between risk assessment and risk management. In this paper we argued that research that evaluate efforts to assess risk must take into account the level of risk management in the sample. We attempted to illustrate this using prospective follow-up data on the frequency and type of inpatient violent behaviours and their relationship to risk management within the context of care. Risk assessments were made upon admission to hospital with the Historical-Clinical-Risk assessment (HCR-20, Webster et al., 1997) in 54 forensic patients followed through three different risk management conditions: High security risk management, medium risk management, and only risk monitoring (low). The results showed large differences in baserate and type of violence in the three management conditions. Results also suggested that the HCR-20 accurately assessed risk in medium and low security conditions, but not in the high security condition. We conclude that the findings reinforce rather than contraindicate the usefulness of the HCR-20 in for clinical practice

Preliminary findings on reliability and validity of the Historical-Clinical-Risk assessment in a forensic psychiatric setting

The purpose of this study was to establish inter-rater reliability and retrospective validity of the Historical-Clinical-Risk assessment (HCR-20). HCR-20 is an instrument for assessing risk, incorporating three different approaches to the area. Six patients sentenced to Forensic psychiatric care for violent crimes were individually rated on the HCR-20 by 6 raters, trained in the assessment manual. The correlation's between raters were in the range of 0.76 to 0.96 for the full scale. The range for the Clinical evaluation was found to be somewhat weaker (0.52-0.95). Overall the results indicates that the HCR-20 has a satisfactory level of reliability provided that raters are properly trained. The HCR-20 was also compared to independent ratings of past violent crimes. The independent ratings were done by two professionals using the criminal records of the clients. These were rated in a 6 point crime-index scale, considering criminal versatility and seriousness of violent crimes. The correlate of the crime-index Scale and "HCR-19" was 0.67. The results were discussed with respect to the usefulness of HCR-20 as a risk assessment instrument with good levels of reliability and validity