Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

There is a lack of appropriate services to manage youth with comorbid mental health problems and violence risks. To address this gap, we implemented a forensic satellite clinic in a youth mental health service. This paper characterises offending histories among 45 young patients referred to the clinic, and compares them with matched clinical controls (n = 45). Levels of prior risk taking and aggression were prominent among referred patients. Forensic cases and controls did not differ on demographic and clinical variables, with the exception of psychiatric inpatient admissions, which were higher among referred patients. Group differences were observed for prior offending variables (e.g., physical aggression), which were significantly higher among referred patients than controls. Findings suggest that referrals were made to the clinic based on challenging and aggressive behaviour rather than specific clinical characteristics. The role of specialist assessment, treatment and management of violence risks in youth mental health services are discussed.

Transitioning to routine breast cancer risk assessment and management in primary care: what can we learn from cardiovascular disease?

To capitalise on advances in breast cancer prevention, all women would need to have their breast cancer risk formally assessed. With ~85% of Australians attending primary care clinics at least once a year, primary care is an opportune location for formal breast cancer risk assessment and management. This study assessed the current practice and needs of primary care clinicians regarding assessment and management of breast cancer risk. Two facilitated focus group discussions were held with 17 primary care clinicians (12 GPs and 5 practice nurses (PNs)) as part of a larger needs assessment. Primary care clinicians viewed assessment and management of cardiovascular risk as an intrinsic, expected part of their role, often triggered by practice software prompts and facilitated by use of an online tool. Conversely, assessment of breast cancer risk was not routine and was generally patient- (not clinician-) initiated, and risk management (apart from routine screening) was considered outside the primary care domain. Clinicians suggested that routine assessment and management of breast cancer risk might be achieved if it were widely endorsed as within the remit of primary care and supported by an online risk-assessment and decision aid tool that was integrated into primary care software. This study identified several key issues that would need to be addressed to facilitate the transition to routine assessment and management of breast cancer risk in primary care, based largely on the model used for cardiovascular disease.

Violence risk assessment in psychiatric patients in China: a systematic review

Objectives: The aim of this study was to undertake a systematic review on violence risk assessment instruments used for psychiatric patients in China.

Methods: A systematic search was conducted from 1980 until 2014 to identify studies that used psychometric tools or structured instruments to assess aggression and violence risk. Information from primary studies was extracted, including demographic characteristics of the samples used, study design characteristics, and reliability and validity estimates.

Results: A total of 30 primary studies were identified that investigated aggression or violence; 6 reported on tools assessing aggression while an additional 24 studies reported on structured instruments designed to predict violence. Although measures of reliability were typically good, estimates of predictive validity were mostly in the range of poor to moderate, with only 1 study finding good validity. These estimates were typically lower than that found in previous work for Western samples.

Conclusion: There is currently little evidence to support the use of current violence risk assessment instruments in psychiatric patients in China. Developing more accurate and scalable approaches are research priorities.

Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors

Background : Violence risk assessment in schizophrenia relies heavily on criminal history factors.

Aims : To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia.

Method : A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification.

Results : Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder.

Conclusions : Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance.

Delaware Reservoirs’ Drought Risk Assessment: A Paleo View

The Delaware River provides half of New York City's drinking water, is a habitat for wild trout, American shad and the federally endangered dwarf wedge mussel. It has suffered four 100‐year floods in the last seven years. A drought during the 1960s stands as a warning of the potential vulnerability of the New York City area to severe water shortages if a similar drought were to recur. The water releases from three New York City dams on the Delaware River's headwaters impact not only the reliability of the city’s water supply, but also the potential impact of floods, and the quality of the aquatic habitat in the upper river. The goal of this work is to influence the Delaware River water release policies (FFMP/OST) to further benefit river habitat and fisheries without increasing New York City's drought risk, or the flood risk to down basin residents. The Delaware water release policies are constrained by the dictates of two US Supreme Court Decrees (1931 and 1954) and the need for unanimity among four states: New York, New Jersey, Pennsylvania, and Delaware ‐‐ and New York City. Coordination of their activities and the operation under the existing decrees is provided by the Delaware River Basin Commission (DRBC). Questions such as the probability of the system approaching drought state based on the current FFMP plan and the severity of the 1960s drought are addressed using long record paleo‐reconstructions of flows. For this study, we developed reconstructed total annual flows (water year) for 3 reservoir inflows using regional tree rings going back upto 1754 (a total of 246 years). The reconstructed flows are used with a simple reservoir model to quantify droughts. We observe that the 1960s drought is by far the worst drought based on 246 years of simulations (since 1754).

Harmonised framework for ecological risk assessment of sediments from ports and estuarine zones of North and South Atlantic

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cancer risk assessment of ethyl carbamate in alcoholic beverages from Brazil with special consideration to the spirits cachaca and tiquira

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efficacy of dip slide test for mutans streptococci in caries risk assessment

The aim of this study was to evaluate the efficacy of a dip slide test for mutans streptococci in caries risk assessment, when the microbiological results were compared to well-defined clinical criteria (DCC) for caries risk, clinically measured through high and low caries activity. Eighty-one volunteers from the 6(th) to 8(th) grades from public schools of Piracicaba, São Paulo, Brazil, were evaluated for dental caries. All free smooth surfaces were evaluated to check whether or not there were white spots. Based on the subjects' caries experience, a calibrated clinician divided them into groups of high and low caries activity. The subjects were submitted to a salivary test (CARITEST SM (R)) from the same batch number. Kappa statistics (kappa) were applied to verify the reproducibility of the simplified test, checked through interexaminer agreement when the results were classified by independent and blind means. The microbiological results were validated according to expressions of sensitivity and specificity. A moderate agreement was verified as the results were classified according to 6 scores (kappa =0.55), and the agreement was substantial when the results were classified according to high and low microbiological count (kappa =0.78). The sensitivity and specificity values were 0.59 and 0.85, respectively, showing that the test was more specific than sensitive, and could thus better identify the low caries risk subjects.

Risk assessment of cadmium toxicity on hepatic and renal tissues of rats

Pollution and industrial practices result in concentrations of metals and other environmental agents that are related to environmental toxicity. A rat bioassay was utilized for the identification of toxic effects of cadmium intake. This demonstrated increased total urinary proteins and increased kidney weights in rats exposed to CdCl2, for 7 days, in drinking water (100 mg/L). Serum creatinine, total and direct bilirubin concentrations and alanine transaminase activity were increased in Cd-exposed rats, indicating renal and hepatic toxicity. It was also observed that lipoperoxide concentrations were increased, while Cu-Zn superoxide dismutase activity was decreased in rats treated with cadmium. This indicated that the renal and hepatic toxicity induced by cadmium involved superoxide radicals. (C) 1998 Academic Press.

Impedance e-tongue instrument for rapid liquid assessment

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Risk-assessment algorithm and recommendations for venous thromboembolism prophylaxis in medical patients

The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. Purpose: To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate recommendations (RECs) for prophylaxis that can be implemented into practice. Data sources: A multidisciplinary group of experts from 12 Brazilian Medical Societies searched MEDLINE, Cochrane, and LILACS. Study selection: Two experts independently classified the evidence for each RF by its scientific quality in a standardized manner. A risk-assessment algorithm was created based on the results of the review. Data synthesis: Several VTE RFs have enough evidence to support RECs for prophylaxis in hospitalized medical patients (eg, increasing age, heart failure, and stroke). Other factors are considered adjuncts of risk (eg, varices, obesity, and infections). According to the algorithm, hospitalized medical patients ≥40 years-old with decreased mobility, and ≥1 RFs should receive chemoprophylaxis with heparin, provided they don't have contraindications. High prophylactic doses of unfractionated heparin or low-molecular-weight-heparin must be administered and maintained for 6-14 days. Conclusions: A multidisciplinary group generated evidence-based RECs and an easy-to-use algorithm to facilitate VTE prophylaxis in medical patients. © 2007 Rocha et al, publisher and licensee Dove Medical Press Ltd.

ECOTOXICITY AND ENVIRONMENTAL RISK ASSESSMENT OF LARVICIDES USED IN THE CONTROL OF Aedes aegypti TO Daphnia magna ( CRUSTACEA, CLADOCERA)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reactive power planning under conditional-value-at-risk assessment using chance-constrained optimisation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)