A Classification Tree Approach to the Development of Actuarial Violence Risk Assessment Tools

Since the 1970s, a wide body of research has suggested that the accuracy of clinical risk assessments of violence might be increased if clinicians used actuarial tools. Despite considerable progress in recent years in the development of such tools for violence risk assessment, they remain primarily research instruments, largely ignored in daily clinical practice. We argue that because most existing actuarial tools are based on a main effects regression approach, they do not adequately reflect the contingent nature of the clinical assessment processes. To enhance the use of actuarial violence risk assessment tools, we propose a classification tree rather than a main effects regression approach. In addition, we suggest that by employing two decision thresholds for identifying high- and low-risk cases--instead of the standard single threshold--the use of actuarial tools to make dichotomous risk classification decisions may be further enhanced. These claims are supported with empirical data from the MacArthur Violence Risk Assessment Study.     

On Correcting Biases in Self-Reports of Age at First Substance Use with Repeated Cross-Section Analysis

Household survey data on age at first use of alcohol, tobacco, marijuana,and hard drugs can be biased due to sample selection and inaccuraterecall. One potential concern is attrition, whereby individuals who getinvolved with substance use at an early age become increasingly less likelyto be surveyed in successive years. A comparison of data from the NationalHousehold Survey on Drug Abuse (NHSDA) with data from a longitudinal studysuggested that attrition might have caused substantially less bias thandid forward telescoping, the inflating of age at first useover time. The evidence of forward telescoping was particularly pronouncedwith respect to age at first use of alcohol. This paper presents a procedurefor correcting the distribution of age at first use for forward telescoping(but not attrition) by viewing a portion of the NHSDA data collected insuccessive years as constituting a cohort study. Results are presented fromapplying this procedure with NHSDA data collected from 1982 to 1995 forrespondents born 1968–1973. The findings suggest that preventionprograms need to be introduced at an earlier age than would be indicatedby uncorrected retrospective data. Other implications are alsohighlighted.     

Governance and order-making in Central Asia: from illiberalism to post-liberalism?

ABSTRACT

This forum brings together five different angles on the question as to whether and how political regimes and forms of order-making can and should be researched through the concept of ‘illiberalism’. The discussion engages critically with this and associated concepts, such as ‘illiberal peace’ and ‘authoritarian conflict management’, which have been developed out of the Central Asian / Eurasian context and discussed in their wider global ramifications and, within the framing of ‘illiberal peace’, explored in various contexts in and beyond Central Asia. While further assessing the relevance and implications of this approach, this forum also attempts to think beyond ‘illiberalism’ by introducing and discussing the idea of ‘post-liberalism’. This way, the authors engage in an exchange that serves to probe both concepts and to determine their strengths and limitations when it comes to analysing and understanding politics and societal processes in Central Asia.     

A review of the analysis of vegetable oil residues from fire debris samples: spontaneous ignition, vegetable oils, and the forensic approach

This paper reviews the literature on the analysis of vegetable (and animal) oil residues from fire debris samples. The process of self-heating and spontaneous ignition is well-known by fire investigators and causes many fires. Vegetable oils are often the chemicals that originate such phenomenon. Vegetable oils are composed of lipids, which contain fatty acids. The autooxidation of the double bonds present in unsaturated fatty acids is the exothermic reaction at the origin of the self-heating process. The degree of unsaturation of fatty acids directly influences the propensity of an oil to undergo self-heating and, eventually, spontaneous ignition. When fire debris samples are collected, it is possible to examine them at the laboratory to extract and identify vegetable oil residues. This is typically performed by solvent extraction, followed by gas chromatographic(-mass spectrometric) analysis of the extract. Such analyses differ from ignitable liquid residue analyses, so a different forensic approach is necessary.     

Family Representative Payeeship and Violence Risk in Severe Mental Illness

Although representative payeeship is prevalent among people with mental illness and shows promise to positively influence clinically relevant outcomes, research also suggests this legal mechanism could be implemented in ways that are problematic. The current study examined whether family representative payeeship was associated with elevated risk of family violence perpetrated by persons with severe mental illness (SMI). Data were collected every 4 months for 1 year in structured interviews with N = 245 persons with SMI who received disability benefits. Multivariate analyses showed that substance abuse, history of violence, frequency of family contact, and family representative payeeship were associated with elevated odds of family violence. Analyses also showed family contact and family representative payeeship had a cumulative effect on increasing the predicted probability of family violence (controlling for covariates such as violence history and substance abuse). The data shed light on the potential for family representative payeeship to be associated with increased risk of interpersonal conflict and violence in SMI.     

Community-based care for people with severe mental illness in Canada

The development of mental health services for people with severe mental illness has in many ways paralleled that in other countries, particularly the United States. As reliance on inpatient psychiatric care has been sharply reduced, a wide range of community supports have been developed. Several distinct institutional and legal features have contributed to shaping the nature of these community supports, which are described herein. At present, the result is a highly fragmented system of care. Key evidence-based practices, notably assertive community treatment, supported employment, and integrated treatment for concurrent severe mental illness and substance use disorder, achieve considerable integration at the clinical level, but remain relatively unavailable in most provinces. The policy of regionalization of services risks inhibiting the development of such practices, which require more centralized technical assistance and monitoring. An evolutionary approach of gradually introducing integrated, evidence-based programs may provide the most feasible strategy for improving the system.     

Public opinion and the politics of obesity in America

Health policy experts have recently sounded the warning about the severe health and economic consequences of America's growing rates of obesity. Despite this fact, obesity has only begun to enter America's political consciousness and we have little information about what average Americans think of obesity or whether they support obesity-related policies. Using unique survey data collected by the authors, this essay examines public attitudes toward obesity and obesity policy. We find that, contrary to the views of health experts, most Americans are not seriously concerned with obesity, express relatively low support for obesity-targeted policies, and still view obesity as resulting from individual failure rather than environmental or genetic sources. Given the absence of elite discourse on this problem, we also find that typical determinants of policy preferences, such as ideology or partisanship, are not good predictors of attitudes on obesity policy. Rather, with a low-valence issue such as obesity, the public utilizes other attitudinal frameworks such as their opinions on smoking policy and the environmental culpability for obesity. The implications of these findings for obesity policy and research on health-related public opinion are discussed.