Patient information on drug therapy. A problem of medical malpractice law: between product safety and user safety

Medicinal products are associated with risks as well as potential therapeutic benefits. This is reflected by the legal requirements for patient information on drug therapy which can be differentiated into general product information, regulated by pharmaceutical (i. e. product safety) law, and individual patient information on the treatment with the product, which is subject to medical malpractice law. The physician's duty to inform the patient comprises therapeutic information as well as information required for informed consent. Therapeutic information intends to empower the patient to comply with the requirements of treatment and to protect him/her against preventable danger and risk; it is part of the medical treatment, aimed at the individual patient and his/her personal situation. Information required for informed consent enables the patient to a self-determined decision on the treatment offered; it can be divided into information on the course of treatment and risk information. Product information and treatment information complement each other; the former should be the basis of individual information on the concrete treatment, provided by the physician in a mandatory oral conversation with the patient. Product information cannot replace the physician's individual information about the treatment.     

Assessment and management of risk for intimate partner violence by police officers using the Spousal Assault Risk Assessment Guide

Intimate partner violence (IPV) is a crime that is present in all countries, seriously impacts victims, and demands a great deal of time and resources from the criminal justice system. The current study examined the use of the Spousal Assault Risk Assessment Guide, 2nd ed. (SARA; Kropp, Hart, Webster, & Eaves, 1995), a structured professional judgment risk assessment and management tool for IPV, by police officers in Sweden over a follow-up of 18 months. SARA risk assessments had significant predictive validity with respect to risk management recommendations made by police, as well as with recidivism as indexed by subsequent contacts with police. Risk management mediated the association between risk assessment and recidivism: High levels of intervention were associated with decreased recidivism in high risk cases, but with increased recidivism in low risk cases. The findings support the potential utility of police-based risk assessment and management of IPV, and in particular the belief that appropriately structured risk assessment and management decisions can prevent violence.     

Psychopathic traits and offending trajectories from early adolescence to adulthood

Purpose

Measures of adolescent psychopathy have yet to be examined in offending trajectory studies. This may explain why identifying etiological differences between individuals following high-rate and moderate-rate offending trajectories has remained elusive. The current study used the Psychopathy Checklist: Youth Version (PCL:YV) to examine psychopathic traits and offending trajectories within a sample of incarcerated offenders.

Methods

Convictions were measured for Canadian male (n = 243) and female (n = 64) offenders at each year between ages 12 and 28. Semi-parametric group based modeling identified four unique trajectories: adolescence-limited (AL) (27.3% of sample), explosive-onset fast desister (EOFD) (30.6%), high-rate slow desister (HRSD) (14.6%), and high frequency chronic (HFC) (27.5%).

Findings

Both a three and a four factor model of psychopathy were tested, and both factor structures were positively and significantly associated with the HRSD and HFC trajectories. Regarding individual factors of psychopathy, the ‘Antisocial’ factor of the PCL:YV was the only individual dimension significantly associated with membership in high-rate compared to moderate-rate offending trajectories.

Conclusions

Psychopathic traits appear more commonly present amongst individuals who follow chronic versus moderate offending trajectories. Implications for early intervention and risk management of offenders are discussed.     

Working with children as stakeholders in development: the challenges of organisational change

This article considers the challenges of promoting children's participation in development programming. It argues against the tendency to see the main obstacle to achieving this aim as technical. Instead it explores the institutional dimensions of change that may be required. The experience of a four-year process of training and organisational review within Save the Children Denmark provides the substance for reflection about the kinds of cultural and structural change that are implicated in enabling a development organisation to become capable of engaging young people as stakeholders in a meaningful and sustainable manner.     

Psychopathy and Nonverbal Indicators of Deception in Offenders

The current study examined psychopathy and nonverbal indicators of deception in an incarcerated sample. Nonverbal behaviors were coded from videotapes of 45 male offenders telling true and fabricated stories about crimes. Interpersonal features of psychopathy were associated with inflated views of lying ability, verbosity, and increases in blinking, illustrator use, and speech hesitations. While lying, the more psychopathic offenders spoke faster and demonstrated increases in blinking and head movements. Indicators of deception in offenders were somewhat different from those typically observed in non-offender populations. These findings indicate that personality factors may have an impact on nonverbal indicators of deception in criminal justice settings where the detection of deception is of utmost concern.     

Workplace Assessment of Targeted Violence Risk: The Development and Reliability of the WAVR‐21

This study describes the development of the WAVR‐21, a structured professional judgment guide for the assessment of workplace targeted violence, and presents initial interrater reliability results. The 21‐item instrument codes both static and dynamic risk factors and change, if any, over time. Five critical items or red flag indicators assess violent motives, ideation, intent, weapons skill, and pre‐attack planning. Additional items assess the contribution of mental disorder, negative personality factors, situational factors, and a protective factor. Eleven raters each rated 12 randomly assigned cases from actual files of workplace threat scenarios. Summary interrater reliability correlation coefficients (ICCs) for overall presence of risk factors, risk of violence, and seriousness of the violent act were in the fair to good range, similar to other structured professional judgment instruments. A subgroup of psychologists who were coders produced an ICC of 0.76 for overall presence of risk factors. Some of the individual items had poor reliability for both clinical and statistical reasons. The WAVR‐21 appears to improve the structuring and organizing of empirically based risk‐relevant data and may enhance communication and decision making.