WATER RESOURCE DEVELOPMENT

Both the federal and state governments have strong constitutional daims and political resources with which to influence the allocation of water resources. Until the 1970s. federal agencies were able to dominate kr setting goals and objectives. However, when the federal government attempted to implement a national water policy in the 1970s, effective opposition was mounted by the states. Both the states and the federal government now exert decisive influence in water policy.     

A comparison of actuarial methods for identifying repetitively violent patients with mental Illnesses

This is a progress report on the development of practical methods for the actuarial prediction of violence. The literature indicates that actuarial prediction is more accurate than clinical prediction, but in practice actuarial methods seem to be used rarely. Here we address two obstacles to the clinical use of actuarial prediction methods. First, clinicians may be averse to actuarial methods that require calculations. To remedy this, we developed a regression tree screen that presents actuarial information about violence in a series of yes/no questions. Second, using actuarial methods to identify the small minority of violent patients in a general psychiatric population may be too costly. To remedy this, we developed a method to prescreen patients for intensive evaluation using an inexpensive assessment. We evaluated regression trees and two-stage screening by comparing their accuracies against conventional actuarial methods. The results showed that actuarial predictions based on regression trees and two-stage screens were as accurate as regression-based methods in identifying repetitively violent patients. These easier-to-use methods may therefore be useful techniques for actuarial predictions.     

Extra information about treatment is too much for the patient with psychosis

BackgroundCase law across jurisdictions requires ever more complete disclosure of material facts when obtaining consent to treatment.AimsTo determine whether giving extra information impairs the mental capacity to make decisions about treatment.MethodThe MacCAT-T, MacCAT-FP, PANSS and GAF were administered to 88 detained forensic patients with psychosis. Two positive and two negative facts were given about each of two anti-psychotic drugs, and no treatment (twelve items). A choice was elicited. The criterion for incompetence was inability to express a choice. Two extra positive and two extra negative facts about each of the three options were given (twelve extra items) and a choice was again elicited, while repeating the MacCAT-T.ResultsGiving extra information led to a decline in the total score on the MacCAT-T. Twenty one were initially unable to make a choice (24%). After additional information, 33 were incapable (37.5%, Chi-squared p < 0.001). Those initially incapable had the lowest scores on all measures of functional capacity and GAF, with highest scores for symptoms. Those able to choose a treatment option had the highest levels of function and least symptoms. Those who became incapable had intermediate scores.ConclusionsGiving extra information made an extra 15% unable to choose. Clinical judgement must be exercised concerning the amount of information disclosed. Deciding what is material to the individual is arbitrary when so few items of information can be processed. Greater use of guardianship and independent second opinions is recommended.     

Performance Appraisal or Performance Development? a Tale of Two Schemes

After reviewing some of the literature on performance appraisal, this evaluation presents a case study of the introduction of two related schemes in a single Australian government agency. The reasons one was successful and the other less so included the ownership by the agency of the successful scheme; its rapid implementation; and its focus on development rather than appraisal