[Therapy drop-out as a predictor of re-delinquency : Legal probation of substance addicted patients according to §64 of the German Legal Code]. / Therapieabbruch als Prädiktor erneuter Straftaten : Legalbewährung von Patienten nach Unterbringungen gemäß § 64 StGB.

BACKGROUND: Recidivism rates in substance-addicted patients placed in institutions according to §64 of the German legal code are approximately 50%, 3 years after discharge from inpatient treatment. The recidivism rates of patients with premature termination of inpatient treatment who had then been referred back to prison and were finally discharged into the community are unknown. RESEARCH QUESTION: Is premature termination of treatment a risk factor for recidivism? METHODS: Patients released from forensic treatment according to § 64 of the German legal code were followed up for violent and non-violent recidivism. Full data were acquired for Baden-Württemberg patients released in 2010 and 2011 with regular vs. premature termination of treatment. RESULTS: All measures revealed highly significant group differences: 48% of the patients discharged after subsequent prison sentences recidivated within the first year and 73% within 3 years after discharge. Among recidivists, the severity of offences was much higher (odds ratio > 3.8 each). Regularly discharged patients also re-offended to a remarkable extent (50%). DISCUSSION: Patients serving prison sentences after unsuccessful forensic treatment are a high-risk group for recidivism. Alternative concepts of clinical and legal treatment of this group should be developed.

[Healthcare research in forensic commitment or poking around in the dark : Consensus paper on the necessity for more uniform and better data]. / Versorgungsforschung im Maßregelvollzug oder das Stochern im Nebel : Konsenspapier zur Notwendigkeit einheitlicher und besserer Daten.

Complex trends in occupancy determined by many influencing factors, clear state-specific differences in imprisonment practices as well as recently implemented statutory alterations to the appropriate paragraphs in criminal law, underline the necessity for qualitative high-grade concomitant research of German forensic commitment; however, neither the structural prerequisites nor an adequate data situation are currently present in order to do justification to this aim. Not even the total number of patients currently accommodated in forensic commitment can be elucidated from the publicized (partial) statistics. This consensus paper, which was formulated by three research institutes active at the state level, describes the limited possibilities for current forensic healthcare research and raises the demand for a nationwide uniform data situation on patients in forensic commitment. Furthermore, how the appropriate elicitation instrument should be organizationally and structurally achieved, is sketched from a scientific perspective. This article aims at initiating a discussion on a sustainable improvement in the prerequisites for healthcare research in German forensic commitment and targets a sensitization of decision makers in politics and administration for this topic.

[Characteristics of forensic patients assigned to forensic outpatient treatment]. / Welche Maßregelvollzug-Patienten erhalten nach der stationären Behandlung eine Weisung für die forensische Ambulanz?

OBJECTIVE: In the Federal State of Baden-Württemberg an administrative regulation specifies which patients should be assigned to forensic outpatient treatment. Empirically, little is known about the clinical and criminological factors supporting these decisions. METHODS: A complete survey of forensic inpatients in Baden-Württemberg was undertaken. RESULTS: From 476 patients released from unlimited detention (§â€Š63 StGB) 235 (45.6 %) received a court order for forensic aftercare between 2009 and 2012. Social, forensic, and psychiatric history differed only slightly compared with patients not assigned. Schizophrenia as diagnosis was overrepresented, personality disorder and paraphilia underrepresented. Both groups differed most with respect to the duration of detention. CONCLUSIONS: The decision for forensic outpatient treatment seems to be determined by process variables of inpatient treatment but not by criminological risk factors. This contradicts the R-N-R principles by Andrews and Bonta.

Investigations of milk quality from teats with milk flow disorders.

The objective of this study was to investigate the quality of milk from teats with milk flow disorders. Somatic cell count, pathogens, and signs of mastitis (>100,000 cells/ml and pathogens detected) were determined in the milk from all teats of the udder before treatment of the affected teat, as well as 1 and 6 mo later. Teats with milk flow disorders were compared to all of the other teats from the same udder. Before treatment, the SCC from affected teats was 4.3 million higher, the odds of detecting pathogens 6 times higher, and the odds of mastitis 11 times higher than in control teats (when adjusted for other significant explanatory variables). SCC and the risk of mastitis decreased after surgical treatment of the affected teats, whereas the chance of detecting pathogens was not affected. Six months after treatment, the SCC was 1.3 million higher, and the odds of mastitis 6.5 times higher than in control teats. Throughout the study period neither SCC, the odds of detecting pathogens, nor mastitis changed significantly in control teats. It may be concluded from this study that milk quality from teats with milk flow disorders is decreased before treatment and does not reach the milk quality from unaffected teats within 6 mo after treatment.

Comparative evaluation of SIMPL silicone implants and NIT natural teat inserts to keep the teat canal patent after surgery.

The objective of this study was the comparative evaluation of SIMPL silicone implants and NIT natural teat inserts to keep the teat canal patent after teat surgery. The study was performed on 100 teats of 97 cows treated surgically for milk flow disorders. After surgery, 53 teats were administered with SIMPL and 47 with NIT, and rested for several days. Before treatment and 1 and 6 mo later quarter milk flow and milk yield were measured with Lactocorders; quarter milk was examined for somatic cell count (SCC), pathogens, and signs of mastitis (SCC > 100,000 and pathogens detected). Half a year after surgery milk flow, milk yield and SCC were equal from teats that had been inserted with SIMPL or NIT. The odds of detecting pathogens or signs of mastitis in the milk was lower in SIMPL than in NIT teats at this point in time. SIMPL teats stayed in the herd as long as NIT teats. Based on the results, it may be expected that teats inserted with a SIMPL or NIT do not differ long term in regards to milk flow, milk yield, SCC, and risk of removal from the herd. After the use of SIMPL, fewer pathogens may be detected in the milk long term than after the use of NIT.