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In accordance with modern understandings of criminal law science and solutions present in the comparative criminal legislation, the Criminal Code of the Republic of Serbia pays special attention to security measures as special and above all specific criminal sanctions. They are one of the four types of criminal sanctions provided for in this legal text. Among the eleven security measures, four are of a medical nature and they differ in a number of features, not only in relation to other criminal sanctions, but also other security measures. One of the medical safety measures is the obligatory treatment of alcoholics. There are a number of specifics of this security measure, and one of them is its manner of execution. Given this, the subject of analysis in the paper are two aspects of the safety measure of compulsory treatment of alcoholics. These are: normative and practical. The justification of this approach in the analysis of the subject matter is contained in the fact that only adequately performed and this security measure is in the function of its standardization - the function of eliminating conditions or conditions that may affect the perpetrator in the future does not commit crimes due to alcohol dependence. to the expression of criminal acts of violence that are increasingly present in the total mass of crime.

The prevalence of malocclusion among school going children in KwaZulu-Natal remains poorly defined despite the known physiological and psychological impact of this dental occurrence. The aim and objectives of this study was to determine the prevalence of malocclusion and possible treatment need in 13-15 year-old school going children in Durban, Kwa-Zulu Natal. This was a descriptive, cross-sectional epidemiological study conducted on 270 school-going children aged 13 to 15 years, in the Umlazi and Pinetown school districts. A two-staged clustered and systematic random sampling technique was used to draw the study sample. Data was collected through an intraoral examination of occlusal status and the malocclusion and orthodontic treatment need was assessed through use of the Dental Aesthetic Index (DAI). Questionnaires were developed to collect information on the learners’ health status and socio demographic profile. The results indicated that 144 (53.3%) of the 270 learners had DAI scores 36 (very severe or handicapping malocclusion requiring mandatory orthodontic treatment). There was an increase in the proportion of malocclusion in older children. The age group of 15 years old had a mean and standard deviation of 30.02+8.9 when compared to the age group 13 years old (27.76+12.17). The association between gender distribution and severity of malocclusion was found to be statistically significant (p=0.01). The present study primarily indicated a significant prevalence of malocclusion in the identified children. Although 53.3% of children did not require treatment, 37.1% presented with severe and handicapping malocclusion. This suggests a definite and mandatory treatment need for this group of children. The study could provide useful baseline epidemiological data that could inform oral health planning on the prevalence of malocclusion and orthodontic treatment need for 13-15 year-old school going children in the identified geographical area.

In recent years, the relationship of hyperuricemia and gout with a high risk of cardiovascular disease has been widely discussed. Therefore, it is important to systematically examine patients in order to diagnose comorbidities, among which cardiovascular disease and its complications occupy a leading place and consider mandatory treatment of patients with hyperuricemia and gout with high cardiovascular risk with lowering drugs, which fully reflects the provisions of the latest European recommendations for the management and treatment of patients with gout.Гиперурикемия, подагра и высокий кардиоваскулярный риск - как ими управлять в клинической практике В последние годы широко обсуждается связь гиперурикемии и подагры с высоким риском кардиоваскулярных болезней. Поэтому важно систематически обследовать пациентов с целью диагностики сопутствующих заболеваний, среди которых сердечно - сосудистая патология и ее осложнения занимают ведущее место, и считать обязательным лечение пациентов с гиперурикемией и подагрой с высоким кардиоваскулярным риском уратснижающими препаратами, что полностью отражает положения последних европейских рекомендаций по ведению и лечению пациентов с гиперурикемией и подагрой.

Tibbi mudahaleler niteligi bakimindan kisilik hakkina mudahale olusturmaktadir ve bu nedenle kisilik hakkini ihlal etmemesi icin oncelikle ve kural olarak ilgilinin onaminin alinmis olmasi gereklidir. Tibbi mudahalede biyoloji ve tibbin elde ettigi nitelikli bilginin kullanimi sebebiyle onamin hukuka uygunlugu belirli ozel kosullari gerekli kilmaktadir, bu kosullardan biri de onamin mesru bir amaca yonelik olarak verilmis olmasidir. Ote yandan biyoloji ve tibba iliskin ozel, nitelikli bilgi toplumsal duzen acisindan iktidar sahiplerine tehlikeli bir arac sunmaktadir. Onam yerine gecen hukuka uygunluk sebepleri anayasal ilkeler dogrultusunda yasallik, olcululuk gibi kriterlere uygun olarak somutlastirilarak kisilerin bedenleri uzerinde onam alinmaksizin mudahalede bulunulabilmektedir. Soz konusu hukuka uygunluk sebepleri, tibbi mudahaleler soz konusu oldugunda ustun yarar kavrami altinda ozellestirilebilmektedir. Onam alinmadan gerceklestirilecek mudahale ilgilinin kendi yararina veya ucuncu bir kisi yararina olabildigi gibi genel olarak kamunun yararina da olabilir. Ne var ki gercekte neyin hastalik oldugu veya hangi mudahalenin kime gore nasil bir yarar saglayacagi salt bilimsel degil, ayni zamanda politik bir meseledir. Ilgilinin kendisiyle veya yasal temsilcisiyle catisma icine dusulerek girisilen tibbi mudahalelerin mesrulugunun sinirlari elestirel bir yaklasimla degerlendirilmistir.

Victim-offender contact has been studied extensively in prisons, but research on contact between victims and mentally disordered offenders in forensic mental health settings is lacking. Therefore, an exploratory study was conducted on contact between victims and offenders in four Dutch forensic psychiatric hospitals. These offenders have committed serious (sexually) violent offenses, for which they could not be held fully responsible due to severe psychopathology. During the mandatory treatment, it is possible for offenders and their victims to engage in contact with each other if both parties agree to this. To explore the conditions under which this contact is suitable, we interviewed 35 social workers about their experiences in 57 cases from four Dutch forensic psychiatric hospitals. Findings demonstrated that, according to the social workers, no type of offense or psychopathology were obvious exclusion criteria for victim-offender contact. Social workers described offenders' problem awareness, stable psychiatric condition, and ability to keep to agreements as important factors that enable victim-offender contact. Implications and suggestions for future research are provided.

International audience; BACKGROUND: Findings from efficacy trials of group psychoeducation (PE) for bipolar disorders (BD) led to its inclusion in evidence-based guidelines as a first-line mandatory treatment. However, pragmatic trials and observational studies are needed to determine its real-world effectiveness, impact on outcomes deemed important to patients and to clarify potential mediators of any benefits. METHODS: Individuals with BD were offered the opportunity to participate in 20h of PE and asked to complete pre- and post-intervention ratings of symptoms, knowledge about BD, medication adherence, and illness perception. A priori, two key patient outcomes were identified (social functioning and self-esteem); sample attrition due to dropout or relapse was recorded. RESULTS: Of 156 individuals who completed the pre-PE assessments, 103 completed the program and post-PE assessments. Only 4 of 53 dropouts were associated with BD relapse. Post-intervention, the PE completers demonstrated a statistically significant improvement in social functioning (p = 0.003, Effect Size (ES) = 0.26) and a trend towards improved self-esteem (ES = 0.14). Whilst there were significant changes in medication adherence (p = 0.002, ES = 0.28), knowledge of BD (p < 0.001, ES = 1.20), and illness perception (p < 0.001, ES = -0.37), mediational analysis demonstrated that only change in illness perception was associated to change in functioning (p=0.03) with no contribution from changes in knowledge of BD or medication adherence. CONCLUSIONS: In real-world settings, over 60% individuals completed 10-session course of PE. After controlling for demography and baseline clinical state, change in illness perception, rather than change in knowledge or medication adherence, emerged as a potential mediator of some benefits of PE.

Sarcoidosis is a disease characterized by granulomatous inflammation potentially affecting multiple organ systems. Although it can affect any organ, lungs, lymph nodes, skin and eyes are most commonly involved. Renal sarcoidosis, although rare, remains a challenging clinical issue requiring mandatory treatment, given the risk of developing renal failure. Taking into consideration the rarity of the disease, data regarding its diagnosis and treatment are scarce. This case series describes seven cases of sarcoidosis with predominantly renal manifestations, and moreover provides a review of the current literature on renal sarcoidosis.

Background: The intrinsic motivation behind the “need to complete” is more influential than external incentives. We introduced a novel progress-bar tool to motivate the completion of programs designed to treat stimulant and cannabis use disorders. We further examined the effectiveness of the progress bar's scoring approach in forecasting consistently negative urine tests. Methods: This study's participants included 568 patients with stimulant, amphetamine-type, and cannabis use disorders who were undergoing 12-month mandatory treatment programs at Taichung Veterans General Hospital in Taiwan. Patients were given scores of 1, -1, or 0 depending on whether they received negative, positive, or missing urinalysis reports, respectively. The autonomic progress bar generated weekly score totals. At the group level, scorei donated scores from all patients for a given week (i denoted the week). Scorei was standardized to adjusted scorei. We then conducted Autoregressive Integrated Moving Average (ARIMA) Model of time-series analyses for the adjusted scorei. Results: A total of 312 patients maintained treatment progress over the 12-month program. The autonomic score calculator totaled the shared achievements of these patients. The coefficients of the lag variables for mean (p), lag variables for residual error term (q), and number of orders for ensuring stationary (d) were estimated at p = 3, d = 4, and q = 7 for the first half of the treatment program, and were estimated at p = 2, d = 2, and q = 3 for the second half. Both models were stationary and tested as fit for prediction (p < 0.05). Sharply raised adjusted scores were predicted during the high-demand treatment phase. Discussion: This study's novel progress-bar tool effectively motivated treatment completion. It was also effective in forecasting continually negative urine tests. The tool's free open-source code makes it easy to implement among many substance-treatment services.

Compression therapy is a mandatory treatment of leg ulcers whether the goal is cure (stage C6 in the international classification for chronic venous disease) or prevention of recurrence (stage C5). Different indications for compression therapy were proposed by the French Superior Health Authority (HAS) in 2010, but new studies have modified attitudes since that time. Considering the very large number of options available, the many co-morbid conditions observed in these patients, as well as patient age and available assistance, it is important to adapt to the variable clinical and social situations encountered. One must keep in mind that a well-controlled treatment should improve trophic disorders and patient comfort. A poorly-adapted treatment with little or even deleterious effect will be abandoned by the patient.

Empowering those under criminal justice supervision to cease drug use on their own - rather than forcing them into formal treatment against their will - is a policy approach that warrants further evaluation.

The paper discusses the results of studies conducted in international clinics and the authors’ data on approaches to treating borderline ovarian tumors. It analyzes and comparatively assesses groups of patients who have received chemotherapy and those who have not. The authors mainly state the view that chemotherapy for borderline ovarian tumors affects their prognosis in no way, but makes it even worse in a number of investigations. They also give the data of their observations, which show that attitudes towards chemotherapy for borderline ovarian tumors change in different decades. If in the 1980s chemotherapy was a mandatory treatment stage, it is nowadays prescribed only in exceptional cases in the author’s clinic. Different predictors, such as microinvasion, the micropapillary pattern of borderline tumors, invasive implants, their impact on the probability of recurrences and survival are being investigated. Whether chemotherapy against unfavorable factors, such as invasive implants, may be used is considered. There is evidence that conservative and ultraconservative surgeries for borderline ovarian tumors may be performed. Ultraconservative operations that can spare ovarian tissue as much as possible demonstrate the best pregnancy and labor outcomes as compared with conservative surgical approaches. Thus, this paper considers whether it is expedient to use chemotherapy in patients with borderline ovarian tumors. It also discusses scientists’ views and the authors’ data on neoadjuvant and adjuvant treatments, predictors in borderline ovarian tumors, and survival rates in different international clinics.

© 2014 The Author. This paper reports on an ethnographic study conducted in two eating disorders treatment settings in New South Wales, Australia. The study set out to make a social work contribution to the debate on the ethics of involuntary treatment for anorexia nervosa (AN) drawing on the authors' practice experience. An empirical ethics approach was taken to support a reflective process of theorising from practice focused on how the treatment decision-making context is relevant for ethics. Three key issues of relevance for social work and the ethics debate were revealed: (i) the operation of power, knowledge and values affirms particular knowledge during treatment decision making that may justify the use of paternalism; (ii) particular knowledge and values are privileged in the treatment environment and associated with 'good practice' and 'professionalism'. This may or may not promote the core social work values of 'empowerment', 'participation' and 'self-determination'; (iii) the operation of power, knowledge and values has implications for the patient-professional relationship that may be counterproductive to recovery from AN.

Death rates from sepsis in New York state fell more quickly than in other states after a state wide mandatory treatment protocol was introduced, a study has shown. The retrospective study examined more than a million admissions to hospital of people with sepsis to evaluate the effect of New York state’s regulations. “Rarely in the US do we force hospitals to implement specific clinical protocols,” said the lead author, Jeremy Kahn, from the University of Pittsburgh. “For the first time, state officials are enshrining in regulations that hospitals must follow certain evidence based protocols when it comes to sepsis. …

Intraoperative nasal cerebrospinal fluid leak are common during the transnasal transsphenoidal interven tions. In certain cases, it is a feature of these interventions. However, its amplification needs a mandatory treatment. In this article, we describe the technique for closure dural defects that have developed during the transnasal removal of hormone active pituitary adenomas, using thrombin and fibrinogen containing colla genic sponge.

The use of legally coerced treatment for substance‐using offenders is now widespread internationally. To justify the continued use of coerced treatment, policy‐makers, practitioners, and researcher...

The present study is aimed at exploring the characteristics of Chinese relapsed drug users associated with their treatment experience in police mandatory treatment centers. The exploration is based on a comparison of Chinese drug users who received the police mandatory treatment for multiple times (the “relapse” group) with those who had the treatment for the first time (the “first-time” group). The comparative analysis is conducted using data collected from a 2009 survey of 177 drug users in several police mandatory treatment centers in a large city of China. The data indicate that both the “relapse” and the “first-time” groups have similar demographic characteristics except age. However, respondents in the “relapse” group were more likely to be heroin users, have a high level of drug dependence, have prior treatment, experience a high level of mental disorder, and have drug-use friends than those in the “first-time” group. The findings imply that relapse among Chinese drug users are likely to have multiple factors which is comparable to that discovered in Western research.

Record keeping is integral to home treatment for hemophilia. Identified problems with paper diaries include suboptimal compliance and questionable data validity and quality. The effects of an electronic data recording system, Advoy, on data quality, patient adherence, and satisfaction were examined. An exploratory approach was used to examine the sequential use of paper diaries and e-diaries by 38 patients. Data were obtained from paper records for the 6 months preceding the introduction of the electronic record and from the first 6 months of use of Advoy. Completion of mandatory and additional treatment details was also compared. More mandatory information (27.57%) was recorded with the e-diary. As well, the amount of completed additional fields nearly doubled (19.9%-36.5%). Patients tended to complete a greater variety of additional fields with the e-diary than with paper records. Finally, a higher percentage of survey respondents (29.4%) indicated that they were "very satisfied" with Advoy compared with paper records (6.7%). Most survey respondents (94.4%) had a previous experience with electronic programs. The use of the e-diary significantly improved patient adherence in recording mandatory treatment information; the increase in additional data provided by the patients was also found to be an added benefit of this technology.

Health treatments usually need a consenting patient but in cases as infective diseases, industrial accidents or mental diseases physicians can apply to MT (Mandatory Treatment). In Italy the first laws concerning obligatory treatment of psychiatric diseases date back to the beginning of 20th century and have been recently modified to have more guarantees of patient’s life and health. In order to allow a MT we need 3 conditions: an emergency situation caused by a health diseases, a non-consenting patient, impossibility to begin an adequate therapy outside hospitals. Any physician can “suggest” a MT to his patient describing briefly the disease and his clinical conditions. The “proposal” must be sent to the Mayor and has to be approved by another doctor working in the ASL (local public health unit). Then the Mayor has 48 hours to send everything to a judge who will validate or not the MT. Health treatment is carried out by Police. MT cannot last longer than 7 days.

Although imaging studies in and of themselves have significant contributions to the study of human behavior, imaging in drug abuse has a much broader agenda. Drugs of abuse bind to molecules in specific parts of the brain in order to produce their effects. Positron emission tomography (PET) provides a unique opportunity to track this process, capturing the kinetics with which an abused compound is transported to its site of action. The specific examples discussed here were chosen to illustrate how PET can be used to map the regional distribution and kinetics of compounds that may or may not have abuse liability. We also discussed some morphological and functional changes associated with drug abuse and different stages of recovery following abstinence. PET measurements of functional changes in the brain have also led to the development of several treatment strategies, one of which is discussed in detail here. Information such as this becomes more than a matter of academic interest. Such knowledge can provide the bases for anticipating which compounds may be abused and which may not. It can also be used to identify biological markers or changes in brain function that are associated with progression from drug use to drug abuse and also to stage the recovery process. This new knowledge can guide legislative initiatives on the optimal duration of mandatory treatment stays, promoting long-lasting abstinence and greatly reducing the societal burden of drug abuse. Imaging can also give some insights into potential pharmacotherapeutic targets to manage the reinforcing effects of addictive compounds, as well as into protective strategies to minimize their toxic consequences.

Despite the proliferation of drug courts and other mandatory treatment models, few studies have compared the impact of different program features comprising these models. This study compared three groups of clients (N = 330) mandated to the same long-term residential treatment facilities. Study participants were referred from two highly structured programs or from more conventional legal sources, such as probation or parole agents. Analyses showed that these clients varied substantially in their perceptions of legal pressure, and these perceptions generally corresponded to the programs' different coercive policies and practices. Retention analyses confirmed that the odds of staying in treatment for six months or more was nearly three times greater for clients in the most coercive program compared to clients in the third group. Results support the use of structured protocols for informing clients about legal contingencies of participation and how that participation will be monitored, and developing the capacity to enforce threatened consequences for failure.

A drug court is a mandated judicial supervision and addiction treatment alternative to incarceration for drug offenders. Enthusiasm for drug courts is high in the USA where the number of programs has expanded exponentially over the past decade in an attempt to reduce high incarceration rates for convicted drug offenders. Despite the popularity of drug courts, there is no evidence that drug court programs produce outcomes that are superior or even equal to outcomes achieved by voluntary treatment programs. Canadian drug policy should promote expansion of proven effective voluntary treatment for illicit drug misusers before endorsing unproven mandatory treatment programs, e.g. drug courts, that rely on legal coercion.

Background: The documentation of magnitude of malocclusion in terms of prevalence and severity has not been done till date in Himachal Pradesh, India. Aims: To assess the prevalence of malocclusion and orthodontic treatment needs (OTNs) among 9-and 12-year-old school children by using the Dental Aesthetic Index (DAI) in the state. Materials and Methods: A cross-sectional study was conducted among 1188 children from randomly selected schools. The survey was done according to the Oral Health Assessment Form (modified). DAI was used to assess the severity of malocclusion, along with collection of demographic data. Results: The overall prevalence of malocclusion was 12.5% and required orthodontic treatment, whereas 87.5% did not require treatment. A severe malocclusion for which treatment was highly desirable was recorded in 3.1%; 8% had a definite malocclusion for which treatment was elective. Only about 1.3% had a handicapping malocclusion that needed mandatory treatment. Almost equal proportions of males and females were affected with malocclusion with the means 20 ± 4.6 and 19.9 ± 4.9, respectively ( P < 0.641). The prevalence and severity of malocclusion was more in 12-year age group than in 9-year age group ( P = 0.002**). There was an increase in the proportion of malocclusion among older children: In 12-year age group, 15.7% with mean 20.5 ± 5.1 and in 9-year-old children, 8.9% with the mean 19.3 ± 4.1 were in the need of orthodontic treatment. Conclusion: Severity and treatment needs, both are important factors in public health planning.

The authors argue for the extension of mandatory treatment to persons gravely disabled by substance abuse. The problem is examined from ideological, clinical, legal, economic, and ethical perspectives.

Objective To assess the prevalence of malocclusion and its relationship with dental caries among school children in southern India. Methods This cross-sectional study included 1,800 students aged 11 - 15 years whose Dental Aesthetic Index (DAI) and dentition status were recorded and analyzed. The chi-square test, ANOVA, and Spearman's correlation tests were carried out. Results The mean DAI score ± the standard deviation was 18.61 ± 6.1. Approximately 85% of the students (83.0% males, 86.8% females) had DAI scores of < 26 and were classified as not requiring orthodontic treatment. One tenth of the sample had mean DAI scores between 26 - 30 (indicating definite malocclusion and elective treatment), while about 3% had mean scores between 31 - 35 (indicating severe malocclusion and treatment desirability). Only 29 children (1.6%; 16 boys, 13 girls) had a DAI score of > 35, which suggested very severe or handicapping malocclusion requiring mandatory treatment. The mean decayed, missing, filled teeth (DMFT) was 2.28 ± 1.47. A DMFT of > 0 was observed in 91.8% of the study subjects. Children with a DAI score of > 35 were found to have significantly (p < 0.001) higher caries experience as compared to other children. Moreover, the DAI scores showed a significant correlation with the mean DMFT scores (r = 0.368, p < 0.05). Conclusions A positive correlation was found between the severity of malocclusion and dental caries.

This study explores the role of China's criminal justice system in treating drug abusers and provides a preliminary assessment of the mandatory treatment centers administered by police and reeducation-through-labor camps managed by correction agencies in China. The exploration and assessment are conducted using data collected from recent surveys of drug users in several mandatory treatment centers and a reeducation-through-labor camp in a large city of China in 2009. The data reveal that the treatment involvement levels of drug users in these mandatory treatment centers and reeducation-through-labor camps varied and their perceptions of the treatments they had received for their recovery seem fairly positive. The implication of these findings was discussed in the context of Chinese social and legal tradition.

Although Dr Kisely will suggest that there is minimal evidence to indicate that CTOs work and, further, that CTOs have significant negative effects, I will show that both of these propositions are incorrect. Although this debate is an academic exercise, the decision to support or oppose CTOs has profound implications for people with severe mental illness. Most jurisdictions in the developed world have introduced or are considering the introduction of legislation to support CTOs. If Dr Kisely's position were to be adopted, clinicians would be prevented from using any form of mandatory treatment in the community. Currently, psychiatrists and other clinicians must strive to manage, in community settings, individuals who lack any awareness of their mental illness or of their need for treatment. This challenge is only going to get worse. Remember, deinstitutionalization is not a historical event-it is an ongoing process! In the coming years, patients suffering from psychosis and having increasingly problematic behaviours will be discharged to our communities. We have not been able to manage these individuals in hospitals without requiring them to take treatment. Why would anyone think that we are suddenly going to be able to do this in the community? In fact, the opposition to the introduction of CTOs is only the latest battleground for the groups that have campaigned against inpatient committal and compulsory inpatient treatment. However, a CTO makes it possible for a reluctant patient to receive essential treatment while living in his or her community and is thus consistent with the principle of using the least restrictive alternative. Only extreme libertarians such as Thomas Szasz, who disavow the very existence of mental illness, suggest that individuals who lose contact with reality should be left to fend for themselves. Most of us believe that a caring society has a responsibility to look after individuals who are unable to care for themselves. Individuals who do not recognize that they are ill do not seek treatment. Indeed, many actively reject treatment, even when they desperately need it. The first question, then, is whether CTOs actually increase the probability that an individual with a psychotic illness and a history of not following up with services will receive the treatment and supervision necessary to live safely in the community. This is an important, but also deceptively simplistic, question. The answer will in part depend on the specifics of the CTO legislation. For example, the legal powers available to clinicians to respond to a patient's refusal of treatment are likely to be important factors in determining effectiveness. The answer will also depend on the types of patients for whom CTOs are used. Space does not permit a full discussion of these issues, but I have discussed them elsewhere (1). Bearing these complexities in mind, there is extensive evidence that various forms of CTO legislation improve several important outcomes for patients with severe mental illness. Research has demonstrated that patients on a CTO are more likely to attend appointments and to have improved quality of life and that they are less likely to present at the emergency department, to be hospitalized, to be victimized, to be violent, or to be arrested (2). These studies have examined several legislative models used in Canada (3,4), as well as models in the United States, the United Kingdom, and Australia (2). Some of these studies have been criticized because of their small size, but critics duplicitously overlook the fact that others include more than 4000 subjects (5). Dr Kisely will probably try to ignore the numerous studies indicating positive effects of CTOs and suggest that only the findings from RCTs should be considered. This is a naive approach. The extensive research using the test-retest strategy and control groups does have methodological problems not present in the existing RCTs; however, the RCTs in turn have significant failings that do not compromise the other studies. …

This paper reviews the major studies of mandatory outpatient treatment (MOT) and examines why there has been inconsistency in some of the findings. Attempts to answer the question "is mandatory treatment effective?" must first clarify the type of mandatory treatment being examined, the type of patient being treated, and the outcome by which effectiveness is measured. There is consistent evidence that various forms of MOT increase follow-up with psychiatric services and that court-ordered outpatient committal decreases victimization of patients in the community. It also appears likely that MOT reduces the use of hospitalization; but, due to methodological problems associated with the research, this conclusion remains controversial.

Considering treatment of serious mental illnesses, it might appear that the recovery model would be incompatible with any form of mandatory treatment. The authors suggest that this is not so. With individuals whose psychotic illness substantially impairs decision making, mandatory treatment may offer the best hope of getting well enough for recovery to be possible. It is essential, however, that any program involving involuntary community treatment involves recovering individuals who have themselves experienced a serious mental illness. The authors propose the use of a consumer-run guardianship program and a capacity review panel as two possible ways to achieve such participation.

Over the four years from 1 January 1985 to 31 December 1988, 192 patients were treated for aortoiliac occlusive disease by the Oxford Regional Vascular Service. The number of patients treated by percutaneous transluminal angioplasty increased from two in the first year of the study to 34 in the third year of the study. This increase was accompanied by a decrease in the proportion of patients treated by aortobifemoral bypass but the proportion of patients treated by extra-anatomic bypass remained constant at around 30 per cent. Twice as many patients were treated in the fourth year as in the first year of the study so that the number of surgical operations increased despite many patients being treated exclusively by percutaneous transluminal angioplasty. The number of patients requiring mandatory treatment for limb salvage increased by 109 per cent and optional treatment for intermittent claudication by 85 per cent. The introduction of percutaneous transluminal angioplasty in Oxford has coincided with an increase in the number of patients presenting with symptomatic aortoiliac occlusive disease and has allowed twice as many people to be treated while the number of aortobifemoral bypass operations has remained unchanged. It is concluded that the introduction of percutaneous transluminal angioplasty has not only generated its own workload but has also led to an increased demand for surgical reconstruction for aortoiliac occlusive disease.

The purpose of this study was to evaluate the prevalence of malocclusion and to assess the need for orthodontic treatment among 6-10 year old Turkish primary school children. The Treatment Priority Index (TPI) was used to record and measure the malocclusions. The findings were that 40.38 per cent of the observed population showed normal occlusion, 21.85 per cent had minor manifestations of malocclusion and treatment need was slight, 25.17 per cent of the subjects showed definite malocclusion, 7.54 per cent had severe malocclusion and 5.06 per cent had a very severe handicap with a mandatory treatment requirement. Orthodontic treatment need increased between 6 and 10 years of age. No statistically significant difference was found between the mean TPI values of male and female subjects.

Aims To define treatment adherence and criminal history before and after the mandatory treatment of homicidal patients and_correlation of these variables with the severity of the criminal act. Method 160 of the 197 cases, we could be able to contact and who were released from the forensic psychiatry clinic of the Bakirkoy Training and Research Hospital for Psychiatric and Neurological Diseases after mandatory inpatient treatment in 2006 were investigated for treatment adherence and criminal history for five years after release. Criminal Violence Rating Scale is used. Results 30% of the 48 patients who committed homicidal acts, had criminal history prior to the mandatory treatment and these were usually severe violent criminal offenses targeting directly at the victim's life and 14,5 % of them committed more than a criminal act before the homicidal act. After the mandatory inpatient treatment, the homicidal offenders were more likely to be kept in the mandatory outpatient treatment programme in comparison to the non-homicidal patients (87,6 % and 64,3 % respectively). 41,7 % of the homicidal offenders had been rehospitalized. Mean duration of mandatory treatment was 510 days and 148 days for the homicidal and non-homicidal patients respectively. Conclusion The number of criminal offences and number of re-hospitalizations were not significantly different between the homicidal and nonhomicidal patient groups. As a consequence of risk reduction strategies the homicidal patients were internalized longer in terms of mandatory treatment and after the release, their control assessments were done at shorter intervals.

Mandatory and voluntary treatment programs for Skid Row alcoholics are described, and the implications of the Uniform Alcoholism and Intoxication Treatment Act are discussed.