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The purpose of this paper is to review and compare information obtained for four female serial murder perpetrators, exploring possible personality features that make the female serial killer unique. As this is the first project to explore the personalities of female serial murderers through data collected from the offenders themselves, it is primarily an exploratory study.

The data presented were collected as part of a larger project, which solicited participation from incarcerated, suspected serial murderers. Upon agreeing to participate, each potential participant's background was searched to ensure they met the definition of a serial murderer. The participants were sent a survey packet containing measures related to demographics, psychopathology, psychopathy, and personality features. These packets were sent to participants at their respective prisons, with a return envelope provided. Upon return, surveys were scored and analyzed to create a comprehensive profile of each offender.

The subjects of this study each presented a unique personality profile as measured by the Minnesota Multiphasic Personality Inventory-2 and Millon Clinical Multiaxial Invetory-III. Three of the four participants did not appear to by psychopathic, which is not surprising given the low incidence of psychopathy in women.

This study, while limited by the small sample size, provides the first data set of valid psychological measures collected through first-hand accounts with female serial murderers. Although the data presented did not display a single comprehensive profile indicative of a female serial murderer, it does provide a foundation for further research.

Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and offending variables. However, the clinical and criminal presentation of individuals with autism spectrum disorder (ASD) in forensic secure care settings has been underexplored. This paper aims to explore the profiles of internet offenders with ASD admitted to a secure psychiatric unit.

This study provides the results of a service evaluation of individuals with ASD. The demographic, clinical and criminal characteristics of a small sample of internet offenders with ASD admitted to secure care are described and discussed.

Internet offenders present in secure care with high rates of comorbid disorders, histories of violence and traumatic experiences, mood disorders and difficulties with relationships. Of the 24 internet offenders discussed, 18 of them committed an offence of a sexual nature involving children.

This paper highlights the potential risks for individuals with ASD in using the internet and the possible difficulties associated with detecting this because of rapid advancements in technology.

The profile of personality disorder in forensic clinical practice has been raised by key developments over the last decade, although services remain in the large part piecemeal and disconnected. This paper aims to describe the lessons learnt from the development of one specialist service for personality disordered offenders.

The policy context in which the service was developed, the challenges of working in this area, and data relating to the clinical and risk profile of referred cases are presented.

Data demonstrate extensive comorbidity and heterogeneity amongst those referred to the service. With reference to the experience gained in the first four years of the service, it is suggested that a systematic and formalised model of “understanding” the psychology of the individual should be the core process of future developments for this group of offenders, and subsequently recommendations are made to enhance the practical utility of such formulations rate.

Conclusions are mostly based on expert opinion and upon one particular service provision, and therefore care should be exercised in generalising the results of this study to existing services. The need for further research in order to enhance knowledge and understanding of this complex group is highlighted.

The heterogeneity and comorbidity within this group of offenders emphasises the need for services to offer a range of assessment methods and interventions to meet individuals' requirements.

The experiences and recommendations in this paper are valuable to professionals working with personality disordered offenders and to the development of more extensive services for such individuals.

The purpose of this paper is a single-center six-month follow-up study to determine nutritional status of children with maple syrup urine disease (MSUD). Prolonged restriction on essential amino acid could cause malnutrition. By far, there is no study reported in the context of nutritional status among children with maple syrup urine disease (MSUD), who required life-long protein restriction.

A total of 22 children with MSUD, aged from 1 to 12 years (6.54 ± 3.27) undergoing regular treatment in Institute of Pediatrics, Hospital Kuala Lumpur, were recruited. Body height, weight and head circumference were measured for anthropometry, whereas total protein, albumin and plasma branched-chain amino acid were measured for biochemical aspects. Clinical features diagnosed by pediatrician were recorded from children’s medical record. The 24-hour dietary recall was conducted to measure their nutrients intake. All assessments were repeated at six-month interval except clinical profile.

There were no significant differences in all nutritional parameters from baseline to end of the visit. There was a prominence (particular noticeable of) of growth stunting (68; 64 per cent), undernutrition (35; 32 per cent) and microcephalic (57; 57 per cent) among children with MSUD. Nevertheless, children showed no significant improvement of anthropometric variables from baseline and after 6-month follow-up visit. Nearly all biochemical indicators were significantly (p < 0.05) higher than the reference value except valine. Intellectual disability was the most frequently (71 per cent) presenting symptoms among them. The finding also did not show any macro- or micronutrients fail to achieve above recommended nutrient intake in both visits. In conclusion, it is clear that no significant nutritional deficiency was induced by the use of MSUD dietary therapy; however, the findings indicated that MSUD children are at risk of malnutrition and regular nutritional assessment and monitoring should always be emphasized for optimal linear growth without affecting their amino acid profiles.

Multiple 24-hour recalls instead of single 24-hour recall should be used in this study for a better estimate of intake.

Although there are retrospective studies targeted in presenting the clinical and biochemical profile of MSUD children which has been extensively examined, limited research has focused on prospective aspect of nutritional status of these children who are undergoing active and regular diet and medical nutrition therapy because of the absence of comprehensive reliable nutritional assessment data.

Argues that by interpreting the semantic content of different actions, it will be possible to draw boundaries between those aspects of a system that can be computerized and those that will best serve the purpose if left alone. This will dissuade systems developers from being caught in the technology trap. The argument is conducted in the context of developing IT‐based medical thesauri for drug use management.

Work readiness is an important aspect of the transition from higher education to professional practice. The purpose of this study was to explore the perceptions of work readiness of individuals transitioning into physiotherapy practice in Australia and identify any association with personal, education and work factors.

Purpose-built surveys were distributed to final-year students and graduates of physiotherapy programmes nationally. Work readiness was measured using the recently validated Work Readiness Scale for Allied Health Professionals 32 (WRS-AH32), which captures the following four domains: Practical Wisdom, Interpersonal Capabilities, Personal Attributes and Organisational Acumen. The surveys also included personal, education and work data. Work readiness was expressed as percentages for total work readiness and within each domain. Independent t-tests were used to examine the influence of personal, education and work factors on work readiness.

176 participant responses were analysed (84 students and 92 graduates). Total work readiness was 80% [standard deviation (SD)8], with Practical Wisdom the highest scoring domain (91%, SD8) and Personal Attributes the lowest scoring domain (65%, SD14). Considering overall work readiness, individuals reporting some psychological symptoms scored lower than asymptomatic individuals [mean difference 7% (95% confidence interval (CI) 4 to 9)] and final-year students scored less than graduates [mean difference 3% (95%CI 0 to 5)].

All stakeholders, including individuals, universities and employers, need to consider further strategies to develop aspects of work readiness, particularly within the domain of Personal Attributes and those with psychological symptoms.

This study demonstrates that physiotherapy students and graduates perceive themselves to be well prepared to transition to the workforce.

While there is debate about the extent to which patients are harmed when they are cared for in hospital, it is clear that admission as an inpatient is not without risk. This paper presents works on the progress to date with identifying what these risks are and quantifying the likelihood and severity of the risk. The clinical risk profiling tool that has been developed as part of this exercise has assisted with the identification and prioritisation of clinical risks and is the first step in risk reduction and elimination.

This paper aims to illustrate by means of a case study how HKT-R Spider reference profiles of recidivists and non-recidivists may be supportive in leave decisions.

The authors describe what is known for recidivists and non-recidivists about changes in risk factors during treatment. The HKT-R Spider is introduced. By comparing a case study to group profiles, the authors illustrate how discussions about leave may be rationalised. From a study among 278 patients to explore the profiles, the authors report the inter agreement, and differences between recidivists and non-recidivists of the clinical HKT-R factors. Intra correlation coefficients, Wilcoxon signed ranks test and independent and paired t-tests are applied. To explore which combination of factors are discriminating between both groups, the authors also performed logistic regression analyses at six treatment stages.

The inter agreement reliability and internal consistency of the clinical HKT-R scale were acceptable to good in all six stages studied. The HKT-R Spider and profiles can be used to assist in evidence-informed decision-making about leave.

Globally recidivists had somewhat higher levels of clinical risk factors at all six decision moments, but the interpretation of HKT-R Spiders profiles should always be adapted to the individual’s context.

Applying the HKT-R Spider reference profiles on individual cases may structure and rationalize discussions lead to decisions based on clinical facts.

The first NHS forensic low secure unit for adolescents, the Westwood centre, opened in 2004. This paper seeks to focus on service utilisation and initial outcomes for the young people admitted in the first 45 months compared with young people accessing a neighbouring open adolescent unit.

In order to understand service utilisation and initial outcomes, the clinical profiles of young people admitted in the first 45 months were evaluated. This included demographics, locality, admission status, length of stay, medication use, presenting problem, diagnosis, previous and discharge destination. The profiles of young people accessing the low secure unit were then compared with young people accessing a neighbouring open adolescent unit. Clinical profiles were ascertained from available healthcare records and service data. These were inspected and analysed using descriptive statistics.

Thirty (54 per cent) of the 56 Westwood young people were male, the mean age at admission was 16.3 years and mean length of stay was 202 days. Twenty‐five (44 per cent) young people had a discharge diagnosis related to psychosis, the remainder having primary problems relating to emotional and/or conduct problems. 26 (47 per cent) were discharged to another hospital setting and 20 (35 per cent) returned to their home of origin. Young people accessing the low secure unit were significantly older at admission and there was a trend for a higher proportion of females to be admitted to the open setting. In addition, the low secure unit had a greater proportion of young people with psychotic disorders and longer lengths of stay. Case examples illustrate a pilot of initial outcomes.

There were time differences in comparison of low secure and open unit and retrospective use of health care records.

Clinical profiling is useful as a basis to consider clinical outcomes, pathways, utilization of a service, service/training needs and development. Comparisons between inpatient units provide further evidence to the areas above and help dispel myths that may otherwise guide decisions, e.g. about which diagnoses or gender affecting length of stay. Most young people progress positively from the low secure service onto open or community settings. Improving future outcomes for young people include such as through diversion from custody, length of admission, reduced symptoms/risks and planned progress to suitable community placements or home.

The paper provides a clinical profile of young people accessing a low secure setting in comparison to an open unit. This has relevance to other secure and inpatient adolescent units and is important in considering pathways and outcomes.

Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.

Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.

Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.

Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.

This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.