The superiority of the MST condition in reducing offending and antisocial behavior suggests that MST adds value to current U.K. statutory evidence-based youth services. The provision of MST does not supplant existing services but is best used to facilitate the appropriate and cost-effective organization of statutory services for young persons and their families.

Risks of reoffending remain for a subgroup of discharged patients. Future research should aim to improve their identification and risk management following discharge.

No abstract

The CSI, complemented by information on functional impairment and stress is an appropriate measure of recent somatic symptoms and somatization risk in young people for use in the UK.

Neither service was superior on measures of subsequent offending or hospitalisation. Specialist forensic after-care conveyed no added benefit. Case management may have been the same in both services.

ObjectiveTo evaluate whether multisystemic therapy (MST) is more cost-effective than statutory interventions that are currently available for young offenders in England.MethodA cost-offset evaluation of MST based on data from a randomised controlled trial conducted in North London, England, comparing MST with usual services provided by two youth offending teams (YOT). Service costs were compared to cost savings in terms of rates of criminal re-offending.Results108 adolescents, aged 11–17 years, were randomly allocated to MST+YOT (n = 56) or YOT alone (n = 52). Reductions in offending were evident in both groups, but were higher in the MST+YOT group. At 18-month follow-up, the MST+YOT group cost less in terms of criminal activity (£9,425 versus £11,715, p = 0.456). The MST+YOT group were significantly cheaper in terms of YOT services than the YOT group (£3,402 versus £4,619, p = 0.006), but more expensive including the cost of MST, although not significantly so (£5,687 versus £4,619, p = 0.195). The net benefit per young person for the 18-month follow-up was estimated to be £1,222 (95% CI −£5,838 to £8,283).ConclusionsThe results reported in this study support the finding that MST+YOT has scope for cost-savings when compared to YOT alone. However, the limitations of the study in terms of method of economic evaluation, outcome measures used and data quality support the need for further research.

Almost half of school children reported that they were bitten (Beck & Jones,1985; Spiegel, 2000) and in other research, 20% of dog-owning parents reported their child bitten (Wilson, Dwyer and Bennett, 2003, see also Lakestani, Donaldson, Verga & Waran, 2006). Child-initiated interactions with the dog trigger up to 86 % of injuries at home. Recently, it was found that young children do not discriminate a dogs body signals, but look mainly at the dogs face (Lakestani et al., 2006). While there has been anecdotal evidence that children mistake an angry, teeth-baring dog face for a smiling one, there is to date no systematic empirical evidence on the misinterpretation of dogs facial expressions. We tested 4-, 5-, 6-year-old children and adults on neutral, aggressive and happy human and dog facial expressions. Results show that while adults make hardly any mistakes (less than 1%) on both stimulus types (dog and human faces), 69% of 4-year-olds interpreted aggressive dog faces as smiling and happy. Five-year-olds show 35% and 6-year-olds 25% misinterpretations whereas they are over 90% correct on all human facial expressions. This result indicates a severe lack in interpretation abilities in children of facial expressions of dogs which could contribute to the high incidence of dog bites, especially in younger children. Given this result, we can advise children and parents to prevent injuries and inform dog bite prevention programmes to help prevent further dog bite incidents.

Preliminary evidence supports the existence of distinct developmental trajectories within this population and points to a key role for traits of emerging severe personality disorder.