title: The Identification of Recidivism Indicators in Intellectually Disabled Violent Individuals

authors: Courtney, Jo

subjects: Intellectually Disabled

abstract: The Assessment of Risk and Manageability in Intellectually Disabled IndividuaLs who Offend (ARMIDILO) was developed to address the need for assessment tests specifically designed for intellectually disabled (ID) individuals who offend. This is the first study focusing on the application of the ARMIDILO by using comparative current risk assessment tests to evaluate the ARMIDILO as an effective risk assessment tool.  In this research 16 ID people who have recorded sexual and or violent behaviour offences were evaluated using the Violent Offender Risk Assessment Scale (VORAS), Static-99 and ARMIDILO risk assessment tests. The ARMIDILO, VORAS and Static-99 assessments were completed using individual history files kept within the Regional Forensic Psychiatric Service. The VORAS and Static-99 were adapted to incorporate reported, but not charged or otherwise litigated offences and convictions. The adapted tests were then compared against the ARMIDILO as a risk assessment tool. 
Analysis of the ARMIDILO showed strong validity in assessing ID people who offend. The main strength of the ARMIDILO is in identifying the risk needs of the ID person who offends and may be an effective management test when used in assessing individual needs and program implementation. Risk assessment through the ARMIDILO showed similar results to Static-99 but compared only moderately with the VORAS in measuring the risk of re-offending. Future research with a larger population may further validate the reliability of the ARMIDILO as an assessment tool. Adaptation of the current score sheet for use by non-clinical and correctional staff may prove cost effective.

text: The Identification of Recidivism Indicators in Intellectually Disabled Violent Individuals The Assessment of Risk and Manageability in Intellectually Disabled IndividuaLs who Offend (ARMIDILO) was developed to address the need for assessment tests specifically designed for intellectually disabled (ID) individuals who offend. This is the first study focusing on the application of the ARMIDILO by using comparative current risk assessment tests to evaluate the ARMIDILO as an effective risk assessment tool.  In this research 16 ID people who have recorded sexual and or violent behaviour offences were evaluated using the Violent Offender Risk Assessment Scale (VORAS), Static-99 and ARMIDILO risk assessment tests. The ARMIDILO, VORAS and Static-99 assessments were completed using individual history files kept within the Regional Forensic Psychiatric Service. The VORAS and Static-99 were adapted to incorporate reported, but not charged or otherwise litigated offences and convictions. The adapted tests were then compared against the ARMIDILO as a risk assessment tool. 
Analysis of the ARMIDILO showed strong validity in assessing ID people who offend. The main strength of the ARMIDILO is in identifying the risk needs of the ID person who offends and may be an effective management test when used in assessing individual needs and program implementation. Risk assessment through the ARMIDILO showed similar results to Static-99 but compared only moderately with the VORAS in measuring the risk of re-offending. Future research with a larger population may further validate the reliability of the ARMIDILO as an assessment tool. Adaptation of the current score sheet for use by non-clinical and correctional staff may prove cost effective.

year: 2008

title: Supplementary notes for 2024 Moana Oceania NZ soil judging handbook

authors: Lowe, David J.

abstract: These supplementary maps and tables were compiled by David J. Lowe to accompany and enhance the NZ soil judging handbook prepared for the 2024 Moana Oceania Soil Judging competition held in the Rotorua region 29 November-1 December 2024 (prior to the joint NZSSS and SSA soils conference 2-5 December 2024 in Rotorua). They include maps of volcanic centres and explosively erupted products in North Island, the general soil pattern for tephra-derived soils, the main rhyolitic tephras deposited in the Rotorua-Tarawera region over the past c. 25,400 years, and the distribution of Taupo tephra (c. 232 AD), Kaharoa tephra (c. 1314 AD) and Tarawera tephra (10 June 1886 AD). Notes on the development of the Mamaku Plateau via ignimbrite emplacement and erosion and on the nature and formation of the nanoclay, allophane, are also included.

text: Supplementary notes for 2024 Moana Oceania NZ soil judging handbook These supplementary maps and tables were compiled by David J. Lowe to accompany and enhance the NZ soil judging handbook prepared for the 2024 Moana Oceania Soil Judging competition held in the Rotorua region 29 November-1 December 2024 (prior to the joint NZSSS and SSA soils conference 2-5 December 2024 in Rotorua). They include maps of volcanic centres and explosively erupted products in North Island, the general soil pattern for tephra-derived soils, the main rhyolitic tephras deposited in the Rotorua-Tarawera region over the past c. 25,400 years, and the distribution of Taupo tephra (c. 232 AD), Kaharoa tephra (c. 1314 AD) and Tarawera tephra (10 June 1886 AD). Notes on the development of the Mamaku Plateau via ignimbrite emplacement and erosion and on the nature and formation of the nanoclay, allophane, are also included.

year: 2024-11-20

title: Rising demand for health care: The sustainability of community general practice in the Waikato

authors: Amey, Janet Heather

subjects: General practice

abstract: Community general practice is the cornerstone of New Zealand’s health system, providing first contact health care, care coordination and acting as gatekeeper to expensive hospital services. An ageing population now brings increasing demand for the care provided in general practice, with chronic conditions a major contributing factor. This rising demand, alongside limited workforce capacity will seriously test general practice sustainability. 

These evolving and multifaceted challenges are within the context of long-standing health access and outcome inequalities, particularly for Māori (and more recently the Pacific population) compared with Pākehā. The pursuit of equity is inherent in all health sector strategies, but any meaningful improvement will necessitate wide-ranging reform of current planning, funding and service delivery pathways across traditional sector boundaries.

The sustainability of general practice is about the sustainability and efficiency of the entire health system. To better measure the contribution of general practice care to the system, and improve demand projections, an expanded service use measure was developed, combining services of a general practice nature from Emergency Department and Accident & Medical settings with services delivered in community general practice.

Drawing on approaches from demography, epidemiology and health services research, linked demographic and health administrative data were used to undertake a retrospective, observational study of service use for 235,666 people enrolled with the Pinnacle Midlands Health Network in 2013/14. Using the new expanded measure, service use levels at a locality level were established by age, gender, ethnic group, chronic condition status, practice funding model, high needs status, income and geography of residence.

Significant variation was found in annual average consults (1.0 to 13.4 consults in 2013/14). Statistical analysis identified age, chronic conditions and gender as the key demand drivers responsible for such variation, with regional level results masking significant spatial variation. Where the cost of care was lower, people used a higher level of services in the enrolled practice setting and a lower level outside of it, suggesting the importance of affordable care. Māori and Pacific used significantly fewer services than Pākehā although there was substantial sub-regional variation. Using the expanded measure, the vast majority of care was delivered in the enrolled setting, including for those with chronic conditions.

Demand projections, based on the expanded measure of general practice, out to 2038 show the uneven geography of future demand due to disordered cohort flows and sub-regional population contexts. Overall, demand for services is projected to rise by 34 per cent to almost two million consults across the Waikato District Health Board catchment, with this driven predominantly by services for those aged 65+ years (or 45+ years in Hamilton City, Waikato and Waipa Districts).

Models of care are being transformed as general practices and Primary Health Organisations look to the future. Reorganisation of work roles, improved use of health information and use of emerging health technologies will be required to re-configure general practice in preparation for an ageing future, and to eliminate recalcitrant health inequalities. Real and inclusive collaboration across traditional system boundaries is perhaps the greatest challenge to general practice sustainability.

text: Rising demand for health care: The sustainability of community general practice in the Waikato Community general practice is the cornerstone of New Zealand’s health system, providing first contact health care, care coordination and acting as gatekeeper to expensive hospital services. An ageing population now brings increasing demand for the care provided in general practice, with chronic conditions a major contributing factor. This rising demand, alongside limited workforce capacity will seriously test general practice sustainability. 

These evolving and multifaceted challenges are within the context of long-standing health access and outcome inequalities, particularly for Māori (and more recently the Pacific population) compared with Pākehā. The pursuit of equity is inherent in all health sector strategies, but any meaningful improvement will necessitate wide-ranging reform of current planning, funding and service delivery pathways across traditional sector boundaries.

The sustainability of general practice is about the sustainability and efficiency of the entire health system. To better measure the contribution of general practice care to the system, and improve demand projections, an expanded service use measure was developed, combining services of a general practice nature from Emergency Department and Accident & Medical settings with services delivered in community general practice.

Drawing on approaches from demography, epidemiology and health services research, linked demographic and health administrative data were used to undertake a retrospective, observational study of service use for 235,666 people enrolled with the Pinnacle Midlands Health Network in 2013/14. Using the new expanded measure, service use levels at a locality level were established by age, gender, ethnic group, chronic condition status, practice funding model, high needs status, income and geography of residence.

Significant variation was found in annual average consults (1.0 to 13.4 consults in 2013/14). Statistical analysis identified age, chronic conditions and gender as the key demand drivers responsible for such variation, with regional level results masking significant spatial variation. Where the cost of care was lower, people used a higher level of services in the enrolled practice setting and a lower level outside of it, suggesting the importance of affordable care. Māori and Pacific used significantly fewer services than Pākehā although there was substantial sub-regional variation. Using the expanded measure, the vast majority of care was delivered in the enrolled setting, including for those with chronic conditions.

Demand projections, based on the expanded measure of general practice, out to 2038 show the uneven geography of future demand due to disordered cohort flows and sub-regional population contexts. Overall, demand for services is projected to rise by 34 per cent to almost two million consults across the Waikato District Health Board catchment, with this driven predominantly by services for those aged 65+ years (or 45+ years in Hamilton City, Waikato and Waipa Districts).

Models of care are being transformed as general practices and Primary Health Organisations look to the future. Reorganisation of work roles, improved use of health information and use of emerging health technologies will be required to re-configure general practice in preparation for an ageing future, and to eliminate recalcitrant health inequalities. Real and inclusive collaboration across traditional system boundaries is perhaps the greatest challenge to general practice sustainability.

year: 2018