Showing papers by "University of Salford published in 2006"

A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous cyclophosphamide followed by oral azathioprine for the treatment of pulmonary fibrosis in scleroderma.

Abstract: OBJECTIVE: The lack of randomized controlled trials (RCTs) in pulmonary fibrosis in systemic sclerosis (SSc) has hampered an evidence-based approach to treatment. This RCT was undertaken to investigate the effects of intravenous (IV) cyclophosphamide (CYC) followed by azathioprine (AZA) treatment in pulmonary fibrosis in SSc. METHODS: Forty-five patients were randomized to receive low-dose prednisolone and 6 infusions (monthly) of CYC followed by oral AZA, or placebo. Primary outcome measures were change in percent predicted forced vital capacity (FVC) and change in single-breath diffusing capacity for carbon monoxide (DLCO). Secondary outcome measures included changes in appearance on high-resolution computed tomography and dyspnea scores. An intent-to-treat statistical analysis was performed. RESULTS: At baseline, there were no significant group differences in factors linked to outcome, including severity of pulmonary fibrosis and autoantibody status. Sixty-two percent of the patients completed the first year of treatment. Withdrawals included 9 patients (6 from the placebo group) with significant decline in lung function, 2 with treatment side effects (both from the active treatment group), and 6 with non-trial-related comorbidity. No hemorrhagic cystitis or bone marrow suppression was observed. Estimation of the relative treatment effect (active treatment versus placebo) adjusted for baseline FVC and treatment center revealed a favorable outcome for FVC of 4.19%; this between-group difference showed a trend toward statistical significance (P = 0.08). No improvements in DLCO or secondary outcome measures were identified. CONCLUSION: This trial did not demonstrate significant improvement in the primary or secondary end points in the active treatment group versus the group receiving placebo. However, for FVC there was a trend toward statistical significance between the 2 groups. This suggests that treatment of pulmonary fibrosis in SSc with low-dose prednisolone and IV CYC followed by AZA stabilizes lung function in a subset of patients with the disease. Therapy was well tolerated with no increase in serious adverse events.

Balance disability after stroke

Abstract: Background and Purpose. Balance disability is common after stroke, but there is little detailed information about it. The aims of this study were to investigate the frequency of balance disability; to characterize different levels of disability; and to identify demographics, stroke pathology factors, and impairments associated with balance disability. Subjects. The subjects studied were 75 people with a first-time anterior circulation stroke; 37 subjects were men, the mean age was 71.5 years (SD=12.2), and 46 subjects (61%) had left hemiplegia. Methods. Prospective hospital-based cross-sectional surveys were carried out in 2 British National Health Service trusts. The subjects’ stroke pathology, demographics, balance disability, function, and neurologic impairments were recorded in a single testing session 2 to 4 weeks after stroke. Results. A total of 83% of the subjects (n=62) had a balance disability; of these, 17 (27%) could sit but not stand, 25 (40%) could stand but not step, and 20 (33%) could step and walk but still had limited balance. Subjects with the most severe balance disability had more severe strokes, impairments, and disabilities. Weakness and sensation were associated with balance disability. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. Discussion and Conclusion. Subjects with the most severe balance disability had the most severe strokes, impairments, and disabilities. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. [Tyson SF, Hanley M, Chillala J, et al. Balance disability after stroke. Phys Ther . 2006;86:30–38.]

A molecular phylogeny of the genus Echinococcus inferred from complete mitochondrial genomes

Abstract: Taxonomic revision by molecular phylogeny is needed to categorize members of the genus Echinococcus (Cestoda: Taeniidae). We have reconstructed the phylogenetic relationships of E. oligarthrus, E. vogeli, E. multilocularis, E. shiquicus, E. equinus, E. ortleppi, E. granulosus sensu stricto and 3 genotypes of E. granulosus sensu lato (G6, G7 and G8) from their complete mitochondrial genomes. Maximum likelihood and partitioned Bayesian analyses using concatenated data sets of nucleotide and amino acid sequences depicted phylogenetic trees with the same topology. The 3 E. granulosus genotypes corresponding to the camel, pig, and cervid strains were monophyletic, and their high level of genetic similarity supported taxonomic species unification of these genotypes into E. canadensis. Sister species relationships were confirmed between E. ortleppi and E. canadensis, and between E. multilocularis and E. shiquicus, regardless of the analytical approach employed. The basal positions of the phylogenetic tree were occupied by the neotropical endemic species, E. oligarthrus and E. vogeli, whose definitive hosts are derived from carnivores that immigrated from North America after the formation of the Panamanian land bridge. Host-parasite co-evolution comparisons suggest that the ancestral homeland of Echinococcus was North America or Asia, depending on whether the ancestral definitive hosts were canids or felids.

Resist, comply or workaround? An examination of different facets of user engagement with information systems

Abstract: This paper provides a summary of studies of user resistance to information technology and identifies workaround activity as an understudied and distinct, but related, phenomenon. Previous categorisations of resistance have largely failed to address the relationships between the motivations for divergences from procedure and the associated workaround activity. This paper develops a composite model of resistance/workaround derived from two case study sites. We find four key antecedent conditions derived from both positive and negative resistance rationales and identify associations and links to various resultant workaround behaviours, providing supporting chains of evidence from the two case studies.

Heterogeneity of ubiquitin pathology in frontotemporal lobar degeneration: classification and relation to clinical phenotype.

Abstract: We have investigated the extent and pattern of immunostaining for ubiquitin protein (UBQ) in 60 patients with frontotemporal lobar degeneration (FTLD) with ubiquitin-positive, tau-negative inclusions (FTLD-U), 37 of whom were ascertained in Manchester UK and 23 in Newcastle-Upon-Tyne, UK. There were three distinct histological patterns according to the form and distribution of the UBQ pathology. Histological type 1 was present in 19 patients (32%) and characterised by the presence of a moderate number, or numerous, UBQ immunoreactive neurites and intraneuronal cytoplasmic inclusions within layer II of the frontal and temporal cerebral cortex, and cytoplasmic inclusions within granule cells of the dentate gyrus; neuronal intranuclear inclusions (NII) of a “cat’s eye” or “lentiform” appearance were present in 17 of these patients. In histological type 2 (16 patients, 27%), UBQ neurites were predominantly, or exclusively, present with few intraneuronal cytoplasmic inclusions within layer II of the cerebral cortex, while in histological type 3 (25 patients, 42%), UBQ intraneuronal cytoplasmic inclusions either within the cortical layer II or in the granule cells of the dentate gyrus, with few or no UBQ neurites, were seen. In neither of these latter two groups were NII present. The influence of histological type on clinical phenotype was highly significant with type 1 histology being associated clinically with cases of frontotemporal dementia (FTD) or progressive non-fluent aphasia (PNFA), type 2 histology with semantic dementia (SD), and type 3 histology with FTD, or FTD and motor neurone disease (MND).

Regional differences in response of flow in glacier-fed Himalayan rivers to climatic warming

Abstract: River flow from glacierized areas in the Himalaya is influenced both by intra-annual variations in precipitation and energy availability, and by longer term changes in storage of water as glacier ice. High specific discharge from ice melt often dominates flow for considerable distances downstream, particularly where other sources of runoff are limited, providing a major water resource. Should Himalayan glaciers continue to retreat rapidly, water shortages might be widespread within a few decades. However, given the difference in climate between the drier western and monsoonal eastern ends of the region, future warming is unlikely to affect river flow uniformly throughout. A simple temperature-index-based hydro-glaciological model, in which glacier dimensions are allowed to decline through time, has been developed with a view to assessing, in data-sparse areas, by how much and when climate warming will reduce Himalayan glacier dimensions and affect downstream river flows. Two glaciers having the same initial geometries were located (one each) in the headwaters of two identical nests of hypothetical catchments, representing contrasting climates in the west and east of the region. The hypothetical catchments were nested such that percentage ice cover declined with increasing basin area. Model parameters were validated against available but limited mass-balance and river flow measurements. The model was applied for 150 years from an arbitrary start date (1990), first with standard-period (1961-1990) climate data and then with application of a 0·06 °C year-1 transient climatic warming scenario. Under this warming scenario, Himalayan rivers fed by large glaciers descending through considerable elevation range will respond in a broadly similar manner, except that summer snowfall in the east will suppress the rate of initial flow increase, delay peak discharge and postpone eventual disappearance of the ice. Impacts of declining glacier area on river flow will be greater in smaller and more highly glacierized basins in both the west and east, and in the west, where precipitation is scarce, for considerable distances downstream

Developing Employability Skills: Peer Assessment in Higher Education.

Abstract: Purpose – Reports examining graduate employment issues suggest that employers are concerned by the lack of employability skills exhibited by entry‐level job applications. It is also suggested that employers consider it the responsibility of educational institutions to develop such skills. The current study seeks to identify peer assessment as a potential strategy for developing employability skills and aims to examine – from a students' perspective – the process of introducing peer assessment into higher education teaching programmes.Design/methodology/approach – The focus of the study was on the assessment of students' attitudes towards both being assessed by and assessing other students' work. Data were gathered from a sample of undergraduate students following a structured peer assessment exercise.Findings – In line with previous work, the study found that students expressed a positive attitude towards peer assessment but had concerns relating to their capability to assess peers and to the responsibili...

Innovation in Small, Project-Based Construction Firms*

Abstract: Relevant literature is synthesized to provide a holistic picture of our current knowledge of innovation in small, project-based firms, highlighting significant gaps in the broad areas of ‘focus and outcome’, ‘organizational capabilities’, ‘context’ and ‘process’. Research findings from fieldwork focused on the construction industry are offered to address these gaps. In particular, a consensus model is given of the organizational factors dynamically at play. It is shown that typically the innovations of small, projectbased firms are closely tied to their operational activities and are pushed forward by owners who utilize very scarce resources to make progress in the interstices of normal business. This leads to an emphasis on taking up established technologies through ‘learning on the job’. Growth per se is not an important target. The motivation to act is generally to get past a survival mode of operating and to achieve stability by satisfying clients. These characteristics contrast with large organizations, especially in terms of the role of the owner, the close focus on niche markets and the lack of slack resources to innovate in parallel with normal business. It is hoped that these results will be of interest to other sectors where small, project-based firms operate.

Effect of High-Intensity Inspiratory Muscle Training on Lung Volumes, Diaphragm Thickness, and Exercise Capacity in Subjects Who Are Healthy

Abstract: Background and Purpose. Previous investigations have demonstrated that a regimen of high-intensity inspiratory muscle training (IMT) resulted in changes in ventilatory function and exercise capacity in patients with chronic lung disease, although the effect of high-intensity IMT in subjects who are healthy is yet to be determined. The purpose of this study, therefore, was to examine whether high-intensity IMT resulted in changes in ventilatory function and exercise capacity in subjects who were healthy. Subjects. Twenty subjects were randomly assigned to 2 groups. Methods. The training group completed an 8-week program of IMT set at 80% of maximal effort. The control group did not participate in any form of training. Baseline and posttraining measures of body composition, pulmonary function, inspiratory muscle function (including maximal and sustained maximal inspiratory pressures [MIP and SMIP]), relaxed and contracted diaphragm thickness and thickening ratio (Tdi.rel, Tdi.cont, and TR), and exercise capacity were determined. Results. The training group demonstrated significant increases in MIP, SMIP, Tdi.cont, TR, VC, total lung capacity, and exercise capacity compared with the control group, which demonstrated no change from baseline measurements at 8 weeks. Discussion and Conclusion. The findings of this study suggest that high-intensity IMT results in increased contracted diaphragm thickness and increased lung volumes and exercise capacity in people who are healthy. [Enright SJ, Unnithan VB, Heward C, et al. Effect of high-intensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy.

Insights on polymer surfactant complex structures during the binding of surfactants to polymers as measured by equilibrium and structural techniques

Abstract: This tutorial review provides new insights into the binding interactions between anionic surfactant molecules and various macromolecules in solution. The systems are of inherent scientific interest because synergistic mixing between these two components leads to complexes commonly found in applications such as detergency, cosmetic products, rheology control, paint and pharmaceutical formulations. We describe how the basic foundations, which are prerequisite to characterize a given polymer/surfactant system are evaluated together with information on the binding mechanism and structure derived from several methodologies.

Control of cystic echinococcosis/hydatidosis: 1863-2002.

Abstract: Echinococcosis/hydatidosis, caused by Echinococcus granulosus, is a chronic and debilitating zoonotic larval cestode infection in humans, which is principally transmitted between dogs and domestic livestock, particularly sheep Human hydatid disease occurs in almost all pastoral communities and rangeland areas of the underdeveloped and developed world Control programmes against hydatidosis have been implemented in several endemic countries, states, provinces, districts or regions to reduce or eliminate cystic echinococcosis (CE) as a public health problem This review assesses the impact of 13 of the hydatid control programmes implemented, since the first was introduced in Iceland in 1863 Five island-based control programmes (Iceland, New Zealand, Tasmania, Falklands and Cyprus) resulted, over various intervention periods (from 50 years), in successful control of transmission as evidenced by major reduction in incidence rates of human CE, and prevalence levels in sheep and dogs By 2002, two countries, Iceland and New Zealand, and one island-state, Tasmania, had already declared that hydatid disease had been eliminated from their territories Other hydatid programmes implemented in South America (Argentina, Chile, Uruguay), in Europe (mid-Wales, Sardinia) and in East Africa (northwest Kenya), showed varying degrees of success, but some were considered as having failed Reasons for the eventual success of certain hydatid control programmes and the problems encountered in others are analysed and discussed, and recommendations for likely optimal approaches considered The application of new control tools, including use of a hydatid vaccine, are also considered

The role of nitrogen doping on the development of visible light-induced photocatalytic activity in thin TiO2 films grown on glass by chemical vapour deposition

Abstract: A brief review of the findings of a range of studies aimed at describing the influence of the N-doping of TiO2 thin films and particles on possible visible light induced photoactivity is presented. By way of a new approach to the direct growth of N-doped TiO2 thin films, the physical and photochemical effects of the addition of ammonia during atmospheric chemical vapour deposition (CVD) growth of TiO2 are described. It is found that the addition of ammonia to the CVD reactive gas mixture causes a dramatic change in film morphology and a reduction in growth rates. In addition, it is found that although we have clear evidence for the incorporation of ?O-substitutional N atoms within the growing film, there is no evidence of any appreciable photocatalytic activity of the doped TiO2 films when irradiated with visible light. In fact the degradation in film morphology results in a decrease in conventional uv-induced photoactivity as compared to that for an undoped film. These findings are discussed in terms of the findings of other studies of N-doped TiO2 films that have been reported.

Mental health needs of young offenders in custody and in the community.

Abstract: BACKGROUND: Research has revealed high levels of mental health needs in young offenders but many studies have been small, focusing on specific populations. AIMS: To evaluate the mental health and psychosocial needs of a nationally representative sample of juvenile offenders in England and Wales, including female offenders and those from Black and minority ethnic groups. METHOD: A cross-sectional survey of 301 young offenders, 151 in custody and 150 in the community, was conducted in six geographically representative areas across England and Wales. Each young person was interviewed to obtain demographic information, mental health and social needs, and psychometric data. RESULTS: Young offenders were found to have high levels of needs in a number of different areas including mental health (31%), education/work (36%) and social relationships (48%). Young offenders in the community had significantly more needs than those in secure care and needs were often unmet. One in five young offenders was also identified as having a learning disability (IQ<70). CONCLUSIONS: Needs for young offenders were high but often unmet. This emphasises the importance of structured needs assessment within custody and community settings in conjunction with a care programme approach that improves continuity of care.

Clinical features and natural history of neuroferritinopathy caused by the FTL1 460InsA mutation.

Abstract: Neuroferritinopathy is a progressive potentially treatable adult-onset movement disorder caused by mutations in the ferritin light chain gene (FTL1). Features overlap with common extrapyramidal disorders: idiopathic torsion dystonia, idiopathic Parkinson's disease and Huntington's disease, but the phenotype and natural history have not been defined. We studied a genetically homogeneous group of 41 subjects with the 460InsA mutation in FTL1, documenting the presentation, clinical course, biochemistry and neuroimaging. The mean age of onset was 39.4 years (SD = 13.3, range 13-63), beginning with chorea in 50%, focal lower limb dystonia in 42.5% and parkinsonism in 7.5%. The majority reported a family history of a movement disorder often misdiagnosed as Huntington's disease. The disease progressed relentlessly, becoming generalized over a 5-10 year period, eventually leading to aphonia, dysphagia and severe motor disability with subcortical/frontal cognitive dysfunction as a late feature. A characteristic action-specific facial dystonia was common (65%), and in 63% there was asymmetry throughout the disease course. Serum ferritin levels were low in the majority of males and post-menopausal females, but within normal limits for pre-menopausal females. MR brain imaging was abnormal on all affected individuals and one presymptomatic carrier. In conclusion, isolated parkinsonism is unusual in neuroferritinopathy, and unlike Huntington's disease, cognitive changes are absent or subtle in the early stages. Depressed serum ferritin is common and provides a useful screening test in routine practice, and gradient echo brain MRI will identify all symptomatic cases.

The impact of urban areas on weather

Abstract: The industrial revolution led to a rapid development of urban areas. This has continued unremittingly over the last 200 years or so. In most urban areas the surface properties are heterogeneous, which has significant implications for energy budgets, water budgets and weather phenomena within the part of the earth's atmosphere that humans live. In this paper I discuss the structure of the planetary boundary layer, confining our analysis to the region above the rooftops (canopy layer) up to around the level where clouds form. It is in this part of the atmosphere that most of the weather impacting our lives occurs, and where the buildings of our cities impact the weather. In this review, observations of the structure of the urban atmospheric boundary layer are discussed. In particular the use of Doppler lidar provides measurements above the canopy layer. The impact of high-rise buildings is considered. Urban morphology impacts energy fluxes and airflow leading to phenomena such as the urban heat island and convective rainfall initiation. I discuss in situ surface-based remote sensing and satellite measurements of these effects. Measurements have been used with simple and complex numerical models to understand the complexity and balance of the interactions involved. Cities have been found to be sometimes up to 10 degC warmer than the surrounding rural areas, and to cause large increases in rainfall amounts. However, there are situations in which urban aerosol may suppress precipitation. Although much progress has been made in understanding these impacts, our knowledge remains incomplete. These limitations are identified. As city living becomes even more the norm for large numbers of people, it is imperative that we ensure that urban effects on the weather are included in development plans for the built environment of the future. Copyright © 2006 Royal Meteorological Society

Benchmarking Initiatives in the Construction Industry: Lessons Learned and Improvement Opportunities

Abstract: Benchmarking is a systematic process of measuring and comparing an organization's performance against that of other similar organizations in key business activities. The lessons learned from other companies can be used to establish improvement targets and to promote changes in the organization. The benchmarking process can create a fertile ground for ideas, but only in a receptive environment; companies that share good practices and compare their performance against others benefit most. Recently, industry groups in several different countries have initiated benchmarking programs focused mainly on construction performance measures. This paper describes the scope of these initiatives and discusses the lessons learned and improvement opportunities that were identified in their design and implementation. This investigation is focused on four initiatives, carried out in Brazil, Chile, the United Kingdom, and the United States. This paper concludes by recommending some further directions on this research topic.

Attitudes and perceptions of construction workforce on construction waste in Sri Lanka

Abstract: Purpose – The construction industry consumes large amounts of natural resources, which are not properly utilised owing to the generation of waste. Construction waste has challenged the performance of the industry and its sustainable goals. The majority of the causes underlying material waste are directly or indirectly affected by the behaviour of the construction workforce. Waste occurs on site for a number of reasons, most of which can be prevented, particularly by changing the attitudes of the construction workforce. Therefore, the attitudes and perceptions of the construction workforce can influence the generation and implementation of waste management strategies. The research reported in this paper is based on a study aimed at evaluating the attitudes and perceptions of the construction workforce involved during the pre‐ and post‐contract stages towards minimising waste.Design/methodology/approach – A structured questionnaire survey was carried out to understand and evaluate the attitudes and percepti...

Braid Effects on Contractile Range and Friction Modeling in Pneumatic Muscle Actuators

Abstract: Within braided pneumatic Muscle Actuators (pMA) the braid structure is vital to the actuator's performance, preventing over-inflation, converting radial expansion into axial contraction and setting limits for both dilation and contraction. This paper seeks to explore the nature of the contractile limit and the hysteresis observed by researchers during the actuation cycle. Maximum actuator dilation occurs when adjacent braid strands are forced against one another. Within this work this is analyzed mathematically and it is shown that by halving the number of strands used to create the braided shell the actuator's contractile range can be increased by approximately 7%. This also results in a simultaneous peak contractile force increases of over 16%. These results are verified experimentally. Hysteresis due to friction between braid strands during muscle operation is also explored. The paper will show how consideration of the deformation of the strands allows the contact area and therefore friction to be calculated without the need for experimentally obtained data as in previous research. A mathematical model is produced and verified experimentally.

Enhancing the early student experience

Abstract: This paper is concerned with identifying how the early student experience can be enhanced in order to improve levels of student retention and achievement. The early student experience is the focus of this project as the literature has consistently declared the first year to be the most critical in shaping persistence decisions. Programme managers of courses with high and low retention rates have been interviewed to identify activities that appear to be associated with good retention rates. The results show that there are similarities in the way programmes with high retention are run, with these features not being prevalent on programmes with low retention. Recommendations of activities that appear likely to enhance the early student experience are provided.

Review article: intestinal failure

Abstract: Intestinal failure is a specific disease entity resulting from intestinal resection or disease-associated malabsorption and characterized by the inability to maintain protein-energy, fluid, electrolyte or micronutrient balance. We performed a MEDLINE search (1966-2006) to identify relevant articles, using keywords intestinal failure, parenteral or enteral nutrition, intestinal fistula and short bowel syndrome. Causes of intestinal failure are varied, with self-limiting or 'Type 1' intestinal failure occurring relatively commonly following abdominal surgery, necessitating short-term fluid or nutritional support. The rarer, 'Type 2' intestinal failure, is associated with septic, metabolic and complex nutritional complications, usually following surgical resection in patients with Crohn's or mesenteric vascular disease. A multidisciplinary approach to the management of patients with Type 2 intestinal failure is crucial: resolution of sepsis is required before adequate nutritional repletion can be achieved, and it is important to optimize nutritional status, not only through enteral or parenteral supplementation, but also by addressing complications of short bowel syndrome, before considering definitive surgical reconstruction. A structured approach to the management of Type 2 intestinal failure should reduce the likelihood of these complex patients developing 'Type 3' intestinal failure, which is characterized by the need for long-term parenteral nutrition.

New issues in attendance demand: the case of the English Football League.

Abstract: This articles uses an attendance demand model with panel data on more than 4,000 games to examine economic problems of fixture congestion in English Football League schedules. We find that televised, midweek Champions League matches involving English Premier League clubs have substantial adverse impacts on lower division Football League gate attendance. This suggests that affected clubs may have a case for compensation from the Premier League for loss of gate revenue from this source. Scheduling of home games close to one another also has an adverse impact on attendance. Reorganisation of fixture schedules and/or redistribution of income would help offset adverse impacts on team revenues from midweek scheduling.

Treatment of idiopathic club foot using the Ponseti method: INITIAL EXPERIENCE

Abstract: We report our initial experience of using the Ponseti method for the treatment of congenital idiopathic club foot. Between November 2002 and November 2004 we treated 100 feet in 66 children by this method. The standard protocol described by Ponseti was used except that, when necessary, percutaneous tenotomy of tendo Achillis were performed under general anaesthesia in the operating theatre and not under local anaesthesia in the out-patient department. The Pirani score was used for assessment and the mean follow-up time was 18 months (6 to 30). The results were also assessed in terms of the number of casts applied, the need for tenotomy of tendo Achillis and recurrence of the deformity. Tenotomy was required in 85 of the 100 feet. There was a failure to respond to the initial regimen in four feet which then required extensive soft-tissue release. Of the 96 feet which responded to initial casting, 31 (32%) had a recurrence, 16 of which were successfully treated by repeat casting and/or tenotomy and/or transfer of the tendon of tibialis anterior. The remaining 15 required extensive soft-tissue release. Poor compliance with the foot-abduction orthoses (Denis Browne splint) was thought to be the main cause of failure in these patients.

Predicting community violence from patients discharged from mental health services

Abstract: Background The MacArthur Violence Risk Assessment Study (MacVRAS) in the USA provided strong evidence to support an actuarial approach in community violence risk assessment. Aims To examine the predictive accuracy of the MacVRAS measures, in addition to structured professional judgement, in a UK sample of patients discharged from in-patient care in the north-west of England. Method A prospective study of 112 participants assessed pre-discharge and followed up at 24 weeks post-discharge. Pre-discharge measures were compared with prevalence of violent behaviour to determine predictive validity of risk factors. Results Historical measures of risk and measures of psychopathy, impulsiveness and anger were highly predictive of community violence. The more dynamic clinical and risk management factors derived from structured professional judgement (rated atdischarge) added significant incremental validity to the historical factors in predicting community violence. Conclusions Although static measures of risk relating to past history and personality make an important contribution to assessment of violence risk, consideration of current dynamic factors relating to illness and risk management significantly improves predictive accuracy.