Domestic abuse – abusive behaviour perpetrated by an adult towards another adult to whom they are personally connected (e.g. partners, ex-partners or family members) – damages mental health, increases mental health service use and challenges clinical management. Training and guidance for mental health professionals on identifying and responding to patients exposed to domestic abuse are available, but there has been less development of resources for mental health professionals in identifying, assessing and responding to perpetrators of domestic abuse. In this article, we describe a framework for responding to domestic abuse perpetration in clinical settings in general adult mental health services, aimed at improving practice. This could support mental health professionals in sensitive enquiry and assessment for domestic abuse perpetration, and guide appropriate responses, as part of routine training and continuing professional development.

Navigating the complex relationship between violence and psychosis can frequently be challenging. Psychiatrists may find assessing and managing the risk of violence in this context daunting. In their article on the topic, Anderson et al helpfully summarise the role that psychopathology can play in this process. However, although careful elucidation of an individual's experiences may assist in the nuanced formulation of their risk and could offer a specific focus for interventions, the approach has potential shortcomings in certain settings. For some phenomena the link with violence is unclear and it may be constellations of symptoms that are important. Causal pathways are not always linear and there may be important mediators linking psychopathological features to behavioural outcomes. In the resource-limited settings in which many contemporary health services operate, a detailed assessment of psychopathology may be hampered by time or other constraints. Alternative, more scalable solutions may therefore be needed in particular scenarios.

The malicious use of artificial intelligence is growing rapidly, creating major security threats for individuals and the healthcare sector. Individuals with mental illness may be especially vulnerable. Healthcare provider data are a prime target for cybercriminals. There is a need to improve cybersecurity to detect and prevent cyberattacks against individuals and the healthcare sector, including the use of artificial intelligence predictive tools.

Probability-based estimates of the future suicide of psychiatric patients are of little assistance in clinical practice. This article proposes strategic management of the interaction between the clinician and the patient in the assessment of potentially suicidal patients, using principles derived from game theory, to achieve a therapeutic outcome that minimises the likelihood of suicide. Further developments in the applications of large language models could allow us to quantify the basis for clinical decisions in individual patients. Documenting the basis of those decisions would help to demonstrate an adequate standard of care in every interaction.

If livestock at risk of poor welfare could be identified using a risk assessment tool, more targeted response strategies could be developed by enforcement agencies to facilitate early intervention, prompt welfare improvement and a decrease in reoffending. This study aimed to test the ability of an Animal Welfare Risk Assessment Tool (AWRAT) to identify livestock at risk of poor welfare in extensive farming systems in Australia. Following farm visits for welfare- and non-welfare-related reasons, participants completed a single welfare rating (WR) and an assessment using the AWRAT for the farm just visited. A novel algorithm was developed to generate an AWRAT-Risk Rating (AWRAT-RR) based on the AWRAT assessment. Using linear regression, the relationship between the AWRAT-RR and the WR was tested. The AWRAT was good at identifying farms with poor livestock welfare based on this preliminary testing. As the AWRAT relies upon observation, the intra- and inter-observer agreement were compared in an observation study. This included rating a set of photographs of farm features, on two occasions. Intra-observer reliability was good, with 83% of Intra-class Correlation Coefficients (ICCs) for observers ≥ 0.8. Inter-observer reliability was moderate with an ICC of 0.67. The AWRAT provides a structured framework to improve consistency in livestock welfare assessments. Further research is necessary to determine the AWRAT’s ability to identify livestock at risk of poor welfare by studying animal welfare incidents and reoffending over time.

Tropical glaciers are rapidly disappearing, particularly in isolated mountain peaks below 5,000 m elevation. These glaciers are fundamental substrates for unique cryogenic ecosystems in high tropical environments where the ice, melting water and rocky substrate sustain microbiological communities and other meso- and macro-biota. This study uses the Red List of Ecosystems guidelines to diagnose the collapse of the tropical glacier ecosystem of the Cordillera de Mérida, Venezuela. We undertook the assessment with existing estimates of glacier ice extent, indirect historical estimates of ice mass balance and global mechanistic models of future ice mass balance. We complemented these with additional statistical analysis of trends and bioclimatic suitability modelling to calculate and predict rates of decline and relative severity of degradation in selected ecosystem indicators. The evidence suggests an extreme risk of collapse (Critically Endangered) because of a prolonged and acute reduction in ice extent and changes in climatic conditions that are leading to the complete loss of ice mass. The ice substrate has declined 90% in the last 20 years, and observed acceleration of the rate of decline suggests it will probably disappear within the next 5 years. Loss of ice substrate will trigger an immediate loss of supraglacial, englacial and subglacial biotic compartments and initiate a decades-long succession of forefield vegetation. However, ongoing inventories of native biota and monitoring of ecosystem transitions can provide valuable insights and lessons for other ecosystems facing similar risks. The Red List of Ecosystems assessment protocol provides a useful framework for comparative analysis of cryogenic ecosystems.

The Parole Board for England and Wales advises on the release, recall and licence conditions of a small subgroup of prisoners serving determinate sentences and the majority of those serving indeterminate sentences. Since the establishment of the Parole Board in 1968, the parole process has been shaped and clarified by further legislation and case law. In certain scenarios, psychiatric expert evidence may be sought to inform the Board's determination of whether a prisoner can be safely released into the community. Psychiatrists preparing expert reports for the Parole Board should be familiar with the current operationalisation of parole. This involves an understanding not only of the functioning of the Parole Board, but also of the criminal justice context in which prisoners subject to parole are managed. Having set the scene, by describing the role of the Parole Board and the wider context, this article examines how to undertake assessments and complete psychiatric reports for the Board.

When skeletal dysplasias are suspected in the prenatal period, investigation, counseling, and management become especially challenging. By better understanding the complex forces at play and parental values, prenatal health care providers may improve the ways in which they counsel patients to improve the decision-making process under conditions of significant uncertainty, including in cases of prenatally suspected skeletal dysplasia.

Scientific consensus links dietary choices to health outcomes, highlighting the urgency to prioritise healthy food production in food systems. At the EU level, however, defining healthy food and integrating it into food governance remains a challenge, particularly regarding the inclusion of health-related characteristics in food safety assessments. While the EU primarily relies on the risk analysis principle to address food safety concerns, the process still exhibits weaknesses that hinder its direct impact on fostering a healthier food production landscape. This review demonstrates how the risk analysis process, particularly scientific opinions in risk assessment and external factors (economic and political) in risk management, impact food governance and the healthiness of food systems. We find that while external factors play a crucial role in risk management decisions by incorporating non-food safety considerations, they often stem from an imbalance of power favouring major industry and political stakeholders. This imbalance disproportionately influences decision-making, often overshadowing nutritional and health aspects. To address these challenges, we recommend directing research towards filling knowledge gaps and exploring minority scientific findings, and separating external factors from risk management’s decision-making process, to ensure that food governance prioritises public health and healthy food production.