Comparing Face-to-Face, Blended and Online Teaching Approaches for Practical Skill Acquisition: A Randomised Controlled Trial.

Introduction: The efficacy of blended and online teaching methods for practical skill acquisition remains ambiguous, particularly for skills requiring haptic awareness and/or sensory training. This study aims to compare three teaching methods (face-to-face, blended, online) for the acquisition of skills requiring sensory learning and haptic awareness. A secondary aim was to explore student experience of each teaching approach. Design: A post-test only randomised controlled trial. Methods: Forty-seven participants chose between learning two skills: manual measurement of blood pressure during exercise (BPM) and/or skin fold measurement using callipers (SKM). Participants were randomised to one of three learning groups: face-to-face (n = 23), blended (n = 22) and online (n = 26). Assessors determined skill competency during an in-person skill demonstration session. A survey captured student experiences. Results: For SKM, there was a statistically significant difference in skill competency between the online learning group (17% achieved competency) and both the face-to-face (75% achieved competency; p = 0.011) and blended (89% achieved competency; p = 0.001) learning groups. For BPM, the online group had the lowest percentage of participants achieve overall skill competency. Both knowledge-based and sensory-based sub-competencies were negatively affected by the online learning method. For both skills, students in the face-to-face and blended learning group were significantly more confident in their knowledge and their ability to perform the skill in a clinical setting, compared to the online learning group. Conclusion: Both face-to-face and blended teaching methods were more effective at leading to skill acquisition and were preferred by students when compared to a fully online teaching method.

Focused deterrence: A protocol for a realist multisite randomised controlled trial for evaluating a violence prevention intervention in the UK.

INTRODUCTION: Focused deterrence (FD) is a frequently cited intervention for preventing violence, particularly against violent urban gangs. The Youth Endowment Fund (YEF) believes it could be effective in the UK, based primarily on research conducted in the US. However, we contend that these studies have inadequate methodological designs, lack of rigorous testing, and small sample sizes. Therefore, the evidence supporting focused deterrence as an effective method, particularly outside the US, is inconclusive. The aim of the protocol is to better understand the potential effects of FD in the context of the UK, using a multisite evaluation experimental design to more closely investigate the evidence of its likely impact. METHODS: We planned a realist randomised controlled trial. The design is focused on a multisite trial consisting of two-arm randomised experiments in five locations. Each trial location will test their implementation of a core programme specified by the funder. The multisite nature will allow us to understand differential impacts between locations, improving the external validity of the results. Participants will be randomly selected from a wider pool of eligible individuals for the intervention. We estimate a sample size of approximately N = 1,700 individuals is required. Based on this pooled sample size, a relative reduction of 26% would be detectable in 80% of trials. The trial is coupled with a formative process evaluation of delivery and fidelity. The formative evaluation will use a mixed methods design. The qualitative aspect will include semi-structured cross-sectional and longitudinal interviews with programme leads, programme delivery team, and programme participants, as well as observations of the meetings between the programme delivery team (i.e., community navigators/mentors) and programme participants. The quantitative data for the formative evaluation will be gathered by the sites themselves and consist of routine outcome performance monitoring using administrative data. Sampling for interviews and observations will vary, with the researchers aiming for a higher number of individuals included in the first round of cross-sectional interviews and retaining as many as possible for repeat interviews and observations. DISCUSSION: This protocol outlines the process and impact evaluation methodology for the most extensive multisite evaluation of focused deterrence to date in the UK. Spanning five distinct sites with seven trials, the evaluation includes a cohort of 2,000 individuals, marking it as the only multisite trial of focused deterrence. Employing an integrated realist evaluation framework, the study uses qualitative and quantitative research methods. The anticipated findings will offer pivotal insights for formulating future violence prevention policies in the UK. They are also expected to contribute significantly to the corpus of literature on violence prevention and intervention evaluation. TRIAL REGISTRATION: Protocol registration: ISRCTN: 11650008 4th June 2023.

Linkage of the Avon Longitudinal Study of Parents and Children (ALSPAC) to Avon & Somerset Police regional police records.

This data note describes a new resource for crime-related research: the Avon Longitudinal Study of Parents and Children (ALSPAC) linked to regional police records. The police data were provided by Avon & Somerset Police (A&SP), whose area of responsibility contains the ALSPAC recruitment area. In total, ALSPAC had permission to link to crime records for 12,662 of the 'study children' (now adults, who were born in the early 1990s).  The linkage took place in two stages: Stage 1 involved the ALSPAC Data Linkage Team establishing the linkage using personal identifiers common to both the ALSPAC participant database and A&SP records using deterministic and probabilistic methods. Stage 2 involved A&SP extracting attribute data on the matched individuals, removing personal identifiers and securely sharing the de-identified records with ALSPAC. The police data extraction took place in July 2021, when the participants were in their late 20s/early 30s. This data note contains details on the resulting linked police records available. In brief, electronic police records were available from 2007 onwards. In total, 1757 participants (14%) linked to at least one police record for a charge, offence 'taken into consideration', caution, or another out of court disposal. Linked participants had a total of 6413 records relating to 6283 offences. Almost three quarters of the linked participants were male. The most common offence types were violence against the person (22% of records), drug offences (19%), theft (17%) and public order offences (11%). This data note also details important issues that researchers using the local police data should be aware of, including the importance of defining an appropriate denominator, completeness, and biases affecting police records.

The potential for linking cohort participants to official criminal records: a pilot study using the Avon Longitudinal Study of Parents and Children (ALSPAC).

Introduction: Linking longitudinal cohort resources with police-recorded records of criminal activity has the potential to inform public health style approaches and may reduce potential sources of bias from self-reported criminal data collected by cohort studies. A pilot linkage to police records in the Avon Longitudinal Study of Parents and Children (ALSPAC) allows us to consider the acceptability of this linkage, its utility as a data resource, differences in self-reported crime according to consent status for data linkage, and the appropriate governance mechanism to support such a linkage. Methods: We carried out a pilot study that linked data from the ALSPAC birth cohort to Ministry of Justice (MoJ) records on criminal cautions and convictions. This pilot was conducted on a fully anonymous basis, meaning we cannot link the identified records to any participant or the wider information within the dataset. Using ALSPAC data, we used summary statistics to investigate differences in self-reported criminal activity according to socio-economic background and consent status. We used MoJ records to identify the geographic and temporal concentration of criminality in the ALSPAC cohort. Results: We found that the linkage appears acceptable to participants (4% of the sample opted out), levels of criminality are high enough to support research and that the majority of crimes occurred in Avon & Somerset (the policing area local to ALSPAC). Both those who opted out of linkage or did not respond to consent requests had higher levels of self-reported criminal behaviour compared to participants who provided explicit consent. Conclusions: These findings suggest that data linkage in ALSPAC provides opportunities to study criminal behaviour and that linked individual-level records can provide robust research in the area. Our findings also suggest the potential for bias when only using samples that have explicitly consented to data linkage, highlighting the limitations of opt-in consent strategies.

Service Provider Difficulties in Operationalizing Coercive Control.

We examined perspectives of social workers, police officers, and specialist domestic abuse practitioners about their perceived ability and organizational readiness to respond effectively to incidents of coercive and controlling behavior. Interviews revealed intervention and risk assessment strategies structured around an outdated, maladaptive concept of domestic abuse as an unambiguous and violent event and frontline services that lacked appreciation of the power dynamics inherent in controlling relationships. The analysis demonstrates how lack of definitional clarity around nonphysical domestic abuse can increase the use of discretion by frontline services and, by extension, increase the discounting of coercive control by pressured frontline officers.

Police-initiated diversion for youth to prevent future delinquent behavior: a systematic review.

This Campbell systematic review examines the effects police-initiated diversion programs on delinquent behavior, compared to traditional system processing. The review summarizes evidence from nineteen high-quality studies, including 13 randomized controlled trials and six quasi-experimental studies. This review includes studies that evaluated the effects of police-led diversionary practices compared to traditional processing for youth under 18 years of age. We identified a total of 14 manuscripts representing 19 evaluations. Of these 19 evaluations, 13 used randomized controlled designs (random assignment to conditions) and 6 used quasi-experimental designs (no random assignment to conditions). Many of these designs included two or more diversionary conditions compared to a common control (traditional processing) producing 31 treatment-comparison contrasts for analysis. These studies were conducted between 1973 and 2011, inclusively. Most were conducted in the USA (11) with the remaining conducted in Canada (4), Australia (2), and the UK (2). The general pattern of evidence is positive, suggesting that police-led diversion reduces the future delinquent behavior of low-risk youth relative to traditional processing. Assuming a 50 percent reoffending rate for the traditional processing condition, the results suggest a reoffending rate of roughly 44 percent for the diverted youth. This overall benefit of diversion holds for the random assignment studies judged to be free from any obvious risks of bias. No meaningful differences were found across types of diversionary programs. Furthermore, we found no evidence to suggest these findings suffer from publication selection bias. Plain language summary: Police-led diversion of low-risk youth reduces their future contact with the justice system: Police-led diversion of low-risk youth who come into contact with the justice system is more effective in reducing a youth's future contact with the justice system compared to traditional processing.What is this review about?: Youth misconduct and misbehavior is a normal part of adolescence and that misbehavior sometimes crosses the line from disruptive or problematic to delinquent. Nationally representative surveys of youth in the USA have indicated that minor delinquent behavior is normative, particularly for boys. The normative nature of minor delinquent behavior raises the question of how police should respond to minor delinquent behavior in a way that is corrective, but also avoids involving the youth in the criminal justice system beyond what will be effective in reducing future misbehavior.Police diversion schemes are a collection of strategies police can apply as an alternative to court processing of youth. Diversion as an option is popular among law enforcement officers, as it provides an option between ignoring youth engaged in minor wrongdoing and formally charging such youth with a crime. Police-led diversion has the potential to reduce reoffending by limiting the exposure of low-risk youth to potentially harmful effects of engagement with the criminal justice system.What are the main findings of this review?: This review includes studies that evaluated the effects of police-led diversionary practices compared to traditional processing for youth under 18 years of age. We identified a total of 14 manuscripts representing 19 evaluations. Of these 19 evaluations, 13 used randomized controlled designs (random assignment to conditions) and 6 used quasi-experimental designs (no random assignment to conditions). Many of these designs included two or more diversionary conditions compared to a common control (traditional processing) producing 31 treatment-comparison contrasts for analysis. These studies were conducted between 1973 and 2011, inclusively. Most were conducted in the USA (11) with the remaining conducted in Canada (4), Australia (2), and the UK (2).The general pattern of evidence is positive, suggesting that police-led diversion reduces the future delinquent behavior of low-risk youth relative to traditional processing. Assuming a 50 percent reoffending rate for the traditional processing condition, the results suggest a reoffending rate of roughly 44 percent for the diverted youth. This overall benefit of diversion holds for the random assignment studies judged to be free from any obvious risks of bias. No meaningful differences were found across types of diversionary programs. Furthermore, we found no evidence to suggest these findings suffer from publication selection bias.What do the findings of this review mean?: The findings from this systematic review support the use of police-led diversion for low-risk youth with limited or no prior involvement with the juvenile justice system. Thus, police departments and policy-makers should consider diversionary programs as part of the mix of solutions for addressing youth crime.Many of the studies included in the review were conducted in the 1970s and 1980s. Newer high quality studies are needed to ensure that the findings still hold for contemporary juvenile justice contexts. Additional studies are also needed outside of the USA for this same reason. Finally, we recommend that research explore the usefulness of diversion for low-risk adult offenders.How up-to-date is this review?: The search for eligible studies was completed in January of 2017, so only studies identifiable through January 2017 were included. This Campbell systematic review was published in May 2018. Executive summary/Abstract: Background: Overly punitive responses to youth misconduct may have the unintended consequence of increasing the likelihood of future delinquency; yet, overly lenient responses may fail to serve as a corrective for the misbehavior. Police diversion schemes are a collection of strategies police can apply as an alternative to court processing of youth. Police-initiated diversion schemes aim to reduce reoffending by steering youth away from deeper penetration into the criminal justice system and by providing an alternative intervention that can help youth address psychosocial development or other needs that contribute to their problem behavior.Objectives: The objective of this review was to synthesize the evidence on the effectiveness of pre-court interventions involving police warning or counseling and release, and cautioning schemes in reducing delinquent behavior.Search methods: A combination of 26 databases and websites were searched. References of relevant reviews were also scanned to identify studies. We also consulted with experts in the field. Searches were executed by two reviewers and conducted between August 2016 and January 2017.Selection criteria: Only experimental and quasi-experimental designs were eligible for this review. All quasi-experimental designs must have had a comparison group similar to the police diversion intervention group with respect to demographic characteristics and prior involvement in delinquent behavior (i.e., at similar risk for future delinquent behavior). Additionally, studies must have included youth participants between 12 and 17 years of age who either underwent traditional system processing or were diverted from court processing through a police-led diversion program. Studies were also eligible if delinquency-related outcomes, including official and non-official (self-report or third-party reporting) measures of delinquency were reported.Data collection and analysis: This study used meta-analysis to synthesize results across studies. This method involved systematic coding of study features and conversion of study findings into effect sizes reflecting the direction and magnitude of any police-led diversion effect. There were 19 independent evaluations across the 14 primary documents coded for this review. From this, we coded 67 effect sizes of delinquent behavior post diversion across 31 diversion-traditional processing comparisons. We analyzed these comparisons using two approaches. The first approach selected a single effect size per comparison based on a decision rule and the second used all 67 effect sizes, nesting these within comparison condition and evaluation design.Results: The general pattern of evidence is positive, suggesting that police-led diversion modestly reduces future delinquent behavior of low-risk youth relative to traditional processing.Authors' conclusions: The findings from this systematic review support the use of police-led diversion for low-risk youth with limited or no prior involvement with the juvenile justice system. Thus, police departments and policy-makers should consider diversionary programs as part of the mix of solutions for addressing youth crime.

Victim Responses to Violence: The Effect of Alcohol Context on Crime Labeling.

The labeling of an incident as a crime is an essential precursor to the use of criminal law, but the contextual factors that influence this decision are unknown. One such context that is a frequent setting for violence is the barroom. This study explored how the setting of a violent incident is related to the decision by victims to label it as a crime. It tested the hypothesis that violent incidents that took place in or around a licensed premises were less likely to be regarded as crimes than violence in other settings. The hypothesis was tested using a pooled sample of respondents from successive waves of the British Crime Survey (2002/2003-2010/2011). Logistic regression models controlled for demographic factors, victim behavioral characteristics, and incident-specific factors including the seriousness of the violence. Respondents who were in or around a licensed premises at the time of victimization were less likely to regard that violence as a crime (adjusted odds ratio = 0.48, 95% confidence intervals [CIs] = [0.34, 0.67]) than respondents who were victimized in other locations. Despite a disproportionate amount of violence taking place in barrooms, it appears that the criminal nature of violence in these spaces is discounted by victims. The findings emphasize how context affects victim interpretations of crime and suggest a victim-centered reconceptualization of the "moral holiday" hypothesis of alcohol settings.

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury.

OBJECTIVE: To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence-related injury. METHODS: Benefit-cost analysis. RESULTS: Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared with the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. By contrast, the costs associated with the programme were modest: setup costs of software modifications and prevention strategies were £107 769, while the annual operating costs of the system were estimated as £210 433 (2003 UK pound). The cumulative social benefit-cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit-cost ratio of 14.80 for the health service and 19.1 for the criminal justice system. Each of these benefit-cost ratios is above 1 across a wide range of sensitivity analyses. CONCLUSIONS: An effective information-sharing partnership between health services, police and local government in Cardiff, UK, led to substantial cost savings for the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented.

An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom.

BACKGROUND: To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation. METHODS: An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises' customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews. RESULTS: The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises. CONCLUSIONS: It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability. TRIAL REGISTRATION: UKCRN 7090; ISRCTN: 80875696.

Change in alcohol outlet density and alcohol-related harm to population health (CHALICE).

BACKGROUND: Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community. METHODS/DESIGN: A natural experiment of the effect of change in outlet density between 2005-09, in Wales, UK; population 2.4 million aged 16 years and over. Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. The study outcomes are change in (1) alcohol consumption using data from annual Welsh Health Surveys, (2) alcohol-related hospital admissions using the Patient Episode Database for Wales, (3) Accident & Emergency department attendances between midnight-6am, and (4) alcohol-related violent crime against the person, using Police data. The data will be anonymously record-linked within the Secure Anonymised Information Linkage Databank at individual and 2001 Census Lower Super Output Area levels. New methods of network analysis will be used to estimate outlet density. Longitudinal statistical analysis will use (1) multilevel ordinal models of consumption and logistic models of admissions and Accident & Emergency attendance as a function of change in individual outlet exposure, adjusting for confounding variables, and (2) spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration. DISCUSSION: This inter-disciplinary study requires expertise in epidemiology and public health, health informatics, medical statistics, geographical information science, and research into alcohol-related violence. Information governance requirements for the use of record-linked data have been approved together with formal data access agreements for the use of the Welsh Health Survey and Police data. The dissemination strategy will include policy makers in national and local government. Public engagement will be through the Clinical Research Collaboration-Cymru "Involving People" network, which will provide input into the implementation of the research.

In vino silentium? Individual, situational, and alcohol-related factors in reporting violence to the police.

This study identifies the individual, situational, and alcohol-related factors associated with reporting violent victimization to the police. Factors positively associated with reporting included older age and incident severity (the assailant's use of a weapon, incurring injury that required attendance at an emergency department). Factors negatively associated with reporting included higher educational qualifications, assault in the nighttime economy (NTE), and drinking more than two alcoholic drinks immediately prior to victimization. It is possible that drinkers engage in "moratorium" on reporting violence in the NTE. Recognizing and reducing the acceptability of violence in the NTE may help reduce incidence of alcohol-related violence. Organizations that use police records of violence to inform practice and policy should account for uneven distributions in reporting behavior when analyzing trends in violence.

Effectiveness of anonymised information sharing and use in health service, police, and local government partnership for preventing violence related injury: experimental study and time series analysis.

OBJECTIVE: To evaluate the effectiveness of anonymised information sharing to prevent injury related to violence. DESIGN: Experimental study and time series analysis of a prototype community partnership between the health service, police, and local government partners designed to prevent violence. SETTING: Cardiff, Wales, and 14 comparison cities designated "most similar" by the Home Office in England and Wales. INTERVENTION: After a 33 month development period, anonymised data relevant to violence prevention (precise violence location, time, days, and weapons) from patients attending emergency departments in Cardiff and reporting injury from violence were shared over 51 months with police and local authority partners and used to target resources for violence prevention. MAIN OUTCOME MEASURES: Health service records of hospital admissions related to violence and police records of woundings and less serious assaults in Cardiff and other cities after adjustment for potential confounders. RESULTS: Information sharing and use were associated with a substantial and significant reduction in hospital admissions related to violence. In the intervention city (Cardiff) rates fell from seven to five a month per 100,000 population compared with an increase from five to eight in comparison cities (adjusted incidence rate ratio 0.58, 95% confidence interval 0.49 to 0.69). Average rate of woundings recorded by the police changed from 54 to 82 a month per 100,000 population in Cardiff compared with an increase from 54 to 114 in comparison cities (adjusted incidence rate ratio 0.68, 0.61 to 0.75). There was a significant increase in less serious assaults recorded by the police, from 15 to 20 a month per 100,000 population in Cardiff compared with a decrease from 42 to 33 in comparison cities (adjusted incidence rate ratio 1.38, 1.13 to 1.70). CONCLUSION: An information sharing partnership between health services, police, and local government in Cardiff, Wales, altered policing and other strategies to prevent violence based on information collected from patients treated in emergency departments after injury sustained in violence. This intervention led to a significant reduction in violent injury and was associated with an increase in police recording of minor assaults in Cardiff compared with similar cities in England and Wales where this intervention was not implemented.

Predicting and measuring premises-level harm in the night-time economy.

AIMS: To assess associations between measures of premises-level alcohol-related harm and risk factors for harm. METHODS: Thirty-two licensed premises with a history of on-premises violent assault were recruited. An environmental survey of the drinking context of each premises was undertaken. Levels of patron intoxication were assessed using a breathalyser and a visual assessment of customers at each premises. Premise-level violence was identified via routine police and hospital emergency department data. Analyses examined associations between hospital and police data, surveyor and objective ratings of intoxication and the relationship between intoxication, drinking context and violence at the premises level. RESULTS: Hospital and police data were associated. Aggregate levels of surveyor-rated intoxication were associated with aggregate alcometer breath alcohol levels. Analyses further suggest that premises with the highest levels of violence also had customers whose entry-exit change in intoxication was greatest, were open for longer hours, had alcohol promotions and had visible security staff present. CONCLUSIONS: Police and hospital data can be used to identify violent premises and to assess outcomes from premises-level interventions to reduce violence. Relatively low-cost observational survey methods can be used to identify high-risk premises, and can be used as outcomes for premises-level interventions. Features of premises that promote intoxication are associated with violence, suggesting that targeting resources at risky premises will likely address two public health concerns: excessive intoxication and assault-related injury.

Interventions for disorder and severe intoxication in and around licensed premises, 1989-2009.

AIMS: To systematically review rigorous evaluation studies into the effectiveness of interventions in and around licensed premises that aimed to reduce severe intoxication and disorder. METHODS: A systematic search was conducted. Papers that rigorously evaluated interventions based in and around licensed premises to reduce disorder or intoxication were included. RESULTS: Fifteen studies were identified, three randomized controlled trials and 12 non-randomized quasi-experimental evaluations. Outcome measures were intoxication (n = 6), disorder (n = 6) and intoxication and disorder (n = 3). Interventions included responsible beverage service training (n = 5), server violence prevention training (n = 1), enhanced enforcement of licensing regulations (n = 1), multi-level interventions (n = 5), licensee accords (n = 2) and a risk-focused consultation (n = 1). Intervention effects varied, even across studies using similar interventions. CONCLUSIONS: Server training courses that are designed to reduce disorder have some potential, although there is a lack of evidence to support their use to reduce intoxication and the evidence base is weak.

The reduction of intoxication and disorder in premises licensed to serve alcohol: an exploratory randomised controlled trial.

BACKGROUND: Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. OBJECTIVE: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. DESIGN: A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. RESULTS: The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. CONCLUSION: The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level. TRIAL REGISTRATION: UKCRN 7090; ISRCTN: 80875696. FUNDING: Medical Research Council (G0701758) to Simon Moore, Simon Murphy, Laurence Moore and Jonathan Shepherd.

Aggression and attitudes to time and risk in weapon-using violent offenders.

The use of weapons in violence increases both the severity of harm to victims and the severity of legal consequences for offenders, but little is known of the characteristics of violent offenders who choose to use weapons. Levels of anger, attitude to risk, time discounting, and antisocial history among a sample of weapon-using violent offenders (n=15) were compared to violent offenders who had not used a weapon (n=10) and nonviolent offenders (n=15). Results showed that weapon-using violent offenders displayed greater trait aggression and were more risk seeking than other offender types. In addition, weapon-using violent offenders were first convicted at an earlier age and truanted from school more frequently compared to other offender types. The results indicate that weapon users are more aggressive and more risk taking, but no more present focused than other violent and nonviolent offenders. Further research into the cognitive and social factors that influence weapon use is required if this dangerous behavior is to be reduced.