US Homeland Security department officers are already in Australia and will be going to Nauru shortly to start assessments.
They have started providing assessments of pay policies and asking for changes when they decide too much risk is being encouraged.
For example, one intervention home actually started RAI assessments after 6 months because the house manager was on sick leave.
The median number of days between START assessments was 22 (IQR = 20.1) but in some cases there was up to four months between assessments.
Some circularity is possible as discharge decisions will be based on a range of information sources of which START assessments are only one.
In addition a ROC analysis was conducted for all 475 START assessments across all patients to examine the relationship between START ratings and violence in the 30 days after the assessment.
There are clear limitations in terms of the relatively small sample size, reliance on imputed data to fill gaps and the variability of timescales between START assessments and between admission and entry to the study.
Increased discussion of the potential for discharge based on these other sources (e.g. unstructured clinical judgement) could lead to assumptions by the assessor about improvement which then influenced START assessments in a form of self-fulfilling prophecy.
The correspondence was passed on to a specialist team, which "started an assessment process to identify what criminal offences – if any – may have been committed".
As said, should a fluid replacement therapy be started, repeat assessment of IVC parameters provides a cheap and reliable monitoring of response to fluid administration [22, 25].
