Factors Associated With Law Enforcement Reporting in Patients Presenting for Medical Forensic Examinations

2020 ◽  
pp. 088626052094851
Author(s):  
Nancy R. Downing ◽  
Mollie Adams ◽  
Richard J. Bogue
Keyword(s):  
Logistic Regression ◽  
Law Enforcement ◽  
Sexual Assault ◽  
Violent Crimes ◽  
Acute Period ◽  
Factors Associated ◽  
Binomial Logistic Regression ◽  
Forensic Examination ◽  
Sexual Assault Nurse Examiners ◽  
Race Ethnicity

Law enforcement reporting following sexual assault is lower than for other violent crimes. Sexual assault nurse examiners (SANEs) provide care for patients in the acute period following sexual assault and are well-positioned to identify and address barriers to reporting. We examined data from medical forensic examination records documented by SANEs for a 5-year period (2011–2015). We examined 347 records of women 18 and older to identify factors associated with law enforcement reporting at the time of the exam using binomial logistic regression to construct odds ratios (OR). A total of 56.5% of patients in the sample reported to law enforcement. Patients who did not voluntarily consume alcohol were more likely to report than those who did (OR = 4.45; p = .001). Patients who were not students were more likely to report than students (OR = 3.24; p = .002). Patients who had a medical forensic exam within 32 hr of the assault were more likely to report than those having exams after 32 hr (OR = 2.68; p = .007). Patients who had anogenital and/or bodily injuries were more likely to report than those who had no injuries (OR = 2.50; p = .008). Patients who were penetrated (vaginally, orally, and/or anally) were more likely to report than those who were not penetrated (OR = 2.50; p = .056). Knowing the assailant, having multiple assailants, and patient and assailant race/ethnicity were not associated with different likelihood of reporting to law enforcement. SANEs and others who work with victims of sexual assault can use data to understand and address barriers to reporting.

scholarly journals Enacting an Improved Response to Sexual Assault: A Criminal Justice Practitioner’s Guide

2020 ◽  
Author(s):  
Patricia A. Melton
Keyword(s):  
Domestic Violence ◽  
Criminal Justice ◽  
Law Enforcement ◽  
Sexual Assault ◽  
Best Practices ◽  
Violent Crime ◽  
Sexual Assaults ◽  
Law Enforcement Agencies ◽  
Violent Crimes ◽  
Serial Offenders

Sexual assault is a violent crime that traumatizes individual victims and endangers entire communities. Every victim of sexual assault deserves an opportunity for justice and access to the resources they need to recover from this trauma. In addition, many perpetrators of sexual assaults are serial offenders who also commit other violent crimes, including armed robberies, aggravated assaults, burglary, domestic violence, and homicides, against strangers and acquaintances. Criminal justice agencies have the power to create a strategic, sustainable plan for an improved response to sexual assault that aligns with current best practices and national recommendations. In this document, we define an “improved response” as an approach that supports effective investigation and prosecution of sexual assault cases, holds perpetrators accountable, and promotes healing and recovery for victims of sexual assault. This guide will help prosecutor and law enforcement agencies create a process with milestones, goals, and suggested actions, all designed to support a successful and sustainable approach for addressing sexual assault cases. Improving the criminal justice system’s response to sexual assault ultimately improves public safety and promotes trust between criminal justice agencies and the communities they serve.

scholarly journals S241. FACTORS ASSOCIATED WITH EARLY RISK OF DISENGAGEMENT FROM EARLY PSYCHOSIS INTERVENTION SERVICES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S130-S131
Author(s):  
Nicole Kozloff ◽  
Aristotle Voineskos ◽  
George Foussias ◽  
Alexia Polillo ◽  
Sean Kidd ◽  
...  
Keyword(s):  
At Risk ◽  
Substance Use ◽  
Logistic Regression ◽  
Young People ◽  
Family Involvement ◽  
The Body ◽  
Early Psychosis ◽  
First Episode ◽  
Factors Associated ◽  
Race Ethnicity

Abstract Background Despite the body of evidence supporting early psychosis intervention (EPI) programs for young people with psychotic disorders, approximately 30% of individuals with first-episode psychosis disengage from care. To date, two factors, lack of family involvement and presence of a substance use disorder, have emerged as robust predictors of EPI disengagement. Several factors associated with service disengagement in mental health care more broadly have not been well-studied in EPI; some of these, such as homelessness and ethnicity, may be of particular importance to urban, multicultural populations, and ethnicity in particular has been shown to affect pathways into EPI services. Early missed appointments may signal risk for subsequent service disengagement. We sought to identify early predictors of disengagement risk in an urban EPI program. Methods We conducted a prospective chart review of consecutive patients accepted for services in a large, urban EPI program in Toronto, Canada in a 3-month period from July 4-October 3, 2018. Patients were observed in their first 3 months of treatment. The primary outcome of interest was risk of disengagement, defined as having missed at least 1 appointment without cancellation. Extracted data included a variety of demographic and clinical information. The principal investigator trained 2 data abstractors on the first 50 charts; subsequent agreement on the next 5 charts was 88%. Based on previous literature, we hypothesized that risk of disengagement would be increased in individuals with problem substance use, experiences of homelessness, and nonwhite race/ethnicity and decreased in individuals with family involvement in their care. We used logistic regression to examine the odds of disengagement associated with univariate predictors individually, and then together in a multivariate model. Results Seventy-three patients were consecutively admitted to EPI services in the 3-month period. Of these individuals, 59% (N=43) were identified as being at risk of disengagement based on having missed at least 1 appointment without cancellation. In the full sample, 71% (N=52) identified as nonwhite, 23% (N=17) had a documented experience of homelessness, 52% (N=38) had problem substance use, and 73% (N=53) had family involved in their care. In univariate logistic regression, only problem substance use was associated with risk of disengagement (OR=2.91, 95% CI 1.11–7.66); no significant associations were identified with race/ethnicity, experience of homelessness, or family involvement. In multivariate logistic regression, once we controlled for these other factors, the association between risk of disengagement and problem substance use was attenuated and no longer statistically significant (OR=2.15, 95% CI 0.77–5.97). Discussion In this small study of early disengagement in an urban EPI program, only problem substance use was associated with increased odds of missing an appointment, but not when we controlled for other factors thought to be associated with disengagement. Larger studies may be required to identify factors with small but important effects. These factors may be used to identify young people at risk of disengagement from EPI services early in care in order to target them for increased engagement efforts.

Factors associated with civilian and police officer injury during 10 years of officer-involved shooting incidents

2019 ◽  
Vol 26 (6) ◽  
pp. 509-515 ◽  
Author(s):  
Ellen Paddock ◽  
Katelyn Kassarjian Jetelina ◽  
Stephen A Bishopp ◽  
Kelley Pettee Gabriel ◽  
Jennifer Marie Reingle Gonzalez
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Law Enforcement ◽  
Police Officer ◽  
Police Department ◽  
Multiple Shooting ◽  
Fatal Injury ◽  
Factors Associated ◽  
Bivariate Logistic Regression ◽  
Hispanic White

BackgroundPrevious officer-involved shooting (OIS) research has focused primarily on antecedents to fatal shootings, with few studies investigating injury more broadly. Our study examined the factors associated with fatal or non-fatal injury to both civilians and officers during OIS incidents, to better understand how harm might be reduced in the most extreme law enforcement scenarios.MethodsData included 281 officers involved in 177 unique shooting incidents recorded by Dallas Police Department between 2005 and 2015. Bivariate logistic regression and multivariable generalised estimation equation analyses were used to investigate incident characteristics associated with fatal or non-fatal injury to civilians and officers.ResultsCivilian injury occurred in 61% and officer injury in 14% of unique OIS incidents. In adjusted models, multiple shooting officers increased the odds of injury to both civilians (adjusted OR (AOR): 3.22, 95% CI 1.39 to 7.50) and officers (AOR 4.73, 95% CI 1.64 to 13.65). Odds of civilian injury were also significantly higher during the daytime and among non-Hispanic white compared with non-Hispanic black and Hispanic/Latina/o civilians, although a majority of OIS incidents (79%) involved non-Hispanic black or Hispanic/Latino/a civilians. Odds of officer injury were significantly higher for detectives compared with patrol (AOR=9.32, 95% CI 1.85 to 47.03) and during off-duty versus on-duty shootings (AOR=5.23, 95% CI 1.37 to 19.99).ConclusionsBoth civilians and officers are at risk for injury during OIS incidents, though to different degrees and with unique risk factors. Additional research is needed to understand whether these results are replicated elsewhere and to further understand the mechanisms of injury.

Factors Associated With Types of Sexual Assault Victimization and Bystander Behavior Among South Korean University Students

2019 ◽  
Vol 34 (6) ◽  
pp. 952-971
Author(s):  
Dong Ha Kim ◽  
Myung-Yong Um ◽  
Hyunkag Cho ◽  
Eui Bhin Lee ◽  
Jong Serl Chun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Sexual Assault ◽  
Sexual Harassment ◽  
Sexual Misconduct ◽  
Bystander Behavior ◽  
Factors Associated ◽  
South Korean ◽  
Bystander Behaviors ◽  
Korean Universities

The aim of the current study was to gain understanding about incidences of sexual misconduct and bystander behaviors in South Korean universities. Specifically, risk factors were examined associated with three different types of sexual assault victimization (verbal or visual sexual harassment, physically forced sexual assault, and incapacitated sexual assault) and investigated the factors related to bystander behaviors. Data were collected via an online survey tool called SurveyMonkey in 2016. The total sample of participants comprised 1,944 enrolled undergraduate and graduate students from six universities in Seoul, South Korea. One logistic regression was conducted with a sample who reported sexual assault victimization (n = 1,079) to examine the risk factors associated with the three types of sexual misconduct. The other logistic regression was conducted with the subsample of bystanders (n = 540) to examine the relationships between bystander behavior and risk factors. In the main results, each type of sexual misconduct was associated differentially with age, alcohol blackouts, depression, child abuse and neglect, being an international student, and childhood sexual victimization. Also, persons who were older, self-identified LGBT, and victimized by verbal or visual sexual harassment at university were more likely to intervene when sexual misconduct occurred. These findings have implications for policies and interventions to reduce and prevent sexual misconduct in Korean universities.

scholarly journals Risk Factors Associated with Statin-Associated Muscle Symptoms in Patients Attending a Specialized Regional Lipid Clinic

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
M. K. Saeed ◽  
J. Shah ◽  
R. Damani ◽  
F. Rahman ◽  
P. Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Statistical Significance ◽  
University Hospitals ◽  
Antihypertensive Medications ◽  
Factors Associated ◽  
Binomial Logistic Regression ◽  
Lipid Clinic ◽  
The Uk ◽  
Clinical Records

Background. Statin-associated muscle symptoms (SAMS) are the major side effects reported for statins. Data from previous studies suggest that 7–29% of patients on statin had associated muscle symptoms. In the UK, there is a lack of corresponding data on SAMS and factors associated with the development of SAMS. Objective. This analysis is aimed at establishing the prevalence of SAMS and identifying major contributory risk factors in patients attending a lipid clinic. Methods. Clinical records of 535 consecutive patients, who visited the lipid clinic in the University Hospitals of Leicester, were studied retrospectively between 2009 and 2012. SAMS were defined by the presence of muscle symptoms with two or more different statins. Patients who reported muscle symptoms to statin with one or no rechallenge were excluded. The association of SAMS with clinical characteristics such as age and BMI, sex, smoking, excess alcohol, comorbidities, and medications was tested for statistical significance. A binomial logistic regression model was applied to adjust for risk factors significantly associated with SAMS. Results. The prevalence of SAMS was found to be 11%. On unadjusted analysis, the mean age of patients who had SAMS was significantly higher than those without SAMS ( 59.4 ± 10.5 years vs. 50.3 ± 13.4 years, respectively, P < 0.001 ). Nonsmokers were more likely to develop SAMS in comparison to active smokers ( P = 0.037 ). Patients taking antihypertensive medications were more likely to develop SAMS ( P = 0.010 ). In binomial logistic regression analysis, only age was positively and significantly associated with SAMS after adjusting for other risk factors ( β = 0.054 , P = 0.001 ). Conclusion. To the best of our knowledge, this study is the largest cohort of patients with SAMS in the United Kingdom. Our data suggest that the prevalence of SAMS is 11% and increased age is a risk factor associated with the development of SAMS in our cohort of patients.

scholarly journals Predicting rapist type based on crime-scene violence, interpersonal involvement, and criminal sophistication in U.S. stranger rape cases

2021 ◽  
pp. 146135572110365
Author(s):  
Indy SK Mellink ◽  
Elizabeth L Jeglic ◽  
Glynis Bogaard
Keyword(s):  
Logistic Regression ◽  
Law Enforcement ◽  
Sexual Assault ◽  
Sex Offenders ◽  
Predictive Model ◽  
Crime Scene ◽  
Offender Profiling ◽  
Archival Database ◽  
Serial Rapists

Stranger rape cases are one of the most difficult sexual assault crimes to solve for law enforcement. This study aimed to compare crime-scene characteristics between serial rapists and single-victim rapists in stranger rape cases and build a predictive model to predict rapist type. An archival database of released sex offenders included 385 who committed stranger rapes. Of those, 244 were single-victim rapists and 141 were serial rapists. The single-victim rapists were significantly more likely to have violently themed crime-scene characteristics than serial rapists, whereas serial rapists were significantly more likely than single-victim rapists to engage in criminally sophisticated behavior and induce participation from their victims. A logistic regression using 10 crime-scene characteristics correctly identified 75.8% of cases as perpetrated by either single-victim or serial rapists. The most significant predictors of rapist type were whether the offender digitally penetrated their victim, whether the offender choked their victim, whether they were at a new/unknown location or whether they threatened their victim. The implications of these results are that they benefit law enforcement in the investigation of stranger rape cases by potentially narrowing down their suspect pool and add to the classification of stranger rapists in offender profiling literature.

scholarly journals Visit trends and factors associated with telemedicine uptake among persons with HIV during the COVID-19 pandemic

2021 ◽  
Author(s):  
Brian R Wood ◽  
Kristine F Lan ◽  
Yuan Tao ◽  
Eric Y Mose ◽  
Erin Aas ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Private Insurance ◽  
Hiv Care ◽  
Initial Increase ◽  
Patient Portal ◽  
Housing Status ◽  
Face To Face ◽  
Factors Associated ◽  
History Of ◽  
Race Ethnicity

Abstract Background In response to the SARS-CoV-2 pandemic, clinicians in outpatient HIV practices began to routinely offer telemedicine (video and/or phone visits) to replace in-person appointments. Video visits are preferred over phone visits but determinants of video visit uptake in HIV care settings have not been well described. Methods Trends in type of encounter (face-to-face, video, and phone) before and during the pandemic were reviewed for persons with HIV (PWH) at an urban, academic, outpatient HIV clinic in Seattle, WA. Logistic regression was used to assess factors associated with video visit use including sociodemographic characteristics (age, race, ethnicity, language, insurance status, housing status) and electronic patient portal login. Results After an initial increase in video visits to 30% of all completed encounters, the proportion declined and plateaued at approximately 10%. A substantial proportion of face-to-face visits were replaced by phone visits (approximately 50% of all visits were by phone early in the pandemic, now stable at 10 to 20%). Logistic regression demonstrated that older age (&gt;50 or &gt;65 years old compared to 18 to 35 years old), Black, Asian, or Pacific Islander race (compared to White race), and Medicaid insurance (compared to private insurance) were significantly associated with never completing a video visit, whereas history of patient portal login was significantly associated with completing a video visit. Conclusions Since the pandemic began, an unexpectedly high proportion of telemedicine visits have been by phone instead of video. Several social determinants of health and patient portal usage are associated with video visit uptake.

Sexual assault investigations and the factors that contribute to a suspect's arrest

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
James Markey ◽  
Thomas Scott ◽  
Crystal Daye ◽  
Kevin J. Strom
Keyword(s):  
Law Enforcement ◽  
Sexual Assault ◽  
Design Methodology ◽  
Evidence Base ◽  
Data Abstraction ◽  
Sexual Assaults ◽  
Law Enforcement Agencies ◽  
Content Type ◽  
Factors Associated ◽  
Physical Evidence

PurposeSexual assault investigations present uniquely challenging circumstances to detectives, and a small proportion result in arrest. Improving sexual assault investigations requires expanding the evidence base to improve our understanding of how these investigations unfold and the factors associated with positive case outcomes, including the likelihood that an offender is arrested.Design/methodology/approachThe authors abstracted data on 491 adult sexual assaults investigated by five large and midsized law enforcement agencies to describe the characteristics of sexual assault investigations and to explain the relationships between these characteristics and the likelihood that a suspect is arrested.FindingsOverall, detectives move swiftly to investigate sexual assaults but tend to miss investigative opportunities that increase the likelihood of an arrest, like locating and processing the crime scene or pursuing interviews with key witnesses and leads. Sexual assaults typically lack physical evidence that can be used to identify and lead to an arrest of a suspected offender; when this evidence is present, the case is more likely to result in an arrest. Delayed reporting of the crime to law enforcement decreases the likelihood of a suspect being arrested, but the mechanisms are unclear.Originality/valueFew studies have used a detailed data abstraction process for a large sample of cases from multiple law enforcement agencies to understand sexual assault investigations and their case outcomes. The results can improve practitioners' and researchers' understanding of sexual assault investigations, including those factors that increase the likelihood of a suspect's arrest.

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