scholarly journals Urban Security and Counterterrorism: An Approach to Proportionality

2021 ◽  
Vol 14 (3) ◽  
pp. 70-85
Author(s):  
Tegg Westbrook ◽  
Thomas Schive
Keyword(s):  
Risk Assessment ◽  
Urban Design ◽  
Assessment Tool ◽  
Dead Reckoning ◽  
Assessment Tools ◽  
Risk Assessments ◽  
Design Strategies ◽  
Risk Assessment Tools ◽  
Urban Security ◽  
Security Returns

As cities and crowded areas increasingly become targets of terrorist plots and attacks, there is ample demand for risk assessment tools that consider proportional measures that reduce the threat, vulnerability, and possible impacts, whilst providing ‘security returns’ for those investments. There is a risk in this process of over- or under-fortifying places based on practitioners’ subjective biases, experiences, dead reckoning and conflicting agendas. Currently, risk assessments rely on qualitative tools that do not consider proportionality that removes these inherent biases. Critiquing well-known urban design strategies and national risk assessments, this article therefore seeks to develop a supplementary assessment tool – an equation for proportionality – that is more objective and is created to help practitioners make good choices, in particular on: (1) reducing the threat, (2) vulnerability, (3) impact, (4) accepting risk, and (5) measuring a security measure’s ability to deter, delay or stop an attack. It concludes that while no assessment is truly objective, the equation works to remove as much subjectivity as possible when assessing proportional urban security.

scholarly journals Novel Approach to Inpatient Fall Risk Prediction and Its Cross-Site Validation Using Time-Variant Data (Preprint)

2018 ◽  
Author(s):  
Insook Cho ◽  
Eun-Hee Boo ◽  
Eunja Chung ◽  
David W. Bates ◽  
Patricia Dykes
Keyword(s):  
Risk Assessment ◽  
Error Rate ◽  
Fall Risk ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Fall Risk Assessment ◽  
C Statistic ◽  
Risk Assessment Tools ◽  
Hospital Days ◽  
Cross Site

BACKGROUND Electronic medical records (EMRs) contain a considerable amount of information about patients. The rapid adoption of EMRs and the integration of nursing data into clinical repositories have made large quantities of clinical data available for both clinical practice and research. OBJECTIVE In this study, we aimed to investigate whether readily available longitudinal EMR data including nursing records could be utilized to compute the risk of inpatient falls and to assess their accuracy compared with existing fall risk assessment tools. METHODS We used 2 study cohorts from 2 tertiary hospitals, located near Seoul, South Korea, with different EMR systems. The modeling cohort included 14,307 admissions (122,179 hospital days), and the validation cohort comprised 21,172 admissions (175,592 hospital days) from each of 6 nursing units. A probabilistic Bayesian network model was used, and patient data were divided into windows with a length of 24 hours. In addition, data on existing fall risk assessment tools, nursing processes, Korean Patient Classification System groups, and medications and administration data were used as model parameters. Model evaluation metrics were averaged using 10-fold cross-validation. RESULTS The initial model showed an error rate of 11.7% and a spherical payoff of 0.91 with a c-statistic of 0.96, which represent far superior performance compared with that for the existing fall risk assessment tool (c-statistic=0.69). The cross-site validation revealed an error rate of 4.87% and a spherical payoff of 0.96 with a c-statistic of 0.99 compared with a c-statistic of 0.65 for the existing fall risk assessment tool. The calibration curves for the model displayed more reliable results than those for the fall risk assessment tools alone. In addition, nursing intervention data showed potential contributions to reducing the variance in the fall rate as did the risk factors of individual patients. CONCLUSIONS A risk prediction model that considers longitudinal EMR data including nursing interventions can improve the ability to identify individual patients likely to fall.

scholarly journals Validation of HIV Risk Screening Tool to Identify Infected Adults and Adolescents >14 years at Community Level

2021 ◽  
Author(s):  
Kesetebirhan Delele Yirdaw ◽  
Justin Mandala
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Hiv Risk ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Hiv Test ◽  
Risk Assessment Tools ◽  
Hiv Risk Assessment ◽  
Sensitivity Specificity ◽  
Conventional Risk Factors

Abstract Background There are a number of risk factors being used to identify undiagnosed HIV infected adults. As the number of undiagnosed people gets lesser and lesser, it is important to know if existing risk factors and risk assessment tools are valid for use. In this study, we validate existing HIV risk assessment tools and see if they are worth using for HIV case finding among adults who remain undiagnosed. Methods The Tanzania and Zambia Population-Based HIV Impact Assessment (PHIA) household surveys were conducted during 2016. We used adult interview and HIV datasets to assess validity of different HIV risk assessment tools. We first included 12 risk factors (being divorced, separated or widowed (DSW); having an HIV+ spouse; having one of the following within 12 months of the survey: paid work, slept away from home for at least a month, had multiple sexual partners, paid for sex, had sexually transmitted infection (STI), being a tuberculosis (TB) suspect, being very sick for at least 3 months; had ever sold sex; diagnosed with cervical cancer; and had TB disease into a risk assessment tool and assessed its validity by comparing it against HIV test result. Sensitivity, specificity and predictive value of the tool were assessed against the HIV test result. A receiver operator characteristic (ROC) analysis was conducted to determine a suitable cut-off score in order to have a tool with better sensitivity, specificity, and PPV. ROC comparison statistics was used to statistically test equality between AUC (area under the curve) of the different scores. ROC comparison statistics was also used to determine which risk assessment tool was better compared to the tool that contained all risk factors. Results Of 14,820 study participants, 57.8% were men, and had a median age of 30 (IQR: 21-24). HIV prevalence was 2.3% (95% confidence interval (CI): 2.0-2.6). For the tool containing all risk factors, HIV prevalence was 1.0% when none of the risk factors were positive (Score 0) compared to 3.2% when at least one factor (Score ≥1) was present and 8.0% when ≥4 risk factors were present. Sensitivity, specificity, PPV, and NPV were 82.3% (78.6%-85.9%), 41.9% (41.1%-42.7%), 3.2% (2.8%-3.6%), and 99.0% (98.8%-99.3%), respectively. The use of a tool containing conventional risk factors (all except those related with working and sleeping away) was found to have higher AUC compared to the use of all risk factors (p value <0.001), with corresponding sensitivity, specificity, PPV, and NPV of 63.5% (58.9%-68.1%), 66.2% (65.5%-67.0%), 4.2% (3.6%-4.8%), and 98.7% (98.5%-98.9%), respectively. Conclusion Use of a screening tool containing conventional risk factors improved HIV testing yield compared to doing universal testing. Prioritizing people who fulfil multiple risk factors should be explored further to improve HIV testing yield.

scholarly journals Signs of Resistance? Swedish Probation Officers' Attitudes towards Risk Assessments

2011 ◽  
Vol 3 (3) ◽  
pp. 95-107 ◽  
Author(s):  
Anders Persson ◽  
Kerstin Svensson
Keyword(s):  
Risk Assessment ◽  
Risk Management ◽  
Probation Officers ◽  
Assessment Tools ◽  
Risk Assessments ◽  
What Works ◽  
Risk Assessment Tools ◽  
Probation Service ◽  
Organizational Logic ◽  
Risk Concept

The Swedish Prison and Probation Service has been influenced by the ‘What Works’ agenda since the late 1990's and an orientation towards risk and risk management has gradually become visible in the organization. But there is, within the probation service, a discrepancy between two types of logics — an organizational logic and a professional logic. Although guidelines prescribe the use of risk-assessment tools, they are in reality seldom used by practitioners. Through an examination of the reasons given by the probation officers who expressed doubts or concerns about the risk-concept, we question whether this could be seen as signs of resistance based on professional logic.

scholarly journals Fall Risk Assessment Scales: A Systematic Literature Review

2021 ◽  
Vol 11 (2) ◽  
pp. 430-443
Author(s):  
Veronica Strini ◽  
Roberta Schiavolin ◽  
Angela Prendin
Keyword(s):  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tool ◽  
Public Health Problem ◽  
Assessment Tools ◽  
Major Public Health Problem ◽  
Simultaneous Application ◽  
Fall Risk Assessment ◽  
Depth Analysis ◽  
Risk Assessment Tools

Background: Falls are recognized globally as a major public health problem. Although the elderly are the most affected population, it should be noted that the pediatric population is also very susceptible to the risk of falling. The fall risk approach is the assessment tool. There are different types of tools used in both clinical and territorial settings. Material and methods: In the month of January 2021, a literature search was undertaken of MEDLINE, CINHAL and The Cochrane Database, adopting as limits: last 10 years, abstract available, and English and Italian language. The search terms used were “Accidental Falls” AND “Risk Assessment” and “Fall Risk Assessment Tool” or “Fall Risk Assessment Tools”. Results: From the 115 selected articles, 38 different fall risk assessment tools were identified, divided into two groups: the first with the main tools present in the literature, and the second represented by tools of some specific areas, of lesser use and with less supporting literature. Most of these articles are prospective cohort or cross-sectional studies. All articles focus on presenting, creating or validating fall risk assessment tools. Conclusion: Due to the multidimensional nature of falling risk, there is no “ideal” tool that can be used in any context or that performs a perfect risk assessment. For this reason, a simultaneous application of multiple tools is recommended, and a direct and in-depth analysis by the healthcare professional is essential.

scholarly journals Personalized Risk Assessments in the Criminal Justice System

2016 ◽  
Vol 106 (5) ◽  
pp. 119-123 ◽  
Author(s):  
Sharad Goel ◽  
Justin M. Rao ◽  
Ravi Shroff
Keyword(s):  
Risk Assessment ◽  
New York ◽  
Criminal Justice ◽  
Criminal Justice System ◽  
Police Officers ◽  
Justice System ◽  
Assessment Tools ◽  
Risk Assessments ◽  
Risk Assessment Tools ◽  
Personalized Risk

In an effort to bring greater efficiency, equity, and transparency to the criminal justice system, statistical risk assessment tools are increasingly used to inform bail, sentencing, and parole decisions. We examine New York City's stop-and-frisk program, and propose two new use cases for personalized risk assessments. First, we show that risk assessment tools can help police officers make considerably better real-time stop decisions. Second, we show that such tools can help audit past actions; in particular, we argue that a sizable fraction of police stops were conducted on the basis of little evidence, in possible violation of constitutional protections.

scholarly journals Improving Case Plans and Interventions for Adolescents on Probation: The Implementation of the SAVRY and a Structured Case Planning Form

2018 ◽  
Vol 46 (1) ◽  
pp. 42-62 ◽  
Author(s):  
Jodi L. Viljoen ◽  
Catherine S. Shaffer ◽  
Nicole M. Muir ◽  
Dana M. Cochrane ◽  
Etta M. Brodersen
Keyword(s):  
Risk Assessment ◽  
Propensity Scores ◽  
Probation Officers ◽  
Level Of Detail ◽  
Assessment Tools ◽  
Risk Assessments ◽  
Violence Risk ◽  
Risk Assessment Tools ◽  
Case Planning ◽  
Local Tool

Even when probation officers use risk assessment tools, many of their clients’ needs remain unaddressed. As such, we examined whether the implementation of the Structured Assessment of Violence Risk in Youth (SAVRY) and a structured case planning form resulted in better case plans as compared with prior practices (i.e., a nonvalidated local tool and an unstructured plan). Our sample comprised 216 adolescents on probation who were matched via propensity scores. Adolescents in the SAVRY/Structured Plan condition had significantly better case plans than those in the preimplementation condition. Specifically, following implementation, adolescents’ high need domains were more likely to be targeted in plans. Plans also scored higher on other quality indicators (e.g., level of detail). These improvements appeared to be due primarily to the structured plan rather than the SAVRY. Overall, our findings highlight that, just as structure can improve risk assessments, so too might structure improve case plans.

scholarly journals Validation of HIV Risk Screening Tool To Identify Infected Adults And Adolescents >14 Years At Community Level

2021 ◽  
Author(s):  
Kesetebirhan Delele Yirdaw ◽  
Justin Mandala
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Hiv Risk ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Hiv Test ◽  
Risk Assessment Tools ◽  
Hiv Risk Assessment ◽  
Sensitivity Specificity ◽  
Conventional Risk Factors

Abstract BackgroundThere are a number of risk factors being used to identify undiagnosed HIV infected adults. As the number of undiagnosed people gets lesser and lesser, it is important to know if existing risk factors and risk assessment tools are valid for use. In this study, we validate existing HIV risk assessment tools and see if they are worth using for HIV case finding among adults who remain undiagnosed. Methods The Tanzania and Zambia Population-Based HIV Impact Assessment (PHIA) household surveys were conducted during 2016. We used adult interview and HIV datasets to assess validity of different HIV risk assessment tools. We first included 12 risk factors (being divorced, separated or widowed (DSW); having an HIV+ spouse; having one of the following within 12 months of the survey: paid work, slept away from home for at least a month, had multiple sexual partners, paid for sex, had sexually transmitted infection (STI), being a tuberculosis (TB) suspect, being very sick for at least 3 months; had ever sold sex; diagnosed with cervical cancer; and had TB disease into a risk assessment tool and assessed its validity by comparing it against HIV test result. Sensitivity, specificity and predictive value of the tool were assessed against the HIV test result. A receiver operator characteristic (ROC) analysis was conducted to determine a suitable cut-off score in order to have a tool with better sensitivity, specificity, and PPV. ROC comparison statistics was used to statistically test equality between AUC (area under the curve) of the different scores. ROC comparison statistics was also used to determine which risk assessment tool was better compared to the tool that contained all risk factors. Results Of 14,820 study participants, 57.8% were men, and had a median age of 30 (IQR: 21-24). HIV prevalence was 2.3% (95% confidence interval (CI): 2.0-2.6). For the tool containing all risk factors, HIV prevalence was 1.0% when none of the risk factors were positive (Score 0) compared to 3.2% when at least one factor (Score ≥1) was present and 8.0% when ≥4 risk factors were present. Sensitivity, specificity, PPV, and NPV were 82.3% (78.6%-85.9%), 41.9% (41.1%-42.7%), 3.2% (2.8%-3.6%), and 99.0% (98.8%-99.3%), respectively. The use of a tool containing conventional risk factors (all except those related with working and sleeping away) was found to have higher AUC compared to the use of all risk factors (p value <0.001), with corresponding sensitivity, specificity, PPV, and NPV of 63.5% (58.9%-68.1%), 66.2% (65.5%-67.0%), 4.2% (3.6%-4.8%), and 98.7% (98.5%-98.9%), respectively. Conclusion Use of a screening tool containing conventional risk factors improved HIV testing yield compared to doing universal testing. Prioritizing people who fulfil multiple risk factors should be explored further to improve HIV testing yield.

scholarly journals Riskbedömningens logiker i arbetet med mäns våld mot kvinnor

2018 ◽  
Vol 24 (3-4) ◽  
Author(s):  
Mikael Skillmark
Keyword(s):  
Risk Assessment ◽  
Social Workers ◽  
Violence Against Women ◽  
Assessment Tool ◽  
Male Partner ◽  
Assessment Tools ◽  
The Social ◽  
Risk Assessment Tools ◽  
The Subject ◽  
Victims Of Violence

  Risk assessment logics when working with men’s violence against women Over the past two decades, social workers’ assessment and decision-making skills in client cases have been the subject of increased attention. The profession’s ability to conduct accurate assessments has been questioned. One way to seek to improve assessment work has been to implement various risk assessment tools. This article describes how social workers reason in risk assessment situations involving women exposed to violence by a previous male partner. The assessments studied here have been carried out with the assessment tool FREDA. The analysis reveals three logics in the social workers’ reasoning: the addiction logic, the normalization logic and the safety logic. These logics illustrate how social workers’ deliberations and assessments are not governed in a rectilinear manner by the standardized tool but that risk is negotiated also by drawing on other knowledge sources. Although standardization can be seen as a way for professionals to strive for more secure social work, the participants at the same time acknowledge the uncertainty associated with assessment work in which future violence is to be predicted. This however can have consequences for how the victims of violence are expected to live their lives.

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