Impact of Safe@Home on Placement and Permanency Outcomes: Results of a quasi-experimental study

The purpose of this study was to rigorously test the effectiveness of Safe@Home, an in-home parent skill-based intervention implemented in Clark County, Nevada. Safe@Home is designed to prevent out-of-home placement for children at imminent risk of placement (Placement Prevention population) and minimize time in out-of-home care for children already in foster care (Reunification population). This paper presents a retrospective, longitudinal, quasi-experimental study that examined placement and permanency outcomes of Safe@Home. Using Coarsened Exact Matching (CEM), children who received Safe@Home were matched to a historical comparison group of children served before Safe@Home was available in their community. All children in the study were determined by Clark County Department of Family Services to be unsafe and in need of immediate intervention. Children were matched based on age, race/ethnicity, previous in-home or out-of-home child welfare case, and safety threats Matched study samples demonstrated strong baseline equivalence. Children who received Safe@Home experienced a significantly lower rate of out-of-home placements, substantially higher rate of permanency with a parent, fewer days in out-of-home care, and shorter time to case closure. There was no effect of Safe@Home on post-permanency outcomes of maltreatment after case closure and re-entry. Large favorable placement prevention effects were sustained for 12 months after the end of Safe@Home.

Data quality issues leading to sub optimal machine learning for money laundering models

Purpose Good quality input data is critical to developing a robust machine learning model for identifying possible money laundering transactions. McKinsey, during one of the conferences of ACAMS, attributed data quality as one of the reasons for struggling artificial intelligence use cases in compliance to data. There were often use concerns raised on data quality of predictors such as wrong transaction codes, industry classification, etc. However, there has not been much discussion on the most critical variable of machine learning, the definition of an event, i.e. the date on which the suspicious activity reports (SAR) is filed. Design/methodology/approach The team analyzed the transaction behavior of four major banks spread across Asia and Europe. Based on the findings, the team created a synthetic database comprising 2,000 SAR customers mimicking the time of investigation and case closure. In this paper, the authors focused on one very specific area of data quality, the definition of an event, i.e. the SAR/suspicious transaction report. Findings The analysis of few of the banks in Asia and Europe suggests that this itself can improve the effectiveness of model and reduce the prediction span, i.e. the time lag between money laundering transaction done and prediction of money laundering as an alert for investigation Research limitations/implications The analysis was done with existing experience of all situations where the time duration between alert and case closure is high (anywhere between 15 days till 10 months). Team could not quantify the impact of this finding due to lack of such actual case observed so far. Originality/value The key finding from paper suggests that the money launderers typically either increase their level of activity or reduce their activity in the recent quarter. This is not true in terms of real behavior. They typically show a spike in activity through various means during money laundering. This in turn impacts the quality of insights that the model should be trained on. The authors believe that once the financial institutions start speeding up investigations on high risk cases, the scatter plot of SAR behavior will change significantly and will lead to better capture of money laundering behavior and a faster and more precise “catch” rate.

Analisis Pemeriksaan CT-Scan Toraks pada Kasus Covid-19 untuk Mendapatkan Pengukuran Kuantitatif di RSUP Fatmawati

CT Toraks has high sensitivity to diagnose Covid-19. This research aims to evaluate the CT Toraks procedure on Covid-19 at Fatmawati Central General Hospital in the year 2020 and giving a quantitative measurement of lung volume using Thoracic VCAR. This research design is quantitative descriptive with study case closure, data collecting and interview was done at Radiology Installation of Fatmawati Central General Hospital on November to December 2020 with ten patients as the research sample, with age range between 25 to 85 years old. The sample took examination data such as patient data, image results, and Radiology Expertise from CT Toraks on Covid-19. The research instrument used are observation paper, software, interview paper, GE’s 128 slice CT-Scan machine, and Advanced Workstation. The data obtained from observation and interviews from the respondent were then processed and analyzed using a comparative method comparing observation results with references from books, journal articles, and the official web. Can conclude the result of this study that toraks CT-Scan examination in Covid-19 cases with a low dose computer tomography toraxs (LDCT Toraxs) protocol produces optimal scanning images, is very helpful in establishing patient diagnoses, determining treatment rooms, screening actions, and treatment evaluation measures. In Covid-19 patients, quantitative measurement with Thoracic VCAR technique determines the degree of involvement of the lungs affected by the Covid-19 virus. The higher the percentage value in the inferior inflated and atelectasis range, the more severe the lung injury and the lower or smaller lung volume quantity.

Restorative Justice for Survivors of Sexual Violence Experienced in Adulthood: A Scoping Review

Sexual violence (SV) is a widespread human rights issue. Survivors of SV often experience profound dehumanization and poor health outcomes when their trauma is not properly addressed, rendering it critical that they are honored and empowered within subsequent processes of healing and seeking justice. With adjudication through the criminal legal system largely underutilized due to retraumatization, scrutiny from law enforcement professionals, and high rates of case closure, restorative justice (RJ) has emerged as a promising option for survivors to repair harm and experience accountability. Little is known, however, regarding the best practices for its use in cases of SV. To meet this need, a scoping review was conducted to identify the best practices for the implementation of RJ after instances of SV experienced in adulthood. Following the search methodology outlined by the JBI Manual for Evidence Synthesis for scoping reviews, 15 articles met search criteria, including four empirical studies and 11 nonempirical research materials spanning five academic disciplines. Best practices and structures for RJ were subsequently identified, including key phases for appropriate implementation. This review can be used to create increasingly productive RJ processes for SV survivors, which is particularly important for those coming from marginalized communities facing structural inequities, as well as survivors on university campuses. As researchers, we have the power to use science to propel society toward the creation of more efficacious healing spaces for survivors of SV, and optimizing safe RJ processes plays a key role in bringing this to fruition.

Effects of Injury Pattern and Treatment on Case Length and Disposition for Hand Injuries Treated Under a Workers’ Compensation Claim

Background: In treating occupational hand injuries under workers’ compensation, the 2 most important goals are to maximize patient function, ideally to preinjury levels, and permit a timely return to work (RTW). The purpose of this study was to determine factors affecting total case length, that is, the total time from injury until primary closure of a patient’s claim, and disposition among patients with hand injuries treated under workers’ compensation. Methods: All cases treated under workers’ compensation by a single fellowship-trained hand surgeon within a single year were retrospectively reviewed. A case is defined as the entire management and treatment of a single patient related to a single occupational injury incident. Independent variables included age, sex, body mass index, comorbidity, occupation, injury pattern, and treatment modality. Dependent variables included treatment duration from injury to case closure and final case disposition (RTW, functional capacity evaluation [FCE], or loss to follow-up [LTFU]). Comparison between groups was accomplished with analysis of variance. Multivariate linear and logistic regression analysis was performed to predict case length and disposition. Results: In all, 447 cases involving a workers’ compensation claim were reviewed. Among these, 75 (16.8%) were LTFU, 24 (5.4%) required an FCE, and 346 (77.4%) an RTW. The RTW cases averaged 138.5 days, whereas those requiring FCE averaged 331.5 days. Compared with average case length, crush injuries (76.8 days. P < .001) and fractures (111.8 days, P = .0224) had significantly shorter time to closure. In a multivariate linear model, cases of soft tissue and nerve injury were associated with longer case lengths, remaining open for an additional 56.8 and 347.1 days, respectively ( P < .001). Each treatment modality studied, therapy, injections, and surgery, was associated with an increase in case length. Conclusions: Cases requiring FCE were open significantly longer than those resulting in RTW. In addition, injury pattern and treatment modality were associated with significant variations in total case length. These results imply that a specific subset of patients, namely those with soft tissue and nerve injuries, may experience delayed resolution among patients treated under a workers’ compensation claim.

Young People Who Meaningfully Improve Are More Likely to Mutually Agree to End Treatment

Objective: Symptom improvement is often examined as an indicator of a good outcome of accessing mental health services. However, there is little evidence of whether symptom improvement is associated with other indicators of a good outcome, such as a mutual agreement to end treatment. The aim of this study was to examine whether young people accessing mental health services who meaningfully improved were more likely to mutually agree to end treatment.Methods: Multilevel multinomial regression analysis controlling for age, gender, ethnicity, and referral source was conducted on N = 8,995 episodes of care [Female = 5,469, 61%; meanAge = 13.66 (SD = 2.87) years] using anonymised administrative data from young people's mental health services.Results: Compared to young people with no change in mental health difficulties, those showing positive meaningful changes in mental health difficulties were less likely to have case closure due to non-mutual agreement (Odds Ratio or OR = 0.58, 95% Confidence Interval or CI = 0.50–0.61). Similarly, they were less likely to transfer (OR = 0.61, 95% CI = 0.49–0.74) or end treatment for other reasons (OR = 0.59, 95% CI = 0.50–0.70) than by case closure due to mutual agreement.Conclusion: The findings suggest that young people accessing mental health services whose symptoms meaningfully improve are more likely to mutually agree to end treatment, adding to the evidence that symptom improvement may be appropriate to examine as an indicator of a good outcome of accessing mental health services.

The role of detective experience on homicide clearances

PurposeThe study aims to examine the effect of detective experience on the likelihood of clearing a homicide, while controlling for additional extralegal and case/investigative characteristics.Design/methodology/approachThis study uses homicide and policing data collected from case files in a mid-sized US city. Detective experience is measured in multiple ways. Analytical models include extralegal variables, case characteristics, and proxies of investigative quality as controls. The study uses logistic regression with a dichotomous clearance outcome.FindingsThe results suggest a robust and significant inverse relationship between the years spent as a homicide detective and the likelihood of case closure. However, years of experience with the department overall has a significant and positive relationship to clearance. Investigation-related variables and case characteristics contribute more to model explanatory power than extralegal factors.Originality/valueThe potential role of experience has not been fully explored, with contradictory findings over time. This work builds on previous research to highlight the potential role of experience in clearing cases, while questioning previous assumptions tied to the belief that more experience improves investigative outcomes.

Adult Protective Services’ Intervention on Elder Abuse: Using Standardized Measures for Outcomes

Adult Protective Services (APS) investigates and substantiates vulnerable adult abuse, neglect, and exploitation (ANE) cases. The frontline social service agency also refers or provides needed services to ANE victims. Outcomes of APS has been scarce, with definitions of outcomes varying from study to study. Using a pretest-posttest design, we partnered with San Francisco and Napa APS to measure changes of ANE harm from case investigation (pretest) to case closure (posttest) using standardized measures called the Identification, Services, and Outcomes (ISO) Matrix. Forty-five APS supervisors and caseworkers used the ISO Matrix on 2,063 cases during the six-month pilot demonstration. Dr. Pi-Ju (Marian) Liu will examine findings on changes of ANE harm and APS services that effectively decreased ANE harm. Responding to 2020’s Annual Scientific Meeting theme “Turning 75: Why Age Matters”, ANE harm and APS services will be compared between younger APS clients age 18-64 and older ones above the age of 65. Dr. Zachary Hass will discuss allegation, abuse severity assessment, services provided, and outcomes across racial and language groups. Dr. Kendon Conrad will present reliability and validity of the ISO Matrix and a shorter version useful for APS practice. Ms Sara Stratton will review unusual cases with outlier ISO Matrix scores to inform researchers’ implementation and practitioners’ use of standardized measures. Dr. Kathleen Wilber, our discussant, will reflect on the use of standardized measures in APS and its impact on both practice and research based on the four presentations.

The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States

Spine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentation. However, the medicolegal impact of misplaced screws on spine surgery has not been directly reported in the literature. The authors of the current study aimed to describe this impact in the United States, as well as to suggest a potential method for mitigating the problem.This retrospective analysis of 68 closed medicolegal cases related to misplaced screws in spine surgery showed that neurosurgeons and orthopedic spine surgeons were equally named as the defendant (n = 32 and 31, respectively), and cases were most commonly due to misplaced lumbar pedicle screws (n = 41, 60.3%). Litigation resulted in average payouts of $1,204,422 ± $753,832 between 1995 and 2019, when adjusted for inflation. The median time to case closure was 56.3 (35.2–67.2) months when ruled in favor of the plaintiff (i.e., patient) compared to 61.5 (51.4–77.2) months for defendant (surgeon) verdicts (p = 0.117).