Risk Assessment—the Key to More Security? Factors, Tools, and Practices in Dealing with Extremist Individuals

In recent years, risk assessments for violent extremism have attracted great interest from both scholars and practitioners, and many assessment tools have been developed. After a critical review of this development, the paper examines differences and similarities between the indicators of various violent extremist risk assessment tools and checklists. Based on an interview study with 34 experts in the field of Counter Violent Extremism and 24 (formerly) radicalized persons from the right-wing radical and Salafi-Jihadist spectrum, risk factors were identified and the findings merged and compared with already existing risk assessment tools. The paper will present results especially regarding the risk signals’ occurrence and applicability in the German context. One key finding is that existing assessment tools insufficiently take into account personal contacts in the radicalization process. Thus, the paper—based on the results of a social network analysis—draws attention to the potential and importance of networks. The paper concludes by outlining the potential of risk assessment, suggesting improvements, and raising awareness of the limits and deficits of these tools. The paper thus scientifically addresses the challenge of more security through efficient risk assessment and management. It offers a list of radicalization process characteristics (ARISNA: Assessment of Radicalized Individuals including Social Network Analysis), which is designed to help users analyze the risk of radicalization based on concrete traits of a person and their environment.

Old and New Biomarkers Associated with Endothelial Dysfunction in Chronic Hyperglycemia

Chronic hyperglycemia and vascular damage are strictly related. Biomarkers of vascular damage have been intensively studied in the recent years in the quest of reliable cardiovascular risk assessment tools able to facilitate risk stratification and early detection of vascular impairment. The present study is a narrative review with the aim of revising the available evidence on current and novel markers of hyperglycemia-induced vascular damage. After a discussion of classic tools used to investigate endothelial dysfunction, we provide an in-depth description of novel circulating biomarkers (chemokines, extracellular vesicles, and epigenetic and metabolomic biomarkers). Appropriate use of a single as well as a cluster of the discussed biomarkers might enable in a near future (a) the prompt identification of targeted and customized treatment strategies and (b) the follow-up of cardiovascular treatment efficacy over time in clinical research and/or in clinical practice.

Tools for Assessing Cardiovascular Disease Risk Factors in Underserved Young Adult Populations: A Systematic Review

Cardiovascular disease (CVD, i.e., disease of the heart and blood vessels) is a major cause of death globally. Current assessment tools use either clinical or non-clinical factors alone or in combination to assess CVD risk. The aim of this review was to critically appraise, compare, and summarize existing non-clinically based tools for assessing CVD risk factors in underserved young adult (18–34-year-old) populations. Two online electronic databases—PubMed and Scopus—were searched to identify existing risk assessment tools, using a combination of CVD-related keywords. The search was limited to articles available in English only and published between January 2008 and January 2019. Of the 10,383 studies initially identified, 67 were eligible. In total, 5 out of the 67 articles assessed CVD risk in underserved young adult populations. A total of 21 distinct CVD risk assessment tools were identified; six of these did not require clinical or laboratory data in their estimation (i.e., non-clinical). The main non-clinically based tools identified were the Heart Disease Fact Questionnaire, the Health Beliefs Related to CVD-Perception measure, the Healthy Eating Opinion Survey, the Perception of Risk of Heart Disease Scale, and the WHO STEPwise approach to chronic disease factor surveillance (i.e., the STEPS instrument).

Recommendations for an Innovative Gender-Sensitive Training and Education for Various Frontline Responder Groups

Rigid gender roles and gender stereotypes can limit both women's and men's choices, opportunities and access to power and resources. While both sexes suffer from domestic violence, women are more likely to experience repeated and severe forms of abuse, including sexual violence. However, the concept of gender goes beyond numbers, and it is an important human factor that is not integrated sufficiently in existing training, risk assessment tools and procedures. Understanding the gendered nature of domestic violence, but nevertheless taking into account that both men and women can suffer from violence, or be perpetrators, enables front-line responders to develop services that are sensitive to the different needs of individuals affected by domestic violence (DV). This chapter introduces the principles of innovative gender-sensitive training and education for various front-line responder groups. This chapter explains the reasons for it and how the gender norms and perceptions identified in the IMPRODOVA research, which may have a negative impact on front-line responders' responses to DV, were addressed in all IMPRODOVA instruments and guidelines in teaching formats.

Trauma and institutional risk in a secure developmental disorder service: does the SAVRY inflate risk in adolescents exposed to ACEs?

Purpose Adverse childhood experiences (ACEs) are highly prevalent in people with developmental disorders who engage in offending behaviour. Many violence-based risk assessment tools include items pertaining to ACEs, and may inflate risk scores in trauma-exposed groups. This paper aims to explore the relationships between ACEs, risk assessment scores, incidents of risk and restrictive practices, in adolescents with developmental disorders in a forensic inpatient setting. Design/methodology/approach Secondary analysis was conducted on clinical data for 34 adolescents detained to a developmental disorder service. Data were extracted for Structured Assessment of Violence Risk in Youth (SAVRY) risk scores and risk behaviours and restrictive practices, as measures of observed risk. Findings Participants exposed to more ACEs had higher SAVRY risk scores (p < 0.001, two-tailed), with elevations specifically on the historical subscale (p < 0.001, two-tailed). Neither ACEs nor risk scores were associated with the frequency of risk behaviours. Nevertheless, participants exposed to four or more ACEs were secluded more frequently (p = 0.015, two-tailed), indicating a potential association between trauma and risk severity. Those with more complex developmental disorders experienced fewer ACEs (p = 0.02, two-tailed) and engaged in self-harm behaviours less frequently (p = 0.04, two-tailed). Research limitations/implications The inclusion of ACEs in risk assessment tools may lead to the inadvertent stigmatization of trauma-exposed individuals. Further investigation is necessary to offer clarity on the impact of early adversity on risk assessment accuracy and levels of institutional risk, and the role of developmental disorders in this relationship. Originality/value To the best of the authors’ knowledge, this study is the first to explore the relative associations between ACEs, risk assessment scores and observed institutional risk and does so in a highly marginalized population.

Surgeons’ Attitudes About Use of Preoperative Risk Assessment Tools

Background: Formal surgical risk assessment tools have been developed to predict risk of adverse postoperative patient outcomes. Such tools accurately predict common postoperative complications, inform patients and providers of likely perioperative outcomes, guide decision making, and improve patient care. However, these are underutilized. We studied the attitudes towards and techniques of how surgeons preoperatively assess risk.Methods: 108 surgical faculty, 95 surgical residents, and 58 affiliate surgeons at a large academic tertiary referral hospital and affiliate community hospitals were emailed a 16-question survey between 8/2019-6/2020. Surveys were analyzed using descriptive statistics (frequency distributions and percentages for categorical variables, means, and standard deviations for continuous variables), and Fisher’s exact test and unpaired t-tests comparing responses by surgical attendings vs. residents.Results: Overall response rates were 50.0% for faculty surgeons, 47.4% for residents, and 36.2% for affiliate surgeons. Only 20.8% of surgeons used risk calculators most or all of the time. Attending surgeons were more likely to use prior experience and current literature while residents used risk calculators more frequently. Risk assessment tools were more likely to be used when predicting major complications and death in older patients with significant risk factors. Greatest barriers for use of risk assessment tools included time, inaccessibility, and trust in accuracy.Conclusions: Even though risk assessment tools are available, few surgeons use them as part of their routine practices. Developers of the tools need to design the tools to better promote the positive features and to avoid the burdens commonly reported by users.

An age-old issue: Evaluating the applicability of adult criminal risk assessment tools for use with youth offenders

<p>Research has consistently recognized that youth and adults share risk factors for crime, although whether certain factors are of increased importance during adolescence is debated. The present research evaluated the extent to which two risk assessment tools could predict criminal and breach reconviction in a matched sample of youth (aged 17-19) and adult (aged 20-60) community- supervised offenders: The Dynamic Risk Assessment for Offender Re-entry (DRAOR) and the static Risk of re-Conviction X Risk of re-Imprisonment (RoC*RoI). Cox regression and AUC analyses revealed initial DRAOR scores had mixed predictive validity for both groups, while proximal risk scores showed comparably moderate to high accuracy for youth and adults. Protective scores were consistently poor predictors for adults. The proximal assessment predicted reconviction better than the initial assessment, and decreases in risk scores between assessments were associated with a reduction in the likelihood of reconviction, showing the value in monitoring risk and updating assessment. The RoC*RoI predicted criminal reconviction for adults but did not predict either reconviction outcome for youth. These findings support the use of the DRAOR for identifying which youth and adults are likely to reoffend, and suggest that dynamic factors might be more useful predictors than static for assessing and monitoring youth offenders.</p>