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

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 to prior practices (i.e., a non-validated 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 pre-implementation 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

Predictive Validity of the SAVRY With Indigenous and Caucasian Female and Male Adolescents on Probation

Indigenous people and the courts have emphasized that it is important to examine whether violence risk assessment tools are valid and appropriate for Indigenous youth. However, studies are scarce. Therefore, we examined the predictive validity of youth probation officers’ SAVRY ratings for 744 Canadian youth, including 299 Indigenous youth (219 male, 80 female), and 445 Caucasian youth (357 male, 88 female) in a prospective field study. The SAVRY summary risk ratings and risk total scores significantly predicted violent and any reoffending for Indigenous female and male youth with medium effect sizes. Relatively few significant differences in the predictive validity emerged for Indigenous and Caucasian youth. However, Historical, Protective, and Risk Total scores predicted any recidivism better for Caucasian males than Indigenous males. Also, Indigenous youth scored significantly higher on all risk domains than Caucasian youth. Opposite to predictions, the rates of false positives were higher for Caucasian youth than for Indigenous youth. Based on the results, the SAVRY appears to be a reasonable tool to use for assessing risk in youth who are Indigenous. However, assessors should take steps to ensure that they use the SAVRY in a culturally appropriate manner, such as considering cultural factors in case formulations and treatment planning as the SAVRY does not ground assessments in an understanding of factors such as colonialism. In addition, future research should examine culturally salient risk factors (e.g., discrimination) and examine potential causes of higher risk scores in Indigenous youth, particularly the role of both past and present-day colonialism

Impact of Risk Assessment Instruments on Rates of Pretrial Detention, Postconviction Placements, and Release: A Systematic Review and Meta-Analysis

Objective: Many agencies use risk assessment instruments to guide decisions about pretrial detention, post-conviction incarceration, and release from custody. Although some policymakers believe that these tools might reduce overincarceration and recidivism rates, others are concerned that they may exacerbate racial and ethnic disparities in placements. The objective of this systematic review was to test these assertions.   Hypotheses: It was hypothesized that the adoption of tools might slightly decrease incarceration rates. Impact on disparities might vary by tool and context.   Method: Published and unpublished studies were identified by searching 13 databases, reviewing reference lists, and contacting experts. In total, 22 studies met inclusion criteria; these studies included 1,444,499 adolescents and adults who were accused or convicted of a crime. Each study was coded by two independent raters using a data extraction form and a risk of bias tool. Results were aggregated using both a narrative approach and meta-analyses.    Results: The adoption of tools was associated with (1) small overall decreases in restrictive placements (aggregated OR = 0.63, p < .001), particularly for individuals who were low risk and (2) small reductions in any recidivism (OR = 0.85, p = .020). However, after removing studies with a high risk of bias, the results were no longer significant.   Conclusions: Although risk assessment tools might help to reduce restrictive placements, the strength of this evidence is low. Furthermore, due to a lack of research, it is unclear how tools impact racial and ethnic disparities in placements. As such, future research is needed

Genetic variants within NOGGIN, COL1A1, COL5A1, and IGF2 are associated with musculoskeletal injuries in elite male Australian football league players: A preliminary study

Introduction: Australian Football is a dynamic team sport that requires many athletic traits to succeed. Due to this combination of traits, as well as technical skill and physicality, there are many types of injuries that could occur. Injuries are not only a hindrance to the individual player, but to the team as a whole. Many strength and conditioning personnel strive to minimise injuries to players to accomplish team success. Purpose: To investigate whether selected polymorphisms have an association with injury occurrence in elite male Australian Football players. Methods: Using DNA obtained from 46 elite male players, we investigated the associations of injury-related polymorphisms across multiple genes (ACTN3, CCL2, COL1A1, COL5A1, COL12A1, EMILIN1, IGF2, NOGGIN, SMAD6) with injury incidence, severity, type (contact and non-contact), and tissue (muscle, bone, tendon, ligament) over 7 years in one Australian Football League team. Results: A significant association was observed between the rs1372857 variant in NOGGIN (p = 0.023) and the number of total muscle injuries, with carriers of the GG genotype having a higher estimated number of injuries, and moderate, or combined moderate and high severity rated total muscle injuries. The COL5A1 rs12722TT genotype also had a significant association (p = 0.028) with the number of total muscle injuries. The COL5A1 variant also had a significant association with contact bone injuries (p = 0.030), with a significant association being found with moderate rated injuries. The IGF2 rs3213221-CC variant was significantly associated with a higher estimated number of contact tendon injuries per game (p = 0.028), while a higher estimated number of total ligament (p = 0.019) and non-contact ligament (p = 0.002) injuries per game were significantly associated with carriage of the COL1A1 rs1800012-TT genotype. Conclusions: Our preliminary study is the first to examine associations between genetic variants and injury in Australian Football. NOGGIN rs1372857-GG, COL5A1 rs12722-TT, IGF2 rs3213221-CC, and COL1A1 rs1800012-TT genotypes held various associations with muscle-, bone-, tendon- and ligament-related injuries of differing severities. To further increase our understanding of these, and other, genetic variant associations with injury, competition-wide AFL studies that use more players and a larger array of gene candidates is essential

Do Structured Risk Assessments Predict Violent, Any, and Sexual Offending Better Than Unstructured Judgment? An Umbrella Review

Although it is widely believed that risk assessment tools lead to more accurate estimates of risk of violence and offending than unstructured clinical judgments, the nature and quality of evidence that supports this view is unclear. As such, we conducted an umbrella review of systematic reviews. Through a search of 15 databases, we identified nine systematic reviews, including six meta-analyses and three narrative systematic reviews, that compared unstructured and structured risk judgments for any, violent, and sexual offending. Each review was independently coded by two raters. Raters also coded the 46 primary studies on unstructured judgment included in these reviews. Although the reviews concluded that structured risk judgments are superior to unstructured judgments, the data supporting these conclusions have limitations. None of the systematic reviews directly compared risk assessment tools with unstructured judgments. In addition, two thirds of the primary studies included in the systematic reviews were from the 1980s or earlier, and 89% had serious methodological limitations that created a high risk of bias. In many cases, the primary studies did not examine unstructured judgments per se but instead used proxies such as legal and administrative decisions. As such, there is a pressing need for an updated systematic review that focuses on direct comparison studies and carefully addresses study limitations. To address this gap, we have initiated a preregistered systematic review

Bridging Risk Assessments to Case Planning: Development and Evaluation of an Intervention-Planning Tool for Adolescents on Probation

Even though risk assessment tools are often intended to inform case planning, they do not provide much direct guidance. As such, we developed an intervention-planning tool called the Adolescent Risk Reduction and Resilient Outcomes Work-Plan (ARROW) to accompany the Structured Assessment of Violence Risk in Youth. The ARROW includes a decision support system, guide, and training, and is one of the first tools of its kind. To evaluate the ARROW, we conducted two studies: (a) a vignette study with 178 professionals and (b) a field study with 320 propensity-score matched adolescents. Most professionals (>98%) rated the ARROW as useful. Moreover, compared with (a) unstructured plans and (b) a simple form, ARROW plans were more likely to include supported interventions, adhere to best practices, and integrate culturally tailored approaches for Indigenous adolescents. Formulations also showed improvements. However, further research is needed on strategies to bridge risk assessment and risk management

Neptune Odyssey: A Flagship Concept for the Exploration of the Neptune–Triton System

The Neptune Odyssey mission concept is a Flagship-class orbiter and atmospheric probe to the Neptune-Triton system. This bold mission of exploration would orbit an ice-giant planet to study the planet, its rings, small satellites, space environment, and the planet-sized moon Triton. Triton is a captured dwarf planet from the Kuiper Belt, twin of Pluto, and likely ocean world. Odyssey addresses Neptune system-level science, with equal priorities placed on Neptune, its rings, moons, space environment, and Triton. Between Uranus and Neptune, the latter is unique in providing simultaneous access to both an ice giant and a Kuiper Belt dwarf planet. The spacecraft - in a class equivalent to the NASA/ESA/ASI Cassini spacecraft - would launch by 2031 on a Space Launch System or equivalent launch vehicle and utilize a Jupiter gravity assist for a 12 yr cruise to Neptune and a 4 yr prime orbital mission; alternatively a launch after 2031 would have a 16 yr direct-to-Neptune cruise phase. Our solution provides annual launch opportunities and allows for an easy upgrade to the shorter (12 yr) cruise. Odyssey would orbit Neptune retrograde (prograde with respect to Triton), using the moon's gravity to shape the orbital tour and allow coverage of Triton, Neptune, and the space environment. The atmospheric entry probe would descend in ~37 minutes to the 10 bar pressure level in Neptune's atmosphere just before Odyssey's orbit-insertion engine burn. Odyssey's mission would end by conducting a Cassini-like "Grand Finale,"passing inside the rings and ultimately taking a final great plunge into Neptune's atmosphere

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Do Risk Assessment Tools Help to Manage and Reduce Risk of Violence and Reoffending? A Systematic Review

Although it is widely believed that risk assessment tools can help manage risk of violence and offending, it is unclear what evidence exists to support this view.  As such, we conducted a systematic review and narrative synthesis.  To identify studies, we searched 13 databases, reviewed reference lists, and contacted experts.  Through this review, we identified 73 published and unpublished studies (N = 31,551 psychiatric patients and offenders, N = 10,002 professionals) that examined either professionals’ risk management efforts following the use of a tool, or rates of violence or offending following the implementation of a tool.  These studies included a variety of populations (e.g., adults, adolescents), tools, and study designs.    The primary findings were as follows: (1) despite some promising findings, professionals do not consistently adhere to tools or apply them to guide their risk management efforts; (2) following the use of a tool, match to the risk principle is moderate and match to the needs principle is limited, as many needs remained unaddressed; (3) there is insufficient evidence to conclude that tools directly reduce violence or reoffending, as findings are mixed; and (4) tools appear to have a more beneficial impact on risk management when agencies use careful implementation procedures and provide staff with training and guidelines related to risk management.  In sum, although risk assessment tools may be an important starting point, they do not guarantee effective treatment or risk management.  However, certain strategies may bolster their utility