Discovering a Predictive Mechanism to Identify Risk and Harm in Extra-Familial Child Exploitation: Time to Reconsider the Multi-agency Child Exploitation (MACE) Response?

This paper examines the multi-agency identification of risk and harm in extra-familial child exploitation (CE). It explores several data prediction methods to effectively target and prevent harm. It provides a taxonomy analysis of repeat victimisation and cumulative victim harm. It also examines the relationship between age and harm and, finally, the conditional probability of repeat victimisation in exploited children. Research Question Are the most harmed exploited children referred to Multi-Agency Child Exploitation (MACE) Panels, and what other methods exist to identify and prevent high harm in child exploitation? Methods This is a descriptive quantitative statistical analysis using a whole population of children in a Northern English county, aged between 10 and 17 who were recorded in police data as either victims, offenders or MACE referrals between January 2017 and June 2018, encompassing 12,457 children. It utilises an 18-month study window, an 18-month follow-up and 18-month prior time censored period using data between 2015 and 2019 inclusive. This data identifies CE victims using CE flagging and additionally, offence classification with familial abuse and familial exploitation cases removed. It identifies repeat victims and those children referred to MACE for tailored multi-agency intervention. Application of Sherman et al.’s (Policing (Oxford) 10:171–183, 2016) Cambridge Crime Harm Index (CCHI) provided an analysis of harm in victimisation and offending. Findings Exploited repeat victims (90.7%) were not referred to MACE, and there was no significant difference in the harm they sustained in the 18 months following a repeat victimisation compared to exploited children subject to MACE. The most harmed CE victim (Victim-CCHI 15,330) in the 18-month study window was not referred to MACE, nor was the highest frequency CE victim within 18 months (31 victimisations). Exploited victims, victim offenders and MACE children are re-victimised at a significantly higher rate than other children. Exploited victims (73.4%) will not suffer a repeat victimisation of any kind. Forty-two percent of exploited repeat victims will have a third victimisation given a second, and this will attract additional mean victim harm of 464 (for comparison, penetrative sexual activity with a girl under 16 by an Offender 18 or over has a CCHI harm score of 365). Conclusion Whilst MACE provides a forum to share multi-agency information, it only does so for 9.3% of exploited repeat victims. This has implications for the role and focus of MACE. Whilst several quantitative methods were explored to predict harm in CE, this research favours the use of conditional probability and harm association. By using this method, 90.7% of missed repeat victims become visible to professionals. This is essential in providing the opportunity to minimise the risk of further victimisation and increased harm that 42% of this group will have within an 18-month period. This research provides a predictive and evidence-based framework to identify exploited children at risk of further harm and victimisation

Evidence vs. Professional Judgment in Ranking “Power Few” Crime Targets: a Comparative Analysis

Abstract: Research question: How accurately can local police officers use professional judgement to identify the highest-crime street locations and offenders with the most crime and harm, in comparison to an evidence-based rank-ordering of all possible locations and names derived from police force records? Data: A face-to-face survey was conducted in groups with a purposive convenience sample of 123 operational police officers to ask their professional judgement for selecting the ten most crime-prone streets and suspected offenders in their command areas. Separate rankings by crime harm were also requested. Cambridgeshire Constabulary crime and confirmed suspect reports were analysed to create the same lists the officers were asked to provide. Methods: The study compared results of surveys of police officers asked to name the top 10 streets and offenders for volume and harm of crimes committed in each policing area to the top ten lists generated by comprehensive and systematic analysis of reported crimes. Findings: The top ten lists generated by officers were highly inaccurate compared to the lists produced by comprehensive analysis of crime and charging records. Officers surveyed were 91% inaccurate in naming the most prolific suspected offenders in their areas and 95% inaccurate in naming the most harmful suspected offenders. Officers were slightly less inaccurate in naming the streets in their areas with the highest frequency of crimes (77% incorrect) and the greatest severity of crimes (74% incorrect). Officers in urban areas (N = 42) were substantially more accurate than officers working in semi-rural areas (N = 30) in identifying streets with the highest crime frequency (Cohen’s d = 0.9; p = .00) and highest total harm (Cohen’s d = 1.3; p = .00), but urban officers still failed to name about two-thirds of the most harmful streets. Conclusions: Police officers can benefit from evidence-based targeting analysis to help them decide where their proactive and preventive work can be deployed with the greatest benefit

Impact of a Training Programme on Police Attitudes Towards Victims of Rape: a Randomised Controlled Trial

Funder: University of Cambridge Abstract Research Question Does an in-service training programme designed to address the attitudes of student officers, uniformed response officers and specialist rape crime investigators towards victims of rape change their perspective on adult victims, both male and female, who report rape offences? Data Police officers from four separate policing roles completed questionnaires designed to measure their attitudes towards victims of rape. The questions were already validated and used four specific subscales: ‘Asked for it’, ‘Didn’t mean to’, ‘It wasn’t really rape’ and ‘S/he lied’. Two questionnaires, one focused on male victims and one on females, were administered at different points in time. Methods This randomised controlled trial used a block design, randomly assigning eligible police officers to treatment and control conditions within each of four groups. Participants were grouped as rape detectives (N = 40), uniformed response officers in urban areas (N = 50); uniformed response officers in rural areas (N = 50) and student officers (N = 53). Officers in the treatment condition undertook a bespoke training programme, based on an online College of Policing e-learning programme, enhanced with audio and video content, discussion groups and short online webinar sessions delivered by a psychologist specialising in sexual offending. Both groups were surveyed before and after the treatment group was trained. Findings The training programme resulted in positive attitude changes towards male and female rape victims when responses are combined across all four police groups (but not within all groups separately) compared with the attitudes of those who did not undertake the training. Effects were found for both levels of rape myth acceptance and assessment of victim credibility. The effect was largest for the subscales ‘S/he lied’ and ‘it wasn’t really rape’. Training had more effect on attitudes towards female victims than towards males and more effect on uniformed response officers than on other categories of officers. Conclusion The use of this mixed online webinar and in-person discussion group training delivery was effective in changing attitudes towards rape victims on issues relating to the treatment of people who report being raped. </jats:sec

Impact of a Training Programme on Police Attitudes Towards Victims of Rape: a Randomised Controlled Trial

Funder: University of Cambridge Abstract Research Question Does an in-service training programme designed to address the attitudes of student officers, uniformed response officers and specialist rape crime investigators towards victims of rape change their perspective on adult victims, both male and female, who report rape offences? Data Police officers from four separate policing roles completed questionnaires designed to measure their attitudes towards victims of rape. The questions were already validated and used four specific subscales: ‘Asked for it’, ‘Didn’t mean to’, ‘It wasn’t really rape’ and ‘S/he lied’. Two questionnaires, one focused on male victims and one on females, were administered at different points in time. Methods This randomised controlled trial used a block design, randomly assigning eligible police officers to treatment and control conditions within each of four groups. Participants were grouped as rape detectives (N = 40), uniformed response officers in urban areas (N = 50); uniformed response officers in rural areas (N = 50) and student officers (N = 53). Officers in the treatment condition undertook a bespoke training programme, based on an online College of Policing e-learning programme, enhanced with audio and video content, discussion groups and short online webinar sessions delivered by a psychologist specialising in sexual offending. Both groups were surveyed before and after the treatment group was trained. Findings The training programme resulted in positive attitude changes towards male and female rape victims when responses are combined across all four police groups (but not within all groups separately) compared with the attitudes of those who did not undertake the training. Effects were found for both levels of rape myth acceptance and assessment of victim credibility. The effect was largest for the subscales ‘S/he lied’ and ‘it wasn’t really rape’. Training had more effect on attitudes towards female victims than towards males and more effect on uniformed response officers than on other categories of officers. Conclusion The use of this mixed online webinar and in-person discussion group training delivery was effective in changing attitudes towards rape victims on issues relating to the treatment of people who report being raped. </jats:sec

Effects of Judicial Instructions and Juror Characteristics on Interpretations of Beyond Reasonable Doubt

Purpose and Methods: The standard of proof, beyond reasonable doubt (BRD), serves as a threshold for reaching verdicts in criminal cases. Past research has demonstrated that factors such as the wording of judicial instructions defining the standard can influence people’s interpretation of it. In addition, there is some concern that instructions may not be effective for the wider jury-eligible population. In an experimental study involving members of the general public, we examined the effect of two commonly used judicial instructions (i.e., sure and firmly convinced) against a situation when BRD was undefined, on people’s quantitative interpretations of BRD as well as on their self-reported understanding of the standard and confidence in applying it. We also explored the effect of juror characteristics (i.e., gender, age and education). Results: Compared to when the standard was undefined, the sure instruction helped to reduce inter-individual variability in interpretations of BRD and the firmly convinced instruction increased people’s understanding of the standard. However, neither instruction was effective in increasing confidence in applying the standard or in reducing observed individual differences. Conclusion: These findings underscore the importance of developing evidence-based judicial instructions that can benefit the broad jury-eligible population equally and in a variety of way

Genetic architecture of subcortical brain structures in 38,851 individuals

Subcortical brain structures are integral to motion, consciousness, emotions and learning. We identified common genetic variation related to the volumes of the nucleus accumbens, amygdala, brainstem, caudate nucleus, globus pallidus, putamen and thalamus, using genome-wide association analyses in almost 40,000 individuals from CHARGE, ENIGMA and UK Biobank. We show that variability in subcortical volumes is heritable, and identify 48 significantly associated loci (40 novel at the time of analysis). Annotation of these loci by utilizing gene expression, methylation and neuropathological data identified 199 genes putatively implicated in neurodevelopment, synaptic signaling, axonal transport, apoptosis, inflammation/infection and susceptibility to neurological disorders. This set of genes is significantly enriched for Drosophila orthologs associated with neurodevelopmental phenotypes, suggesting evolutionarily conserved mechanisms. Our findings uncover novel biology and potential drug targets underlying brain development and disease

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic