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Byline: Brian. Goh, Gerald. Zeng, Tze-Yi. Low, Darren. Chua, Ye-Xin. Koh, Kai-Inn. Lim Background: Minimally-invasive pancreato-biliary surgery (MIPBS) is increasingly reported worldwide. This study examines the changing trends, safety and [...]

Byline: Gerald. Zeng, Nan. Teo, Brian. Goh Introduction: Minimally invasive surgery (MIS) for gallbladder cancer (GBCa) has traditionally been discouraged, with limited studies reporting on its outcomes. The aim of [...]

Background: Current literature lacks consensus regarding the impact of obesity on clinical outcomes of total hip arthroplasty (THA). The variability of results may reflect the lack of minimal clinically important difference (MCID) analysis, which helps to standardise the interpretation of patient-reported outcome measures (PROMs). We compared the PROMs, patient satisfaction and survivorship between obese and non-obese patients after THA. Methods: Prospectively collected registry data of 192 obese patients and 192 propensity score-matched controls who underwent primary THA at a single institution were reviewed. Clinical outcomes and satisfaction rates were assessed at 6 months and 2 years. Reoperations for surgical complications and revision rates were analysed. Results: Obese patients had a significantly poorer Oxford Hip Score (OHS) at 6 months and WOMAC-Function at 2 years. However, there was no difference in overall WOMAC, WOMAC-Pain, WOMAC-stiffness, SF-36 mental and physical component summary (PCS). A similar proportion of patients in each group achieved the MCID for OHS, WOMAC and SF-36 PCS. At 2 years, 90.3% of obese patients and 91.7% of controls were satisfied (p = 0.755). At a mean follow-up of 9 years, there were 5 reoperations (2.6%) for surgical complications in the obese group and 1 (0.5%) in the control group; whereas 12 revisions (6.3%) were recorded in the obese group and 3 (1.6%) in the control group (p = 0.021). Conclusions: Despite a higher revision rate, obese patients undergoing THA may experience a similar level of clinical meaningful improvement and satisfaction as their non-obese counterparts. This study provides valuable prognostic information for obese patients and guides preoperative counselling. [ABSTRACT FROM AUTHOR]

Knee subchondroplasty (SCP) is one of the most novel minimally invasive methods for treating bone marrow lesions. The literature suggests that it is safe, with few complications and good outcomes. However, no studies have documented its usage for managing large subchondral bone cysts. This article outlines a case report and details the pearls and pitfalls of SCP in treating large subchondral bone cysts. Our patient underwent arthroscopic debridement with medial femoral condyle SCP. Mild posterior extravasation of synthetic bone substitute was observed on Postoperative Day 1, which was immediately rectified on revision arthroscopy. Gradual escalation of weight bearing and good pain relief were subsequently achieved, and the patient has remained complication-free after two years. No further extravasation were observed on repeat radiography. SCP is a feasible temporising measure that may help to delay the need for bone allograft or immediate knee arthroplasty in younger patients while retaining function and delaying loss of productivity. [ABSTRACT FROM AUTHOR]

The study examined the risk and protective factors for the successful completion of probation orders among youth offenders in Singapore. Specifically, we proposed a typology whereby a predictor can be labeled as a promotive factor, hazard factor, or mixed factor in a direct relationship; or a booster factor or buffering factor in an interactive relationship. This study included 701 youth offenders. Retrospective case file coding was conducted to score the Youth Level of Service/Case Management Inventory (YLS/CMI) and Structured Assessment of Protective Factors for Violence Risk–Youth Version (SAPROF-YV). Most SAPROF factors were shown to be mixed protective factors, whereas most YLS/CMI domains were either mixed risk factors or hazard factors. An absence of a supportive external pedagogical climate (PC) was the strongest mixed factor. For youth with high PC, significant booster factors included high levels of attitudes toward agreements and conditions, motivation for treatment, perseverance, and bonding to school/work, as well as low levels of risk in peer relations and education/employment. For youth with limited PC, buffering factors with the strongest effects include self-control, future orientation, and school/work. Implications for practice and future research were discussed. [ABSTRACT FROM AUTHOR]

Summary Offender rehabilitation seeks to minimise recidivism. Using their experience and actuarial-type risk assessment tools, probation officers in Singapore make recommendations on the sentencing outcomes so as to achieve this objective. However, it is difficult for them to maximise the utility of the large amounts of data collected, which could be resolved by using predictive modelling informed by statistical learning methods. Findings Data of youth offenders (N = 3744) referred to the Probation Service, Ministry of Social and Family Development for rehabilitation were used to create a random forests model to predict recidivism. No assumptions were made on how individual predictor values within the risk assessment tool and other administrative data on an individual’s socio-economic status such as level of education attained and dwelling type collected in line with organisational requirements influenced the outcome. Sixty per cent of the data was used to develop the model, which was then tested against the remaining 40%. With a classification accuracy of approximately 65%, and an Area under the Curve value of 0.69, it outperformed existing models analysing aggregated data using conventional statistical methods. Application This article identifies how analysis of administrative data at the discrete level using statistical learning methods is more accurate in predicting recidivism than using conventional statistical methods. This provides an opportunity to direct intervention efforts at individuals who are more likely to reoffend. [ABSTRACT FROM AUTHOR]

Youth violence is a costly social problem. This study compared the risk and needs of nonviolent youth offenders, with those who had committed violent offenses only (violent only) and those who had committed violent and nonviolent offenses (violent plus) to determine whether violent youth were a different “type” from nonviolent youth. The case files of 3,744 youth offenders (3,327 males and 417 females, between 12 and 18 years old) were retrospectively coded, before official recidivism records were obtained. Multivariate analysis of variance (MANOVA), χ2, and Cox regressions were conducted. Violent-plus youth were younger; higher in their total risk and all criminogenic needs; more likely to have several noncriminogenic needs; and at higher risk of any reoffending, violent reoffending, and nonviolent reoffending than nonviolent youth. Violent-only youth had the same total risk and risk of general and violent recidivism as nonviolent offenders but presented different criminogenic and noncriminogenic needs and risk of nonviolent recidivism. Compared to violent-only youth, violent-plus youth were younger, had higher total risk and criminogenic needs on five domains, were more likely to have several noncriminogenic needs, and were at higher risk of all types of reoffending (except sexual reoffending), suggesting subtypes of violent youth offenders. The implication is that nonviolent and violent youth offenders require different dosage and types of intervention. [ABSTRACT FROM AUTHOR]

An increasing amount of research has been carried out to understand the characteristics of subgroups of adult sex offenders, but there is limited research into the risk factors and criminogenic needs of subgroups of youth who sexually offended. The current study investigated if there were differences in the risk and criminogenic needs of 167 Singaporean youth who sexually offended based on two typologies - youth who offended both sexually and nonsexually versus youth who offended only sexually, and youth who offended against child victims versus youth who offended against nonchild victims. Results show that youth who offended both sexually and nonsexually were found to have higher risk and criminogenic needs as compared to youth who only sexually offended. In addition, youth who offended against child victims were found to have higher numbers of previous sexual assaults as compared to youth who offended against nonchild victims. These differences have implications for the management and intervention of youth who sexually offended. [ABSTRACT FROM AUTHOR]

There has been an increased focus on understanding youth sexual offending in recent years, but there has been limited empirical research on the causes, pathways, and treatment of youth who have sexually offended—especially within a non-Western context. The Good Lives and Self-Regulation Models have often been used to understand and rehabilitate adult sexual offenders, but (unfortunately) there is scant research on youth who sexually offended using these models. The present study aims to describe the different primary goods that are associated with youth sexual offending behaviors in an Asian context. In addition, the study sought to explore whether the age of victim (child vs. nonchild) and nature of sexual offense (penetrative vs. nonpenetrative) influenced the youth’s engagement in offense pathways. The results suggest that pleasure, relatedness, and inner peace were the primary human goods that were most sought after by a sample of 168 youth who sexually offended in Singapore. In addition, offender classification (in relation to the age of victim and nature of sexual offense) influenced the pathways to sexual offending. Therefore, these findings have important clinical implications for assessment, management, and intervention planning for youth who sexually offended. [ABSTRACT FROM AUTHOR]

Sexual offending has attracted increasing public concern because of its long-term effects. Although there is an increasing amount of research on the risk factors for recidivism among youth who have sexually offended, there is a dearth of research on the protective factors for desistence from recidivism. The current study investigated the associations between protective factors and recidivism among 97 Singaporean youth who sexually offended (YSO). In addition, the predictive validity with regard to two new measures of protective factors—the Desistence for Adolescents Who Sexually Harm (DASH-13), and Structured Assessment of Protective Factors for Violence Risk (SAPROF)—were also evaluated. Results indicated that both the DASH-13 and the SAPROF were inversely related to the Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR). However, neither the DASH-13 nor the SAPROF were found to have adequate predictive validity or incremental validity for sexual or nonsexual recidivism. The implications for the assessment and management of YSO are discussed. [ABSTRACT FROM PUBLISHER]

Empirical support for the usage of the Youth Level of Service measures has been reported in studies conducted in the North America, United Kingdom, and Australia. Recent meta-analytic studies on the Youth Level of Service/Case Management Inventory (YLS/CMI) have revealed that the measure has modest to moderate predictive validity for general recidivism, but there are very few studies on the predictive validity of the YLS/CMI ratings for recidivism in non-Western contexts. This study examined the predictive validity of the YLS/CMI 2.0 ratings for general recidivism in a sample of 3,264 youth offenders within a Singaporean context (Mfollow-up = 1,764.5 days; SDfoIlow-up = 521.5). Results showed that the YLS/CMI 2.0 overall risk ratings and total scores significantly predicted general recidivism for both male and female youth offenders. Overall, the results suggest that the YLS/CMI 2.0 is suited for assessing youth offenders in terms of their risk for general recidivism within a non-Western context. [ABSTRACT FROM AUTHOR]

An increasing amount of research has been carried out to understand the characteristics of subgroups of adult sex offenders, but there is limited research into the risk factors and criminogenic needs of subgroups of youth who sexually offended. The current study investigated if there were differences in the risk and criminogenic needs of 167 Singaporean youth who sexually offended based on two typologies - youth who offended both sexually and nonsexually versus youth who offended only sexually, and youth who offended against child victims versus youth who offended against nonchild victims. Results show that youth who offended both sexually and nonsexually were found to have higher risk and criminogenic needs as compared to youth who only sexually offended. In addition, youth who offended against child victims were found to have higher numbers of previous sexual assaults as compared to youth who offended against nonchild victims. These differences have implications for the management and intervention of youth who sexually offended., (© The Author(s) 2014.)