Does Treatment Quality Matter?

Research Summary

The Florida Department of Juvenile Justice has implemented a process to evaluate the treatment quality of interventions provided statewide in all long‐term residential programs. In the current study, we examine the predictive validity of this treatment quality component in the prediction of recidivism of youth (N = 2,397) who completed juvenile justice residential programs from July 1, 2013 to June 30, 2014. We use hierarchical linear modeling to assess the effects of treatment quality (as youth are nested within programs), controlling for demographic and criminal history factors. The results indicate that higher average treatment quality scores of interventions received within a residential program decreased the likelihood of subsequent arrest, conviction, and reincarceration, whereas the highest treatment quality score of any specific intervention provided within the program decreased the odds of reincarceration only.

Policy Implications

In this study, we confirm the importance of fidelity and implementation quality in the provision of crime prevention treatment interventions to serious, deep‐end juvenile offenders. Additionally, our results shed light on the ability of a juvenile justice agency to measure treatment quality in a substantively meaningful way with the use of limited additional resources. The services provided to keep communities safe, prevent future offending, and rehabilitate juvenile offenders must be held accountable for producing such outcomes, and one method of measuring such compliance is to evaluate the quality of the interventions with respect to staff training, fidelity adherence, evaluation, and corrective action processes.     

Fatal Complications of Aesthetic Techniques: The Gluteal Region

Cosmetic procedures are common and utilize many techniques to obtain aesthetically good outcomes for patient satisfaction with acceptable safety standards. Cosmetic procedures that involve the gluteal region are becoming increasingly popular as various procedures can target the gluteal region such as liposuction, tumescent liposuction, cosmetic filler injections, autologous fat transfer, depot drug delivery, and implants. Complications of cosmetic gluteal procedures can be localized or systemic with systemic complications being responsible for most deaths. These reported systemic complications include sepsis, thromboembolism, fat embolism with or without fat embolism syndrome, macroscopic fat embolism, anesthesia‐related and blood volume abnormalities. We herein report 10 deaths due to elective gluteal cosmetic procedures. Autologous fat transfer (fat grafting, lipoinjection) following liposuction resulted in 8 of 10 fatal outcomes of the gluteal aesthetic procedures. A comprehensive discussion of gluteal anatomy, gluteal contouring procedures, and the approach to such cases is presented along with the autopsy findings of the reported cases.     

“Second Generation” Voices: Queer Youth with Lesbian/Bisexual Mothers

Research on the experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth with LGBTQ parents is absent in the social science literature. The present qualitative, exploratory study utilized a social constructionist and queer theoretical lens through which to explore the sexual/gender identity formation and disclosure experiences of 18 LGBTQ young adults with lesbian/bisexual mothers. Findings suggest that LGBTQ parents may have a uniquely positive influence on their LGBTQ children in regard to their sexual and gender identity development. However, some participants reported perceiving societal scrutiny related to their mothers’ lesbian/bisexual identities and, thus, felt pressure to be heterosexual and gender-conforming. Furthermore, some participants did not necessarily utilize or view their lesbian/bisexual mothers as sources of support in relation to their own sexual/gender identity formation. While much more research is needed that examines the experiences of LGBTQ children with LGBTQ parents, this study represents a first step in addressing the existing literature gap.     

Nancy Alfaro as an Exemplary Collaborative Public Manager: How Customer Service Was Aligned with Customer Needs

Nancy Alfaro is the quintessential practitioner of collaborative public management. More than that, she is a collaborative public manager focused on delivering customer service. Finding herself in the midst of a flurry of activity when San Francisco mayor Gavin Newsom suddenly ordered her to allow same-sex marriages in 2004, she pulled together the resources to perform more than 1,000 weddings in three days. Now, as director of San Francisco's 311 Customer Service Center, Alfaro oversees an operation that has reduced the number of telephone numbers residents may need to call for information and nonemergency services from 2,300 to just one. How Ms. Alfaro accomplished these remarkable tasks can be the source of fruitful lessons for other public officials.     

Psychological Distress,Substance Use,and HIV/STI Risk Behaviors Among Youth

Psychological distress has been inconsistently associated with sexual risk behavior in youth, suggesting additional factors, such as substance use, may explain this relationship. The mediating or moderating role of substance use on the relationship between psychological distress and sexual risk behaviors was prospectively examined over the four high school years in a sample of urban youth (N = 850; 80% African American; 50% female). Growth curve modeling was used to estimate changes in sexual risk across adolescence and to test its association to psychological distress symptoms and frequency of substance use. Substance use was associated with psychological distress. Greater psychological distress was associated with increased sexual intercourse frequency, decreased condom use, and increased number of partners. Substance use fully mediated the relationship between psychological distress and intercourse frequency and condom use, and partially mediated the relationship between psychological distress and number of partners. We found no differences in mediation by sex or race/ethnicity and no evidence to support moderation of psychological distress and substance use on sexual risk. Findings suggest that psychological distress is associated with sexual risk because youth with greater psychological distress are also more likely to use substances. Practical implications for adolescent HIV/STI prevention are discussed.