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- Stenström, Anders, 1981-
(författare)
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The Plural Policing of Fraud : Power and the investigation of insurance and welfare fraud in Sweden
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a vast literature on plural policing and the ways in which non-governmental actors now have and are assuming more responsibility for crime control. This literature argues that the connection between policing and the state is being eroded, questioned and sometimes abandoned in favour of networks in which the state acts as one actor among many others. This thesis examines the Swedish policing of insurance and welfare fraud via an analysis of the ways in which power is organized and articulated by actors in the private insurance industry, and at the Swedish Social Insurance Agency and police authority.The three articles included in the thesis contribute to a field that has received comparatively little attention, particularly in Sweden but also internationally. The existing literature has primarily been interested in the control of street-level criminality and the operations of uniformed security actors. Investigation practices in general and the plural policing of white-collar crime in particular have received far less attention. In Sweden, studies of policing are primarily state-centred, and the interactions between the police and other policing actors require further consideration. When examining insurance fraud, scholars have not considered the ways in which the insurance institution controls fraud; instead, this literature focuses on the characteristics of fraudsters. Thus the current thesis furthers our knowledge of a field of policing about which we currently know relatively little.The thesis takes as its general assumption the view that this form of policing is marked by a basic ambiguity between on the one hand being responsibilized and assuming responsibility for crime control, and on the other being responsible for other goals, such as promoting trust in, and the legitimacy and survival of the insurance institution. Existing research suggests that this ambiguity is resolved by simply denying compensation, adjusting premium levels, and cancelling policies or social benefits. My research shows that there is no Swedish exceptionalism in this sense.Based on a Foucauldian understanding of power, the thesis furthers our understanding of how the insurance institution is organized to tolerate fraud. The uncertainty between crime control and additional organizational goals is embedded in attempts to police the policing actors themselves, which is reflected in forces that make the policing of fraud a professional risk for the policing actors. The thesis argues that power relations provide opportunities to ensure that organizational goals are not endangered, while at the same time maintaining the public image that crime is being controlled. In contrast with existing research, the thesis shows that the law and the state – analytical categories that existing research, and particularly post-Foucauldian approaches, tend to reject or avoid – are critical to the plural policing of fraud. It is further suggested that scholars need to pay more attention to the way different technologies of power shape relationships between the actors involved in plural policing and their definitions of their own roles. In particular, scholars need to consider the role of the state and the legal framework in such arrangements.
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| 2. |
- Yuh, Esther L, et al.
(författare)
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Pathological computed tomography features associated with adverse outcomes after mild traumatic brain injury : A TRACK-TBI study with external validation in CENTER-TBI.
- 2021
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Ingår i: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 78:9, s. 1137-1148
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT features have been shown to be associated with outcomes. In mild TBI (mTBI; GCS scores 13-15), distribution and co-occurrence of pathological CT features and their prognostic importance are not well understood.OBJECTIVE: To identify pathological CT features associated with adverse outcomes after mTBI.DESIGN, SETTING, AND PARTICIPANTS: The longitudinal, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study enrolled patients with TBI, including those 17 years and older with GCS scores of 13 to 15 who presented to emergency departments at 18 US level 1 trauma centers between February 26, 2014, and August 8, 2018, and underwent head CT imaging within 24 hours of TBI. Evaluations of CT imaging used TBI Common Data Elements. Glasgow Outcome Scale-Extended (GOSE) scores were assessed at 2 weeks and 3, 6, and 12 months postinjury. External validation of results was performed via the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Data analyses were completed from February 2020 to February 2021.EXPOSURES: Acute nonpenetrating head trauma.MAIN OUTCOMES AND MEASURES: Frequency, co-occurrence, and clustering of CT features; incomplete recovery (GOSE scores <8 vs 8); and an unfavorable outcome (GOSE scores <5 vs ≥5) at 2 weeks and 3, 6, and 12 months.RESULTS: In 1935 patients with mTBI (mean [SD] age, 41.5 [17.6] years; 1286 men [66.5%]) in the TRACK-TBI cohort and 2594 patients with mTBI (mean [SD] age, 51.8 [20.3] years; 1658 men [63.9%]) in an external validation cohort, hierarchical cluster analysis identified 3 major clusters of CT features: contusion, subarachnoid hemorrhage, and/or subdural hematoma; intraventricular and/or petechial hemorrhage; and epidural hematoma. Contusion, subarachnoid hemorrhage, and/or subdural hematoma features were associated with incomplete recovery (odds ratios [ORs] for GOSE scores <8 at 1 year: TRACK-TBI, 1.80 [95% CI, 1.39-2.33]; CENTER-TBI, 2.73 [95% CI, 2.18-3.41]) and greater degrees of unfavorable outcomes (ORs for GOSE scores <5 at 1 year: TRACK-TBI, 3.23 [95% CI, 1.59-6.58]; CENTER-TBI, 1.68 [95% CI, 1.13-2.49]) out to 12 months after injury, but epidural hematoma was not. Intraventricular and/or petechial hemorrhage was associated with greater degrees of unfavorable outcomes up to 12 months after injury (eg, OR for GOSE scores <5 at 1 year in TRACK-TBI: 3.47 [95% CI, 1.66-7.26]). Some CT features were more strongly associated with outcomes than previously validated variables (eg, ORs for GOSE scores <5 at 1 year in TRACK-TBI: neuropsychiatric history, 1.43 [95% CI .98-2.10] vs contusion, subarachnoid hemorrhage, and/or subdural hematoma, 3.23 [95% CI 1.59-6.58]). Findings were externally validated in 2594 patients with mTBI enrolled in the CENTER-TBI study.CONCLUSIONS AND RELEVANCE: In this study, pathological CT features carried different prognostic implications after mTBI to 1 year postinjury. Some patterns of injury were associated with worse outcomes than others. These results support that patients with mTBI and these CT features need TBI-specific education and systematic follow-up.
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