Revised Risk Assessment Research Articles

Statement on the refined environmental risk assessment and impact of the new classification for captan.

On 24 July 2020, the EFSA conclusion on the peer review of the pesticide risk assessment of the active substance captan drawn in the context of the renewal of approval of the active substance captan conducted in accordance with Commission Implementing Regulation (EC) No 844/2012 was approved. In December 2023, the European Commission asked EFSA to provide a statement on its view as regards the RMS's revised environmental risk assessment concerning some uses in pome fruits and cherries and the potential impact of the recent new classification recommended by RAC on the toxicological reference values of captan stated in the EFSA Conclusion. The current statement contains the conclusions of the considerations related to the environmental revised risk assessment performed by the RMS, Austria, and to the new classification proposed by RAC on the toxicological reference values.

Pesticide soil microbial toxicity: setting the scene for a new pesticide risk assessment for soil microorganisms (IUPAC Technical Report)

Abstract Pesticides constitute an integral part of modern agriculture. However, there are still concerns about their effects on non-target organisms. To address this the European Commission has imposed a stringent regulatory scheme for new pesticide compounds. Assessment of the aquatic toxicity of pesticides is based on a range of advanced tests. This does not apply to terrestrial ecosystems, where the toxicity of pesticides on soil microorganisms, is based on an outdated and crude test (N mineralization). This regulatory gap is reinforced by the recent methodological and standardization advances in soil microbial ecology. The inclusion of such standardized tools in a revised risk assessment scheme will enable the accurate estimation of the toxicity of pesticides on soil microorganisms and on associated ecosystem services. In this review we (i) summarize recent work in the assessment of the soil microbial toxicity of pesticides and point to ammonia-oxidizing microorganisms (AOM) and arbuscular mycorrhizal fungi (AMF) as most relevant bioindicator groups (ii) identify limitations in the experimental approaches used and propose mitigation solutions, (iii) identify scientific gaps and (iv) propose a new risk assessment procedure to assess the effects of pesticides on soil microorganisms.

Nonclinical safety assessment of epigenetic modulatory drugs: Current status and industry perspective

Pharmaceutic products designed to perturb the function of epigenetic modulators have been approved by regulatory authorities for treatment of advanced cancer. While the predominant effort in epigenetic drug development continues to be in oncology, non-oncology indications are also garnering interest. A survey of pharmaceutical companies was conducted to assess the interest and concerns for developing small molecule direct epigenetic effectors (EEs) as medicines. Survey themes addressed (1) general levels of interest and activity with EEs as therapeutic agents, (2) potential safety concerns, and (3) possible future efforts to develop targeted strategies for nonclinical safety assessment of EEs. Thirteen companies contributed data to the survey. Overall, the survey data indicate the consensus opinion that existing ICH guidelines are effective and appropriate for nonclinical safety assessment activities with EEs. Attention in the framework of study design should, on a case by case basis, be considered for delayed or latent toxicities, carcinogenicity, reproductive toxicity, and the theoretical potential for transgenerational effects. While current guidelines have been appropriate for the nonclinical safety assessments of epigenetic targets, broader experience with a wide range of epigenetic targets will provide information to assess the potential need for new or revised risk assessment strategies for EE drugs.

Assessing firesetters with intellectual disabilities

PurposePeople with intellectual disabilities who set fires are a heterogeneous and clinically complex group who present significant challenges to the wider community and to forensic practitioners working in forensic mental health and correctional settings. There is little available in the literature to support professionals when considering assessment and formulation for clients exhibiting these perturbing behaviours. The paper aims to discuss this issue.Design/methodology/approachIn this paper the materials available to assist forensic practitioners in considering assessment and formulation of people with intellectual disabilities who set fires are described and outlined.FindingsAn assessment scheme is proposed for organising information from a variety of sources to assist professionals in understanding the nature of risks and clinical needs of firesetters with intellectual disabilities. A newly revised risk assessment measure designed for this population is provided.Practical implicationsForensic practitioners are provided with a framework and tools to assist with their assessment and formulation of firesetters with intellectual disabilities.Originality/valueThis is the first time a newly revised risk assessment for firesetting behaviour by people with intellectual disabilities has been presented.

Respecting privacy in care services

Purpose In care homes concerns about abuse have established a culture where all information pertaining to a person must be shared, and little attention is paid to privacy in its broader sense. The purpose of this paper is to take a human rights perspective and consider how information governance may impact on the health, well-being and quality of life of residents. It proposes a proactive approach and presents a template for a privacy impact assessment which services could use to improve their approach to privacy, protecting the human rights of those in their care, contributing to their independence and improving outcomes. Design/methodology/approach A review of historical and current thinking about the value of privacy in human services and wider society leads to a series of challenges to the way in which privacy is upheld in residential care services. Findings Recent preoccupations with data privacy have led to a myopic neglect of broader considerations of privacy. Whilst it continues to be important to protect the confidentiality of personal data and to ensure that residents are protected from abuse, human services that provide 24 hour care in congregated settings must not neglect broader components of privacy. Research limitations/implications Privacy impact assessments have been widely used to check whether data privacy is being upheld. The broader concept that might be termed “Big Privacy” is introduced within which data privacy is but one section. It is suggested that big privacy is severely compromised in residential care settings, thus denying residents their human right to privacy. The extent of such violation of rights should be investigated. Practical implications Having set out the potential reach of the human right to privacy, important work needs to be done to find out how privacy might be upheld in the real world of congregate residential care. Some service providers may have solutions to the organisational challenges, have addressed staff training needs and revised risk assessment strategies so that privacy is upheld alongside other rights. Social implications Nearly half a million people live in congregate residential care settings in England, and deprivation of privacy is argued to be a significant deprivation of human rights. Occasional tragedies and scandals in congregate settings create pressure for increasing the level of surveillance, and the right to privacy is sacrificed. This paper offers a challenge to this process, arguing that competing rights need to be balanced and privacy is an essential component of a decent quality of life. Originality/value Personal growth and development depends to some extent on choice and control over access to privacy. Recent changes in the law regarding data protection have narrowed our thinking about privacy until it is a small concept, largely concerned with data handling. This paper invites consideration of big privacy, and invites congregate residential care settings to consider how a deep and broad definition of privacy could transform these services.

Racial Bias and LSI-R Assessments in Probation Sentencing and Outcomes

Risk assessments are now implemented in correctional settings across the United States as an evidence-based strategy to inform sentencing and supervision decisions. Despite growing research examining racial bias in the predictive validity of risk assessments, few studies have investigated racial bias in the context of judicial decision-making. We investigated the interactive contributions of race and Level of Service Inventory–Revised (LSI-R) risk assessments in predicting sentence length and probation outcomes in 11,792 Black and White probationers. Results showed White probationers at low-risk levels received longer sentences relative to Black probationers classified at the same risk levels. However, there were few differences at higher risk levels and no evidence of racial bias in the predictive accuracy of LSI-R assessments for other probation outcomes. Findings highlight the need for prospective and carefully controlled investigations into whether risk assessments improve the fairness and accuracy of sentencing and other risk management decisions.

Outcomes associated with the use of a revised risk assessment strategy to predict antibiotic resistance in community-onset pneumonia: a stewardship perspective

There is growing evidence that patients with community-onset pneumonia and recent healthcare exposure are not at equally high risk of infection with MDR organisms. An individualized approach is necessary with regard to risk assessment and choice of antibiotics. We reviewed the records of 102 patients admitted for community-onset pneumonia, before and after the implementation of a revised risk assessment programme for MDR organisms using the drug resistance in pneumonia (DRIP) score. The primary aim of the study was to identify the effects of this intervention on antibiotic days of therapy (DOT), and secondary outcomes included all-cause readmissions and time to clinical improvement. Statistical analysis was performed using generalized linear regression and Cox hazards models. Implementation of the programme resulted in a decrease in anti-MRSA (-1.44 DOT, P = 0.007) and anti-pseudomonal (-2.03 DOT, P < 0.001) antibiotic utilization, but was not associated with a significant difference in the odds of readmissions (OR 0.64, 95% CI 0.16-2.57) or in time to clinical improvement (HR 1.19, 95% CI 0.62-2.21). An individualized MDR organism risk assessment strategy using a clinical prediction score for community-onset pneumonia can decrease the utilization of broad-spectrum antibiotics without an increase in adverse outcomes.

Hand-held X-ray device: A review

This is an era of digital revolution where the world is shifting from analogue to digital electronics. This revolution has led to the invention miniaturization of devices and one such invention is hand-held X-ray devices. With the introduction of new technology in dental radiology, there is a need to change or update old guidelines that many states use to regulate the use of ionizing radiation. Currently, there are voluntary guidelines promulgated by the NCRP for dental radiation protection. Many states use the Conference of Radiation Control Program Directors Suggested State Regulations for the Control of Radiation to regulate the use of X-ray equipment. Hand-held portable X-ray devices are increasingly used for intraoral radiography. This development introduced new challenges to operator and patient safety, for which new or revised risk assessments must be made and acted upon prior to use.

Updated peer review of the pesticide risk assessment of the active substance flurtamone.

The conclusions of EFSA following the peer review of the initial risk assessments and the peer review of the revised risk assessments carried out by the competent authorities of the rapporteur Member State, the Czech Republic, and co‐rapporteur Member State, Ireland, for the pesticide active substance flurtamone are reported. The context of the peer review and the updated peer review was that required by Commission Implementing Regulation (EU) No 844/2012. The conclusions were reached on the basis of the evaluation of the representative uses of flurtamone as a herbicide on spring cereals (barley, wheat) and winter cereals (barley, oat, rye, triticale, wheat, spelt). The reliable end points, appropriate for use in regulatory risk assessment are presented. Missing information identified as being required by the regulatory framework is listed. Concerns are identified.

Predictive Validity of the HKT-R Risk Assessment Tool: Two and 5-Year Violent Recidivism in a Nationwide Sample of Dutch Forensic Psychiatric Patients.

This study has examined the predictive validity of the Historical Clinical Future [Historisch Klinisch Toekomst] Revised risk assessment scheme in a cohort of 347 forensic psychiatric patients, which were discharged between 2004 and 2008 from any of 12 highly secure forensic centers in the Netherlands. Predictive validity was measured 2 and 5 years after release. Official reconviction data obtained from the Dutch Ministry of Security and Justice were used as outcome measures. Violent reoffending within 2 and 5 years after discharge was assessed. With regard to violent reoffending, results indicated that the predictive validity of the Historical domain was modest for 2 (area under the curve [AUC] = .75) and 5 (AUC = .74) years. The predictive validity of the Clinical domain was marginal for 2 (admission: AUC = .62; discharge: AUC = .63) and 5 (admission: AUC = .69; discharge: AUC = .62) years after release. The predictive validity of the Future domain was modest (AUC = .71) for 2 years and low for 5 (AUC = .58) years. The total score of the instrument was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .68) years. Finally, the Final Risk Judgment was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .63) years time at risk. It is concluded that this risk assessment instrument appears to be a satisfactory instrument for risk assessment.

Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study.

BackgroundA need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes.MethodsA total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning), changing (action), and refreezing (results) were carried out. During each cycle, focus group interviews, field observations of the care staff’s practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results.ResultsThe following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the revised risk assessment method, the timely and appropriate use of PU prevention materials, the empowering of staff to improve the quality of PU care, and improved home management.ConclusionThrough the action research approach, the care staff were empowered and their PU prevention care practices had improved, which contributed to the decreased incidence of pressure ulcers. A PU prevention protocol that was accepted by the staff was finally developed as the standard of care for such homes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0361-8) contains supplementary material, which is available to authorized users.

Justification and good practice in using handheld portable dental X-ray equipment: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR).

Handheld portable X-ray devices are increasingly used for intraoral radiography. This development introduces new challenges to staff and patient safety, for which new or revised risk assessments must be made and acted upon prior to use. Major issues might be: difficulties in using rectangular collimation with beam aiming devices, more complex matching of exposure settings to the X-ray receptor used (e.g. longer exposure times), movements owing to the units' weight, protection of the operator and third persons, and the use in uncontrolled environments. These problems may result in violation of the "as low as reasonably achievable'', that is, ALARA principle by an increase in (re)exposures compared with the other available intraoral X-ray devices. Hence, the use of handheld portable X-ray devices should be considered only after careful and documented evaluation (which might be performed based on medical physics support), when there is evidence that handheld operation has benefits over traditional modalities and when no new risks to the operators and/or third parties are caused. It is expected that the use of handheld portable X-ray devices will be very exceptional, and for justified situations only. Special attention should be drawn to beam-aiming devices, rectangular collimation, the section of the X-ray receptor, focus-skin distance, and backscatter shielding, and that the unit delivers reproducible dose over the full set of environmental conditions (e.g. battery status and temperature).

The management of work-related asthma guidelines: a broader perspective.

The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden. Several hundred occupational agents, mainly allergens but also irritants and substances with unknown pathological mechanisms, have been identified as causing work-related asthma. The essential message of these guidelines is that the management of work-related asthma can be considerably optimised based on the present knowledge of causes, risk factors, pathomechanisms, and realistic and effective interventions. To reach this goal we urgently require greatly intensified primary preventive measures and improved case management. There is now a substantial body of evidence supporting the implementation of comprehensive medical surveillance programmes for workers at risk. Those workers who fail surveillance programmes need to be referred to a clinician who can confirm or exclude an occupational cause. Once work-related asthma is confirmed, a revised risk assessment in the workplace is needed to prevent further cases. These new guidelines confirm and extend already existing statements and recommendations. We hope that these guidelines will initiate the much-needed research that is required to fill the gaps in our knowledge and to initiate substantial improvements in preventative measures.

Toxicological risks to humans of toxaphene residues in fish

A revised risk assessment for toxaphene was developed, based on the assumption that fish consumers are only exposed to toxaphene residues that differ substantially from technical toxaphene due to environmental degradation and metabolism. In vitro studies confirmed that both technical toxaphene and degraded toxaphene inhibit gap junctional intercellular communication that correlates with the mechanistic potential to cause tumor promotion. In vivo rat studies established the NOAEL for degraded and technical toxaphene at the highest dose tested in the bioassay. Toxaphene residue intakes from European fishery products were estimated and compared to the provisional tolerable daily intakes (TDIs) from various regulatory agencies including Canada, the United States, and Germany. The estimated intake was also compared to a new calculated provisional MATT pTDI. The MATT pTDI is based on new toxicological information (in vivo rat studies) developed on a model for environmental toxaphene residues rather than technical toxaphene. A MATT pTDI (1.08 mg total toxaphene for a person of 60 kg) for tumor promotion potency was adopted for use in Europe and is referred to here as the MATT pTDI. These new data result in a better estimate of safety and a higher TDI than previously used. Based on realistic fish consumption data and recent baseline concentration data of toxaphene in European fishery products, the toxaphene intake for the consumers of Germany, Ireland, Norway, and the Netherlands was estimated. For an average adult fish consumer, the average daily intake of toxaphene was estimated to be 1.2, 0.4, 0.5, and 0.2 µg for the consumers of Norway, Germany, Ireland, and the Netherlands, respectively. The toxaphene intake of these average fish consumers was far below the MATT pTDI of 1.08 mg/60 kg bw. In conclusion, based on the most relevant toxicological studies and the most realistic estimates of fish consumption and recent concentrations of toxaphene in European fishery products, adverse health effects are unlikely for the average European consumer of fishery products. In no case is the MATT pTDI exceeded.

Alien invasive plants in China: risk assessment and spatial patterns

With a wide range of habitats and exploding development of international trade, China is facing escalating risk of the plant invasion. Research on the risk assessment of alien invasive plants may help us manage the invasive with priority, and is imperatively needed in China. However, until now, few studies have been conducted for the risk of alien invasive plants and its spatial patterns in China, especially with a regard to ecosystem conservation and biodiversity protection. In this paper, we assessed the risk of invasive plants and its spatial patterns. We focused on the following basic questions: Which alien invasive plants are the most noxious, and which of them are mild? How are the spatial patterns of alien invasive plants at different risk ranks? In the present study, the risk of 100 major alien invasive plants in China was assessed based on a revised risk assessment system and an extensive consult with literatures. The results indicated that there were 18 species of rank 1st, 29 of rank 2nd, 33 of rank 3rd and 20 of rank 4th. Although, there was high richness of alien invasive plants in South China, most of them were of low risk. By contrast, low richness of alien invasive plants was observed in North China and the regions in high altitude, but most of the invasive were of high risk. Compared with previous studies, our study appears to have delivered credible results and may play an early warning function, and also further our understanding of the risk of invasive plants and its spatial patterns in China, though we acknowledged that the risk assessment may have some potential weakness, and appealed timely and further investigations in future.

Guidance for the assessment of risks to bees from the use of plant protection products under the framework of Council Directive 91/414 and Regulation 1107/2009

About 15 years have passed since the implementation of Directive 91/414/EEC and the regulatory framework with regard to pesticide use and environmental protection aims, as well as the plant protection techniques involving pesticides, have evolved over this period. In the case of honey bees, further developments and updates with regards to larval testing have been undertaken. Experimental protocols for semi‐field and field testing have been reviewed in detail. Finally, a dedicated risk assessment scheme has been developed for seed coating and soil applications that involve systemic compounds. A revision of the original EPPO Standards: the Risk Assessment Scheme PP 3/10(2) Honeybees and the test guidelines PP1/170 (3) Side‐effects on honeybees has thus been undertaken in order to benefit from these improvements. This paper aims to provide the details of the reasoning on which the revised risk assessment scheme relies as well as providing the necessary references to the data which have been reviewed in the context of this revision.

Plastics, the environment and human health: current consensus and future trends

Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the entire century that preceded.

Quantitative risk assessment for Listeria monocytogenes in selected categories of deli meats: impact of lactate and diacetate on listeriosis cases and deaths.

Foodborne disease associated with consumption of ready-to-eat foods contaminated with Listeria monocytogenes represents a considerable pubic health concern. In a risk assessment published in 2003, the U.S. Food and Drug Administration and the U.S. Food Safety and Inspection Service estimated that about 90% of human listeriosis cases in the United States are caused by consumption of contaminated deli meats. In this risk assessment, all deli meats were grouped into one of 23 categories of ready-to-eat foods, and only the postretail growth of L. monocytogenes was considered. To provide an improved risk assessment for L. monocytogenes in deli meats, we developed a revised risk assessment that (i) models risk for three subcategories of deli meats (i.e., ham, turkey, and roast beef) and (ii) models L. monocytogenes contamination and growth from production to consumption while considering subcategory-specific growth kinetics parameters (i.e., lag phase and exponential growth rate). This model also was used to assess how reformulation of the chosen deli meat subcategories with L. monocytogenes growth inhibitors (i.e., lactate and diacetate) would impact the number of human listeriosis cases. Use of product-specific growth parameters demonstrated how certain deli meat categories differ in the relative risk of causing listeriosis; products that support more rapid growth and have reduced lag phases (e.g., turkey) represent a higher risk. Although reformulation of deli meats with growth inhibitors was estimated to reduce by about 2.5- to 7.8-fold the number of human listeriosis cases linked to a given deli meat subcategory and thus would reduce the overall risk of human listeriosis, even with reformulation deli meats would still cause a considerable number of human listeriosis cases. A combination of strategies is thus needed to provide continued reduction of these cases. Risk assessment models such as that described here will be critical for evaluation of different control approaches and to help define the combinations of control strategies that will have the greatest impact on public health.

Longitudinal trends in organophosphate incidents reported to the National Pesticide Information Center, 1995–2007

BackgroundRegulatory decisions to phase-out the availability and use of common organophosphate pesticides among the general public were announced in 2000 and continued through 2004. Based on revised risk assessments, chlorpyrifos and diazinon were determined to pose unacceptable risks. To determine the impact of these decisions, organophosphate (OP) exposure incidents reported to the National Pesticide Information Center (NPIC) were analyzed for longitudinal trends.MethodsNon-occupational human exposure incidents reported to NPIC were grouped into pre- (1995–2000) and post-announcement periods (2001–2007). The number of total OP exposure incidents, as well as reports for chlorpyrifos, diazinon and malathion, were analyzed for significant differences between these two periods. The number of informational inquiries from the general public was analyzed over time as well.ResultsThe number of average annual OP-related exposure incidents reported to NPIC decreased significantly between the pre- and post-announcement periods (p < 0.001). A significant decrease in the number of chlorpyrifos and diazinon reports was observed over time (p < 0.001). No significant difference in the number of incident reports for malathion was observed (p = 0.4), which was not phased-out of residential use. Similar to exposure incidents, the number of informational inquiries received by NPIC declined over time following the phase-out announcement.ConclusionConsistent with other findings, the number of chlorpyrifos and diazinon exposure incidents reported to NPIC significantly decreased following public announcement and targeted regulatory action.

The Incremental Benefits of a Forensic Accounting Course on Skepticism and Fraud-Related Judgments

ABSTRACT: This study examines the extent to which providing a course that emphasizes forensic accounting influences students’ fraud-related judgments. We follow a cohort of students (trained students) who have enrolled in a forensic accounting course and examine their fraud judgments at various points in time—the first day of instruction, the last day of instruction, and seven months later. We compare these fraud judgments to a control group of students who have completed a typical two-course audit sequence (untrained students) and to a panel of fraud experts. We find that when confronted with a bad debt expense account that is unusually small, trained students provide significantly higher initial risk assessments post-training (1) than they did pre-training and (2) than did the untrained students. In addition, after being presented with a set of potential fraud-risk factors, trained students provided higher revised risk assessments post-training than they did pre-training, and importantly, not significantly different from a panel of experts. Using risk assessments as an indication of skepticism, we infer that the forensic accounting course raised the students’ level of skepticism. We also find, in general, that post-training students assigned higher relevancy ratings to fraud-risk factors than did a panel of experts, while the untrained students ascribed significantly less relevance than the experts did to these same facts. Finally, we find seven months after the course that the trained students’ performance is sustained, suggesting that the effects produced by taking a fraud-specific forensic accounting course persist.