Who goes to prison for breaching an Apprehended Domestic Violence Order? An analysis of police narratives

Aim: To identify the situational and offender characteristics associated with prison sentences for Apprehended Domestic Violence Order (ADVO) breaches. Method: Case narratives from police incident reports of ADVO breach incidents in NSW were analysed. Two samples were examined: (1) breach incidents where the offender involved was imprisoned (n=250) and (2) breach incidents where the offender involved received a non-custodial sentence (n=250). The nature of the breach and the characteristics of persons involved in these two breach samples were compared using descriptive data and logistic regression models. Results: The majority of ADVO breaches in both samples involved male to female offending in spousal/ex-spousal relationships, occurred in the victim’s house and involved face-to-face contact. Compared with offenders in the non-prison group, a higher proportion of offenders who received a custodial penalty for the breach ADVO matter were male, Indigenous, had 5 or more prior court appearances (including prior offences for domestic violence (DV), assault and breach ADVO), had 3 or more prior prison penalties and had breached two or more conditions of their order. Breaches resulting in prison also had a higher proportion of matters involving physical assault, property damage, psychological aggression and parties who had a history of violence. After controlling for other factors, the following factors were independently associated with imprisonment for ADVO; the offender’s gender, prior imprisonment, prior proven DV offence, history of violence, involvement of physical assault in the breach, victim/offender relationship and residing with the victim. Conclusion: The profile of offenders who receive imprisonment for a breach ADVO offence is significantly different from those who receive a non-custodial penalty for these offences. The nature of the breach and the circumstances surrounding the event also vary for matters where prison is imposed for an ADVO breach

Risk assessment of violence in offenders with learning disability

Methods to predict dangerousness (recidivism and institutional violence) in mentally disordered offenders are well established in the research literature. In stark contrast there have been fewer developments in the prediction of violence in offenders with learning disabilities (LD), a subgroup of mentally disordered offenders. Chapter 1 reviewed the prevalence of offending and recidivism in offenders with LD and concluded that risk assessment of violence was an area that required further research. The literature regarding the risk factors for offending in this population illustrated that it was unclear if the risk factors for offending are qualitatively different to other mentally disordered offenders without LD. This was tested in Chapter 2 and it was found that the factors related to offending in offenders with LD were not different to other mentally disordered offenders. This provided evidence for the criterion validity of 'best practice' risk assessment instruments, the VRAG, the PCL-R and the HCR- 20, already validated in mentally disordered offenders (the predictive efficacy of these instruments was also reviewed in Chapter 1). Chapter 3 and 4 tested the predictive efficacy of the VRAG, the PCL-R (and its variants) and the HCR-20 in offenders with LD by evaluating the ability of the risk assessment instruments to predict long-term re-convictions (Chapter 3) and institutional violence (Chapter 4) in offenders with LD in comparison to a control group of other mentally disordered offenders. It was found that the VRAG, the PCL- R (and its variants) and the HCR-20 have comparable or superior predictive efficacy in offenders with LD. Chapter 5 served to complement these findings with the development of a screening tool for risk of violence in offenders with LD. The research contained in this thesis has extended the evidence base on risk assessment in offenders with LD and should hopefully serve to improve evidence based practice and service provision in forensic services for people with LD.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Risk assessment of violence in offenders with learning disability

Methods to predict dangerousness (recidivism and institutional violence) in mentally disordered offenders are well established in the research literature. In stark contrast there have been fewer developments in the prediction of violence in offenders with learning disabilities (LD), a subgroup of mentally disordered offenders. Chapter 1 reviewed the prevalence of offending and recidivism in offenders with LD and concluded that risk assessment of violence was an area that required further research. The literature regarding the risk factors for offending in this population illustrated that it was unclear if the risk factors for offending are qualitatively different to other mentally disordered offenders without LD. This was tested in Chapter 2 and it was found that the factors related to offending in offenders with LD were not different to other mentally disordered offenders. This provided evidence for the criterion validity of 'best practice' risk assessment instruments, the VRAG, the PCL-R and the HCR- 20, already validated in mentally disordered offenders (the predictive efficacy of these instruments was also reviewed in Chapter 1). Chapter 3 and 4 tested the predictive efficacy of the VRAG, the PCL-R (and its variants) and the HCR-20 in offenders with LD by evaluating the ability of the risk assessment instruments to predict long-term re-convictions (Chapter 3) and institutional violence (Chapter 4) in offenders with LD in comparison to a control group of other mentally disordered offenders. It was found that the VRAG, the PCL- R (and its variants) and the HCR-20 have comparable or superior predictive efficacy in offenders with LD. Chapter 5 served to complement these findings with the development of a screening tool for risk of violence in offenders with LD. The research contained in this thesis has extended the evidence base on risk assessment in offenders with LD and should hopefully serve to improve evidence based practice and service provision in forensic services for people with LD

Evaluation of the 'Risk Assessment Protocol for Intellectual Disabilites' in community services for adults with a learning disability

Review of the research literature on the prevalence of physical aggression in community teams for adults with a learning disability (CLDTs) suggests that services are managing people who are physically aggressive, which impacts on services. This suggests that there is a need for services to use risk assessment instruments of physical aggression to support teams to accurately identify those who will be physically aggressive to others. Established risk assessment instruments are resource intensive and so a screen, such as The Risk Assessment Protocol for Intellectual Disabilities (RAPID), developed in forensic psychiatric patients with a learning disability (LD), could support services to target their limited resources. The predictive validity of the RAPID to predict physical aggression, property aggression and verbal aggression, in a community sample of adults with a LD was evaluated. The RAPID was compared to an established risk assessment instrument, the VRAG, in order to assess its concurrent validity. The predictive validity of the items of the RAPID were analysed to provide a measure of construct validity. The RAPID was also compared to a Risk Rating made by staff, to assess incremental validity. In addition, the ability of the RAPID to be easily and reliably scored was evaluated. The RAPID predicted incidents of physical aggression with a large effect size. The RAPID was highly correlated with the VRAG, which suggests that it has good concurrent validity. Some of the items of the RAPID predicted physical aggression, which suggests some construct validity. It was not possible to establish that the RAPID has incremental validity above the VRAG or the Risk Rating. The RAPID was found to have good inter-rater reliability. The findings of the study suggest that the RAPID could be used to support CLDTs to make informed decisions about the completion of risk assessment instruments, risk management plans and interventions that aim to reduce the risk of physical aggression

A study protocol of a randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) for frail older medical patients in the acute setting

Background: Older adults experience functional decline in hospital leading to increased healthcare burden and morbidity. The benefits of augmented exercise in hospital remain uncertain. The aim of this trial is to measure the short and longer-term effects of augmented exercise for older medical in-patients on their physical performance, quality of life and health care utilisation. Design and Methods: Two hundred and twenty older medical patients will be blindly randomly allocated to the intervention or sham groups. Both groups will receive usual care (including routine physiotherapy care) augmented by two daily exercise sessions. The sham group will receive stretching and relaxation exercises while the intervention group will receive tailored strengthening and balance exercises. Differences between groups will be measured at baseline, discharge, and three months. The primary outcome measure will be length of stay. The secondary outcome measures will be healthcare utilisation, activity (accelerometry), physical performance (Short Physical Performance Battery), falls history in hospital and quality of life (EQ-5D-5 L). Discussion: This simple intervention has the potential to transform the outcomes of the older patient in the acute setting

OVPR Initiatives

http://deepblue.lib.umich.edu/bitstream/2027.42/61283/1/S_and_D-Fall_2006.pd

The Microenvironment of Visceral Adipose Tissue and Liver Alter Natural Killer Cell Viability and Function

The role of NK cells in visceral adipose tissue (VAT) and liver inflammation in obesity is not fully understood. This study investigated the frequency, cytokine expression, chemokine receptor, and cytotoxicity receptor profile of NK cells in the blood, omentum, and liver of patients with the obesity-associated cancer, oesophageal adenocarcinoma (OAC). The effect of chronically inflamed tissue microenvironments on NK cell viability and function was also examined. We identified significantly lower NK cell frequencies in the liver of OAC patients compared with healthy controls and within the omentum and liver of OAC patients compared with blood, whereas IL-10-producing populations were significantly higher. Interestingly, our data suggest that reduced frequencies of NK cells in omentum and liver of OAC patients are not a result of impaired NK cell chemotaxis to these tissues. In fact, our functional data revealed that secreted factors from omentum and liver of OAC patients induce significant levels of NK cell death and lead to reduced percentages of TNF-α+ and NKP46+ NK cells and higher frequencies of IL-10-producing NK cells. Together, these data suggest that the omental and hepatic microenvironments of OAC patients alter the NK cell phenotype to a more anti-inflammatory homeostatic role