500 research outputs found
The use of risk and need factors in forensic mental health decision-making and the role of gender and index offense severity
Canadian legislation makes Review Boards (RBs) responsible for rendering dispositions for individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) after considering public safety, the mental condition of the accused, and his/her potential for community reintegration. We reviewed 6,743 RB hearings for 1,794 individuals found NCRMD in the three largest Canadian provinces to investigate whether items from two empirically supported risk assessment measures, the Historical Clinical Risk Managementâ20 and the Violence Risk Appraisal Guide, were considered. Less than half the items were included in expert reports or in RBs' reasons for dispositions, and consideration of these items differed according to gender and index offense severity of the accused. These items included evidenceâbased risk factors and/or legally specified criteria: mental health, treatment, and criminal history. These results illustrate the gap between research on risk factors and the integration of this evidence into practice. In particular, we recommend the implementation of structured measures to reduce the potential for clinicians to be unduly influenced by gender and offense severity
Factors associated with review board dispositions following re-hospitalization among discharged persons found not criminally responsible
In the Canadian forensic mental health system, a person found Not Criminally Responsible on
account of Mental Disorder (NCRMD) and given a conditional discharge returns to the
community while remaining under the jurisdiction of a provincial/territorial Review Board.
However, the individual can be re-hospitalized while on conditional discharge, for reasons such
as substance use, violation of conditions, or violence. We investigated whether being rehospitalized has an impact on the factors associated with the subsequent Review Board
disposition. Persons found NCRMD from the three largest Canadian provinces who were
conditionally discharged at least once during the observation period were included in the sample
(N=1,367). These individuals were involved in 2,920 disposition hearings; nearly one-third of
patients (30%) were re-hospitalized after having been conditionally discharged by the Review
Board. The factors examined included the scales of the Historical Clinical Risk Management-20
and salient behavior that occurred since the previous hearing, such as substance use or
violence. The greater presence of clinical items resulted in a greater likelihood of a hospital
detention decision at the next hearing. The effect was larger for the re-hospitalized group than
for the group who successfully remained in the community since the last hearing. The results
suggest that dynamic factors, specifically indicators of mental health, are heavily weighted by
the Review Boards, consistent with the literature on imminent risk and in line with the NCRMD
legislation
The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 1 : context and methods
The National Trajectory Project examined longitudinal data from a large sample of people found not criminally responsible on account of mental disorder (NCRMD) to assess the presence of provincial differences in the application of the law, to examine the characteristics of people with serious mental illness who come into conflict with the law and receive this verdict, and to investigate the trajectories of NCRMDâaccused people as they traverse the mental health and criminal justice systems. Our paper describes the rationale for the National Trajectory Project and the methods used to collect data in Quebec, Ontario, and British Columbia, the 3 most populous provinces in Canada and the 3 provinces with the most people found NCRMD.Les membres du Projet national des trajectoires ont examinĂ© les donnĂ©es longitudinales dâun
vaste échantillon de personnes déclarées non criminellement responsables pour cause de
troubles mentaux (NCRTM) afin dâĂ©valuer la prĂ©sence de diffĂ©rences provinciales en matiĂšre
dâapplication de la loi, dâĂ©tudier les caractĂ©ristiques de personnes ayant une maladie mentale
grave qui, ayant des dĂ©mĂȘlĂ©s avec la justice, sont dĂ©clarĂ©es non criminellement responsables,
et dâexaminer les trajectoires des accusĂ©s NCRTM Ă travers les systĂšmes de santĂ© mentale et
de justice pĂ©nale. Le prĂ©sent document dĂ©crit la raison dâĂȘtre du Projet national des trajectoires
et les mĂ©thodes utilisĂ©es pour recueillir des donnĂ©es au QuĂ©bec, en Ontario et en ColombieBritannique, les 3 provinces les plus populeuses du Canada et celles oĂč se trouve la majoritĂ©
des personnes déclarées NCRTM
The National Trajectory Project of individuals found not criminally responsible on account of mental disorder in Canada. Part 3 : trajectories and outcomes through the forensic system
Objective : To examine the processing and Review Board (RB) disposition outcomes of people found not criminally responsible on account of mental disorder (NCRMD) across the 3 most populous provinces in Canada. Although the Criminal Code is federally legislated, criminal justice is administered by provinces and territories. It follows that a person with mental illness who comes into conflict with the law and subsequently comes under the management of a legally mandated RB may experience different trajectories across jurisdictions.
Method : The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 and April 2005, followed until December 2008.
Results : We found significant interprovincial differences in the trajectories of people found NCRMD, including time detained in hospital and time under the supervision of an RB. The odds of being conditionally or absolutely discharged by the RB varied across provinces, even after number of past offences, diagnosis at verdict, and most severe index offence (all covariates decreased likelihood of discharge) were considered.
Conclusions : Considerable discrepancies in the application of NCRMD legislation and the processing of NCRMD cases through the forensic system across the provinces suggests that fair and equitable treatment under the law could be enhanced by increased national integration and collaboration.Objectif : Examiner les rĂ©sultats du processus et des dispositions de la Commission d'examen (CE) pour les personnes dĂ©clarĂ©es non criminellement responsables pour cause de troubles mentaux (NCRTM) dans les 3 provinces les plus populeuses du Canada. Le Code criminel relĂšve de la compĂ©tence du gouvernement fĂ©dĂ©ral, mais la justice pĂ©nale est administrĂ©e par les provinces et territoires. Il s'ensuit qu'une personne ayant un trouble mental qui a des dĂ©mĂȘlĂ©s avec la justice et qui est subsĂ©quemment placĂ©e sous la supervision d'une CE peut connaĂźtre diffĂ©rentes trajectoires dans diffĂ©rentes juridictions ou rĂ©gions ou provinces.
Méthode : Le Projet national des trajectoires a permis d'examiner 1800 hommes et femmes déclarés NCRTM en Colombie-Britannique (n = 222), au Québec (n = 1094) et en Ontario (n = 484) de mai 2000 à avril 2005, et de les suivre jusqu'en décembre 2008.
RĂ©sultats : Nous avons constatĂ© des diffĂ©rences interprovinciales significatives dans les trajectoires des personnes dĂ©clarĂ©es NCRTM, notamment le temps de dĂ©tention dans un hĂŽpital et le temps sous la supervision d'une CE. Les probabilitĂ©s d'une libĂ©ration conditionnelle ou absolue accordĂ©e par la CE variaient entre les provinces, mĂȘme aprĂšs examen du nombre d'infractions passĂ©es, du diagnostic au verdict, et des infractions rĂ©pertoriĂ©es les plus graves (toutes les covariables rĂ©duisaient la probabilitĂ© d'une libĂ©ration).
Conclusions : Les Ă©carts considĂ©rables dans l'application de la lĂ©gislation NCRTM et dans le traitement des cas NCRTM au sein du systĂšme psycho-olĂ©gal entre les provinces suggĂšrent qu'un traitement juste et Ă©quitable en vertu de la loi pourrait ĂȘtre amĂ©liorĂ© par une plus grande intĂ©gration et collaboration nationale
The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 4 : criminal recidivism.
OBJECTIVE:
To examine criminal recidivism rates of a large sample of people found not criminally responsible on account of mental disorder (NCRMD) in Canada's 3 most populous provinces, British Columbia, Ontario, and Quebec. Public concern about the dangerousness of people found NCRMD has been fed by media attention on high-profile cases. However, little research is available on the rate of reoffending among people found NCRMD across Canadian provinces.
METHOD:
Using data from the National Trajectory Project, this study examined 1800 men and women in British Columbia (n = 222), Ontario (n = 484), and Quebec (n = 1094) who were found NCRMD between May 2000 and April 2005 and followed until December 2008.
RESULTS:
Recidivism was relatively low after 3 years (17%). There were interprovincial differences after controlling for number of prior criminal offences, diagnosis, seriousness of the index offence, and supervision by the review boards. British Columbia (10%) and Ontario (9%) were similar, whereas Quebec had almost twice the recidivism (22%). People who had committed severe violent index offences were less likely to reoffend than those who had committed less severe offences. People from the sample were less likely to reoffend when under the purview of review boards, across all 3 provinces.
CONCLUSION:
The results of this study, along with other research on processing differences, suggest systemic differences in the trajectories and outcomes of persons found NCRMD need to be better understood to guide national policies and practice
The National Trajectory Project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2 : the people behind the label
Objective : To examine the psychosocio-criminological characteristics of not criminally responsible on account of mental disorder (NCRMD)âaccused people and compare them across the 3 most populous provinces. In Canada, the number of people found NCRMD has risen during the past 20 years. The Criminal Code is federally legislated but provincially administered, and mental health services are provincially governed. Our study offers a rare opportunity to observe the characteristics and trajectories of NCRMDâaccused people.
Method : The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 to April 2005, followed until December 2008.
Results : The most common primary diagnosis was a psychotic spectrum disorder. One-third of NCRMDâaccused people had a severe mental illness and a concomitant substance use disorder, with British Columbia having the highest rate of dually diagnosed NCRMDâaccused people. Most accused people (72.4%) had at least 1 prior psychiatric hospitalization. Two-thirds of index NCRMD offences were against the person, with a wide range of severity. Family members, followed by professionals, such as police and mental health care workers, were the most frequent victims. Quebec had the highest proportion of people with a mood disorder and the lowest median offence severity. There were both interprovincial differences and similarities in the characteristics of NCRMD-accused people.
Conclusions : Contrary to public perception, severe violent offenses such as murder, attempted murder or sexual offences represent a small proportion of all NCRMD verdict offences. The results reveal a heterogeneous population regarding mental health and criminological characteristics in need of hierarchically organized forensic mental health services and levels of security. NCRMDâaccused people were well known to civil psychiatric services prior to being found NCRMD. Risk assessment training and interventions to reduce violence and criminality should be a priority in civil mental health services.Objectif : Examiner les caractĂ©ristiques psychologiques, sociales et criminologiques des accusĂ©s dĂ©clarĂ©s non criminellement responsables pour cause de troubles mentaux (NCRTM) et les comparer dans les 3 provinces les plus peuplĂ©es. Au Canada, le nombre de personnes dĂ©clarĂ©es NCRTM a augmentĂ© ces 20 derniĂšres annĂ©es. Le Code criminel relĂšve de la compĂ©tence du gouvernement fĂ©dĂ©ral mais son application relĂšve des provinces, et les services de santĂ© mentale sont rĂ©gis par les provinces. Cette Ă©tude offre l'occasion unique d'observer les caractĂ©ristiques et la trajectoire des accusĂ©s NCRTM.
Méthode : Le Projet national des trajectoires a permis d'examiner 1800 hommes et femmes déclarés NCRTM en Colombie-Britannique (n = 222), au Québec (n = 1094) et en Ontario (n = 484) de mai 2000 à avril 2005, et de les suivre jusqu'en décembre 2008.
Résultats : Le diagnostic principal le plus courant était un trouble du spectre de la psychose. Un tiers des accusés NCRTM souffraient d'une maladie mentale grave et d'un trouble concomitant lié à l'utilisation de substances, la Colombie-Britannique ayant le taux le plus élevé d'accusés NCRTM ayant ces troubles concommitants. La plupart des accusés (72,4%) avaient déjà été hospitalisés au moins une fois dans un établissement psychiatrique. Les deux tiers des infractions répertoriées des accusés NCRTM étaient des infractions contre la personne, de niveaux de gravité variables. Les membres de la famille, puis des intervenants comme les agents de police et les travailleurs de la santé mentale, étaient les victimes les plus fréquentes. C'est au Québec que la proportion de personnes souffrant d'un trouble de l'humeur était la plus élevée et que la gravité médiane des infractions était la plus basse. Les caractéristiques des accusés NCRTM entre les provinces présentent à la fois des différences et des similarités.
Conclusions : Contrairement Ă la perception publique, les infractions graves avec violence comme le meurtre, les tentatives de meurtre ou les agressions sexuelles reprĂ©sentent une faible proportion de tous les verdicts NCRTM. Les rĂ©sultats rĂ©vĂšlent une population hĂ©tĂ©rogĂšne en termes de santĂ© mentale et de caractĂ©ristiques criminologiques ayant besoin de services hiĂ©rarchisĂ©s et des niveaux de sĂ©curitĂ©s variables. Les personnes dĂ©clarĂ©es NCRTM Ă©taient bien connues des services de psychiatrie gĂ©nĂ©rale avant d'ĂȘtre trouvĂ©es NCRTM. La formation et les interventions en Ă©valuation du risque, afin de rĂ©duire la violence et la criminalitĂ©, devraient ĂȘtre une prioritĂ© dans les services de santĂ© mentale civils
The National Trajectory Project of individuals found not criminally responsible on account of mental disorder. Part 5 : how essential are gender-specific forensic psychiatric services?
Objective : To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men's and women's treatment and management needs are different.
Method : Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men.
Results : There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men.
Conclusions : Not criminally responsible on account of mental disorder-accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services.Objectif : Ătablir les caractĂ©ristiques sociodĂ©mographiques, les antĂ©cĂ©dents de santĂ© mentale, les caractĂ©ristiques de l'infraction rĂ©pertoriĂ©e, et les antĂ©cĂ©dents criminels des patients masculins et fĂ©minins de psychiatrie lĂ©gale. Cliniciens et chercheurs revendiquent que les organisations de santĂ© mentale et de justice pĂ©nale offrent des services sexospĂ©cifiques; toutefois, peu d'Ă©tudes ont Ă©valuĂ© Ă quel point les besoins de traitement et de prise en charge des hommes et des femmes sont diffĂ©rents dans des Ă©chantillons de patients mĂ©dicolĂ©gaux.
Méthode : Les données ont été recueillies dans les dossiers de la CE, de mai 2000 à avril 2005, dans les 3 provinces les plus populeuses. Au moyen des casiers judiciaires officiels, les participants ont été suivis de 3 à 8 ans, jusqu'en décembre 2008. L'échantillon final comptait 1800 personnes dont 15,6% étaient des femmes et 84,4%, des hommes.
Résultats : Il y avait peu de différences démograhiques, mais les femmes avaient un fonctionnement psychosocial plus élevé que celui des hommes. Les hommes comme les femmes avaient de longs antécédents de santé mentale, les femmes étant plus susceptibles de recevoir un diagnostic de trouble de l'humeur ou de la personnalité et les hommes, un diagnostic du spectre de la schizophrénie ou d'un trouble lié aux substances. La nature de l'infraction répertoriée ne différait pas selon le sexe, sauf que les femmes étaient plus susceptibles d'avoir commis un meurtre ou une tentative de meurtre. Pour les infractions contre la personne, les femmes étaient plus susceptibles de s'en prendre à leurs enfants et leurs partenaires et moins à des étrangers, comparées aux hommes. Elles avaient des antécédents criminels significativement moins lourds que les hommes.
Conclusions : Les femmes NCRTM ont un profil psychosocial, clinique et criminologique distinct de celui des hommes, suggérant ainsi qu'une évaluation, une gestion de risque et un traitement sexospécifiques dans les services psycho-légaux pourraient bénéficier aux patients. Les résultats sont aussi conformes aux modÚles traditionnels (risque-besoin-réceptivité) et démontrent finalement l'importance de l'évaluation individuelle et des services axés sur le client
Identification of dichloroacetic acid degrading Cupriavidus bacteria in a drinking water distribution network model
Aims: Bacterial community structure and composition of a drinking water
network were assessed to better understand this ecosystem in relation to
haloacetic acid (HAA) degradation and to identify new bacterial species having
HAA degradation capacities.
Methods and Results: Biofilm samples were collected from a model system,
simulating the end of the drinking water distribution network and supplied
with different concentrations of dichloroacetic and trichloroacetic acids at
different periods over the course of a year. The samples were analysed by
culturing, denaturing gradient gel electrophoresis (DGGE) and sequencing.
Pipe diameter and HAA ratios did not impact the bacterial community
profiles, but the season had a clear influence. Based on DGGE profiles, it
appeared that a particular biomass has developed during the summer
compared with the other seasons. Among the bacteria isolated in this study,
those from genus Cupriavidus were able to degrade dichloroacetic acid.
Moreover, these bacteria degrade dichloroacetic acid at 18°C but not at 10°C.
Conclusions: The microbial diversity evolved throughout the experiment, but
the bacterial community was distinct during the summer. Results obtained on
the capacity of Cupriavidus to degrade DCAA only at 18°C but not at 10°C
indicate that water temperature is a major element affecting DCAA
degradation and confirming observations made regarding season influence on
HAA degradation in the drinking water distribution network.
Significance and Impact of the Study: This is the first demonstration of the
HAA biodegradation capacity of the genus Cupriavidu
Strain-induced effects in colloidal quantum dots: lifetime measurements and blinking statistics
Abstract A series of samples of CdSe/Cd x Zn 1âx S core/shell quantum dots have been synthesized in order to measure the influence of lattice-mismatch-induced strain on the photoluminescence (PL) and blinking behaviour. The PL spectra show a significant variation of the fluorescence wavelength even though the colloidal quantum dots (cQDs) are similar in size. The PL excitation spectra show a gradual splitting of the first exciton level as the proportion of Zn is increased in the shell and as the shell grows. On the other hand, blinking studies clearly demonstrate a significant dependence on the amount of Zn present in the shell. Distributions of on and off times go from the usual power-law distributions to power-law distributions with exponential cut-offs. These cut-offs become increasingly pronounced as the proportion of Zn increases. We interpret these results in the framework of diffusion-controlled electron transfer. Exciton relaxation lifetime measurements strongly suggest that lattice mismatch is responsible for a greater number of defects in core/shell cQDs. Therefore, strain and lattice mismatch are shown to be parameters of significant importance for the electronic structure of nanocrystals, influencing the photoluminescence, exciton relaxation lifetime and blinking behaviour
Factors influencing the practice of new graduate nurses : a focused ethnography of acute care settings
Aim: To explore the influence of an acute care setting on competency deployment of new graduate
nurses (NGNs) from a competency
-based undergraduate programme
.
Background: In the last 15 years, nursing education has shifted to competency
-based education
(CBE). Few studies have focused on how NGNs from these reformed programmes use the
competencies they have developed. To be paradigmatically coherent with the nature of a
competence, studies should also examine how context influences nursing practice and competency
deployment.
Design: A focused ethnography of three acute care units from one academic hospital in Canada.
Methods: Purposive and snowball sampling strategies were used to recruit 19 participants: NGNs (n
= 4), nurse preceptors (n = 2), clinical nurse specialists (n = 9)
, and nurse managers (n = 4). Data were
collected through individual interviews, focus groups
, observation and documentation. Data were
analysed according to Roper and Shapiraâs (2000) ethnographic nursing analysis framework.
Results: Organizational and individual factors were identified as influencing NGNs
â competenc
y
deployment. Organizational factors are orientation, stability, workload, and the scientific culture of
the unit. Personal factors have been linked to groups of professionals: for NGNs, personality and
clinical placements during their initial education; for nurses working with NGNs, to be role models,
to promote integration and to denounce bullying; and for other health professionals, to recognize
nursing expertise.
Conclusion: One way to s
mooth the transition from academic to clinical settings for NGNs is by
offering transition or orientation programmes that will provide them with stability and a reduced
workload, allowing them to progressively deploy their competencies.
Relevance to clinical practice: Organizational and individual factors influence how new graduate
nurses deploy their competencies. Clinical educators and nurse managers can help new nurses by
acting on these factors
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