Cost-benefit analyses of developmental crime prevention programmes.

Background: Children and youth who are at risk of becoming early-onset life-course-persistent offenders often slip through the cracks of other systems in society (e.g., health, education, child welfare, substance use and mental health).

Socio-demographic and psycho-social determinants of HIV late presentation in Germany - results from the FindHIV study.

Delayed HIV diagnosis at advanced stages of disease remains common (33%-64%). This analysis of the multi-center FindHIV study including newly diagnosed HIV-infected adults in Germany, focused on the potential role of socio-demographic and psychological factors on late diagnosis (formerly "late presentation", AIDS diagnosis or CD4 cells <350/µL). These data were collected from patient profiles, physician-patient interviews and questionnaires.

High prevalence of recreational and illicit drug use in German people living with HIV with a potential for drug-drug interactions with antiretroviral therapy.

Recreational drug use is higher in people living with HIV (PLHIV) than in the general population in Europe. This use increases the risk for drug-drug interactions (DDIs) and adverse events. We assessed the prevalence and clinical consequences of substance abuse among PLHIV.

Estimating the monetary cost of risk factors for crime in boys using the EARL-20B.

This study examined the relationship between early childhood risk factors for antisocial behavior and the monetary costs associated with criminal convictions for 379 clinic-referred boys. Participants were assessed using a structured risk assessment instrument, the Early Assessment Risk List for Boys (EARL-20B), intended for use with boys aged 6-11 with conduct problems. Criminal conviction data were used to calculate costs borne by victims, the correctional system, and other areas of the criminal justice system for participants between the ages of 12 and 20.

Similar long-term efficacy of dual therapy containing raltegravir and a boosted protease inhibitor versus standard triple therapies in pretreated HIV-1-infected patients in a retrospective, real-life cohort of 14 years.

Objectives: Raltegravir is used in many antiretroviral combinations, but its use in treatment-experienced patients without knowledge of baseline resistance is discussed controversially as a number of comparative studies have shown a higher rate of virological failure. However, it has been used frequently for the management of treatment failure, as it was the first integrase inhibitor to become available, and thus offered new options for patients with multiple resistance. The strategic use of raltegravir in this setting is examined in this study.

Dolutegravir monotherapy as treatment de-escalation in HIV-infected adults with virological control: DoluMono cohort results.

Background: The potential toxicity of long-term antiretroviral therapy (ART) requires ongoing investigation of novel strategies for treatment of HIV-infected patients. Monotherapy with the integrase inhibitor (INSTI) dolutegravir (DTG) may offer a favourable safety profile. Additionally, DTG has a high barrier of resistance, crucial for successful maintenance of virological control.

A comparison of outpatients with intellectual disability receiving specialised and general services in Ontario's psychiatric hospitals.

Background: This study compares outpatients with intellectual disability (ID) receiving specialised services to outpatients with ID receiving general services in Ontario's tertiary mental healthcare system in terms of demographics, symptom profile, strengths and resources, and clinical service needs.

Methods: A secondary analysis of Colorado Client Assessment Record data collected from all tertiary psychiatric hospitals in the province was completed for a stratified random sample of 246 outpatients identified as having ID, from both specialised and general programmes.

Results: Individuals with ID in specialised programmes differed from patients with ID in general programmes with regard to demographics, diagnostic profile, symptom presentation and recommended level of care.

Clinician perceptions of childhood risk factors for future antisocial behavior.

We asked 176 mental health clinicians to list factors that place a child at risk for engaging in future antisocial behavior. Participants were randomly assigned to do this in relationship to boys and girls. Listed factors were then coded into broad item categories using the Early Assessment Risk Lists (EARL).

Treatment during primary HIV infection does not lower viral set point but improves CD4 lymphocytes in an observational cohort.

Objective: To investigate if early treatment of primary HIV-1 infection (PHI) reduces viral set point and/or increases CD4 lymphocytes.

Methods: Analysis of two prospective multi-centre PHI cohorts. HIV-1 RNA and CD4 lymphocytes in patients with transient treatment were compared to those in untreated patients.

Gender differences in psychiatric diagnoses among inpatients with and without intellectual disabilities.

There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities, women were more likely to have a diagnosis of mood disorder and sexual abuse history; men were more likely to have a substance abuse diagnosis, legal issues, and past destructive behavior.

Prevalence and profile of people with co-occurring mental and substance use disorders within a comprehensive mental health system.

Objective: To examine the prevalence and profile of people with co-occurring mental and substance use disorders in relation to numerous demographic, diagnostic, and needs-related variables across a comprehensive system of mental health services using a standard methodology.

Method: Data were collected on cases (n = 9839) sampled from specialty tertiary inpatient, specialty outpatient, and community-based mental health programs. Status with respect to co-occurring disorders was based on recorded diagnosis of substance use disorder and the substance abuse measure within the Colorado Client Assessment Record.

Evaluation of a targeted cognitive-behavioral program for children with conduct problems--the SNAP Under 12 Outreach Project: service intensity, age and gender effects on short- and long-term outcomes.

This study tested the effectiveness of a multifaceted, cognitive-behavioral therapy (CBT) program for antisocial children--the SNAP Under 12 Outreach Project (ORP)--in relation to age, sex and indices of treatment intensity. Study participants were 80 clinic-referred children (59 boys and 21 girls) aged 6-11 years assigned to one of the following groups: control (CG; n = 14) who did not receive the ORP, matched (MG; n = 50) who received the ORP, and experimental (EG; n = 16) who received an enhanced version of the ORP. Results indicated significant pre-post changes for the EG and MG for Child Behavior Checklist (CBCL)-measured delinquency and aggression, but no improvement for the CG.

System-wide implementation of ACT in Ontario: an ongoing improvement effort.

In the late 1990s, the government of Ontario undertook a province-wide implementation of Assertive Community Treatment (ACT). Capacity grew to 59 teams within 6 years. This paper describes the implementation process, focusing on three phases--start-up, or the enabling phase; feedback, or the reinforcement phase; and response, or the corrective action phase.

A comparison of patients with intellectual disability receiving specialised and general services in Ontario's psychiatric hospitals.

Background: Over the years, the closure of institutions has meant that individuals with intellectual disabilities (IDs) must access mainstream (i.e. general) mental health services.

The clinical profile and service needs of hospitalized adults with mental retardation and a psychiatric diagnosis.

Objective: This study compared patients with both mental retardation and a psychiatric diagnosis with patients who did not have co-occurring mental retardation who were served in Ontario's tertiary mental health care system in terms of demographic characteristics, symptom profile, strengths and resources, and clinical service needs.

Methods: A secondary analysis of data from the Colorado Client Assessment Record (CCAR) that were collected between 1999 and 2003 from all tertiary psychiatric hospitals in Ontario, Canada, was completed for a random sample of 3,927 cases, representing 12,470 patients receiving psychiatric services.

Results: Patients with both mental retardation and a psychiatric diagnosis differed from those who did not have mental retardation in terms of demographic characteristics, diagnostic and symptom profile, resources, and recommended level of care.

Young people's experience of the Canadian youth justice system: interacting with police and legal counsel.

Young people's knowledge and experience of the youth justice system was examined to explore self-reported factors that influenced their decisions regarding assertion versus waiver of rights to silence and legal counsel. Participants were 50 adolescents from Toronto, Canada ranging in age from 12 to 18 (mean age=15.6 years).

Adolescents' and children's knowledge about rights: some evidence for how young people view rights in their own lives.

The present study examined the development of knowledge about rights from childhood to adolescence. One hundred and sixty-nine 8-16-year-olds participated in individual semi-structured interviews assessing knowledge and importance of rights both generally and in children's and adolescents' lives. Detailed content analyses indicated that a global stage account may not capture key features of the development of young people's knowledge about rights.