Digital Commons Network^™

Healthcare Utilization Costs Of Emerging Adults With Mood And Anxiety Disorders In An Early Intervention Treatment Program Compared To A Matched Cohort, Ava A. John-Baptiste, Lihua Li, Wanrudee Isaranuwatchai, Elizabeth Osuch, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: The First Episode Mood and Anxiety Disorder Program (FEMAP) provides treatment to emerging adults with mood and anxiety disorders in an accessible, youth-friendly environment. We sought to investigate FEMAP's impact on the costs of care.

METHODS: We conducted a retrospective observational study of one-year health service costs using linked administrative datasets to compare emerging adults treated at FEMAP (FEMAP users) to propensity-score matched controls (non-users). Costs from the perspective of the Ontario Ministry of Health and Long-Term Care, included drug benefit claims, inpatient, physician and ambulatory care services. We used bootstrapping to perform unadjusted comparisons between FEMAP users and …

Politics Versus Policies: Fourth Wave Feminist Critiques Of Higher Education’S Response To Sexual Violence, Rita A. Gardiner Ph.D, Michelle Shockness, Jennifer Almquist, Hayley Finn

Education Publications

This article uses the lens of fourth wave feminism to examine media accounts of institutional and student responses in two cases of sexual violence at institutions of higher education. Competing discourses reveal a disconnect between what institutions say they do and students’ actual experiences of the institutional handling of sexual violence cases. When policies, actions, and values are not fully aligned, institutions of higher education are unable to respond to societal and institutional injustices. Hence, recommendations for better alignment between institutional values and actions are proposed.

Immigrant Perpetrators Of Domestic Homicide: Unique Risks And Service Needs, Randal David

Electronic Thesis and Dissertation Repository

This integrated dissertation comprises of three studies exploring severe and/or lethal domestic violence among male immigrant perpetrators. The first study analyzed the differences between immigrant and Canadian-born perpetrators of domestic homicide using a sample of 186 cases of domestic homicide that occurred from 2002-2016 in Ontario; 93 perpetrators that were Canadian-born and 93 immigrant perpetrators. Results revealed sociodemographic differences between groups, such as immigrant perpetrators’ increased likelihood to reside in large urban areas, have children, and have a higher level of education.

Criminogenic differences were also identified between groups, with immigrant perpetrators less likely to have probation, parole, and bail …

Increasing Support For Victims Of Sexual Assault Through The Adoption Of A Victim-Centered Approach To Police Investigations, Kara Brooks

The Dissertation in Practice at Western University

Police services across North America have been criticized for their lack of support for victims throughout the investigative process, especially when investigating crimes involving sexual violence. The Problem of Practice addressed in this Organizational Improvement Plan (OIP) focuses on the lack of victim support throughout sexual assault investigations in a large police service in Canada. Taking a victim-centered approach to sexual assault investigations pushes the police organization to consider victims’ needs and rights ahead of strictly gathering information throughout a sexual assault investigation.

A gap analysis identified two main areas of focus for this (OIP): the need for enhanced training …

Balancing The Dialectic In Non-Profit Leadership: Exploring The Use Of Critical Andragogy To Achieve Uniform Service Delivery In A Harm Reduction Team, While Maintaining Their Activist Ethos., Evan Wick

The Dissertation in Practice at Western University

The social service sector provides services to the communities they are a part of. In an environment where resources are scarce and the needs of the community are high, the sector is in a constant struggle to do more with less. This is especially true within youth and harm reduction services. The social service agencies also grapple internally, as neoliberal discourses permeate the management of community services. The social service agency within this Organizational Improvement Plan (OIP) houses a program that provides harm reduction services to youth over a large geographical urban and suburban landscape. The program is experiencing …

Learning To Succeed: Supporting, Tracking And Engaging Education In The Workplace, John Mbakulo

The Dissertation in Practice at Western University

This Organizational Improvement Plan (OIP) identifies a need to support, track, and engage employees pursuing post-secondary education in a large-sized police service. The organization’s current investment in post-secondary education support is relatively small compared to the costs that learners face, and this figure has not increased in over a decade. Moreover, though education is tracked upon entering the workforce, due to technological changes these records are not easily obtainable, and any additional educational achievements are not recorded once an employee has started working. Expanding this focus on supporting education will reinforce the recognition of the value that additional education brings …

“She Was A Disgrace To Her Sex” : Prostitution And Moral Panic In London, Ontario, 1880-1885, Margaret E. Ross

Electronic Thesis and Dissertation Repository

This thesis examines the lives and work of prostitutes in London, Ontario, from 1880 to 1885. The city’s sex trade was shaped by class, and women worked in upscale houses of ill-fame, disorderly houses, or on the streets. Prostitutes performed domestic and sexual labour in the same spaces, and their daughters often entered the sex trade, creating a multi-generational profession. In addition to class, a woman’s race and age shaped her experience in sex work and ability to protect her labour interests from local authorities. Sex workers increasingly became the target of repressive reform efforts from the city’s elites. Late-nineteenth …

Overcoming Resistance When Adopting A Strengths-Based Case Management Service Delivery Model, Sheri-Lynn Mayhew

The Dissertation in Practice at Western University

In 2016, Rapp & Goscha’s (2012) Strengths-based Case Management (SBCM) Service Delivery Model was adopted as an agency wide, best practice within Organization X. However, the clinicians within Service N, who support persons with developmental disabilities and mental illness known as a dual diagnosis, resisted this service delivery model implementation. Outcome measures following implementation for those with a dual diagnosis were poor. Specifically, goal attainment and fidelity scores were consistently lower since Rapp & Goscha’s (2012) SBCM Service Delivery Model implementation. This Organizational Improvement plan (OIP) examines which leadership theories and frameworks could address the resistance in adopting Rapp & …

Pilot And Adaptation Of A Social-Emotional Learning Program In Youth Justice Settings, Amanda J. Kerry

Electronic Thesis and Dissertation Repository

Interventions for youth offenders should aim to reduce risk factors and promote protective factors. Social-emotional learning (SEL) programs aim to enhance intrapersonal, interpersonal, and cognitive competencies. Research demonstrates that SEL programs reduce antisocial behaviours and improve prosocial skills; however, to date, SEL programs have been primarily implemented in schools. This integrated-article dissertation explored the feasibility and preliminary outcomes of implementing a SEL program in youth justice settings. The first paper proposes the implementation of SEL programs in youth justice settings and identifies unique programming and implementation considerations for this population.

The second paper presents a two-phase study examining the feasibility, …

Improving Civilian Protection During War Through Conflict-Specific Behavioural Regulation Of Combatants, Kirsten Md Stefanik

Electronic Thesis and Dissertation Repository

This thesis advances the claim that there is a gap between the regulation of behaviour for the protection of individuals in peace and the regulations needed to protect civilians from combatant violence during war. Social psychology and criminology theories can help to develop the necessary conflict-specific behavioural regulations. This is because social psychology and criminology theories can explain how combatant deviance is adversely affected by psychological processes that reframe combatants’ conceptions of right and wrong and, in so doing, fundamentally alter the way in which combatants view the IHL rules intended to protect civilians. This thesis uses legal doctrinal methodology …

Police Prevention Of Domestic Homicide: Missed Opportunities And Barriers To Change, Michael D. Saxton

Electronic Thesis and Dissertation Repository

This integrated-article dissertation focused on the critical role of police in responding to domestic violence (DV) and recognizing the potential risk of adult and child homicides. The first study examined the police role in domestic homicide through an analysis of cases reviewed by the Domestic Violence Death Review Committee in Ontario, Canada. Homicide cases with police contact were found to have 1.6 times more risk factors compared to those without police contact. Cases also show an overall scarcity of formal risk assessments, even when there was prior police contact. The second study was a national survey on the types of …

Financial Frictions: Money And Materiality In American Literary Naturalism, 1890-1925, Patricia Luedecke

Electronic Thesis and Dissertation Repository

My dissertation argues that American literary naturalists employ money—particularly the tension between its materiality and immateriality—as a metaphor for hidden ontological instability in the following nineteenth-century cultural cornerstones: financial speculation, criminal justice, race law, and social-Darwinian individualism. My first chapter investigates the tension between material accounting and Gothic ethereality in Theodore Dreiser’s The Financier (1912). This chapter argues that, since the Gothic genre involves a compulsive need to account for the incredible and incorporeal, The Financier’s irresolvable tensions between gambling and speculation, home and market, are Gothically inflected. I conclude that, just as speculation haunts the ontological coherence of …

Cannabis Legalization And Driving: Exploring Young Ontarians’ Knowledge, Perceptions And Attitudes, Robert Colonna

Electronic Thesis and Dissertation Repository

The legalization of recreational cannabis may increase driving under the influence of cannabis (DUIC) among youth, a behavior proven to increase the risk of collisions. We conducted a mixed methods study including an online survey (N=426; 53% female) and two focus groups (N=12) exploring young drivers’ knowledge, perceptions, and attitudes towards cannabis use and DUIC. 83.6% (356) of survey’s participants had used cannabis, 69% (296) in the past year. Among past-year users, 47.9% (142) have previously DUIC. Quantitative predictors of future DUIC included: prior DUIC, minor accident risk, dangerousness, perceived enforcement of penalties, punishment avoidance, and moral awareness. Qualitative themes …

Review Of Recent Physical Activity Guidelines During Pregnancy To Facilitate Advice By Health Care Providers, Kelly R. Evenson, Michelle F. Mottola, Raul Artal

Paediatrics Publications

Importance: Physical activity during pregnancy can offer many maternal and fetal health benefits. Objective: The aim was to summarize American, Canadian, and international recommendations published recently on physical activity during pregnancy to aid health care providers in their delivery of advice on the topic. Evidence Acquisition: A descriptive review of 3 national guidelines and 1 international guideline on physical activity during pregnancy was conducted. The guidelines included the 2019 Canadian recommendations, the 2018 United States' Physical Activity Guidelines for Americans (second edition), the 2015 (reaffirmed in 2017) American College of Obstetrics and Gynecology guideline, and the 2016-2018 International Olympic Committee …

"A Deadly Game Of Russian Roulette": Exploring The Framing Of The Opioid Crisis In Canadian News Media, Lorna Ferguson

Electronic Thesis and Dissertation Repository

The purpose of this study is to investigate the framing of the opioid crisis in Canadian news media. Using a 'frame analysis' approach (Entman 1993), the following questions are addressed: (1) How has the opioid crisis been framed in recent Canadian news articles?; (2) How often (frequency) are each of the frames documented in recent Canadian news articles?; and (3) What is the dominant frame? To answer these questions, this study draws on the results of a content analysis of 314 news articles published between January 2018 to December 2018. Data collected through systematic searches of the Canadian Major Dailies …

Exploring The Mental Health Care Experiences Of Youth Transitioning From Paediatric To Adult Psychiatric Services Using The Photovoice Method: A Participatory Analysis Of The Photostream Project, Brianna Jackson

Electronic Thesis and Dissertation Repository

The transition from adolescence to adulthood brings with it many new challenges and stressors that may negatively impact psychosocial wellbeing. Unfortunately, the disjointed progression from paediatric to adult psychiatric services leaves transitional-aged youth (TAY) vulnerable to its deleterious sequelae, including social isolation, self-harm, substance use, and suicidal ideation. As devised, the Canadian mental health sector is ill-equipped to meet the care demands of emerging adults, resulting in undue suffering. Current evidence validates the need for clinical practice reform and policy revision to address this issue, yet the perspectives of young people are consistently underrepresented in conversations regarding youth-oriented psychiatric program …

Descriptive And Prescriptive Belief In A Just World, Joel Armstrong

Electronic Thesis and Dissertation Repository

The Justice Motive has traditionally been conceptualized as a homeostatic, prevention-focused motivation, but attempts to measure individual differences in the Justice Motive (i.e., the Belief in a Just World) have not treated it as one. The measurement of a motivation requires accounting for both the current state and the goal state, but traditional measurement techniques have relied solely on beliefs about how just the world currently is (i.e., the current state). This has resulted in two major issues in the literature. First is the assumption that everyone who reports believing in a just world has reached that belief because of …

Missed Opportunities For Saving Children From Domestic Homicide: Implications For Prevention, Intervention, & Community Collaboration, Katherine Reif

Electronic Thesis and Dissertation Repository

This dissertation is comprised of three studies that explored the risks faced by children exposed to domestic violence, as well as systemic and agency-related recognition of, and responses to, these risks. Literature in the field has demonstrated that children living in these circumstances are at risk of significant adverse outcomes stemming from their exposure to domestic violence, and at its extreme, domestic homicides (Alisic et al., 2017; Jenney & Alaggia, 2014). In addition, these children are also at risk of becoming homicide victims in the context of domestic violence, either through being directly targeted in the homicide, or as a …

Access And Health System Impact Of An Early Intervention Treatment Program For Emerging Adults With Mood And Anxiety Disorders, Kelly K. Anderson, Ava John-Baptiste, Arlene G. Macdougall, Lihua Li, Paul Kurdyak, Elizabeth A. Osuch

Paediatrics Publications

Objectives: Early intervention programs are effective for improving outcomes in first-episode psychosis; however, less is known about their effectiveness for mood and anxiety disorders. We sought to evaluate the impact of an early intervention program for emerging adults with mood and anxiety disorders in the larger health system context, relative to standard care. Methods: Using health administrative data, we constructed a retrospective cohort of cases of mood and anxiety disorders among emerging adults aged 16 to 25 years in the catchment of the First Episode Mood and Anxiety Program (FEMAP) in London, Ontario, between 2009 and 2014. This cohort was …

Involuntary Hospitalization Among Young People With Early Psychosis: A Population-Based Study Using Health Administrative Data., Rebecca Rodrigues, Arlene G Macdougall, Guangyong Zou, Michael Lebenbaum, Paul Kurdyak, Lihua Li, Salimah Z Shariff, Kelly K Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: Early psychosis is an important window for establishing long-term trajectories. Involuntary hospitalization during this period may impact subsequent service engagement in people with newly diagnosed psychotic disorder. However, population-based studies of involuntary hospitalization in early psychosis are lacking. We sought to estimate the proportion of people aged 16 to 35 years with early psychosis in Ontario who are hospitalized involuntarily at first admission, and to identify the associated risk factors and outcomes.

METHODS: Using linked population-based health administrative data, we identified incident cases of non-affective psychosis over a five-year period (2009-2013) and followed cases for two years to ascertain …

Offender Characteristics: Influence On Attitudes And Sentencing Patterns Of Female Undergraduates, Madison Mcaskill

Brescia Psychology Undergraduate Honours Theses

Offender rehabilitation has more positive outcomes, yet the public prefers the punishment of incarceration. Disparity in the punitivity of sentencing has been related to age and gender of offenders, with adult, male offenders receiving more punitive, less rehabilitative sentences than youth, female offenders. The present study examined patterns of sentencing in an all female sample (N=103). After reading a crime story manipulating offender gender and age, participants were asked to “sentence” the offender. Gender of offender did not cause differences in sentences given, however youth offenders were sentenced significantly less. Participants showed no significant attitudinal differences on the Treatment Attitude …

The Impact Of Maltreatment On Children And Youth: Exploring The Potential Mediating Effects Of Resilience To Traumatic Life Events, Rebecca Pschibul

Electronic Thesis and Dissertation Repository

Abstract

Childhood is an acutely vulnerable period for trauma, as it can significantly influence normative childhood development. Specifically, trauma resulting from maltreatment (i.e., neglect, sexual abuse, physical abuse, and witnessing domestic violence) offers unique challenges, as it often includes violations of boundaries and trust by caretakers. The aim of the present study was to examine child and youth maltreatment, and its impact on internalizing (e.g., mood disturbances) and externalizing behaviours (e.g., behavioural deviance). The sample was comprised of 9,002 participants who were assessed between the years of 2012-2017 on the interRAI Child and Youth Mental Health instrument (ChYMH). The ChYMH …

Extending Our Promise: Providing Help To Mentally Ill Accused As Soon As Practicable, Cassandra Demelo

Electronic Thesis and Dissertation Repository

This thesis examines the current state of the criminal law’s interaction with mentally ill persons, with a specific interest in this interaction during pre-trial phases such as arrest and bail. It argues that the current provisions in the Criminal Code of Canada that allow for limited instances of pre-trial mental health assessments for adults are insufficient. The current options, including assessments to determine “not criminally responsible for reasons of mental disorder” or “fitness”, are not applicable in many situations. Other options available to accused outside of the Criminal Code are also lacking, as they are limited to the Mental Health …

Female And Male Perpetrators Of Domestic Homicide: A Gendered Phenomenon?, Jackie Salas

Electronic Thesis and Dissertation Repository

Domestic violence is a global issue extending across regional, cultural, and social boundaries. In 2017, 137 women across the world were killed everyday by intimate partners or relatives. By far, women over-represent victims of domestic violence and domestic homicide across time. Although disproportionate, equally concerning is the issue of violence against men. Researchers have started to question whether the risk factors related to male and female’s use of violence is gendered, however no clear consensus has been reached. A retrospective case analysis was completed using domestic homicide cases reviewed by the Domestic Violence Death Review Committee based in Ontario, Canada. …

Dating Violence And Homicide With Younger Adults: Are We Taking The Dangers Seriously Enough?, Corinne Qureshi

Electronic Thesis and Dissertation Repository

A significant proportion of domestic violence involves dating partners, however little research has examined domestic homicides in this context. The purpose of the current study was to examine domestic homicides in the context of dating violence in comparison to cohabiting and married couples. The dataset for these comparisons was derived from the Ontario Domestic Violence Death Review Committee (DVDRC). The study hypothesized that dating partners would differ from their cohabiting and married counterparts in several areas due to the unique nature of dating relationships, whereby they are less likely to be characterized by legal, economic, and familial ties to their …

Children's And Caregivers' Perspectives About Mandatory Reporting Of Child Maltreatment: A Meta-Synthesis Of Qualitative Studies, Jill R. Mctavish, Melissa Kimber, Karen Devries, Manuela Colombini, Jennifer C.D. Macgregor, Nadine Wathen, Harriet L. Macmillan

Nursing Publications

Objective To systematically synthesise qualitative research that explores children's and caregivers' perceptions of mandatory reporting. Design We conducted a meta-synthesis of qualitative studies. Data sources Searches were conducted in Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Criminal Justice Abstracts, Education Resources Information Center, Sociological Abstracts and Cochrane Libraries. Eligibility criteria English-language, primary, qualitative studies that investigated children's or caregivers' perceptions of reporting child maltreatment were included. All healthcare and social service settings implicated by mandatory reporting laws were included. Data extraction and synthesis Critical appraisal of included studies involved a modified checklist from the Critical Appraisal …

Factors Affecting Resistance And Receptivity To Evidence-Based Policing Practices In Canada, Hina Jawaid Kalyal

Electronic Thesis and Dissertation Repository

Evidence-based policing (EBP) is based on the use of research for decision-making in police organizations. Despite its noted importance, there is a dearth of research that identifies specific reasons which lead to receptivity to EBP or the lack thereof. Based on a qualitative methodology, the present dissertation addresses this gap in literature by exploring the contextual factors which may be responsible for police resistance or receptivity to the use of evidence. Data were collected from Canadian police organizations through qualitative questions added to a survey (n = 353) as well as in-depth interviews with police leaders across Canada ( …

Examining The Relationship Between Intrinsic Drivers Of Motivation And Functional Outcomes In A Cross-Section Of Individuals With Psychotic Disorders, Sahana Kukan

Electronic Thesis and Dissertation Repository

Impaired functioning is recognized as a major barrier to recovery among individuals with psychotic disorders. Research on the role of negative symptomatology on functioning has identified avolition (i.e. lack of motivation) as being highly correlated with functional outcomes. However, current measures of avolition fail to consider more intrinsic factors that influence motivation. There is a need for more nuanced research on the drivers of motivation and their relationship with functioning to inform the observed relationship between avolition and impaired functioning. This cross-sectional study uses data obtained from the Prevention and Early Intervention Program for Psychoses, in London, Ontario. 105 clients …

Adolescents With Fasd: Education-Based Strategies For Social Skills Development, Samantha Louise Wiendels

Electronic Thesis and Dissertation Repository

Fetal Alcohol Spectrum Disorder (FASD) is a permanent neurodevelopmental disorder characterized by physical, mental, and learning disabilities. Despite variability, individuals with FASD consistently struggle with acquiring appropriate social skills. Limited research has explored educational strategies that facilitate or hinder the development of social skills acquisition. The purpose of this study was to evaluate whether secondary schools have or plan to implement social skills training programs, and whether or not they are effectively targeting areas of vulnerability. In addition, the study hoped to produce recommendations for forming a successful social skills program. Nine semi-structured interviews were conducted with caregivers and service …

Resource Intensity For Children And Youth: The Development Of An Algorithm To Identify High Service Users In Children’S Mental Health, Shannon L. Stewart, Jeff W. Poss, Elizabeth Thornley, John P. Hirdes

Paediatrics Publications

Children’s mental health care plays a vital role in many social, health care, and education systems, but there is evidence that appropriate targeting strategies are needed to allocate limited mental health care resources effectively. The aim of this study was to develop and validate a methodology for identifying children who require access to more intense facility-based or community resources. Ontario data based on the interRAI Child and Youth Mental Health instruments were analysed to identify predictors of service complexity in children’s mental health. The Resource Intensity for Children and Youth (RIChY) algorithm was a good predictor of service complexity in …