La thèse s’intéresse à la construction et l’évolution de sous-classes de réfugiés au sein du système international de protection mis en place par le Haut Commissariat des Nations Unies pour les Réfugiés depuis les années 1950. Par un premier travail d’analyse des archives de l’organisation internationale, elle montre comment le système de protection a toujours fonctionné en opérant un tri parmi les réfugiés statutaires. L’analyse porte plus particulièrement sur la manière dont les « réfugiés africains » ont, dès leur arrivée dans le système international durant les années 1970, été pensés et traités comme des réfugiés particuliers. Par un second travail qualitatif mené au Maroc entre 2014 et 2015, la thèse s’intéresse au prolongement et à l’actualisation de ces enjeux en analysant le cas des « réfugiés subsahariens ». Réfugiés statutaires, ils constituent pourtant l’incarnation du « faux réfugié » sur lequel pèse un soupçon permanent. La thèse s’intéresse alors à l’expérience des individus pris dans cette sous-classe et à leurs tactiques pour tenter d’être reconnus et traités « comme des réfugiés à part entière ». / This PhD research focuses on the construction et evolution of refugees’ subclasses within the international protection system implemented since the 1950s by the Office of the United Nations High Commissioner for Refugees. This work firstly explains, based on this international organisation’s archives, how the protection system has always operated by selecting within recognised refugees. The analysis examines how « African refugees », since their arrival in the international system in the 1970s, have been thoughts of and treated as peculiar refugees. Secondly, a fieldwork in Morocco between 2014 and 2015 addresses the realisation of these issues thanks to a case study analysis of the « sub-Saharan refugees ». Despite being recognised refugees, they embody the « bogus refugee » under constant suspicion. This research focuses on the experience of individuals caught up in this subclass and on their tactics in order to be recognised and treated as « full-fledged refugees ».

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Angiotensin-converting enzyme 2 (ACE2) has been identified as the cellular entry receptor for the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). High ACE2 tissue expression and low glycine levels were suggested to increase susceptibility for SARS-CoV-2 infection and increasing circulating ACE2 has been proposed as one possible strategy to combat COVID-19. In humans, aerobic physical exercise induces an increase in plasma ACE2 in some individuals. However, it is not clear whether glycine and ACE2 levels depend on intrinsic exercise capacity or on exercise training. We used rats selectively bred for high intrinsic exercise capacity (HCR) or low exercise capacity (LCR) and tested the influence of this genetic predetermination and/or aerobic exercise on metabolites, ACE2 tissue expression and circulating ACE 2. ACE2 expression was measured in different tissues in the sedentary animals and again after 4 weeks of high-intensity aerobic exercise in both LCRs and HCRs. Sedentary HCRs exhibited significantly higher circulating ACE2 concentrations compared to LCRs, but a lower expression of ACE2 in all investigated tissues except for adipose tissue. Body weight was negatively correlated with serum ACE2 and positively correlated with ACE2 expression in the heart. Aerobic exercise caused a significant decrease in ACE2 expression in the lung, heart, muscle, and kidney both in LCRs and HCRs. Our results suggest that ACE2 expression, circulating ACE2 and glycine serum concentration are related to aerobic intrinsic exercise capacity and can be influenced with exercise. These results may support the hypothesis that physically fit individuals have a lower susceptibility for COVID-19 infection.

When assessing the risk of violence, increasing interest has been shown in bringing science and practice closer together. Moving from clinical intuition in the first generation of risk assessment via actuarial scales in the second generation to the structured professional judgments where risk assessments are today produces better, more valid results when assessing the risk of violence. One of the best predictors of violence is gender. Approximately 10% of the violent criminality can be attributed to women; even so, it is increasing, especially among young women. It is therefore important to examine risk assessments from a gender perspective. Another important factor when assessing the risk of violence is psychopathy and there are indications that there might be gender differences in this diagnosis. Thus, a special interest has been focused on psychopathy in this thesis. The purpose with this work is to explore the similarities and differences in assessing risk for violence in male and female mentally disordered offenders, while the overall aim is to validate the violence risk assessment instrument HCR-20 for Swedish offender populations. The risk assessments for all six studies in this thesis were made by trained personnel using the HCR-20 instrument, where psychopathy was diagnosed with the screening version of the Psychopathy Checklist (PCL:SV). The study populations were both male and female mentally disordered offenders in either the correctional or the forensic setting. The findings show that both the validity and the reliability of the HCR-20 and the PCL:SV were good and the clinical and risk management subscales were found to have better predictive validity than the historical scale. Another finding was that there were more similarities than differences between genders in the HCR-20, while the opposite applied to the PCL:SV, where the antisocial behavior was performed in a different manner. Moreover, it was found that the gender of the assessor might be a factor to take into account when assessing the risk of violence in women, where the recommendation was that at least one assessor should be female. The conclusions were that the HCR-20 and the PCL:SV can be used In Swedish offender populations with valid results. For female offenders, there are differences in the antisocial behavior that is assessed in order to diagnose psychopathy and these differences tend to underestimate psychopathy among female offenders. Furthermore, the gender of the assessor might be of greater importance than has previously been realized. The overall conclusion was that this thesis supports the structural professional judgment method of making risk assessments in order to prevent violence in the community.

<p>Forskning har visat att förekomst av riskfaktorer för brottsrecidiv skiljer sig mellan vålds- och sexualbrottslingar. Ytterligare forskning behövs dock om skillnader mellan mer specifika brottskategorier. Syftet var att undersöka skillnader mellan män dömda för mord (n=363), dråp (n=110), rån (n=238), sexualbrott mot vuxen (n=71) respektive sexualbrott mot barn (n=57) avseende ålder, psykopatiprofil enligt PCL-R samt riskkaraktäristika bedömt med HCR-20. Resultatet visade att personer dömda för sexualbrott mot barn hade lägre förekomst av historiska riskfaktorer, lägre grad av psykopati, samt var äldre än övriga grupper. Gruppen dömda för dråp hade en lägre grad av psykopatisk personlighet (faktor 1) än de andra våldsbrottsgrupperna, mord och rån, medan de hade den antisociala livsstilen typisk för psykopater (faktor 2). Det omvända gällde för gruppen sexualbrott mot vuxen. Grupperna rån och mord liknade varandra på flertalet variabler, dock var personer dömda för rån yngre än samtliga grupper. Resultaten har betydelse för utformande av åtgärder avsedda att minska recidivrisken.</p>

When assessing the risk of violence, increasing interest has been shown in bringing science and practice closer together. Moving from clinical intuition in the first generation of risk assessment via actuarial scales in the second generation to the structured professional judgments where risk assessments are today produces better, more valid results when assessing the risk of violence. One of the best predictors of violence is gender. Approximately 10% of the violent criminality can be attributed to women; even so, it is increasing, especially among young women. It is therefore important to examine risk assessments from a gender perspective. Another important factor when assessing the risk of violence is psychopathy and there are indications that there might be gender differences in this diagnosis. Thus, a special interest has been focused on psychopathy in this thesis. The purpose with this work is to explore the similarities and differences in assessing risk for violence in male and female mentally disordered offenders, while the overall aim is to validate the violence risk assessment instrument HCR-20 for Swedish offender populations. The risk assessments for all six studies in this thesis were made by trained personnel using the HCR-20 instrument, where psychopathy was diagnosed with the screening version of the Psychopathy Checklist (PCL:SV). The study populations were both male and female mentally disordered offenders in either the correctional or the forensic setting. The findings show that both the validity and the reliability of the HCR-20 and the PCL:SV were good and the clinical and risk management subscales were found to have better predictive validity than the historical scale. Another finding was that there were more similarities than differences between genders in the HCR-20, while the opposite applied to the PCL:SV, where the antisocial behavior was performed in a different manner. Moreover, it was found that the gender of the assessor might be a factor to take into account when assessing the risk of violence in women, where the recommendation was that at least one assessor should be female. The conclusions were that the HCR-20 and the PCL:SV can be used In Swedish offender populations with valid results. For female offenders, there are differences in the antisocial behavior that is assessed in order to diagnose psychopathy and these differences tend to underestimate psychopathy among female offenders. Furthermore, the gender of the assessor might be of greater importance than has previously been realized. The overall conclusion was that this thesis supports the structural professional judgment method of making risk assessments in order to prevent violence in the community.

Forskning har visat att förekomst av riskfaktorer för brottsrecidiv skiljer sig mellan vålds- och sexualbrottslingar. Ytterligare forskning behövs dock om skillnader mellan mer specifika brottskategorier. Syftet var att undersöka skillnader mellan män dömda för mord (n=363), dråp (n=110), rån (n=238), sexualbrott mot vuxen (n=71) respektive sexualbrott mot barn (n=57) avseende ålder, psykopatiprofil enligt PCL-R samt riskkaraktäristika bedömt med HCR-20. Resultatet visade att personer dömda för sexualbrott mot barn hade lägre förekomst av historiska riskfaktorer, lägre grad av psykopati, samt var äldre än övriga grupper. Gruppen dömda för dråp hade en lägre grad av psykopatisk personlighet (faktor 1) än de andra våldsbrottsgrupperna, mord och rån, medan de hade den antisociala livsstilen typisk för psykopater (faktor 2). Det omvända gällde för gruppen sexualbrott mot vuxen. Grupperna rån och mord liknade varandra på flertalet variabler, dock var personer dömda för rån yngre än samtliga grupper. Resultaten har betydelse för utformande av åtgärder avsedda att minska recidivrisken.

While forensic psychiatric inpatient violence is a serious problem, research on risk assessment for this outcome is limited; the current research investigated the predictive validity of a number of structured risk/forensic instruments for inpatient violence. Research objectives included: 1) observing the profile of dynamic changes in violence risk detected by existing violence risk assessment instruments; 2) assessing whether existing violence risk assessment instruments could be used to assess risk for inpatient violence; 3) evaluating the contribution of dynamic risk measures to the prediction of inpatient violence; and 4) assessing the relationship between dynamic changes in risk and inpatient violence. Instruments included: the Historical Clinical Risk Management 20 - Version 3 (HCR-20V3), the Psychopathy Checklist Revised (PCL-R), the Short-Term Assessment of Risk and Treatability (START), the Revised Violence Risk Appraisal Guide (VRAG-R), and the Violence Risk Scale (VRS). Two studies were conducted on a maximum-security forensic psychiatric unit at Alberta Hospital Edmonton. Study 1 was a pseudo-prospective archival investigation (n = 99), while Study 2 was a prospective investigation (n = 19); all risk assessment scores were based on information available in institutional files. Instruments designed to capture dynamic/clinical risk variables (HCR-20V3, START, VRS) detected dynamic changes in risk in this setting over longer follow-ups (i.e., between admission and discharge), but not over shorter follow-ups (i.e., 28 day periods). Predictive validity analyses indicated that specialized measures designed to capture relevant dynamic/clinical variables were significant predictors of inpatient violence; instruments that were not designed for this purpose (PCL-R and VRAG-R), did not demonstrate predictive validity for inpatient violence. Dynamic measures consistently demonstrated incremental predictive validity for inpatient violence, beyond the static measures. Additionally, change scores demonstrated incremental relationships with decreased inpatient violence, beyond pretreatment scores. Put another way, positive risk change was associated with decreased violence over the course of the patients’ stays in hospital. Reliable and valid risk assessments are a necessary component of effective offender programming (Risk-Need-Responsivity Model) and the current results indicated that valid violence risk assessments for forensic psychiatric inpatient violence are possible. Implications for clinical practice and the reduction/mitigation of inpatient violence are discussed.

In state psychiatric hospitals in the United States, many patients are admitted with a history of trauma. Although trauma-focused interventions are offered within these psychiatric facilities, there remain issues with the higher-than-average length of treatment and rehospitalization rates for patients with a diagnosis of posttraumatic stress disorder or for those who are suffering with a history of trauma. This study investigated between group differences for measured levels of attendance and type of group intervention (which included the men's trauma recovery empowerment model, dialectical behavior therapy, and art and healing) on the risk for violence as measured by scores on the historical, clinical, and risk-20 (HCR-20 v2) checklist. Participants had documented trauma history as well as mental health disorders including schizophrenia, schizoaffective, bipolar disorder, major depressive disorder, posttraumatic stress disorder, and substance abuse. Cognitive behavioral and social learning theory comprised the theoretical foundations for the study. Archival data from the past 6 years included 16 participants from the M-TREM group, 15 participants from the DBT group, and 15 participants from the Art and healing group. Data were used to complete a nonequivalent control group design and data analysis included an ANOVA, correlation, and regression analysis. The results of this study identified a statistically significant difference in risk for violence based on level of attendance but not by type of group intervention. The findings of this study will assist psychiatric hospital administrators and mental health professionals in the development and implementation of effective trauma programming to lower the risk for violence for patients with trauma.

La problématique de cette thèse est d'interroger la catégorie « réfugié » et son impact dans le processus de construction identitaire à Delhi, lieu de convergence et espace de dispersion. Se dégage-t-il, parmi des personnes de divers groupes ethniques, religions, nationalités et aux origines sociales variées, des représentations et des modes d'action communs, témoins de l'existence d'une identité basée sur la condition de réfugié ? <br />La déconstruction de la catégorie « réfugié » s'opère à trois niveaux : celui des organisations de tutelle des réfugiés qui donnent corps à ce « label » réfugié ; celui des acteurs politiques et sociaux qui apportent leur soutien aux réfugiés ; et celui des acteurs religieux (chrétiens) qui, eux aussi, sont partie prenante du « système-réfugié ».<br />Un regard transversal permet de conclure à l'émergence d'une société civile portant l'expression d'une identité hétérogène et d'une dynamique communautaire par laquelle peut se définir l'identité « réfugié ».