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The thesis contends that holistic, community-based treatment is preferable to carceral options for offenders with fetal alcohol conditions, presents emerging support for this contention, identifies barriers to the implementation of community-based treatment, and culminates with analyses of ways of influencing policy reform or of legally mandating non-carceral treatment options. Potential avenues that will be examined include:<P> &bull;&#x00A0;&#x00A0; Charter of Rights and Freedoms, s. 15, including an analysis from Eldridge, Law, and Auton, based on the duty to accommodate disabilities;<BR> &bull;&#x00A0;&#x00A0; Constitution Act, 1982, s. 35 and its recognition and affirmation of such relevant treaty right as the alcohol ban, particularly as the ban operates as a contextual factor in a s. 15 Charter analysis as applied to affected treaty beneficiaries; and<BR> &bull;&#x00A0;&#x00A0; Articles 23, 24 and 40 of the Convention on the Rights of the Child, and Article 12(1) of the International Covenant on Economic, Social and Cultural Rights, particularly as they influence the s. 1 analysis under the Charter. <P> A remedy mandating a positive state obligation to provide community-based treatment likely would require favourable cost-benefit analyses, as well as evidence of effectiveness of the treatment (the latter to be studied in a subsequent interdisciplinary Ph.D. program using qualitative research techniques). The implications of a finding of disability and mental disorder related to fetal alcohol conditions will be examined. The present research topic is at the interface of health and justice, and indeed is multidisciplinary in nature as fetal alcohol influences every aspect of affected individuals' lives. Moreover, the problem is situated in its historical, ideological, global, and trans-disciplinary context.

The thesis contends that holistic, community-based treatment is preferable to carceral options for offenders with fetal alcohol conditions, presents emerging support for this contention, identifies barriers to the implementation of community-based treatment, and culminates with analyses of ways of influencing policy reform or of legally mandating non-carceral treatment options. Potential avenues that will be examined include:<P> &bull;&#x00A0;&#x00A0; Charter of Rights and Freedoms, s. 15, including an analysis from Eldridge, Law, and Auton, based on the duty to accommodate disabilities;<BR> &bull;&#x00A0;&#x00A0; Constitution Act, 1982, s. 35 and its recognition and affirmation of such relevant treaty right as the alcohol ban, particularly as the ban operates as a contextual factor in a s. 15 Charter analysis as applied to affected treaty beneficiaries; and<BR> &bull;&#x00A0;&#x00A0; Articles 23, 24 and 40 of the Convention on the Rights of the Child, and Article 12(1) of the International Covenant on Economic, Social and Cultural Rights, particularly as they influence the s. 1 analysis under the Charter. <P> A remedy mandating a positive state obligation to provide community-based treatment likely would require favourable cost-benefit analyses, as well as evidence of effectiveness of the treatment (the latter to be studied in a subsequent interdisciplinary Ph.D. program using qualitative research techniques). The implications of a finding of disability and mental disorder related to fetal alcohol conditions will be examined. The present research topic is at the interface of health and justice, and indeed is multidisciplinary in nature as fetal alcohol influences every aspect of affected individuals' lives. Moreover, the problem is situated in its historical, ideological, global, and trans-disciplinary context.

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Class of 2008 Abstract / Objectives: To describe a pharmacist-based treatment adherence program at an HIV ambulatory care clinic setting; to describe the patient population that the pharmacist provided services to from 2005 to 2007; and to describe the clinical outcomes of the program. Methods: A retrospective chart review of 381 patients enrolled in the pharmacist-based treatment adherence program from 2/01/05 to 03/01/2007. Inclusion criteria: HIV positive; greater than or equal to 18 years of age; a medical record; and enrollment in the treatment adherence program. The program provided support, education, and clinical management. Results: Patients were predominately male (86%), ages 45-64 (58%) or 25-44 (38%), identifying as Caucasian (57%) or Hispanic (31%), with psychiatric (50%) or substance abuse (39%) comorbidities (with 25% reporting both comorbidities). Baseline HIV viral loads were compared at four different follow-up periods: 90-180 days, 181-365 days, greater than 365 days, and the entire period of follow-up through the pharmacist-based HIV treatment adherence program. At baseline 34% of the patients had an undetectable HIV viral load (< copies/mL) and a mean CD4 count of 340. All follow-up periods reported significant improvements. At follow-up >365 days, 76% of the patients had undetectable virus (p<0.001) and a mean CD4 count of 442 (p<0.001). There were no significant results when viral load and mean CD4 counts were examined within the context of number of pharmacist visits and SA and/or psychiatric comorbidities. Conclusions: Patients in the pharmacist-based treatment adherence program showed significant improvements in CD4 count and percent of patients with undetectable virus from baseline to all follow-up periods. The magnitude of the improvement increased during each follow-up period suggesting an additive effect of continued enrollment in the program.

Mindfulness is a way of managing chronic pain and its consequences as it fosters anaccepting approach to pain that can be beneficial in several aspects of life affected bypain. This study sought to examine whether an online mindfulness training programcould reduce the experience of pain, increase acceptance of pain, and increase qualityof life in a group of individuals suffering from chronic pain. The study was arandomized controlled trial with a partly active control group. Initially 52 participantswere randomized to the intervention group and 55 to the control group. The drop outrates were high, 21 participants from the intervention group and 40 participants fromthe control group completed post measurement. Increased levels of mindfulness,reduced pain related distress, and heightened pain acceptance, as well as increasedquality of life, was observed in the intervention group. A strong tendency towards aperceived reduction of pain intensity was also evident in the intervention group. Asthe mindfulness program had positive effects on the overall experience of pain it mayserve as a cost‐effective and useful method of dealing with chronic pain. / Mindfulness är ett sätt att hantera kronisk smärta och dess konsekvenser då det lär uten accepterande inställning till smärta som kan vara till hjälp i flera aspekter av livetpåverkade av smärta. Denna studie undersökte huruvida ett online‐baseratmindfulnessprogram kunde minska upplevelsen av smärta, öka acceptans av smärtaoch öka livskvaliteten hos en grupp individer med kronisk smärta. Studien varrandomiserad och kontrollerad med en delvis aktiv kontrollgrupp. Initialtrandomiserades 52 deltagare till experimentgruppen och 55 deltagare tillkontrollgruppen. Bortfallet var högt, 21 deltagare från experimentgruppen och 40deltagare från kontrollgruppen fullgjorde eftermätningarna. Ökade nivåer avmindfulness, reducerat smärtrelaterat lidande, ökad acceptans av smärta såväl somökad livskvalitet återfanns i experimentgruppen. En stark tendens till minskadupplevd smärtintensitet var också tydlig hos experimentgruppen. Dåmindfulnessprogrammet hade positiva effekter på den övergripande upplevelsen avsmärta kan det fungera som en kostnadseffektiv och användbar metod att hanterakronisk smärta.

Depression is a common mental health problem. This study utilized a randomized, controlled trial design to assess the effect of a new web-based depression information decision aid compared to general depression information available on a well-known website on important factors involved in decision-making: knowledge of depression and treatment options, stigma, help-seeking attitudes, confidence in making a decision, sense of being well-informed, and preference for different treatment options. Introductory psychology students completed pre-, post-, and follow-up assessments in Study 1, and post- and follow-up assessments in Study 2. Overall, the two depression websites yielded similar responses across the measures, and the information decision aid was not superior to general information on the currently available website. Study 1 participants reported less decisional conflict and felt more informed following the review of the website compared to before website review. There were no changes from pre- to post-assessment on knowledge, stigma, or help-seeking attitudes. Study 2 also found few differences between the groups. Participants in this study indicated reduced stigma one-month after website review, which could be due to a delayed effect of the information, or exposure to other sources of information. In addition, decisional conflict increased and participants felt less informed one-month following the review of the website, compared to just after review. This is not surprising given that different treatment options are likely fresh in their minds just after review compared to one-month later. Given the largely negative findings in the two studies, alternative research approaches to comparing information resources are discussed. / October 2016

Fibromyalgia Syndrome (FMS) is a disease of unknown etiology that affects up to 3 million Canadians, or 2-10% of the general population (Carruthers & van de Sande, 2005). Acceptance-based behavioural therapy (ABBT) is a relatively recent approach to treating human suffering in general and chronic pain in particular (Hayes, Strosahl, & Wilson, 1999; McCracken, 2005). ABBT treatments have been shown to effectively treat pain, pain-related anxiety, depression, and other behavioural measures of disability (McCracken, 2005; McCracken, Vowles, Gregg, & Almada, 2010; Pear & Simister, 2016, p. 160). In-person treatments can place significant burden on patients and the overall health-care system. Outcomes for online programs can be similar to those for in-person treatment while allowing for increased flexibility for both patients and professionals (Ritterband & Tate, 2009; Strecher, 2007). The current study extended a pilot study (Shay, Tkachuk, Simister, Bailly, & Skrabek, 2011), modifying the previous treatment to a 6 unit program that could be delivered online. Sixty-one participants completed the study, being randomly assigned to an online ABBT plus treatment-as-usual (online ABBT + TAU) group or a treatment-as-usual alone (TAU) group. All participants completed a series of self-report measures at baseline, at post-treatment, and at a 3-month follow-up. Linear mixed modelling supported significant differences between the groups in favour of the ABBT + TAU treatment group on the primary outcome measure (Fibromyalgia Impact Questionnaire-Revised (FIQ-R); F (2, 52.82) = 20.10, p < .0001) following treatment. The online ABBT + TAU group also had significantly greater improvements in depression, pain, acceptance, perceived helplessness, and kinesiophobia. Increased acceptance mediated the effects of treatment on improvements in FMS quality of life and FMS impact, while reduced helplessness mediated the effects of treatment on improvements in level of reported pain. Comments and subjective ratings of improvement were consistent with the quantitative results. Participants rated mindfulness (contact with present moment experience) as the most useful treatment unit. / February 2016

An interactive activation model for picture naming was used to guide treatment of a semantic-level deficit in 4 individuals with aphasia and severe picture-naming problems. Participants exhibited a profile consistent with Broca's aphasia with severe naming deficits, part of which was attributable to a semantic impairment based on testing of the lexical system. A semantic-based treatment was used to train naming of nouns in two semantic categories using a single-participant multiple baseline across behaviors and participants. Additional treatment, which included orthographic and phonological information about target words, then was applied. Treatment responses and error patterns demonstrated that semantic treatment resulted in improved naming of both trained and untrained items for 2 of 4 participants. Two participants did not show improved naming until treatment emphasizing the phonological form of the word was provided. This study demonstrates the utility of using an interactive activation model to plan treatment based on levels of disruption in the lexical processing system.

Objectives: To show forgiveness to be a central component in substance abuse and recovery and to encourage the empirical investigation of such realtionships. Methods: Literature reviewed and synthesized to support the role of forgiveness in addiction and recovery and to justify its empirical investigation. Results: The construct and process of forgiveness are present in 12-Step Facilitation Therapy, Motivational Enhancement Therapy, and Cognitive Behavioral Coping Skills Therapy, and other psychotherapies applicable to the treatment of substance abuse. Nevertheless, few studies exist to provide empirical support for these relationships. Conclusions: Religion and spirituality can have a salutary effect on substance use disorders. However, little is known regarding the effects of specific manifestations of religiosity and spirituality. Forgiveness, decreasing negative responses to offense irrespective of interaction with the offender, has been argued to be highly relevant to problematic substance use. Although the process of forgiveness is conceptually found in empirically validated forms of treatment for alcohol problems, little quantitative evidence exists to verify and illuminate the relationships between forgiveness and substance abuse. Empirical investigation into the basic, indirect, contextual, and interventional relationships between forgiveness and substance use disorders, including development, maintenance, and recovery, is warranted and encouraged.