All legitimerad personal inom hälso- och sjukvården är skyldiga att dokumentera. Noggrann dokumentation vid inskrivning utifrån checklistan leder till säker vård. Det som inte dokumenteras syns inte, är lätt att missa vid överrapportering och kan leda till lidande för patienten. Dokumentationen är central i kommunikationskedjan och ett hjälpmedel för all vårdpersonal. Syfte: Syftet var att undersöka följsamhet till checklista vid inskrivning av patienter i samband med dokumentation i datajournal på medicinsk/geriatrisk akutvårdsavdelning.  Metod: En kvantitativ och explorativ studie med deduktiv ansats genomfördes. Datainsamlingen bestod av journalgranskning utifrån en förutbestämd checklista som används vid inskrivning. Journalgranskningen utfördes på tio inneliggande patienters journaler på en medicinsk/geriatrisk akutvårdsavdelning på ett länsdelssjukhus i södra Sverige. Resultat: Checklistan vid inskrivning följdes till ca 70 % på den medicin/geriatriska akutvårdsavdelning medan ca 30 % av sökorden i checklistan var dokumentation utförd på akutmottagningen. Dokumentationen fördes under relevant sökord. Slutsats: Resultatet visade att sjuksköterskor på medicinsk/geriatrisk akutvårdsavdelning följde flertalet sökord utifrån checklistan vid inskrivningstillfället. Andra sökord i checklistan fanns redan dokumenterade från akutmottagningen när patienten kom upp till akutvårdsavdelningen. / All licensed healthcare professionals have an obligation to document. Keeping an accurate documentation in the electronic health record leads to a patient-safe care. Documentation is key in the communication between healthcare professionals and an important tool in the care that is given. Purpose: The purpose of the study was to investigate adherence to the checklist when documenting in the electronic health record in connection to admitting a patient at a medical/geriatric emergency care department. Method: Quantitative exploratory reviews of electronic health records. A quantitative method with a deductive approach was used when processing data. Data collection consisted of electronic health record reviews based on the checklist used at admittance. The records viewed were those of patients admitted to an emergency care department at a district hospital in southern Sweden. Results: 70% of the documentation from the checklist was kept at the medical/geriatric emergency department while the other 30% where documentation from the emergency room. Documentation was kept under the right search words. Conclusion: Results showed that most keywords were followed by the nurses at the medical/geriatric emergency department and the missing keywords were already documented by nurses at the emergency room.

A segurança do paciente cirúrgico é problemática complexa e desafiadora em âmbito global. A presente pesquisa teve como objetivos (a) analisar as evidências disponíveis na literatura sobre o processo de implementação da lista de verificação de segurança cirúrgica da Organização Mundial da Saúde na prática dos serviços de saúde, e (b) analisar o processo de implementação e o uso diário da lista de verificação de segurança cirúrgica, segundo o relato de enfermeiros que atuavam em unidades de centro cirúrgico de hospitais de duas cidades localizadas no estado do Paraná. A pesquisa foi conduzida em duas fases: revisão integrativa e estudo descritivo. A busca dos estudos primários foi realizada nas bases de dados PubMed, CINAHL e LILACS. A amostra da revisão integrativa foi composta de 27 pesquisas agrupadas em três categorias, a saber: processo de implementação: estratégias para introdução da lista de verificação de segurança cirúrgica nos serviços de saúde (n=15); processo de implementação: estratégias para otimização do uso da lista de verificação de segurança cirúrgica nos serviços de saúde (n=9) e facilitadores e barreiras para implementação da lista de verificação de segurança cirúrgica nos serviços de saúde (n=3). A condução da revisão integrativa possibilitou compreender o processo de implementação da lista, as diferentes estratégias utilizadas para sua implantação, aspectos da implementação considerados bem-sucedidos ou pouco exitosos no alcance dos resultados esperados, facilitadores e barreiras deste processo. O estudo descritivo foi realizado em 25 hospitais de duas cidades que compõem a mesorregião do Norte Central Paranaense (Londrina e Maringá). Os participantes foram 91 enfermeiros que atuavam em centro cirúrgico dos hospitais selecionados. Para a coleta de dados elaborou-se dois instrumentos, os quais foram submetidos à validação aparente e de conteúdo. Os resultados evidenciaram que, na maioria dos hospitais investigados, a lista de verificação de segurança cirúrgica foi implementada, sendo que, para a maioria dos participantes, as estratégias adotadas na introdução da lista foram o planejamento prévio conduzido pelos enfermeiros, a adaptação com predominância do uso no formato impresso e programa educacional. Com relação ao uso diário da lista, a maioria dos enfermeiros apontou a utilização inadequada desta prática nos seguintes aspectos: adesão parcial ao uso pela equipe cirúrgica, diferença de adesão entre as etapas de checagem e entre as categorias profissionais e condutas inadequadas da equipe cirúrgica na checagem da lista em sala cirúrgica (equipe incompleta, desatenta e sem participação ativa de seus membros). Para a maioria dos participantes, o uso da lista trouxe benefícios ou tem potencial para produzir efeitos benéficos para o paciente, equipe cirúrgica e serviço de saúde. As evidências geradas trazem subsídios para os enfermeiros e demais profissionais de saúde na elaboração de protocolos relativos ao processo de implementação ou uso diário da lista mais adequados e compatíveis com as especificidades estruturais e organizacionais dos serviços de saúde nacionais, com o propósito de viabilizar a integração desta ferramenta no processo de trabalho, melhorar a adesão da equipe e alcançar os melhores resultados em prol da segurança do paciente / Surgical patient safety is a complex and challenging problem at the global level. This study aimed to analyze (a) the available evidence in the literature on the process of implementation of the surgical safety checklist of the World Health Organization in the practice of health services, and (b) the implementation process and the daily use of the surgical safety checklist, according to the report of nurses working in surgical center units of hospitals of two cities located in the state of Paraná. The research was conducted in two phases: integrative review and descriptive study. The search for primary studies was carried out in PubMed, CINAHL and LILACS databases. The sample of the integrative review consisted of 27 studies grouped into three categories, namely: implementation process: strategies for the introduction of the surgical safety checklist in the health services (n = 15); implementation process: strategies to optimize the use of the surgical safety checklist in health services (n = 9) and facilitators and barriers to the implementation of the surgical safety checklist (n = 3). Conducting the integrative review made it possible to understand the process of implementing the list, the different strategies used for its implementation, aspects of implementation considered successful or not very successful in achieving the expected results, facilitators and barriers of this process. The descriptive study was carried out in 25 hospitals of two cities that make up the mesoregion of Northern Central of Paraná state (Londrina and Maringá). Participants were 91 nurses who worked in the surgical center of the selected hospitals. For the data collection, two instruments were elaborated, which were submitted to the apparent validation and content. The results showed that, in most of the hospitals investigated, the surgical safety checklist was implemented, and, for most of the participants, the strategies adopted in the introduction of the list were the previous planning conducted by the nurses, the adaptation with predominance of the use in the printed format and educational program. Regarding the daily use of the list, most of the nurses pointed out the inadequate use of this practice in the following aspects: surgical team\'s partial adherence to the use of it, difference in adherence between the check-up stages, and between the professional categories and inadequate behavior of the surgical team in checking the list in the surgical room (incomplete, inattentive team, and members not taking part actively). For most participants, using the list has brought benefits or can potentially produce beneficial effects for the patient, surgical team, and health service. The evidence generated provides subsidies for nurses and other health professionals in elaborating protocols related to the implementation process or daily use of the list more adequate and compatible with the structural and organizational specificities of the national health services, in order to make feasible the integration of this tool into the work process, to improve team adherence and to achieve the best results for patient safety

Introduktion: Vårdrelaterade infektioner och antibiotikaresistens är ett folkhälsoproblem. Kvarliggande urinvägskateter är en riskfaktor för att drabbas av vårdrelaterad urinvägsinfektion. Det finns en tydlig koppling mellan vårdrelaterad infektion, antibiotikaanvändning och antibiotikaresistens. På sjukhusronden har sjuksköterskan en nyckelroll i att förebygga vårdrelaterade infektioner. Syfte: Undersöka om införandet av ett rondkort har någon effekt på sjuksköterskornas upplevelse av sin delaktighet i patientens antibiotika- och urinvägskateterbehandling. Metod: En interventionsstudie utfördes på två vårdavdelningar på Norrlands universitetssjukhus, Umeå, Västerbotten. Interventionen bestod av en checklista, RondkortVLL, som utvecklades för sjuksköterskor att använda vid ronden. Interventionen pågick under fyra veckor. För att mäta deras upplevelse av delaktighet i patienternas antibiotika- och KAD-behandling fick de svara på en enkät före och efter interventionen. Svaren före och efter interventionen jämfördes med Mann Whitney-U test. Resultat: En signifikant förbättring på 1) dagligt ställningstagande till KAD-behandling och 2) sjuksköterskorna upplevde det naturligt att föra en dialog med läkaren om alternativ till urinvägskateter med mindre infektionsrisk. En ökad upplevelse av delaktighet angående patienternas antibiotikabehandling kunde ses på svaren efter interventionen men denna ökning var inte signifikant. Slutsats: Eftersom urvalet var litet och endast två avdelningar undersöktes är det svårt att dra några generella slutsatser. Resultatet tyder på att RondkortVLL har ökat sjuksköterskornas upplevelse av delaktighet i patienternas KAD-behandling och kan ha ökat sjuksköterskornas upplevelse av delaktighet i patienternas antibiotikabehandling. På grund av resultaten och betydelsen av att förebygga vårdrelaterade infektioner förordar vi en ökad klinisk användning av RondkortVLL. Vi hävdar att RondkortVLL kan vara effektivt som en daglig påminnelse, stärka sjuksköterskorna och medvetandegöra dem om deras betydelse i alla aspekter i patientens vård. / Introduction: Healthcare-associated infections and antibiotic resistance are public health problems. Indwelling catheters increase risk for urinary tract infections. There are connections among healthcare-associated infections, antibiotic use and antibiotic resistance. Nurses play a key role in infection control during hospital ward rounds. Aim: To investigate if a ward round checklist affects nursesʼ experiences of participation in patients’ antibiotica and indwelling catheter treatments. Method: An intervention study was conducted in two wards at Norrland University Hospital. The intervention was use of a checklist, RondkortVLL, that we developed for use by nurses at the ward round. The duration of the intervention was 1 month. The nurses answered a questionnaire about the use of antibiotica- and indwelling catheter before and after the intervention. Pre- and post-intervention responses were compared using the Mann Whitney-U test. Results: Significant improvements were found in 1) daily consideration of indwelling catheters and 2) the nurses feeling it was natural to conduct a dialogue with the physician about lower infection risk alternatives to indwelling catheters. While nurses tended to more often report the experience of participation in antibiotic treatment considerations post-intervention, this was not significant. Conclusion: Due to a small sample size and only two wards investigated it is difficult to generalize our results. However, our data indicate that RondkortVLL improved the nurses' experience of participation in patients' indwelling catheter treatments and may improve nursesʼ experiences of participation in a patient’s antibiotic treatment. Given these findings and the importance of infection prevention and control, we are pursuing greater clinical utilization of the RondkortVLL. We assert that RondkortVLL can be useful as a daily reminder, empower the nursesʼand raise awareness of their importance in all aspects of patient care.

Este projeto tem por objetivo desenvolver um checklist de boas práticas de fabricação (BPF) adaptado ao público das agroindústrias familiares de pequeno porte (AFPP) produtoras de embutidos, de modo que sirva como ferramenta de auxílio na recomendação das AFPP ao SUSAF-RS (Sistema Estadual Unificado de Sanidade Agroindustrial Familiar e de Pequeno Porte do RS). Foram visitadas 20 agroindústrias situadas nas regionais da Emater de Lajeado e Soledade, onde foi aplicado o checklist de BPF original (BRASIL, 2002) bem como o checklist adaptado desenvolvido. As agroindústrias foram classificadas em G1, G2 e G3 conforme o percentual de conformidade (C). A proposta do checklist adaptado se justificou uma vez que o instrumento proposto apresentou resultado de agroindústrias classificadas com G1 (>75% C) significativamente superior em relação à classificação obtida das mesmas agroindústrias submetidas ao checklist original. O checklist adaptado mostrou que a maioria das agroindústrias foi classificada como pertencente ao G2 com média de conformidade de 59,2%. Somente 4 agroindústrias, além da unidade onde foi aplicado o piloto, obtiveram mais de 75% de C sendo classificadas como G1. Todas estas estão registradas em Serviços de Inspeção Municipais já aderidos ao SUSAF, e uma apresenta registro no Serviço de Inspeção Estadual. Além destas, 8 agroindústrias foram classificadas no G2 e 7 foram classificadas no G3. As principais não conformidades (NC) identificadas nas classificações G2 e G3 foram relacionadas à gestão documental (SG5) e falhas no quesito higiênico-sanitário (SG2), sendo que 5 das 8 agroindústrias classificadas como G2 apresentaram C superior a 65%. Nestes casos, a gestão documental foi o principal gargalo para o não atingimento dos 75% de C preconizado. Ressalta-se que das 7 agroindústrias classificadas como G3, 4 apresentaram índices preocupantes no quesito sanitário (SG2) com C inferior a 25%. O trabalho evidenciou que as AFPPs localizadas em municípios cujos SIMs não estão estruturados, atrelado à presença de RTs pouco atuantes, ocasionam baixo índice de BPF, pois carecem de informações técnicas e capacitação para implantação das mesmas. Percebeu-se que a realidade da AFPP é distinta à da indústria de larga escala. Por isso, parece justo que os dois segmentos sejam avaliados de forma diferenciada, justificando o propósito do projeto. / This project deals with the adaptation of a Good Manufacturing Practices (GMP) checklist for application in small farm agroindustry producing sausages. The objective will be to enable the proposed checklist to serve as an aid tool in the recommendation of this profile of agroindustries to SUSAF-RS (Unified State System of Agroindustrial Health and Small Porte of RS). Twenty agroindustries distributed in the regional municipalities of Emater de Lajeado and Soledade were visited, where the original BPF checklist (BRASIL, 2002) was applied as well as the adapted checklist. The agroindustries were classified in G1, G2 and G3 according to the percentage of compliance (C). The proposal of the checklist adapted to measure BPF in the scope of the small farm agroindustry was justified, since the proposed instrument presented a result of agroindustries classified with G1 (> 75% C) significantly higher than the classification obtained from the same agroindustries submitted to the original checklist. The adapted checklist showed that most agro-industries were classified as belonging to G2 with a mean of 59.2% compliance. Only 4 agroindustries, besides the unit where the pilot was applied, obtained more than 75% of C being classified as G1, therefore, with GMP implanted. All of these are registered in Municipal Inspection Services that have already joined the SUSAF. In addition, 8 agro-industries were classified in G2 and 7 were classified in G3. The main non-conformities (NC) identified in the G2 and G3 classifications were related to document management (SG5) and sanitary-sanitary (SG2) failures, with 5 of the 8 agro-industries classified in G2 presenting C above 65%. cases, document management was the main bottleneck for not achieving the 75% of C recommended. It is noteworthy that of the 7 agroindustries classified as G3, 4 presented worrying rates in the sanitary (SG2) with C less than 25%. The work can show that the small farm agroindustry s located in municipalities whose Inspcetion Local Service are not fully structured, coupled with the presence of weakly active professional suporting, present a low GMP index, since they lack technical information and capacity to implement the Manual of GMPs and SSOPs. It was perceived that the reality of small farm agroindustry is distinct from that of large-scale industry. Therefore, it seems fair that these two segments are evaluated in a differentiated way, justifying the purpose of the project.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-12-05T13:29:31Z No. of bitstreams: 1 RUY_DE_ALMEIDA_BARCELLOS.pdf: 2171813 bytes, checksum: d242fe874538146ea8081420b788cadb (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-12-06T18:13:57Z (GMT) No. of bitstreams: 1 RUY_DE_ALMEIDA_BARCELLOS.pdf: 2171813 bytes, checksum: d242fe874538146ea8081420b788cadb (MD5) / Made available in DSpace on 2018-12-06T18:20:07Z (GMT). No. of bitstreams: 1 RUY_DE_ALMEIDA_BARCELLOS.pdf: 2171813 bytes, checksum: d242fe874538146ea8081420b788cadb (MD5) Previous issue date: 2018-09-24 / Objective: To evaluate the impact of the implantation of a checklist during multidisciplinary daily round in the period of using invasive mechanical ventilation (MV) and permanence in the ICU. Methods: In a non-randomized clinical trial with historical controls, 466 patients submitted to MV were evaluated in a Hospital in Caxias do Sul (RS). Of this total, 235 and 231 were evaluated in the pre-intervention and post-intervention phases, respectively. The outcomes studied were SAPS-3, SOFA, frequency of infections, ICU stay, days of MV, reintubations, rehospitalizations, deaths in the ICU and hospital. Results: There was a significant reduction after the routine use of the checklist in the lenght of permanence in 37.5% (p <0.001) and 60% (p <0.001) in the time of mechanical ventilation. The frequency of pulmonary focus infection was reduced by 11.9% (p = 0.030). Conclusions: The multidisciplinarity structured through the use of checklists has an impact on the reduction of the days of use of mechanical ventilation and stay in the ICU. / Objetivo: Avaliar o impacto da implanta??o de uma lista de verifica??o durante round di?rio multiprofissional nos tempos de ventila??o mec?nica invasiva (VM) e perman?ncia na UTI. M?todos: Em um ensaio cl?nico n?o randomizado com controles hist?ricos, foram avaliados 466 pacientes submetidos ? VM em um hospital em Caxias do Sul (RS). Foram avaliados 235 e 231 pacientes nas fases pr?-interven??o e p?s-interven??o respectivamente. As vari?veis estudadas foram: Simplified Acute Physiology Score (SAPS-3), Sequential Organ Failure Assessment (SOFA), frequ?ncia de infec??es, perman?ncia na UTI, dias de VM, reintuba??es, reinterna??es, ?bitos na UTI e hospitalar. Resultados: Houve redu??o significativa ap?s a implanta??o da lista de verifica??o no tempo de perman?ncia em 37,5% (p<0,001) e de 60% (p<0,001) no tempo de ventila??o mec?nica. A frequ?ncia de infec??o de foco pulmonar teve redu??o 11,9% (p=0,030). Conclus?es: A multidisciplinaridade estruturada atrav?s da utiliza??o da lista de verifica??o teve impacto na redu??o dos dias de utiliza??o de ventila??o mec?nica e perman?ncia na UTI.

More than 13,000 deaths and $340 million in health care costs are the result of catheter-associated urinary tract infections (CAUTIs) annually in the United States. CAUTIs can also result in acute patient discomfort and potentially preventable exposure to antibiotics. The hospital for which this quality improvement project was developed was above the National Healthcare Safety Network CAUTI bench mark. Framed within the Iowa model of evidence-based practice, a multidisciplinary team of 8 hospital stakeholders guided the project (n=8). The purpose of the project was to develop an indwelling urinary catheter maintenance checklist using evidence-based practice guidelines related to preexisting inappropriate risk factors for catheterization and appropriate indications for catheterization, as well as evidence-based maintenance practices for care of the indwelling catheter. Each piece of evidence to be included in the checklist was evaluated by 4 content experts using a 10 item 5 point Likert scale ranging from 'strongly disagree' to 'strongly agree'. Descriptive analysis showed an average of 4.8/5 for all items with 'agree' being voiced in two of the items rather than 'strongly agree'. The checklist was completed and presented to hospital senior leadership who recommended that the checklist be incorporated into the hospital CAUTI prevention plan. All project team members (n=8) completed an 8 item 5 point Likert scale summative evaluation of the purpose, goal, objectives, and my leadership which averaged as 5 or 'strongly agree' supporting the development of the project. Implications for social change include improved patient outcomes, mindful stewardship of healthcare dollars, and increased patient and family satisfaction.

The purpose of this quantitative study was to examine whether the post-deployment screening instrument currently utilized to assess active-duty Marines for symptoms of PTSD upon their return from a combat deployment can be solely relied upon to accurately assess for PTSD. Additionally, this study sought to compare the number of Marines who have sought trauma-related mental health treatment based on their answers on the Post-Deployment Health Assessment (PDHA) to the number who have sought trauma-related mental health treatment based on their answers on their PTSD Checklist - Military Version (PCL-M). The participants in this study were comprised of a sample of active-duty Marines that had recently returned from a combat deployment. A quantitative secondary data analysis used Item Response Theory (IRT) to examine the answers provided by the participants on both the PDHA and PCL-M. Both instruments proved to be effective when assessing symptoms of PTSD and the participants identified as having symptoms of PTSD were referred for mental health services as required. According to the results, more Marines were identified as having symptoms of PTSD using both assessment instruments (PDHA and PCL-M) compared to those identified using just the PDHA. The result was a better understanding of predictors of Marines who may later develop PTSD. The results of this study can also assist the Marine Corps with its post-deployment screening for symptoms of PTSD which in turn can provide appropriate mental health referrals for Marines if deemed appropriate.

The present investigation evaluated the efficacy of a Cognitive-Behavioural Therapeutic Approach for the anger management of three adolescent males. The study is noteworthy because it utilised essential features of Beck's Cognitive Therapy in the cognitive restructuring phase of treatment. Previous studies have commonly employed Rational Emotive Therapy's disputation of irrational beliefs for this phase. For this reason it is considered to be an original contribution to the literature. A multiple (three) single-case study research design was employed. The three adolescents, aged 13 to 17 years, attended seven to nine one-hour counselling sessions over a two to three month period. Pre-, post-treatment and long-term followup psychometric measures of aggression and anecdotal reports of anger-control were obtained from parents and teachers. Self-reports in the affective and cognitive domain, progress in therapy, psychometric measures (aggressive behaviour subscale of the Child Behaviour Checklist, Adapted Novaco Anger Inventory and Piers-Harris Children's Self-Concept Scale) and continuous (including pre-, post-treatment and long-term follow-up) assessments of the frequency of angry outbursts were obtained. Counsellor assessments of cognitive homework and behaviour in therapy were also made. Results reveal marked reductions in the average daily frequencies of angry outbursts in all cases by post-treatment and treatment effects were maintained throughout the three-month follow-up period. It was concluded that the cognitive-behavioural therapeutic approach warrants further investigation as it is proposed that it is a comprehensive and efficacious treatment for male adolescent anger problems.

The present dissertation on autism spectrum disorders (ASD) addressed several questions. First, the behavioral symptoms of speaking and mute individuals with ASD were compared on the Autism Behavior Checklist (ABC), a commonly used diagnostic instrument. In addition, questions about the construction of the ABC were investigated. In Study I it was found that although the two groups did not significantly differ on the total ABC score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores to speaking, rather than mute, individuals with ASD was called into question. In addition, it was speculated that the expressive language items are weighted too heavily, on both the Language subscale and the total score. Second, because the 57 items of the ABC were categorized into 5 subscales on a subjective basis, an empirical investigation of the factor structure of the ABC was performed. In Study II, a 5-factor model that contained 39 of the items accounted for 80% of the total variance in the checklist. No support was found for classifying the 57 items into the existing 5 subscales. Finally, the two most common forms of instruction to teach children with ASD, discrete-trial teaching and incidental teaching, were assessed. In Study III it was ascertained that discrete-trial teaching was more efficient and produced faster acquisition and initially, greater generalization. However, by follow-up, the incidental teaching methods resulted in equal retention, greater generalization, and equal or greater spontaneous usage. The findings indicate that although it takes a longer time for children with autism to learn with incidental teaching procedures, once they have acquired an ability, it may be more permanent.

High risk offenders are a complex and heterogeneous group of offenders about whom researchers, clinicians, and society still know relatively little. In response to the paucity of information that is specifically applicable to high risk offenders, the present study examined RCMP Integrated Sexual Predator Intelligence Network (ISPIN) data to investigate the relationship between sexual paraphilias, sexual fantasy, and psychopathy among 139 of the highest risk sexual offenders in British Columbia. The sample included 41 child molesters, 42 rapists, 18 rapist/molesters, 30 mixed offenders, and 6 “other” sexual offenders. The majority of offenders in this sample were diagnosed with one primary paraphilia (67%). Data analysis revealed significant differences between offender types for criminal history variables including past sexual and nonsexual convictions, number of victims, and age of offending onset. For example, offenders who victimized children (i.e., exclusive child molesters & rapist/molesters) had a greater number of past sexual convictions than did offenders who victimized adults exclusively. Further, there were significant differences between offender types for paraphilia diagnoses, sexual fantasy themes, and levels of psychopathy. For example, exclusive child molesters were significantly more likely to receive a paraphilia diagnosis, were more likely to report having sexual fantasies, and had lower Psychopathy Checklist Revised (PCL-R) scores than other offender types. Results from the current study will serve to facilitate a more refined and informed understanding of sexual offending behaviour, with important implications for future research, assessment, and treatment issues, as well as law enforcement practices when working with high risk sexual offenders.