Sex offender risk assessment : consideration of human rights in community protection legislation

ObjectivesRisk assessments provided to judicial decision makers as a part of the current generation of legislation for protecting the public from sexual offenders can have a profound impact on the rights of individual offenders. This article will identify some of the human rights issues inherent in using the current assessment procedures to formulate and communicate risk as a forensic expert in cases involving civil commitment, preventive detention, extended supervision, or special conditions of parole. MethodBased on the current professional literature and applied experience in legal proceedings under community protection laws in the United States and New Zealand, potential threats to the rights of offenders are identified. Central to these considerations are issues of the accuracy of current risk assessment measures, communicating the findings of risk assessment appropriately to the court, and the availability of competent forensic mental health professionals in carrying out these functions. The role of the forensic expert is discussed in light of the competing demands of protecting individual human rights and community protection. ConclusionActuarial risk assessment represents the best practice for informing judicial decision makers in cases involving sex offenders, yet these measures currently demonstrate substantial limitations in predictive accuracy when applied to individual offenders. These limitations must be clearly articulated when reporting risk assessment findings. Sufficient risk assessment expertise should be available to provide a balanced application of community protection laws.

Short term reoffending by child victim sex offenders in New Zealand : a comparison of those with and without extended supervision

Sexual offenders with child victims in New Zealand who are considered at high risk for reoffending are subject to an Extended Supervision Order. This allows for a period of supervision of up to ten years following release to the community. The present study examined 89 offenders given Extended Supervision Orders over the 33 month period since the legislation was enacted. All types of reoffending resulting in criminal convictions by this group were included. A matched sample of sexual offenders with child victims released prior to this legislation and a sample of offenders judged to be lower risk were compared to those under extended supervision. Offenders under extended supervision reoffended faster and at a higher rate for both sexual and general offences than those deemed lower risk, but at a lower rate than pre-extended supervision high risk offenders. The relationship between specialist treatment programme attendance and completion, actuarial risk level, and recidivism in the extended supervision sample were also investigated. These variables were found not to be significant predictors of sexual recidivism.

Case formulation with sex offenders : an illustration of individualized risk assessment

There has been a rapid expansion of the professional literature in risk assessment with sexual offenders over the past 20 years.  However, recent professional experience suggests that risk assessment reports often fail to be as relevant or useful as they might be for judicial decision-makers.  Research with large samples of offenders has refined our understanding of identifiable subgroups with different rates of sexual reoffending, but the management of risk requires that we deal effectively with individual offenders.  One area that can be improved is the development of case formulations of risk.  Clinicians must move beyond the mechanical use of actuarial static and dynamic risk factors to a broader integration of relevant information about the individual if they are to assist in managing risk in a way that serves the needs of the offender while protecting public safety.

Commercial sex work, survival sex, sexual violence and HIV/AIDS prevention in Arumeru District, Arusha region Of Tanzania

Objective: To examine the knowledge and practices about HIV/AIDS among female Tanzanian commercial sex workers (CSWs) and assess the contextual dynamics that prevent safer sexual behaviours.

Method: The study used mixed methods and was implemented in two phases. Phase one assessed the knowledge and practices about HIV/AIDS among CSWs. Data were obtained with 54 CSWs, who were selected by using a snowball sampling approach. Semi-structured, face-to-face interviews with the CSWs were undertaken to allow the research participants to describe and discuss their lived realities as they perceive and experience them. In phase two, three discrete focus group discussions, each comprising 6-10 women, were carried out with 26 of the 54 CSWs who were interviewed in phase one.

Results: There was exploitation and inequity in the women's lives due to the multiple and overlapping oppressions of poverty and patriarchy. Sexual violence was framed, legitimised and reinforced by structural and cultural inequities. Such exploitation impacted not only on CSWs' lives as sex workers, but on their previous and/or simultaneous lives as mothers, wives, girlfriends and daughters. The women practised ‘survival sex’ as CSWs and/or sexual partners of men, and experienced sexual violence from their clients/partners. This violence was either culturally legitimised within a patriarchal framework or manifested itself as ‘displaced aggressive sex’ by men experiencing marginalisation in socio-economic spheres.

Is sex-specific mass gain in Cory's shearwaters Calonectris diomedea related to begging and steroid hormone expression?

Mass differences between the sexes of dimorphic bird species often appear early in the nestling development. But how do adults know how much to feed a chick in a sexually dimorphic species? Do chicks of the heavier sex beg more? We studied begging in Cory’s shearwaters Calonectris diomedea, a species with heavier adult and juvenile males than females. We found that begging rates and call numbers were not different between male and female chicks, but parameters of begging intensity differed between the sexes in their relationship to chick body condition. For the same body condition, males had significantly higher begging call numbers and rates. Acoustical parameters, which were analysed semi-automatically, included the lengths of call and silence intervals, the minimum, mean and maximum frequency in a call and the number of frequency peaks within a call. We found no consistent differences of acoustic begging call elements between the sexes. Male and female chicks did not differ in the levels of the steroid hormones testosterone or corticosterone in the second quarter of the nestling period, and the mechanism leading to sex-related differences in begging rates for a given body condition remains unknown.

Single-sex classes in co-educational schools

This research investigated social and academic outcomes from single-sex classrooms in a Tasmanian coeducational government primary school. Interviews, observations and surveys formed the basis of the evidence. Teachers, parents and children reported positive benefits from the class organisation, but these differed according to gender. Staff identified increased confidence and higher self-esteem among girls, whereas boys developed increased motivation and more commitment to schoolwork. Teachers and parents noted that boys' accountability and self-discipline improved. Teachers adopted different strategies from those used with mixed-gender classes and gained higher levels of satisfaction from teaching, attributable to increased children's time 'on task'. Paradoxically, standardised school testing indicated no increase in academic achievements. However, there may be an extended lag between establishing changed social relationships and measurable academic outcomes, suggesting that if the new class structure is to achieve its full potential, it should be established early in primary school and continue to adolescence.

Affect, emotions and sex offending

The role of emotional and other affective states as causes and consequences of sexual offending is emerging as an important area for theoretical analysis and for empirical research. In this paper we focus on whether affective and emotional states serve as causal antecedents for sexual offending. Firstly, we identify five sources of evidence relating to whether emotion is causal. We conclude that the evidence broadly supports the notion that a causal relationship exists, at least for some offenders. We then address attempts to identify mechanisms to explain how such effects are mediated. Finally we discuss the implications of this work for therapeutic interventions with sex offenders.

Sentencing of male and female child sex offenders : Australian study

Research suggests that, in line with the chivalry hypothesis of female offending, a range of mitigatory factors such as mental health problems, substance abuse, and personal experiences of abuse are brought into play when women who offend against children are brought to trial. This is reflected in sentencing comments made by judges and in the sanctions imposed on the offenders, and as a result female offenders are treated differently to male offenders. The current study investigated this in an Australian context. Seven cases of female-perpetrated child sexual abuse were identified over a 6-year period through the Austlii database. Seven cases of male-perpetrated child sex abuse matched as far as possible to these were identified. Court transcripts were then located, and sentencing comments and sanctions imposed were analysed. All offenders were sentenced to imprisonment, but in general the women were more likely than the men to receive less jail time and lower non-parole periods because their personal backgrounds or situation at the time of the offending (i.e., difficulties with intimate relationship, male dependence issues, depression, loneliness and anger) were perceived as worthy of sympathy, and they were considered as likely to be rehabilitated. Further investigations are needed to support these findings.

Sex-specific developmental plasticity in response to yolk corticosterone in an oviparous lizard

Corticosterone exposure during prenatal development as a result of maternal upregulation of circulating hormone levels has been shown to have effects on offspring development in mammals. Corticosterone has also been documented in egg yolk in oviparous vertebrates, but the extent to which this influences phenotypic development is less studied. We show that maternal corticosterone is transferred to egg yolk in an oviparous lizard (the mallee dragon, Ctenophorus fordi Storr), with significant variation among clutches in hormone levels. Experimental elevation of yolk corticosterone did not affect hatching success, incubation period or offspring sex ratio. However, corticosterone did have a sex-specific effect on skeletal growth during embryonic development. Male embryos exposed to relatively high levels of corticosterone were smaller on average than control males at hatching whereas females from hormone-treated eggs were larger on average than control females. The data thus suggest that males are not just more sensitive to the detrimental effects of corticosterone but rather that the sexes may have opposite responses to corticosterone during development. Positive selection on body size at hatching for both sexes in this species further suggests that increased corticosterone in egg yolk may have sex-specific fitness consequences, with potential implications for sex allocation and the evolution of hormone-mediated maternal effects.

Cost-effectiveness of adult circumcision in a resource-rich setting for HIV prevention among men who have sex with men

Background.  We examined the effects and cost‐effectiveness of 4 strategies of circumcision in a resource‐rich setting (Australia) in a population of men who have sex with men (MSM).

Method.  We created a dynamic mathematical transmission model and performed an economic analysis to estimate the costs, outcomes, and cost‐effectiveness of different strategies, compared with those of the status quo. Strategies included circumcision of all MSM at age 18 years, circumcision of all MSM aged 35–44 years, circumcision of all insertive MSM aged 18 years, and circumcision of all MSM aged 18 years . All costs are reported in US dollars, with a cost‐effectiveness threshold of $42,000 per quality‐adjusted life‐year.

Results.  We find that 2%–5% of human immunodeficiency virus (HIV) infections would be averted per year, with initial costs ranging from $3.6 million to $95.1 million, depending on the strategy. The number of circumcisions needed to prevent 1 HIV infection would range from 118 through 338. Circumcision of predominately insertive MSM would save $21.7 million over 25 years with a $62.2 million investment. Strategies to circumcise 100% of all MSM and to circumcise MSM aged 35–44 years would be cost‐effective; the latter would require a smaller investment. The least cost‐effective approach is circumcision of young MSM close to their sexual debut. Results are very sensitive to assumptions about the cost of circumcision, the efficacy of circumcision, sexual preferences, and behavioral disinhibition.

Conclusions.  Circumcision of adult MSM may be cost‐effective in this resource‐rich setting. However, the intervention costs are high relative to the costs spent on other HIV prevention programs.

Gender differences in the prevalence of impaired fasting glycaemia and impaired glucose tolerance in Mauritius. Does sex matter?

Objective: To examine gender differences in the characteristics and prevalence of various categories of glucose tolerance in a population study in Mauritius.

Research design and methods: In 1998, a community-based cross-sectional survey was conducted in Mauritius. Categories of glucose metabolism were determined in 5388 adults, with an oral glucose tolerance test given to those who did not have previously diagnosed diabetes (n = 4036). Other cardiovascular risk factors were assessed among those without known diabetes.

Results: For men and women the prevalence of diabetes (22.0 vs. 21.8%, respectively) and the prevalence of coexisting impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (3.2 vs. 2.9%) were similar. However, men were twice as likely as women to have isolated IFG [5.1% (4.2–6.0) vs. 2.9% (2.3–3.5)], despite being younger, thinner and with lower plasma insulin but higher lipids. Conversely, the prevalence of isolated IGT was lower in men [9.0% (7.9–10.2) vs. 13.9% (12.6–15.1)]. Among non-diabetic individuals, fasting glucose was higher in men than women, whereas 2-h glucose was higher in women. In people without diabetes, women had significantly higher body mass index, beta cell function (HOMA-B), fasting and 2-h insulin than men and significantly lower waist-hip ratios, waist circumference, insulin sensitivity (HOMA-S) and triglycerides.

Conclusion: In Mauritius, the distribution of impaired glucose metabolism differs by sex. The observation that IFG is more prevalent in men and IGT more prevalent in women raises important questions about their underlying aetiology and the ability of the current glucose thresholds to equally identify men and women at high-risk of developing diabetes. IFG should be seen as a complimentary category of abnormal glucose tolerance, rather than a replacement for IGT.

The impact of patient sex on paramedic pain management in the prehospital setting

Objective: The aim of this study was to establish the impact of patient sex on the provision of analgesia by paramedics for patients reporting pain in the prehospital setting.
Methods: This retrospective cohort study of paramedic patient care records included all adult patients with a Glasgow Coma Score higher than 12 transported to hospital by ambulance in a major metropolitan area over a 7-day period in 2005. Data collected included demographics, patient report of pain and its type and severity, provision of analgesia by paramedics, and type of analgesia provided. The outcomes of interest were sex differences in the provision of analgesia. Data analysis was by descriptive statistics, χ2 test, and logistic regression.
Results: Of the 3357 patients transported in the study period, 1766 (53%) reported pain; this forms the study sample. Fifty-two percent were female, median age was 61 years, and median initial pain score (on a 0-10 verbal numeric rating scale) was 6. Forty-five percent of patients reporting pain did not receive analgesia (791/1766) (95% confidence interval [CI], 43%-47%), with no significant difference between sexes (P = .93). There were, however, significant sex differences in the type of analgesia administered, with males more likely to receive morphine (17%; 95% CI, 15%-20%) than females (13%; 95% CI, 11%-15%) (P = .01). The difference remains significant when controlled for type of pain, age, and pain severity (odds ratio, 0.61, 95% CI, 0.44-0.84).
Conclusion: Sex is not associated with the rate of paramedic-initiated analgesia, but is associated with differences in the type of analgesia administered.