16,141 research outputs found

    Identifying and responding to people with mild learning disabilities in the probation service

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    It has long been recognised that, like many other individuals, people with learningdisabilities find their way into the criminal justice system. This fact is not disputed. Whathas been disputed, however, is the extent to which those with learning disabilities arerepresented within the various agencies of the criminal justice system and the ways inwhich the criminal justice system (and society) should address this. Recently, social andlegislative confusion over the best way to deal with offenders with learning disabilities andmental health problems has meant that the waters have become even more muddied.Despite current government uncertainty concerning the best way to support offenders withlearning disabilities, the probation service is likely to continue to play a key role in thesupervision of such offenders. The three studies contained herein aim to clarify the extentto which those with learning disabilities are represented in the probation service, toexamine the effectiveness of probation for them and to explore some of the ways in whichprobation could be adapted to fit their needs.Study 1 and study 2 showed that around 10% of offenders on probation in Kent appearedto have an IQ below 75, putting them in the bottom 5% of the general population. Study 3was designed to assess some of the support needs of those with learning disabilities in theprobation service, finding that many of the materials used by the probation service arelikely to be too complex for those with learning disabilities to use effectively. To addressthis, a model for service provision is tentatively suggested. This is based on the findings ofthe three studies and a pragmatic assessment of what the probation service is likely to becapable of achieving in the near future

    Victims' Access to Justice in Trinidad and Tobago: An exploratory study of experiences and challenges of accessing criminal justice in a post-colonial society

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    This thesis investigates victims' access to justice in Trinidad and Tobago, using their own narratives. It seeks to capture how their experiences affected their identities as victims and citizens, alongside their perceptions of legitimacy regarding the criminal justice system. While there have been some reforms in the administration of criminal justice in Trinidad and Tobago, such reforms have not focused on victims' accessibility to the justice system. Using grounded theory methodology, qualitative data was collected through 31 in-depth interviews with victims and victim advocates. The analysis found that victims experienced interpersonal, structural, and systemic barriers at varying levels throughout the criminal justice system, which manifested as institutionalized secondary victimization, silencing and inequality. This thesis argues that such experiences not only served to appropriate conflict but demonstrates that access is often given in a very narrow sense. Furthermore, it shows a failure to encompass access to justice as appropriated conflicts are left to stagnate in the system as there is often very little resolution. Adopting a postcolonial lens to analyse victims' experiences, the analysis identified othering practices that served to institutionalize the vulnerability and powerlessness associated with victim identities. Here, it is argued that these othering practices also affected the rights consciousness of victims, delegitimating their identities as citizens. Moreover, as a result of their experiences, victims had mixed perceptions of the justice system. It is argued that while the system is a legitimate authority victims' endorsement of the system is questionable, therefore victims' experiences suggest that there is a reinforcement of the system's legal hegemony. The findings suggest that within the legal system of Trinidad and Tobago, legacies of colonialism shape the postcolonial present as the psychology and inequalities of the past are present in the interactions and processes of justice. These findings are relevant for policymakers in Trinidad and Tobago and other regions. From this study it is recognized that, to improve access to justice for victims, there needs to be a move towards victim empowerment that promotes resilience and enhances social capital. Going forward it is noted that there is a need for further research

    The temporality of rhetoric: the spatialization of time in modern criticism

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    Every conception of criticism conceals a notion of time which informs the manner in which the critic conceives of history, representation and criticism itself. This thesis reveals the philosophies of time inherent in certain key modern critical concepts: allegory, irony and the sublime. Each concept opens a breach in time, a disruption of chronology. In each case this gap or aporia is emphatically closed, elided or denied. Taking the philosophy of time elaborated by Giorgio Agamben as an introductory proposition, my argument turns in Chapter One to the allegorical temporality which Walter Benjamin sees as the time of photography. The second chapter examines the aesthetics of the sublime as melancholic or mournful untimeliness. In Chapter Three, Paul de Man's conception of irony provides an exemplary instance of the denial of this troubling temporal predicament. In opposition to the foreclosure of the disturbing temporalities of criticism, history and representation, the thesis proposes a fundamental rethinking of the philosophy of time as it relates to these categories of reflection. In a reading of an inaugural meditation on the nature of time, and in examining certain key contemporary philosophical and critical texts, I argue for a critical attendance to that which eludes those modes of thought that attempt to map time as a recognizable and essentially spatial field. The Confessions of Augustine provide, in the fourth chapter, a model for thinking through the problems set up earlier: Augustine affords us, precisely, a means of conceiving of the gap or the interim. In the final chapter, this concept is developed with reference to the criticism of Arnold and Eliot, the fiction of Virginia Woolf and the philosophy of cinema derived from Deleuze and Lyotard. In conclusion, the philosophical implications of the thesis are placed in relation to a conception of the untimeliness of death

    Clinicians' experiences of using the MCA (2005) with people with intellectual disabilities

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    Section A is a narrative synthesis of the empirical literature of professionals’ knowledge of the MCA and how they apply it when working with people with intellectual disabilities (ID). Eleven papers were identified for inclusion in this review. Four themes, with subthemes, were identified: ‘processes involved’, ‘working with complexity’, ‘knowledge gaps and variability’ and ‘assessor needs’. Methodological strengths and weaknesses are also considered. Findings are discussed in relation to clinical implications and recommendations for future research are outlined. Section B is an empirical study using Interpretative Phenomenological Analysis to explore the experiences of clinicians using the MCA (2005) with people with ID to assess capacity to consent to sex. Eight clinicians, who had completed between 2 and 40-50 (mode=2) MCA assessments regarding consent to sex. Three superordinate themes, with subthemes, are outlined and discussed in relation to the existing literature. Limitations, clinical implications and areas of future research are considered

    Development and evaluation of a treatment package for men with an intellectual disability who sexually offend

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    Sex offending in the general population has been a focus of interest for some time due to the damaging nature of the behaviour, and the need to reduce recidivism. Theoretical and clinical advances (Finke1hor, 1986; HM Prison Service, 1996; Marshall, Anderson, & Fernandez, 1999; Serran & Marshall, 2010) in treatment for sex offenders in the general population have been extended to men with an intellectual disability at risk of sexual offending (Lindsay, 2009). The purpose of this project is to develop and evaluate the SOTSEC-ID version cftrus model. Participants are adult males from 15 different locations across England and Wales, with an intellectual disability or borderline cognitive functioning and who have committed sexual offences. A pilot study clarified assessments and procedures, and individual data over several years is presented. A qualitative study using Interpretive Phenomenological Analysis (JP A) illustrates the 'meaning making' of participants' treatment experience through six major themes. A reliability and validity study assesses the four main quantitative measures, QACSO, SAKA, SOSAS, and VESA, finding limited support for criterion validity for the SOSAS and SAKA, excellent inter-rater reli"ability for all four main measures, and good to excellent inter-rater reliability on all but the SAKA Finally, a quantitative study, in collaboration with the wider SOTSEC-ID group, uses a repeated measures design to compare the QACSO, SOSAS and SAKA across pre-group, post-group and follow. up. Significant main effects and post-hoc comparisons were in the predicted direction for all measures. A range of information on demographic, clinical and criminogenic factors including offending during treatment or follow-up are also presented. A recidivism rate of 12.3% over a year was calculated for the sample. The treatment model and collaborative framework is recommended for wider adoption

    Women’s Experiences of Accessing Breastfeeding and Perinatal Health Support in the Context of Intimate Partner Violence: An Interpretive Description Study

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    Background: Women experiencing intimate partner violence are at a heightened risk of negative perinatal and breastfeeding outcomes. This study explored the experiences of accessing breastfeeding support for women who endorse a history of intimate partner violence. A study of five in-depth semi-structured interviews were completed at 12-weeks postpartum with breastfeeding mothers with a history of intimate partner violence. Findings: Women expressed difficulties in accessing a healthcare provider who had specialized skill in breastfeeding support. Trust in their healthcare provider, built through displays of compassion and competence, was important to mitigate obstacles experienced during care access for this population. Trauma-and-violence-informed care principles were beneficial to the development of the therapeutic relationship in perinatal care. Women placed value on breastfeeding support received from both healthcare providers and social supports, which impacted mothers’ perceived breastfeeding support and self-efficacy. Further, mothers described increased levels of breastfeeding self-efficacy after engaging in a trauma-and-violence-informed care program aimed at supporting breastfeeding. Conclusions: Trauma-informed care may aid in the development of trust in the therapeutic relationship, which in turn impacts access to breastfeeding support and breastfeeding self-efficacy. The inclusion of trauma-and-violence informed principles in perinatal care may be effective at mitigating barriers to access for women who endorse a history of intimate partner violence. health care on how to employ trauma-informed breastfeeding care to may lead to better support for this population

    Exploring the effects of spinal cord stimulation for freezing of gait in parkinsonian patients

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    Dopaminergic replacement therapies (e.g. levodopa) provide limited to no response for axial motor symptoms including gait dysfunction and freezing of gait (FOG) in Parkinson’s disease (PD) and Richardson’s syndrome progressive supranuclear palsy (PSP-RS) patients. Dopaminergic-resistant FOG may be a sensorimotor processing issue that does not involve basal ganglia (nigrostriatal) impairment. Recent studies suggest that spinal cord stimulation (SCS) has positive yet variable effects for dopaminergic-resistant gait and FOG in parkinsonian patients. Further studies investigating the mechanism of SCS, optimal stimulation parameters, and longevity of effects for alleviating FOG are warranted. The hypothesis of the research described in this thesis is that mid-thoracic, dorsal SCS effectively reduces FOG by modulating the sensory processing system in gait and may have a dopaminergic effect in individuals with FOG. The primary objective was to understand the relationship between FOG reduction, improvements in upper limb visual-motor performance, modulation of cortical activity and striatal dopaminergic innervation in 7 PD participants. FOG reduction was associated with changes in upper limb reaction time, speed and accuracy measured using robotic target reaching choice tasks. Modulation of resting-state, sensorimotor cortical activity, recorded using electroencephalography, was significantly associated with FOG reduction while participants were OFF-levodopa. Thus, SCS may alleviate FOG by modulating cortical activity associated with motor planning and sensory perception. Changes to striatal dopaminergic innervation, measured using a dopamine transporter marker, were associated with visual-motor performance improvements. Axial and appendicular motor features may be mediated by non-dopaminergic and dopaminergic pathways, respectively. The secondary objective was to demonstrate the short- and long-term effects of SCS for alleviating dopaminergic-resistant FOG and gait dysfunction in 5 PD and 3 PSP-RS participants without back/leg pain. SCS programming was individualized based on which setting best improved gait and/or FOG responses per participant using objective gait analysis. Significant improvements in stride velocity, step length and reduced FOG frequency were observed in all PD participants with up to 3-years of SCS. Similar gait and FOG improvements were observed in all PSP-RS participants up to 6-months. SCS is a promising therapeutic option for parkinsonian patients with FOG by possibly influencing cortical and subcortical structures involved in locomotion physiology
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