Attitudes, values, beliefs and practices in probation : continuity or change?

In recent decades theories of late modernity place the criminal justice system in a time of change and perceive amongst the general population growing levels of insecurity and intolerance of crime and offenders. Along with government policy and practice, these developments are seen as contributing to an increasingly punitive system that imprisons more than ever before and seeks to punish and manage offenders in the community, rather than to attempt their rehabilitation. For these reasons, along with a loss of faith in rehabilitation, the probation service is described by many as becoming a law enforcement agency, charged by government with the assessment and management of risk, the protection of the public and the management and punishment of offenders, rather than their transformation into pro-social citizens. This study seeks to discover the extent to which a sample of practitioners within the National Probation Service for England and Wales and the National Offender Management Service ascribe to the values, attitudes and beliefs associated with these macro and mezzo level changes and how much their practice has changed accordingly. It examines offender assessment, case management and supervision and the enforcement of community sentences and post-custody licences, concluding that whilst this group of practitioners do not reject these new approaches outright, they interpret them in ways that may be seen to differ somewhat from those of government, mainly around the aims and purposes of probation practice, the enforcement of orders and especially the invasive influence of managerialism. Based on these data, it would appear that successive governments have not succeeded in completely transforming the culture of the service, nor in recruiting and training a 'new breed' of technicians concerned only to manage and punish offenders and protect the public. As a result, 'real practice' may not be developing in quite the way intended by government and may have more links to 'traditional' modes of practice than has sometimes been assumed.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Attitudes, values, beliefs and practices in probation: continuity or change?

In recent decades theories of late modernity place the criminal justice system in a time of change and perceive amongst the general population growing levels of insecurity and intolerance of crime and offenders. Along with government policy and practice, these developments are seen as contributing to an increasingly punitive system that imprisons more than ever before and seeks to punish and manage offenders in the community, rather than to attempt their rehabilitation. For these reasons, along with a loss of faith in rehabilitation, the probation service is described by many as becoming a law enforcement agency, charged by government with the assessment and management of risk, the protection of the public and the management and punishment of offenders, rather than their transformation into pro-social citizens. This study seeks to discover the extent to which a sample of practitioners within the National Probation Service for England and Wales and the National Offender Management Service ascribe to the values, attitudes and beliefs associated with these macro and mezzo level changes and how much their practice has changed accordingly. It examines offender assessment, case management and supervision and the enforcement of community sentences and post-custody licences, concluding that whilst this group of practitioners do not reject these new approaches outright, they interpret them in ways that may be seen to differ somewhat from those of government, mainly around the aims and purposes of probation practice, the enforcement of orders and especially the invasive influence of managerialism. Based on these data, it would appear that successive governments have not succeeded in completely transforming the culture of the service, nor in recruiting and training a 'new breed' of technicians concerned only to manage and punish offenders and protect the public. As a result, 'real practice' may not be developing in quite the way intended by government and may have more links to 'traditional' modes of practice than has sometimes been assumed

Structural basis of peptidoglycan synthesis by E. coli RodA-PBP2 complex

Peptidoglycan (PG) is an essential structural component of the bacterial cell wall that is synthetized during cell division and elongation. PG forms an extracellular polymer crucial for cellular viability, the synthesis of which is the target of many antibiotics. PG assembly requires a glycosyltransferase (GT) to generate a glycan polymer using a Lipid II substrate, which is then crosslinked to the existing PG via a transpeptidase (TP) reaction. A Shape, Elongation, Division and Sporulation (SEDS) GT enzyme and a Class B Penicillin Binding Protein (PBP) form the core of the multi-protein complex required for PG assembly. Here we used single particle cryo-electron microscopy to determine the structure of a cell elongation-specific E. coli RodA-PBP2 complex. We combine this information with biochemical, genetic, spectroscopic, and computational analyses to identify the Lipid II binding sites and propose a mechanism for Lipid II polymerization. Our data suggest a hypothesis for the movement of the glycan strand from the Lipid II polymerization site of RodA towards the TP site of PBP2, functionally linking these two central enzymatic activities required for cell wall peptidoglycan biosynthesis

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk