The Ghost in the Courtroom: When Opinions Are Adopted Verbatim from Prosecutors

Judicial opinions captivate the legal community, serving as a hub for teaching new lawyers and developing the law. These opinions also provide a method for the justice system to communicate with the people it serves—both the parties to the cases and the public. This communication should be well-reasoned and developed from a neutral standpoint. However, this ideal is being seriously threatened by ghostwriting, the practice of allowing a party to write the opinion. This is particularly troubling in criminal cases, where the very lawyers charged with prosecuting defendants are writing the opinions against them. This Note proposes that opinions written by prosecutors should be subject to de novo appellate review. Additionally, states should pass legislation and revise ethics rules to require that judges critically review a proposed opinion, refrain from adopting it verbatim, give the opposing party an opportunity to reply, and write an original legal analysis section. Change is necessary to ensure that opinions are not just a recitation of a prosecutor’s argument, but a thoughtful product of an impartial judge. Left unchecked, ghostwriting will destroy the value of opinions and undermine the integrity of adjudication

Relationship between commuting and health outcomes in a cross-sectional population survey in southern Sweden

<p>Abstract</p> <p>Background</p> <p>The need for a mobile workforce inevitably means that the length of the total work day (working and traveling time) will increase, but the health effects of commuting have been surprisingly little studied apart from perceived stress and the benefits of physically active commuting.</p> <p>Methods</p> <p>We used data from two cross-sectional population-based public health surveys performed in 2004 and 2008 in Scania, Sweden (56% response rate). The final study population was 21, 088 persons aged 18-65, working > 30 h/week. Duration (one-way) and mode of commuting were reported. The outcomes studied were perceived poor sleep quality, everyday stress, low vitality, mental health, self-reported health, and absence from work due to sickness during the past 12 months. Covariates indicating socioeconomic status and family situation, overtime, job strain and urban/rural residency were included in multivariate analyses. Subjects walking or cycling to work < 30 min were used as a reference category.</p> <p>Results</p> <p>Monotonous relations were found between duration of public transport commuting and the health outcomes. For the category commuting > 60 min odds ratios (ORs) ranged from 1.2 - 1.6 for the different outcomes. For car commuting, the relationships were concave downward or flat, with increasing subjective health complaints up to 30-60 min (ORs ranging from 1.2 - 1.4), and lower ORs in the > 60 min category. A similar concave downward relationship was observed for sickness absence, regardless of mode of transport.</p> <p>Conclusions</p> <p>The results of this study are concordant with the few earlier studies in the field, in that associations were found between commutation and negative health outcomes. This further demonstrates the need to consider the negative side-effects of commuting when discussing policies aimed at increasing the mobility of the workforce. Studies identifying population groups with increased susceptibility are warranted.</p

Responsiveness of a modified version of the postural assessment scale for stroke patients and longitudinal change in postural control after stroke- Postural Stroke Study in Gothenburg (POSTGOT) -

Abstract Background Responsiveness data certify that a change in a measurement output represents a real change, not a measurement error or biological variability. The objective was to evaluate the responsiveness of the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in patients with a first event of stroke. An additional aim was to estimate the change in postural control during the first 12 months after stroke onset. Methods The SwePASS assessments were conducted during the first week and 3, 6 and 12 months after stroke in 90 patients. Svensson’s method, Relative Position (RP), Relative Concentration (RC) and Relative Rank Variance (RV), were used to estimate the scale’s responsiveness and the patients’ change in postural control over time. Results From the first week to 3 months after stroke, the patients improved in terms of postural control with 2 to 12 times larger systematic changes in Relative Position (RP), for which 9 items and the total score showed a significant responsiveness to change when compared to the intrarater reliability measurement error of the SwePASS reported in a previous study. When SwePASS was used to assess change in postural control between the first week and 3 months, 74% of the patients received higher scores while 10% received lower scores, RP 0.31 (95% CI 0.219-0.402). The corresponding figures between 3 and 6 and between 6 and 12 months were 37% and 16%, RP 0.09 (95% CI 0.030-0.152), and 18% and 26%, RP −0.07 (95% CI −0.134- (−0.010)), respectively. Conclusions The SwePASS is responsive to change. Postural control evaluated using the SwePASS showed an improvement during the first 6 months after stroke. The measurement property, in the form of responsiveness, shows that the SwePASS scoring method can be considered for use in rehabilitation when assessing postural control in patients after stroke, especially during the first 3 months.</p

Fatigue in stroke survivors: a 5-year follow-up of the Fall study of Gothenburg

Longer term knowledge of post-stroke fatigue (PSF) is limited. Our aim was to describe the prevalence of, and to identify baseline predictors associated with, PSF 5 years after stroke. We undertook a follow-up of stroke survivors from the 504 consecutively recruited participants in the observational "The Fall Study of Gothenburg", conducted between 2014 and 2016. The dependent variable, PSF, was assessed using the Swedish version of the Fatigue Assessment Scale (S-FAS) and defined as having a S-FAS score ≥ 24. The S-FAS questionnaire was mailed to potential participants in August 2020. The independent variables, previously obtained from medical records, included age; sex; comorbidities; stroke severity; hospital length of stay; body mass index (BMI); number of medications and lifestyle factors at index stroke. To identify predictors of PSF, univariable and multivariable logistic regression analyses were performed. Of the 305 eligible participants, 119 (39%) responded with complete S-FAS. Mean age at index stroke was 71 (SD 10.4) years and 41% were female. After a mean of 4.9 years after stroke, the prevalence of PSF was 52%. Among those with PSF, almost two thirds were classified as having both physical and mental PSF. In the multivariable analysis, only high BMI predicted PSF with an odds ratio of 1.25 (95% CI 1.11-1.41, p < 0.01). In conclusion, half of the participants reported PSF 5 years after index stroke and higher body mass index was identified as a predictor. The findings from this study are important for healthcare professionals, for planning health-related efforts and rehabilitation of stroke survivors.ClinicalTrials.gov, Identifier NCT02264470

Rationale for a Swedish cohort consortium

We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts. We envisage a standing Swedish cohort consortium that would drive development of epidemiological research methods and strengthen the Swedish as well as international epidemiological competence, community, and competitiveness.Peer reviewe

Secondary insults following traumatic brain injury enhance complement activation in the human brain and release of the tissue damage marker S100B

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.OBJECT: Complement activation has been suggested to play a role in the development of secondary injuries following traumatic brain injury (TBI). The present study was initiated in order to analyze complement activation in relation to the primary brain injury and to secondary insults, frequently occurring following TBI. METHODS: Twenty patients suffering from severe TBI (Glasgow coma score ≤ 8) were included in the study. The "membrane attack complex," C5b9, which is the cytolytic end product of the complement system was analyzed in cerebrospinal fluid (CSF). The degree of brain tissue damage was assessed using the release of S100B and neuron-specific enolase (NSE) to the CSF and blood. The blood-brain barrier was assessed using the CSF/serum quotient of albumin (Q (A)). RESULTS: Following impact, initial peaks (0-48 h) of C5b9, S100B, and NSE with a concomitant loss of integrity of the blood-brain barrier were observed. Secondary insults at the intensive care unit were monitored. Severe secondary insults were paralleled by a more pronounced complement activation (C5b9 in CSF) as well as increased levels of S100B (measured in CSF), but not with NSE. CONCLUSION: This human study indicates that complement activation in the brain is triggered not only by the impact of trauma per se but also by the amount of secondary insults that frequently occur at the scene of accident as well as during treatment in the neurointensive care unit. Complement activation and in particular the end product C5b9 may in turn contribute to additional secondary brain injuries by its membrane destructive properties

Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses

BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values 105 mL·min-1·1.73 m-2, compared with those with eGFR between 60 and 105 mL·min-1·1.73 m-2. Mendelian randomization analyses for CHD showed an association among participants with eGFR 105 mL·min-1·1.73 m-2. Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin A1c, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function

Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses

BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million personyears of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eG FR values 105 mL.min(-1).1.73 m(-2), compared with those with eG FR between 60 and 105 mL.min(-1).1.73 m(-2). Mendelian randomization analyses for CHD showed an association among participants with eGFR 105 mL.min(-1).1.73 m(-2). Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin Alc, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function

Nya vägar till lärande : Deltagande aktionsforskning kring kenyanska löpares appropriering av smarta telefoner i vardagen för mobilt lärande

In Kenya, mobile technology is widely used, with more and more people gaining access to the Internet. Mobile technology has the potential to support learning and improve lives, particular those of impoverished people. In this study, 30 Kenyan runners from poor backgrounds and with limited formal education participated. They were provided with a basic smartphone and Internet data bundles for one year so that they could participate in m-learning. The participatory action research approach was used. Sources of data included interviews, observations, fieldnotes, web inquiries, and mobile log files. A sociocultural perspective was used to analyze how the participants learned informally using the smartphones. Findings indicate that the Kenyan runners’ rapid appropriation and mastery of the smartphones was based on their curiosity and interest in sports. The runners’ skills and knowledge increased over time, showing how digital resources improved their training, increased their social interactions, developed entrepreneurial skills, created awareness in and with the rest of society, and improved participation in m-learning. Sociocultural analysis showed that feedback from peers and the tool itself were both significant for learning. The participants themselves influenced the research process. From their interest emerged an online course (MOOC) about human rights. Key challenges in the process were power consumption, lack of electricity, and the availability and cost of Internet access. A lack of critical attitude about content on the Internet was also discernible. The main findings highlight how mobile technology can not only improve daily lives, but also develop new ways for people to participate in mlearning.I Kenya är användningen av mobilteknologi och Internet utbredd och ökar stadigt. Mobilteknik visar sig ha potential att öka medborgares intressen för lärande och kunskap, och därigenom förbättra livssituationen särskilt för fattiga människor. Den här studien syftade till att med deltagande aktionsforskning analysera hur sådana processer går till. I studien deltog 30 kenyanska löpare från fattiga förhållanden och med begränsad formell utbildning. Deltagarna utrustades med en enkel smartphone med fri surf under ett år och följdes med intervjuer, observationer, webbenkäter och mobilspårning. Deras lärandeprocesser analyserades ur ett sociokulturellt perspektiv om hur teknik tillägnas – approrieras – och används i vardagliga praktiker och utvecklar lärande. Resultaten visade att de kenyanska löparna snabbt approprierade telefonerna och fann utifrån nyfikenhet och intresset för idrott olika sätt att använda dem. Kunskaper och färdigheter utvecklades över tid och de digitala resurserna förbättrade löparnas träning, ökade sociala interaktioner, utvecklade entreprenöriella färdigheter och nya synsätt på sina möjligheter i världen. Den sociokulturella analysen visade även att feedback från andra deltagare och/eller av tekniken i sig hade betydelse för lärandet. Forskningsprocessen påverkades av deltagarna och utifrån deras intresse skapades en on-line kurs (MOOC) om Mänskliga rättigheter. Problem i studien var telefonens energiförbrukning, brist på elektricitet, tillgång till och kostnad för Internet samt deltagarnas kritiska förhållningssätt till Internet. Det övergripande resultatet är att mobilteknologi kan förbättra livsvillkor och skapa nya vägar till lärande

Teaching Practice Online : Challenges in Japan, India and Kenya Under Pandemic

The coronavirus pandemic affected the whole world in 2020, with high pressure on the health sector, many deaths, reduced business activity, rising unemployment rates, travel restrictions and social distancing. These developments have had severe consequences for all areas of every society around the globe. This also includes education. In many countries, primary and secondary pupils and university students alike were sent home as schools and universities closed abruptly as part of efforts to control the spread of the virus. As teaching moved online, learners and teachers were unprepared for the new situation, which posed a unique set of challenges. In this context, trainee teachers at a Swedish university were encouraged to support online teaching at schools in Japan, India and Kenya. The purpose of the digital internship was threefold: to continue the trainees’ teaching placements in the absence of opportunities for in-class teaching; to provide an opportunity for trainee teachers to develop their own competence in online teaching; and to assist the foreign schools in the challenging task of delivering online classes. This article aims to investigate the challenges faced by pupils in Japanese, Indian and Kenyan schools and by 27 Swedish trainee teachers during this project. Data collection consisted of interviews, an online questionnaire, lesson observations, assessment forms, and reports given by trainees. The main challenges identified through our findings included internet access in host countries, the use of a teacher-centred approach to learning, and difficulty for trainees to relate to the pupils’ life conditions. However, we conclude that the trainee teachers increased their global awareness through a climate-friendly alternative to the traditional teaching placement abroad