Viola Soundscapes

An EP containing 4 or 5 original songs that focus on using the viola as the primary instrumentation for their creation experimenting with its sound acoustically before expanding into Ableton.https://remix.berklee.edu/graduate-studies-contemporary-performance/1091/thumbnail.jp

Australian general practitioners' views on qualities that make effective discharge communication: a scoping review

Transitions of patient care between hospital discharge and primary care are known to be an area of high-risk where communication is imperative for patient safety. Discharge summaries are known to often be incomplete, delayed and unhelpful for community healthcare providers. The aim of this review was to identify and map the literature which discusses Australian general practitioners' (GPs) views on the qualities that make up effective discharge communication. Medline, Scopus and the Cochrane register of controlled drug trails and systematic reviews were searched for publications until October 2021 that discussed Australian GPs' views on discharge communication from hospital to general practice. Of 1696 articles identified, 18 met inclusion and critical appraisal criteria. Five studies identified that GPs view timeliness of discharge summary receipt to be a problem. Communication of medication information in the discharge summary was discussed in six studies, with two reporting that GPs view reasons for medication changes to be essential. Five studies noted GPs would prefer to receive clinical discipline or diagnosis specific information. Four studies identified that GPs viewed the format and readability of discharge summaries to be problematic, with difficulties finding salient information. The findings of this scoping review indicate that GPs view timeliness, completeness, readability, medication related information and diagnosis/clinical discipline specific information to be qualities that make up effective discharge communication from hospital to the community. There are opportunities for further research in perspectives of effective discharge communication, and future studies on interventions to improve discharge communication, patient safety and policy in transfers of care

Re-framing the Analysis: A 3-dimensional Perspective of Prisoners' Children's Well-being

This article highlights three dimensions to understanding children's well-being during and after parental imprisonment which have not been fully explored in current research. A consideration of ‘time’ reveals the importance of children's past experiences and their anticipated futures. A focus on ‘space’ highlights the impact of new or altered environmental dynamics. A study of ‘agency’ illuminates how children cope within structural, material and social confines which intensify vulnerability and dependency. This integrated perspective reveals important differences in individual children's experiences and commonalities in broader systemic and social constraints on prisoners’ children. The paper analyses data from a prospective longitudinal study of 35 prisoners’ children during and after their (step) father's imprisonment to illustrate the arguments

Prisoners’ Families, Penal Power, and the Referred Pains of Imprisonment

This chapter develops the analysis of the ‘punishment beyond the legal offender’. It illustrates how parental imprisonment was experienced differently within and across families, and while not all experiences were negative, there were common experiences of hardship. The chapter considers these personal and social hardships ‘referred pains of imprisonment’. Its analysis shows how these experiences were shaped by the direct contact families had with criminal justice agents, the strength of the relationship with the imprisoned parent, and the anticipated and actual response of others within the local community. The chapter introduces a distinction between ‘acute’ pains that were experienced in the early stages of engagement with the criminal justice process (the arrest, trial, and removal of the father from the family) and ‘chronic’ pains that persisted and burdened family members over the longer term

Safeguarding Children in the Secure Estate, 1960-2016

Background and aims of the research The research for this report was commissioned by the Historical Child Abuse Team of HM Prison & Probation Service (HMPPS), to inform its response to the Independent Inquiry into Child Sexual Abuse (IICSA). Their aim was to enhance HMPPS’s institutional memory, and to suggest avenues for improved practice in safeguarding children in custody. The research set out to review the operation of past safeguarding frameworks within what is now known as ‘the secure estate for young people’. Research methods The initial research strategy was twofold: to conduct an orienting review of risk factors for institutional abuse using existing research and the reports of child abuse inquiries; and to review which kinds of establishment held children sentenced to custody for criminal offences by the courts, and under what policy and legal frameworks they did so. These reviews framed our consideration of inspection reports, archival records, and other primary records concerning institutions of interest. The latter were selected according to where known allegations of sexual abuse have been made. All were male-only; to ensure that female custody was included in our analysis, we added the small number known to have held girls to the list. Systematic catalogue searches were then carried out to identify relevant records in the two principal repositories used for the study (the Radzinowicz Library in Cambridge and The National Archives). The results of these searches were uneven. Archival records for the earlier period (1960 to the 1990s) were sparse, and some issues and institutions of interest were not well-covered. We therefore adopted a more pragmatic strategy, pursuing ‘leads’ by browsing the archive catalogues, following cross-references in archival records, drawing inferences about institutions for children using available information (for example, by reviewing how complaints were handled in adult prisons where information was lacking for complaints by children) and turning to academic literature where archival sources lacked information relevant to certain issues. Freedom of Information (FOI) requests were also made to access relevant closed archival records but no files of interest were opened in time for inclusion in the report. The review of records covering the later period (1990s onwards) faced a contrasting challenge: the volume of documents published on secure institutions for children is enormous. Due to the three-month time limit for the whole project, it was not possible to comprehensively review the available material on specific institutions, and we therefore focused on published reviews of the children’s secure estate overall, and on overviews of the running of all establishments (such as annual reports and thematic inspection reports). References to specific institutions were then chased up in inspection reports. Summary of key developments in safeguarding in the secure estate Safeguards against abuse from 1960 to the 1990s Changes in the nature and scope of the secure estate (and the youth justice system more generally) during this period were highly complex. Between 1960 and 1998, there was particular turbulence; since 1998 things have stabilised somewhat. The period as a whole, however, remains one in which there have been frequent revisions of institutional aims, management problems, resourcing pressures and cycles of expansion, reorganisation and decline. This turbulence is part of the context for historical abuse; it has not been uncommon, at different times, for institutions to become detached from their original aims, and instead to ‘drift’, sometimes with the result that the duty of care was diluted or suspended. In general, from 1960 until at least the 1980s, policies of all kinds were ill-developed, and often poorly implemented. Responses to abuse were reactive and often failed to recognise or counteract the potential harms which custody might inflict on children. It was common for staff to use their power in irregular ways, and penal institutions often featured violent cultures, in which victimisation of some inmates by others was routine, and sometimes carried out with the tacit consent of staff. Systems aiming to balance children’s interests against those of staff (for example, by enabling them to complain) were often ineffective because they failed to correct the disparities in power that were inherent to institutional life. In penal institutions, complaints could be dangerous to raise: there were significant formal and informal barriers to raising a complaint, and significant risks of formal or informal reprisal from staff members. Investigative procedures were also weak, usually relying on investigation within the institution, or (rarely) external investigation by Boards of Visitors. The independence of Boards from prison authorities was not guaranteed. Arrangements to protect the ‘welfare’ of children were also hampered by resourcing, and by the narrow definition of the issue: Welfare Officers were, for the majority of this period, probation officers mostly responsible for heavy resettlement caseloads, and with limited time for other tasks. In the care system, checks and balances against abuse were often weak, left the same people and organisations responsible for the administration and oversight of institutions, and led to serious conflicts of interest. By the 1970s and 1980s, secure custody within the care system was developing along different lines to that in penal institutions. New justifications for custody were being advanced: that it was not a deterrent, or a training opportunity, but a form of treatment. These ideals were not always achieved in practice, but they led to a shift in official thinking whereby secure conditions were reframed as a way of meeting children’s needs, rather than compelling their compliance. One result was to increase awareness of the risks that could be posed by inadequate safeguards. Catalysts for change, 1990-2000 New discourses and practices regarding child protection emerged in the care system during the 1980s and 90s, most particularly as the result of a series of public inquiries which exposed abuses in residential homes. Increasingly, it was recognised that residential institutions possessed their own risks and were particularly vulnerable to certain characteristic risks of abuse. The new practices were formalised into a single legislative framework by the Children Act 1989, which transformed the regulation of the care system. However, its applicability to children in YOIs was legally uncertain until a High Court ruling in 2002. Legal ambiguity did not prevent observers of the prison system making strong criticisms of YOIs (and later, STCs) a major plank in their prison reform agenda. These criticisms were powerful because they drew on the general rights and protections which the 1989 Act had created for children and which, it could be argued, they were denied in custody. These calls for reform applied the 1989 Act to child imprisonment in novel ways, leading to a ‘new orthodoxy’ in safeguarding. The implementation of a ‘new orthodoxy’, 2000-2016 Since 2000, there have been further developments in the policy framework for the secure estate, but also new indications that policies have not been perfectly implemented. Imbalances of supply and demand for places in the secure estate, and a gradual shift towards a more vulnerable and damaged population, have been among the factors making implementation challenging. Even so, some safeguards are undoubtedly more effective than previously. For example, greater controls are applied through staff vetting, and several custodial practices such as restraint and strip-searching have been reassessed in light of children’s lived experience of these forms of power. Yet these new policies have also been circumvented in new ways. Abuses have come to light which possess both new features and others familiar from past inquiries. Most fundamentally, the arrival of new safeguarding policies has led to the recognition of forms of abuse which went unrecognised before. This has had an unforeseen effect: it has expanded the boundaries of what can potentially be considered abusive. The outcome of this shift remains unclear. Conclusions The safeguarding of children in secure institutions can only be evaluated fully through close attention to organisational culture, as well as the actions and motivations of ‘bad’ individuals. Cultural beliefs affect day-to-day decision-making and are not always congruent with what is laid down formally in policy; indeed, in some circumstances culture is used to justify the circumvention or relaxation of standards which are officially sanctioned. This is particularly likely in residential institutions for children, which feature inherent disparities of power. Race and learning difficulties added to vulnerability, though it is unclear whether this resulted in an increased likelihood of sexual abuse. The apparent absence of allegations of sexual abuse in establishments for girls is difficult to explain using the evidence we have reviewed, but does not appear to be because girls in custody were less vulnerable. New safeguarding policies implemented since the 1990s contain their own vulnerabilities and have generated their own forms of illegitimacy. It is difficult for institutions to recognise these. It is a consistent pattern, throughout the history we have reviewed, that abusive practices had often seemed unlikely or unthinkable, but later became visible. Thus while preventive safeguards are, in themselves, important, it is also important that institutions do everything possible to promote trusting, positive relationships between staff members and the children in their care, and to ensure that both staff and children are able to make meaningful challenges to aspects of custodial practice. The size of institutions appears relevant here, as do structures of accountability which avoid excessive formality. It is also important that institutions are open to outside scrutiny. This is not merely a question of regular inspection: it is clear from the historical record that those responsible for scrutinising the secure estate could become acculturated, so that their ideas about what is ‘normal’ and acceptable began to reflect those of the culture around them. Contemporary arrangements for inspection and oversight need to retain awareness of this risk. Abusive cultures develop largely because it is relatively easy for staff, in the context of organisations with steep power differentials, to present certain practices as justifiable means to legitimate ends. Over the long term, the operational context for the secure estate is always likely to be characterised by fluctuations in resourcing, and imbalances between supply and demand. Shifting priorities (of the sort which have been associated with the development of abusive cultures) are likely always to affect provision. In consequence, cultural blind spots will always be possible, and identifying them will always impinge on the interests of those who hold power. This makes protections for whistleblowers a key measure to protect children against abuse. In short, despite safeguarding policies and frameworks and inspection regimes, the potential for abusive practices to develop must be viewed as evolving, and thus always possible. This points to three final reflections: • the use of custody for children should be limited as far as possible, because of the inherent tensions in residential institutions where there is a marked disparity of power and an element of coercion in the allocation of residents; • there are distinct benefits to historical research in this area, because it enables a long view to be taken on present-day safeguards and abuses, and reveals continuities in the kinds of risks affecting the implementation of safeguards; • child safeguarding must be understood as an ongoing, iterative process, rather than as the attainment of a defined standard of practice.The report was commissioned by HM Prison & Probation Service and funding for the project came from them. Their aim was to improve their institutional memory and prepare their evidence to the Independent Inquiry on Child Sexual Abuse. Further details of the research questions agreed with them can be found in the appendices of the report at page 69

Male prisoners’ family relationships and resilience in resettlement

Theories of social bonding and social capital support the argument that positive family relationships are important for resilience in resettlement after release from prison. However, this topic has rarely been addressed in prospective longitudinal studies of resettlement processes. This study gathered interview data from 39 family pairs of British male prisoners and their (ex-)partners before and after release. Questions on the father’s relationship, involvement and contact with the family were used as an index to predict seven resettlement outcomes. At the bivariate level and after control of pre-prison risk variables, family relationships predicted positive outcomes with finding accommodation, alcohol and drug use, the extent to which ex-prisoners felt they were coping with resettlement challenges and the quality of post-release family relations. In contrast, difficulties with employment and finance were neither related to previous family relations nor to the other resettlement outcomes. The findings suggest no general protective influence of family relationships during resettlement, but a strong effect on social and emotional aspects. Theoretical issues, limitations and potential practical consequences are discussed

Neurochemistry-enriched dynamic causal models of magnetoencephalography, using magnetic resonance spectroscopy

We present a hierarchical empirical Bayesian framework for testing hypotheses about neurotransmitters’ concertation as empirical prior for synaptic physiology using ultra-high field magnetic resonance spectroscopy (7T-MRS) and magnetoencephalography data (MEG). A first level dynamic causal modelling of cortical microcircuits is used to infer the connectivity parameters of a generative model of individuals’ neurophysiological observations. At the second level, individuals’ 7T-MRS estimates of regional neurotransmitter concentration supply empirical priors on synaptic connectivity. We compare the group-wise evidence for alternative empirical priors, defined by monotonic functions of spectroscopic estimates, on subsets of synaptic connections. For efficiency and reproducibility, we used Bayesian model reduction (BMR), parametric empirical Bayes and variational Bayesian inversion. In particular, we used Bayesian model reduction to compare alternative model evidence of how spectroscopic neurotransmitter measures inform estimates of synaptic connectivity. This identifies the subset of synaptic connections that are influenced by individual differences in neurotransmitter levels, as measured by 7T-MRS. We demonstrate the method using resting-state MEG (i.e., task-free recording) and 7T-MRS data from healthy adults. Our results confirm the hypotheses that GABA concentration influences local recurrent inhibitory intrinsic connectivity in deep and superficial cortical layers, while glutamate influences the excitatory connections between superficial and deep layers and connections from superficial to inhibitory interneurons. Using within-subject split-sampling of the MEG dataset (i.e., validation by means of a held-out dataset), we show that model comparison for hypothesis testing can be highly reliable. The method is suitable for applications with magnetoencephalography or electroencephalography, and is well-suited to reveal the mechanisms of neurological and psychiatric disorders, including responses to psychopharmacological interventions

The mental health trajectories of male prisoners and their female (ex-)partners from pre- to post-release.

BACKGROUND: There are high rates of mental disorders among prisoners. Prisoners are also likely to have difficulties with intimate relationships, perhaps related to the imprisonment, but their mental health may be relevant. There is a dearth of research on intimate relationship qualities and mental health of offenders and their partners over time. AIMS: To explore mental health and relationship trajectories among men in prison, and their partners, before the men's release, through a time 6 months post-release, and then again 8 years later, and to test associations between relationship quality and mental health. METHOD: Data stem from the Economic and Social Research Council (ESRC)-funded longitudinal 'Families and Imprisonment Research' (FAIR) project on paternal imprisonment and family resilience. Inclusion criteria for the study were men serving a short- to medium-term prison sentence who were within 4 months of release; with a current or ex-partner with whom they have at least one child; and for whom there were data on mental health and relationship factors during imprisonment, and at 6 months and 8 years post-release. Similar data were also obtained for their (ex-)partners. RESULTS: The main sample comprised 39 men and 39 women who were in the same 'family set' for the first two waves, and after 8 years, 26 men and 30 women were retained. Just over 40% of the men and their (ex-)partners each disclosed that they had a mental health problem preceding his release. Proportions fluctuated slightly over time, with some dissonance between self-perceived disorder and self-ratings on a symptoms rating scale. Twenty-nine couples sustained their relationship during the transition between prison and release, but after 8 years, only four remained together. There was little evidence of association between measures of mental health and relationship quality among either the men or their partners. CONCLUSIONS: The findings challenge assumptions about the extent to which partners can play fully supportive roles in a former prisoner's transition from institutional life back into the community, as partners are also likely to be experiencing difficulties during this time. Thus, former prisoners and their families should be afforded equal access to support and assistance during offender rehabilitation

Can neuroimaging predict dementia in Parkinson’s disease?

Dementia in Parkinson’s disease affects 50% of patients within 10 years of diagnosis but there is wide variation in severity and timing. Thus, robust neuroimaging prediction of cognitive involvement in Parkinson’s disease is important: (i) to identify at-risk individuals for clinical trials of potential new treatments; (ii) to provide reliable prognostic information for individuals and populations; and (iii) to shed light on the pathophysiological processes underpinning Parkinson’s disease dementia. To date, neuroimaging has not made major contributions to predicting cognitive involvement in Parkinson’s disease. This is perhaps unsurprising considering conventional methods rely on macroscopic measures of topographically distributed neurodegeneration, a relatively late event in Parkinson’s dementia. However, new technologies are now emerging that could provide important insights through detection of other potentially relevant processes. For example, novel MRI approaches can quantify magnetic susceptibility as a surrogate for tissue iron content, and increasingly powerful mathematical approaches can characterize the topology of brain networks at the systems level. Here, we present an up-to-date overview of the growing role of neuroimaging in predicting dementia in Parkinson’s disease. We discuss the most relevant findings to date, and consider the potential of emerging technologies to detect the earliest signs of cognitive involvement in Parkinson’s disease

Reliability of dynamic causal modelling of resting‐state magnetoencephalography

This study assesses the reliability of resting‐state dynamic causal modelling (DCM) of magnetoencephalography (MEG) under conductance‐based canonical microcircuit models, in terms of both posterior parameter estimates and model evidence. We use resting‐state MEG data from two sessions, acquired 2 weeks apart, from a cohort with high between‐subject variance arising from Alzheimer's disease. Our focus is not on the effect of disease, but on the reliability of the methods (as within‐subject between‐session agreement), which is crucial for future studies of disease progression and drug intervention. To assess the reliability of first‐level DCMs, we compare model evidence associated with the covariance among subject‐specific free energies (i.e., the ‘quality’ of the models) with versus without interclass correlations. We then used parametric empirical Bayes (PEB) to investigate the differences between the inferred DCM parameter probability distributions at the between subject level. Specifically, we examined the evidence for or against parameter differences (i) within‐subject, within‐session, and between‐epochs; (ii) within‐subject between‐session; and (iii) within‐site between‐subjects, accommodating the conditional dependency among parameter estimates. We show that for data acquired close in time, and under similar circumstances, more than 95% of inferred DCM parameters are unlikely to differ, speaking to mutual predictability over sessions. Using PEB, we show a reciprocal relationship between a conventional definition of ‘reliability’ and the conditional dependency among inferred model parameters. Our analyses confirm the reliability and reproducibility of the conductance‐based DCMs for resting‐state neurophysiological data. In this respect, the implicit generative modelling is suitable for interventional and longitudinal studies of neurological and psychiatric disorders