Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies

Bionic bodies, posthuman violence and the disembodied criminal subject

This article examines how the so-called disembodied criminal subject is given structure and form through the law of homicide and assault. By analysing how the body is materialised through the criminal law’s enactment of death and injury, this article suggests that the biological positioning of these harms of violence as uncontroversial, natural, and universal conditions of being ‘human’ cannot fully appreciate what makes violence wrongful for us, as embodied entities. Absent a theory of the body, and a consideration of corporeality, the criminal law risks marginalising, or altogether eliding, experiences of violence that do not align with its paradigmatic vision of what bodies can and must do when suffering its effects. Here I consider how the bionic body disrupts the criminal law’s understanding of human violence by being a body that is both organic and inorganic, and capable of experiencing and performing violence in unexpected ways. I propose that a criminal law that is more receptive to the changing, technologically mediated conditions of human existence would be one that takes the corporeal dimensions of violence more seriously and, as an extension of this, adopts an embodied, embedded, and relational understanding of human vulnerability to violence

The sacrificed generation: youth, history, and the colonized mind in Madagascar

Youth and identity politics figure prominently in this provocative study of personal and collective memory in Madagascar. A deeply nuanced ethnography of historical consciousness, it challenges many cross-cultural investigations of youth, for its key actors are not adults but schoolchildren. Lesley Sharp refutes dominant assumptions that African children are the helpless victims of postcolonial crises, incapable of organized, sustained collective thought or action. She insists instead on the political agency of Malagasy youth who, as they decipher their current predicament, offer potent, historicized critiques of colonial violence, nationalist resistance, foreign mass media, and schoolyard survival. Sharp asserts that autobiography and national history are inextricably linked and therefore must be read in tandem, a process that exposes how political consciousness is forged in the classroom, within the home, and on the street in Madagascar. Keywords: Critical pedagog

The possessed and the dispossessed: spirits, identity, and power in a Madagascar migrant town

This finely drawn portrait of a complex, polycultural urban community in Madagascar emphasizes the role of spirit medium healers, a group heretofore seen as having little power. These women, Leslie Sharp argues, are far from powerless among the peasants and migrant laborers who work the land in this plantation economy. In fact, Sharp's wide-ranging analysis shows that tromba , or spirit possession, is central to understanding the complex identities of insiders and outsiders in this community, which draws people from all over the island and abroad.Sharp's study also reveals the contradictions between indigenous healing and Western-derived Protestant healing and psychiatry. Particular attention to the significance of migrant women's and children's experiences in a context of seeking relief from personal and social ills gives Sharp's investigation importance for gender studies as well as for studies in medical anthropology, Africa and Madagascar, the politics of culture, and religion and ritual