‘Not an Exact Science’: Medical Approaches to Age and Sexual Offences in England, 1850-1914

This thesis examines medical approaches to sexual offences in England between 1850 and 1914, with particular attention to law-making and judicial processes. It addresses two key research questions. Firstly, what was the place of medicine in shaping the law on sexual consent and in the implementation of laws on sexual crime? Secondly, can the analytical category of age be used to understand such medical roles? In addressing the first research question, the thesis shows that relationships between medicine, the law and wider society can be understood in terms of negotiation and shared pools of knowledge rather than impact. It demonstrates that medical ideas on sexual crime and sexual consent were deemed sufficiently valuable to be drawn upon widely by different groups, but they were not imposed ‘from above’ by a coherent medical profession. Medical roles thus need to be studied and understood rather than either oversimplified as ‘dominant’ or dismissed as non-existent. In addressing the second research question, the thesis argues that age has been unduly overlooked as a category of analysis in historiography. It shows that ideas about sexual crime shifted in relation to victims of different ages and that age can productively be situated in relation to other analytical categories, particularly class and gender. By moving beyond treating ‘children’ and ‘adults’ as homogeneous categories, this study opens up new ways of understanding histories of medico-legal relations and sexual crime.AHR

A bibliography of publications by Albert Bates Lord

Note: [at time of printing] All items listed here can be found in Ellis Library at the University of Missouri, Columbia, either in Special Collections (Ellis 401) or in open stacks (see the affixed call numbers below). Many journals are available online to University of Missouri faculty, staff, and students, and of course through other institutions as well. A full collection of article-length items is maintained in hard copy and on CD in Special Collections

Evaluation of a cognitive skills programme for male prisoners – exploring treatment effectiveness

Aim: The current study provides an evaluation of a cognitive skills programme (Enhanced Thinking Skills) with adult prisoners. Method: A pre and post treatment-only design with 171 male prisoners, using self-report psychometric measures. Results: Significant differences were found in the direction expected. Clinical recovery using stringent methods was not indicated, although improvement/partial response was across a number of domains. Originality: This study represents the first prison study to distinguish between levels of positive change. It questions previous interpretations of treatment outcome. Implications for practice: Expectations for treatment outcome for short term interventions should be more realistic; Cognitive skills programmes may be best considered as precursors to longer term therapies; Treatment outcome should focus on improvement and not recovery

Report on social, gender, ethical, regional, and national aspects

Due to the economic crisis, the continuing growth of cities and increasing market prices for secondary raw materials it can be expected that the number of people involved in informal waste collection and recycling activities tends to further increase. Therefore, it is time to rethink potential future developments in the context of low-income countries like Brazil and Nicaragua. When new systems to improve solid waste management are introduced and investment decisions are made, a key question often asked is where and how to make those investments to maximize the intended outcomes. The question is whether to use the knowledge and experience of the existing systems where informal actors play a key role or to strive for modernisation excluding this knowledge and to focus more on technology-based solutions. The contribution of informal activities is difficult to estimate as informal waste claimers have no inherent reason, obligations or simply not the capabilities to keep records regarding their work. As "formal" (official) performance data are usually not covering informal systems, official statistics (if even available) do not reflect the complete picture of waste management in low-income countries. As WEEE contains high concentrations of valuable materials, in comparison to other types of waste, the activity of the informal sector in this sector is high

Improvement of CPD Educational Products

This report contains information on the improvements of CPD modules, courses and educational products based on a pilot phase, where the adjusted and new developed educational products were tested in real-life situations. The main target of the WP4 was to create educational products for non-academic CPD course participants in Brazil and Nicaragua. The modules of the CPD includes the following materials: • CPD Courses: lecture style training materials, based on the materials for academic educations, but reduced in complexity and theory background • WEEE dismantling videos: for 5 product types, videos have been developed describing and showing the process • Practical dismantling trainin

Report on the newly developed CPD educational material

Within course of the project “Latin America-European network on Waste Electrical and Electronic Equipment, research, development and analysis” (LaWEEEda) modern and high quality modules, courses and educational products will be developed. These educational products are especially tailored for Nicaragua and Brazil and include both academic education and continuing professional development (CPD) training courses in the area of WEEE management and related entrepreneurial skills. This report focuses on the newly developed CPD educational material. This comprises following elements: • Dismantling videos: videos demonstrating and explaining the sequence of dismantling for a number of different e-waste products practical • Dismantling training: specifically for practitioners it is important to understand the sequence of dismantling and the output materials from this treatment step • Plant layout design: the participants learn to plan and design processes in the recycling of e-waste products • Entrepreneurship: beside technical knowledge other skills in non-technical areas like cost calculation and business plan development are of importance. Training in these fields is given in connection with the practical dismantling training

Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns.

BACKGROUND: Healthcare organisations often fail to harvest and make use of the 'soft intelligence' about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns. METHODS: Qualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care. Data analysis was based on the constant comparative method. RESULTS: Leaders reported that they valued employee voice; they identified formal organisational channels as a key route for the expression of concerns by employees. Formal channels and processes were designed to ensure fairness, account for all available evidence and achieve appropriate resolution. When processed through these formal systems, concerns were destined to become evidenced, formal and tractable to organisational intervention. But the way these systems operated meant that some concerns were never voiced. Participants were anxious about having to process their suspicions and concerns into hard evidentiary facts, and they feared being drawn into official procedures designed to allocate consequence. Anxiety about evidence and process was particularly relevant when the intelligence was especially 'soft'-feelings or intuitions that were difficult to resolve into a coherent, compelling reconstruction of an incident or concern. Efforts to make soft intelligence hard thus risked creating 'forbidden knowledge': dangerous to know or share. CONCLUSIONS: The legal and bureaucratic considerations that govern formal channels for the voicing of concerns may, perversely, inhibit staff from speaking up. Leaders responsible for quality and safety should consider complementing formal mechanisms with alternative, informal opportunities for listening to concerns

Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial

Background: Accurate clinical problem lists are critical for patient care, clinical decision support, population reporting, quality improvement, and research. However, problem lists are often incomplete or out of date. Objective: To determine whether a clinical alerting system, which uses inference rules to notify providers of undocumented problems, improves problem list documentation. Study Design and Methods: Inference rules for 17 conditions were constructed and an electronic health record-based intervention was evaluated to improve problem documentation. A cluster randomized trial was conducted of 11 participating clinics affiliated with a large academic medical center, totaling 28 primary care clinical areas, with 14 receiving the intervention and 14 as controls. The intervention was a clinical alert directed to the provider that suggested adding a problem to the electronic problem list based on inference rules. The primary outcome measure was acceptance of the alert. The number of study problems added in each arm as a pre-specified secondary outcome was also assessed. Data were collected during 6-month pre-intervention (11/2009–5/2010) and intervention (5/2010–11/2010) periods. Results: 17,043 alerts were presented, of which 41.1% were accepted. In the intervention arm, providers documented significantly more study problems (adjusted OR=3.4, p<0.001), with an absolute difference of 6,277 additional problems. In the intervention group, 70.4% of all study problems were added via the problem list alerts. Significant increases in problem notation were observed for 13 of 17 conditions. Conclusion: Problem inference alerts significantly increase notation of important patient problems in primary care, which in turn has the potential to facilitate quality improvement

A systematic review of the diagnostic accuracy of automated tests for cognitive impairment

Objective The aim of this review is to determine whether automated computerised tests accurately identify patients with progressive cognitive impairment and, if so, to investigate their role in monitoring disease progression and/or response to treatment. Methods Six electronic databases (Medline, Embase, Cochrane, Institute for Scientific Information, PsycINFO, and ProQuest) were searched from January 2005 to August 2015 to identify papers for inclusion. Studies assessing the diagnostic accuracy of automated computerised tests for mild cognitive impairment (MCI) and early dementia against a reference standard were included. Where possible, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios were calculated. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess risk of bias. Results Sixteen studies assessing 11 diagnostic tools for MCI and early dementia were included. No studies were eligible for inclusion in the review of tools for monitoring progressive disease and response to treatment. The overall quality of the studies was good. However, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that statistical analysis was not possible. Conclusion Some tests have shown promising results for identifying MCI and early dementia. However, concerns over small sample sizes, lack of replicability of studies, and lack of evidence available make it difficult to make recommendations on the clinical use of the computerised tests for diagnosing, monitoring progression, and treatment response for MCI and early dementia. Research is required to establish stable cut-off points for automated computerised tests used to diagnose patients with MCI or early dementia

WHY T.R.I.P MATTERS?

Through the work of the House and Senate chief patrons: Delegate Delores L McQuinn (HB 142) and Senator George L. Barker (SB 342) changes to the Transit Ridership Incentive Program (TRIP) intended to increase funding to reduce the impact on public transit fares on individuals with low-incomes were signed into law during Virginia’s 2022 legislative session. House Bill (HB 142) and Senate Bill (SB 342) builds on 2020 legislation establishing TRIP to promote improved transit service in urbanized areas 1 of the Commonwealth with a population of more than 100,000 and to reduce barriers to transit use for low-income individuals. The identified goal of the Transit Ridership Incentive Program as established in 2020,[1] is to increase regional connectivity and fund initiatives to lower public transportation costs to low-income riders by encouraging “the identification and establishment of routes of regional significance, the development and implementation of a regional subsidy allocation model, implementation of integrated fare collection, establishment of bus-only lanes on routes of regional significance, and other actions and service determined by the Board to improve transit service” (LIS, 2022). Language in the 2020 legislation creating TRIP limited funds for reduced and zero-fare transit to 25% of the program with the remaining 75% of the funding dedicated to regional connectivity(LIS, 2022). HB 142/SB 342 (2022) removed this limitation on funding, allowing for greater opportunity to fund reduced and zero-fare transit in Virginia. Per Virginia Department of Rail and Public Transportation (VDRPT) “$24.5 million to multi-year zero-fare/low income projects and$5.2 million to multi-year regional connectivity projects has been allocated”. An example of such an award was announced in a press release by Greater Richmond Transit Company (GRTC). On December 21, 2021, it was announced that $8 million was awarded to GRTC to study zero fares. Effective July 1, 2022, the Transit Ridership Incentive Program (TRIP) removed the maximum threshold of funding of 25% and instead established a minimum of 25% of TRIP funding going towards reduced or zero-fare transit initiatives. The proposed percentage of the TRIP funds will continue to support the establishment of programs to reduce the impact of fares on low-income individuals in the coming years. Unfortunately, a sunset clause was inserted as a Governor’s amendment meaning this change is set to expire on July 1, 2024. As the original legislation that passed the House and Senate was the result of a strong majority of bi-partisan support, based on the research, an extension of the current July 1, 2024 expiration date, or the elimination of the sunset clause is advised. To avoid the barriers for low-income individuals, it has been noted that “Virginia’s program could target low-income individuals through passes or by eliminating fares on certain high-capacity corridors or for entire transit systems\u27\u27 (Pascale, 2021). [1] https://lis.virginia.gov/cgi-bin/legp604.exe?201+sum+HB141