An Inconvenient Truth: Barriers to Truth Recovery in the Aftermath of Institutional Child Abuse in Ireland

Contemporary settled democracies, including the United States, England and Wales and Ireland, have witnessed a string of high profile cases of institutional child abuse in both church and state settings. Set against the broader literature on transitional justice, this analysis argues that there are significant barriers to truth recovery within the particular context of historical institutional abuse by the clergy in the Republic of Ireland. In the main, I argue that the frameworks of the inquiries and commissions into historical institutional child abuse are not conducive to truth recovery or the search for justice in dealing with the legacy of an abusive past. It is the church-state relationship which makes the Irish situation noteworthy and unique. The Catholic Church and child care institutions are especially self-protective, secretive and closed by nature and strongly discourage the drawing of attention to any deficiencies in organisational procedures. The nature of the public inquiry process also means that there is often a rather linear focus on accountability and apportioning blame. Collectively, such difficulties inhibit fuller systemic investigation of the veracity of what actually happened and, in turn, meaningful modification of child care policies. The article concludes by offering some thoughts on implications for transitional justice discourses more broadly as well as the residual issues for Ireland and other settled democracies in terms of moving on from the legacy of institutional child abuse

Sex Offending and Situational Motivation: Findings from a Qualitative Analysis of Desistance from Sexual Offending

Sex offending is typically understood from a pathology perspective with the origin of the behavior thought to be within the offending individual. Such a perspective may not be beneficial for those seeking to desist from sexual offending and reintegrate into mainstream society. A thematic analysis of 32 self-narratives of men convicted of sexual offences against children suggests that such individuals typically explain their pasts utilizing a script consistent with routine activity theory, emphasizing the role of circumstantial changes in both the onset of and desistance from sexual offending. It is argued that the self-framing of serious offending in this way might be understood as a form of “shame management,” a protective cognition that enables desistance by shielding individuals from internalizing stigma for past violence. </jats:p

Desistance from Sexual Offending: Do the Mainstream Theories Apply?

The literature on desistance from crime has become well established in recent years with strong bodies of evidence supporting the role of factors such as employment, relationships and identity change in this process. However, the relevance of this literature to individuals convicted of sexual crimes is not known as such individuals are almost always excluded from this research. This article presents the results from one of the first empirical studies on desistance from sexual offending based on 32 in-depth life story interviews with adult males previously convicted of child sex offences. In this analysis we explore the significance of work, the role of relationships and changes in imagined selves in the self-identities of individuals successfully desisting from sexual offending. The findings provide support for all three factors in helping to sustain desistance from sex offending, but also suggest clear differences between desistance from sex offending and other types of crime in these regards. </jats:p

Desistance from Sexual Offending: A Policy and Research Agenda Whose Time Has Come

For the past three decades or so, criminal justice policies have been enacted under the assumption that individuals who have been convicted of a sex offense are life course persistent sex offenders. In that context, research has been heavily focused on the assessment of risk and the prediction of sexual recidivism. Simultaneously, little to no attention has been given to the majority of individuals convicted of sex offenses who are not arrested or convicted again.Researchers have witnessed a growing gap between scientific knowledge and the sociolegal response to sexual violence and abuse. The current legal landscape carries important social implications and significant life course impact for a growing number of individuals. More recently, theoretical and research breakthroughs in the study of desistance from crime and delinquency have been made that can help shed some light on desistance from sex offending. Desistance research, in the context of sex offending, however, represents serious theoretical, ethical, legal, and methodological challenges. To that end, this article introduces a special issue exploring current themes in desistance research by examining the life course of individuals convicted of a sexual offense while contextualizing their experiences of desistance.No Full Tex

Non-recent Institutional Abuses and Inquiries: Truth, Acknowledgement, Accountability and Procedural Justice

Over the last two decades, historical abuse in state and religiously-operated institutions and some civil society groups and organisations has come under scrutiny around the world. The island of Ireland, comprising Northern Ireland and the Republic of Ireland, has had a large number of investigations, redress schemes or apologies regarding non-recent institutional abuse against women and children, some of which are ongoing. Many of these efforts have been criticised by victims/survivors, academic activists and advocates for deficient processes or inadequate recommendations or outcomes. Despite widespread acknowledgement that recent official responses to non-recent institutional abuse are lacking in terms of their capacity to deliver truth, acknowledgement, accountability, and procedural justice, discourses are rarely informed by detailed empirical assessment of the views of key stakeholders including victims/survivors, victim-advocates/representatives, lawyers and human rights advocates, judges/commissioners, politicians, policymakers and members of churches and religious orders. This is an important moment, therefore, to stand back and assess justice responses to non-recent institutional abuse across the island of Ireland and how they compare to efforts across the world. This research will provide a guiding standard to improve social and public understanding to redress non-recent institutional abuse across Ireland and elsewhere.Higher Education AuthorityTransforming Justice Responses to Historical Institutional Abuse ProjectBritish AcademyUK Arts and Humanities Research Counci

Efficacy and safety of baricitinib or ravulizumab in adult patients with severe COVID-19 (TACTIC-R): a randomised, parallel-arm, open-label, phase 4 trial

Background From early in the COVID-19 pandemic, evidence suggested a role for cytokine dysregulation and complement activation in severe disease. In the TACTIC-R trial, we evaluated the efficacy and safety of baricitinib, an inhibitor of Janus kinase 1 (JAK1) and JAK2, and ravulizumab, a monoclonal inhibitor of complement C5 activation, as an adjunct to standard of care for the treatment of adult patients hospitalised with COVID-19. Methods TACTIC-R was a phase 4, randomised, parallel-arm, open-label platform trial that was undertaken in the UK with urgent public health designation to assess the potential of repurposing immunosuppressants for the treatment of severe COVID-19, stratified by a risk score. Adult participants (aged ≥18 years) were enrolled from 22 hospitals across the UK. Patients with a risk score indicating a 40% risk of admission to an intensive care unit or death were randomly assigned 1:1:1 to standard of care alone, standard of care with baricitinib, or standard of care with ravulizumab. The composite primary outcome was the time from randomisation to incidence (up to and including day 14) of the first event of death, invasive mechanical ventilation, extracorporeal membrane oxygenation, cardiovascular organ support, or renal failure. The primary interim analysis was triggered when 125 patient datasets were available up to day 14 in each study group and we included in the analysis all participants who were randomly assigned. The trial was registered on ClinicalTrials.gov (NCT04390464). Findings Between May 8, 2020, and May 7, 2021, 417 participants were recruited and randomly assigned to standard of care alone (145 patients), baricitinib (137 patients), or ravulizumab (135 patients). Only 54 (39%) of 137 patients in the baricitinib group received the maximum 14-day course, whereas 132 (98%) of 135 patients in the ravulizumab group received the intended dose. The trial was stopped after the primary interim analysis on grounds of futility. The estimated hazard ratio (HR) for reaching the composite primary endpoint was 1·11 (95% CI 0·62–1·99) for patients on baricitinib compared with standard of care alone, and 1·53 (0·88–2·67) for ravulizumab compared with standard of care alone. 45 serious adverse events (21 deaths) were reported in the standard-of-care group, 57 (24 deaths) in the baricitinib group, and 60 (18 deaths) in the ravulizumab group. Interpretation Neither baricitinib nor ravulizumab, as administered in this study, was effective in reducing disease severity in patients selected for severe COVID-19. Safety was similar between treatments and standard of care. The short period of dosing with baricitinib might explain the discrepancy between our findings and those of other trials. The therapeutic potential of targeting complement C5 activation product C5a, rather than the cleavage of C5, warrants further evaluation

Relationship between molecular pathogen detection and clinical disease in febrile children across Europe: a multicentre, prospective observational study

BackgroundThe PERFORM study aimed to understand causes of febrile childhood illness by comparing molecular pathogen detection with current clinical practice.MethodsFebrile children and controls were recruited on presentation to hospital in 9 European countries 2016-2020. Each child was assigned a standardized diagnostic category based on retrospective review of local clinical and microbiological data. Subsequently, centralised molecular tests (CMTs) for 19 respiratory and 27 blood pathogens were performed.FindingsOf 4611 febrile children, 643 (14%) were classified as definite bacterial infection (DB), 491 (11%) as definite viral infection (DV), and 3477 (75%) had uncertain aetiology. 1061 controls without infection were recruited. CMTs detected blood bacteria more frequently in DB than DV cases for N. meningitidis (OR: 3.37, 95% CI: 1.92-5.99), S. pneumoniae (OR: 3.89, 95% CI: 2.07-7.59), Group A streptococcus (OR 2.73, 95% CI 1.13-6.09) and E. coli (OR 2.7, 95% CI 1.02-6.71). Respiratory viruses were more common in febrile children than controls, but only influenza A (OR 0.24, 95% CI 0.11-0.46), influenza B (OR 0.12, 95% CI 0.02-0.37) and RSV (OR 0.16, 95% CI: 0.06-0.36) were less common in DB than DV cases. Of 16 blood viruses, enterovirus (OR 0.43, 95% CI 0.23-0.72) and EBV (OR 0.71, 95% CI 0.56-0.90) were detected less often in DB than DV cases. Combined local diagnostics and CMTs respectively detected blood viruses and respiratory viruses in 360 (56%) and 161 (25%) of DB cases, and virus detection ruled-out bacterial infection poorly, with predictive values of 0.64 and 0.68 respectively.InterpretationMost febrile children cannot be conclusively defined as having bacterial or viral infection when molecular tests supplement conventional approaches. Viruses are detected in most patients with bacterial infections, and the clinical value of individual pathogen detection in determining treatment is low. New approaches are needed to help determine which febrile children require antibiotics.FundingEU Horizon 2020 grant 668303