An area of untapped potential? The use of restorative justice in the fight against serious and organized crime : a perception study

This article presents the results of a perception study which examined the potential for deploying restorative justice (RJ) in the context of serious and organized crime (SOC) offending. This is a hitherto unexplored area of debate and the study sought to engage the key stakeholders in RJ processes – victims, offenders and practitioners – to gather their views as to the suitability and desirability of extending RJ in this way. Employing a mixed methods approach, the study engaged over 40 participants across the three stakeholder groups. The findings challenge existing, deeply embedded orthodoxies concerning the very nature of SOC offending and offenders’ motivations, as well confirming the multiplicity of SOC victims’ expectations. The findings also demonstrate the urgent need for further debate concerning how best to account for the complexity of SOC victims’ needs which are currently unmet by the systemic limits of the criminal justice system

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

The exclusion of serious and organised offenders and their victims from the offer of restorative justice: Should this be so and what happens when the offer is put on the table?

There is scarce research evidence of restorative justice being used in the context of serious and organised crime offending. This study sought to explore the feasibility of using restorative justice by canvassing the views of experts, serious and organised crime offenders and serious and organised crime victims in England. Offenders and victims were given the opportunity to engage in a restorative justice initiative and individual cases were pursued accordingly as a series of case studies. Case studies were limited to large-scale serious and organised fraud. Stark differences in views were apparent between serious and organised crime experts and restorative justice experts, the former doubting offenders’ motivations and pointing to their dangerousness without fully considering victim perspectives. Despite high attrition rates among some offenders expressing an initial willingness to pursue restorative justice, where both parties wished to participate, sustained motivation was observed. This study highlights inequities in the way that police forces have implemented the 2015 Victims Code requirements for restorative justice in England and Wales, potentially blocking opportunities for closure, social integration and reduced reoffending