The Significance of Critical Theory for Restorative Justice in Education

Restorative Justice (rj), a distinctive philosophical approach that seeks to replace punitive, managerial structures of schooling with those that emphasize the building and repairing of relationships (Hopkins 2004) has been embraced in the past two decades by a variety of school systems worldwide in an effort to build safe school communities. Early studies indicate rj holds significant promise, however, proponents in the field identify that theoretical and evidence-based research is falling behind practice. They call for further research to deepen the current understanding of rj that will support its sustainability and transformative potential and allow it to move from the margins to the mainstream of schooling (Braithwaite 2006; Morrison & Ahmed 2006; Sherman & Strang 2007)

Relational restorative justice pedagogy in educator professional development

What would a professional development experience rooted in the philosophy, principles, and practices of restorative justice look and feel like? This article describes how such a professional development project was designed to implement restorative justice principles and practices into schools in a proactive, relational and sustainable manner by using a comprehensive dialogic, democratic peacebuilding pedagogy. The initiative embodied a broad, transformative approach to restorative justice, grounded in participating educators’ identifying, articulating and applying personal core values. This professional development focused on diverse educators, their relationships, and conceptual understandings, rather than on narrow techniques for enhancing student understanding or changing student behaviour. Its core practice involved facilitated critical reflexive dialogue in a circle, organized around recognizing the impact of participants’ interactions on others, using three central, recurring questions: Am I honouring? Am I measuring? What message am I sending? Situated in the context of relational theory (Llewellyn, 2012), this restorative professional development approach addresses some of the challenges in implementing and sustaining transformative citizenship and peacebuilding pedagogies in schools. A pedagogical portrait of the rationale, design, and facilitation experience illustrates the theories, practices, and insights of the initiative, called Relationships First: Implementing Restorative Justice From the Ground Up

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes