‘The rehabilitative role of arts education in prison: accommodation or enlightenment?’

The prisoner constituency is one of the most excluded in society. Addressing recidivism requires amongst other considerations, an enabling of these individuals to fulfil rehabilitative intent. The article argues that this necessitates an educational discourse and methodology that is embedded in concepts of emancipation and empowerment, where creativity and heuristic learning enable personal transformation. The arts are one of the agents that can naturally encourage spontaneous and participatory learning, enabling a more liberating and self-directed rehabilitative process. Notwithstanding, arts education in prison illuminates the struggle between individual creative needs and social accommodation. Historically the shifting paradigm of penal policy has reflected a wider political intention. But there is an irony as the New Labour government that champions social inclusion has overseen the reduction of opportunity in prison to engage with the arts, replaced by an instrumental agenda concerning basic, key and cognitive skills. Furthermore, this has arguably been costly and ineffectual, hence the need to accommodate a more creative and expressive curriculum. The article has been divided into two parts. The first examines competing discourses of penal educational provision in order to assess the role of the arts. The second part examines a radical educational agenda of inclusion based on emancipatory theory, as a conduit for personal transformation, in which the creative arts have a central role

Targeted lung cancer screening selects individuals at high risk of cardiovascular disease

Background: Cardiovascular disease (CVD) is a major cause of morbidity and mortality in populations eligible for lung cancer screening. The aim of this study was to determine whether a brief CV risk assessment, delivered as part of a targeted community-based lung cancer screening programme, was effective in identifying individuals at high risk who might benefit from primary prevention. Methods: The Manchester Lung Screening Pilot consisted of annual low dose CT (LDCT) over 2 screening rounds, targeted at individuals in deprived areas at high risk of lung cancer (age 55–74 and 6-year risk ≥1.51%, using PLCOM2012 risk model). All participants of the second screening round were eligible to take part in the study. Ten-year CV risk was estimated using QRISK2 in participants without CVD and compared to age (±5 years) and sex matched Health Survey for England (HSE) controls; high risk was defined as QRISK2 score ≥10%. Coronary artery calcification (CAC) was assessed on LDCT scans and compared to QRISK2 score. Results: Seventy-seven percent (n=920/1,194) of screening attendees were included in the analysis; mean age 65.6 ± 5.4 and 50.4% female. QRISK2 and lung cancer risk (PLCOM2012) scores were correlated (r = 0.26, p < 0.001). Median QRISK2 score was 21.1% (IQR 14.9–29.6) in those without established CVD (77.6%, n = 714/920), double that of HSE controls (10.3%, IQR 6.6–16.2; n = 714) (p < 0.001). QRISK2 score was significantly higher in those with CAC (p < 0.001). Screening attendees were 10-fold more likely to be classified high risk (OR 10.2 [95% CI 7.3–14.0]). One third (33.7%, n = 310/920) of all study participants were high risk but not receiving statin therapy for primary CVD prevention. Discussion: Opportunistic CVD risk assessment within a targeted lung cancer screening programme is feasible and is likely to identify a very large number of individuals suitable for primary prevention