Magistrates, Managerialism and Marginalisation: Neoliberalism and Access to Justice in East Kent

This thesis examines access to justice in summary criminal proceedings by considering the ability of defendants to play an active and effective role in the proceedings. Summary proceedings are those which take place in magistrates’ courts, and are decided by lay magistrates or a district judge (magistrates’ courts) without a jury. The study uses ethnographic fieldwork to explore the structural/cultural intersection of public services by considering both the effects of structural changes in criminal proceedings in magistrates' courts and the agency of the courtroom workgroup. While the cultural practices of magistrates’ courts have always tended to exclude defendants from active participation in the process, I argue that the structural influences of neoliberalism, in terms of demands for ever more efficient practices and emphasis on individual responsibility as a function of citizenship, have exacerbated the inability of defendants to participate in the process of prosecution. I also observe that, for a number of reasons, the professional workgroup has tended to absorb and adapt to, rather than resist, the neoliberalisation of summary criminal justice. Thus, the combination of structural and cultural influences on magistrates’ court proceedings perpetuates the marginalisation of defendants. Further, in light of neoliberalism's preference for market based approaches to government, there is little political motivation to address the identified problems of access to justice

ON IMPROVISATION, LEARNING, AND LITERACY

Previously, improvisation has served as a term for describing a quality of the action taking place in classrooms between teachers and students. This project begins to theorize a way of understanding embodied literacies and scenes of learning through a lens of improvisation that enhances the description and better equips researchers to analyze this quality. This project synthesizes numerous research threads and theories from theater (Halpern, 1994, 2005; Johnstone, 1992; Spolin, 1999), anthropology (Holland, Lachicotte, Skinner, & Cain, 2003), psychology (Sawyer, 2011b; Vygotsky, 1978), and literary theory (Bakhtin, 1981) in an effort to provide a theory of improvisation that could be deployed in future qualitative studies or serve as a way for literacy teachers to think about their classrooms. A theory of improvisation enables qualitative researchers in the field of education to acquire a more thorough understanding of the way literacies are an improvised process in scenes of learning. This project is necessary because no such theory yet exists. As part of theorizing literacy and improvisation, I draw upon scenes from my own teaching and from theatrical improvisation. I analyze these moments to illustrate various theoretical premises such as instances of "yes, and-ing" that carry a scene of learning forward. This theory building and analysis amount to a first iteration of improv theory

Identifying and designing for the needs of older road users

The number of older road users is continuously increasing over time. Whilst much research focuses on the likely impact on road safety, little work has been carried out examining the impact on older people themselves of their declining ability to cope with the road environment. Additionally, it is known that because of their increased frailty older drivers are more at risk of sustaining a fatal or serious injury than younger roadusers. Consequently older people often feel pressured by family members, health practitioners or an increasing inability to deal with traffic conditions, into giving up driving in favour of some other form of transport. However, the subsequent effect of this may actually be to increase the risk exposure of older people. The aim of this study was to use an accident-independent approach to collect detailed information on the interaction between behaviour, perceived and actual risk and use of transport systems, using both quantitative and qualitative techniques. A focus group and interviews were conducted with older road-users to gain an initial insight into their experiences and perceptions of safety whilst using the UK road infrastructure (including roads, pavements, cycle tracks, pedestrian crossings etc.). Additionally, analysis was undertaken of UK exposure data and casualty rates for older road users. The qualitative and quantitative data sources were compared and contrasted. Older people felt at risk using the road system, and many of these perceptions were upheld according to the statistical reports. Not all of the issues raised by older road-users can be dealt with by improving design, but this study presents a set of recommendations, which, if implemented would increase the safety of all road users

Enhancing the Behaviour Change Wheel with synthesis, stakeholder involvement and decision-making: a case example using the 'Enhancing the Quality of Psychological Interventions Delivered by Telephone' (EQUITy) research programme.

From Europe PMC via Jisc Publications RouterHistory: ppub 2021-05-01, epub 2021-05-14Publication status: PublishedFunder: Programme Grants for Applied Research; Grant(s): RP-PG-1016-20010BackgroundUsing frameworks such as the Behaviour Change Wheel to develop behaviour change interventions can be challenging because judgement is needed at various points in the process and it is not always clear how uncertainties can be resolved. We propose a transparent and systematic three-phase process to transition from a research evidence base to a behaviour change intervention. The three phases entail evidence synthesis, stakeholder involvement and decision-making. We present the systematic development of an intervention to enhance the quality of psychological treatment delivered by telephone, as a worked example of this process.MethodIn phase 1 (evidence synthesis), we propose that the capabilities (C), opportunities (O) and motivations (M) model of behaviour change (COM-B) can be used to support the synthesis of a varied corpus of empirical evidence and to identify domains to be included in a proposed behaviour change intervention. In phase 2 (stakeholder involvement), we propose that formal consensus procedures (e.g. the RAND Health/University of California-Los Angeles Appropriateness Methodology) can be used to facilitate discussions of proposed domains with stakeholder groups. In phase 3 (decision-making), we propose that behavioural scientists identify (with public/patient input) intervention functions and behaviour change techniques using the acceptability, practicability, effectiveness/cost-effectiveness, affordability, safety/side-effects and equity (APEASE) criteria.ResultsThe COM-B model was a useful tool that allowed a multidisciplinary research team, many of whom had no prior knowledge of behavioural science, to synthesise effectively a varied corpus of evidence (phase 1: evidence synthesis). The RAND Health/University of California-Los Angeles Appropriateness Methodology provided a transparent means of involving stakeholders (patients, practitioners and key informants in the present example), a structured way in which they could identify which of 93 domains identified in phase 1 were essential for inclusion in the intervention (phase 2: stakeholder involvement). Phase 3 (decision-making) was able to draw on existing Behaviour Change Wheel resources to revisit phases 1 and 2 and facilitate agreement among behavioural scientists on the final intervention modules. Behaviour changes were required at service, practitioner, patient and community levels.ConclusionFrameworks offer a foundation for intervention development but require additional elucidation at each stage of the process. The decisions adopted in this study are designed to provide an example on how to resolve challenges while designing a behaviour change intervention. We propose a three-phase process, which represents a transparent and systematic framework for developing behaviour change interventions in any setting

T. brucei cathepsin-L increases arrhythmogenic sarcoplasmic reticulum-mediated calcium release in rat cardiomyocytes

Aims: African trypanosomiasis, caused by Trypanosoma brucei species, leads to both neurological and cardiac dysfunction and can be fatal if untreated. While the neurological-related pathogenesis is well studied, the cardiac pathogenesis remains unknown. The current study exposed isolated ventricular cardiomyocytes and adult rat hearts to T. brucei to test whether trypanosomes can alter cardiac function independent of a systemic inflammatory/immune response. Methods and results: Using confocal imaging, T. brucei and T. brucei culture media (supernatant) caused an increased frequency of arrhythmogenic spontaneous diastolic sarcoplasmic reticulum (SR)-mediated Ca2+ release (Ca2+ waves) in isolated adult rat ventricular cardiomyocytes. Studies utilising inhibitors, recombinant protein and RNAi all demonstrated that this altered SR function was due to T. brucei cathepsin-L (TbCatL). Separate experiments revealed that TbCatL induced a 10–15% increase of SERCA activity but reduced SR Ca2+ content, suggesting a concomitant increased SR-mediated Ca2+ leak. This conclusion was supported by data demonstrating that TbCatL increased Ca2+ wave frequency. These effects were abolished by autocamtide-2-related inhibitory peptide, highlighting a role for CaMKII in the TbCatL action on SR function. Isolated Langendorff perfused whole heart experiments confirmed that supernatant caused an increased number of arrhythmic events. Conclusion: These data demonstrate for the first time that African trypanosomes alter cardiac function independent of a systemic immune response, via a mechanism involving extracellular cathepsin-L-mediated changes in SR function

ICD-11 complex Post Traumatic Stress Disorder (CPTSD) in parents with perinatal bereavement: Implications for treatment and care

Introduction The 11th revision of the WHO International Classification of Diseases (ICD-11) has identified Complex PTSD (CPTSD) as a new condition. Aim To explore whether the new diagnosis of CPTSD (ICD11) is relevant to women who have experienced perinatal bereavement and to advance knowledge about the acceptability, feasibility and perceived impact of delivering an innovative flexible Compassionate Focused Therapy (CFT) informed treatment package to alleviate symptoms of this condition. Methods A mixed methods study using survey and interviews was conducted. Participants first completed the International Trauma Questionnaire (ITQ) to assess if they met the criteria for PTSD or CPTSD (n=72), and subsequent semi-structured interviews (n=12) identified participants’ views about different treatment approaches. Participants A convenience sample of women who had experienced perinatal bereavement were recruited from one geographical region in Scotland. Data collection Information was gathered about trauma experiences related to perinatal bereavement; participants’ levels of PTSD or CPTSD using the ITQ; and views regarding the features of treatment options. In-depth interviews with women (n=12) and a focus group with staff (n=5) were also conducted. Findings Of 74 participants (n=74) who fully completed the ITQ, 10.8% (n=8) met the criteria for PTSD and 29.7% (n=22) for CPTSD, equating to a total of 40.5% of participants experiencing traumatic stress. Results suggest that CPTSD is a more common condition than PTSD in people with perinatal bereavement, with qualitative data suggesting that CFT and EMDR can be useful and acceptable interventions for this population group. Conclusion A feasibility study is recommended next to evaluate acceptability of trial processes in preparation for a definitive randomised controlled trial of a new flexible CFT informed treatment package to address PTSD and CPTSD in people with perinatal bereavement. Recommendations for practice Routine assessment of ICD-11 CPTSD is recommended in this population group

Considerations towards a roadmap for collection, handling and storage of blood extracellular vesicles

There is an increasing interest in exploring clinically relevant information that is present in body fluids, and extracellular vesicles (EVs) are intrinsic components of body fluids (?liquid biopsies?). In this report, we will focus on blood. Blood contains not only EVs but also cells, and non-EV particles including lipoproteins. Due to the high concentration of soluble proteins and lipoproteins, blood, plasma and serum have a high viscosity and density, which hampers the concentration, isolation and detection of EVs. Because most if not all studies on EVs are single-centre studies, their clinical relevance remains limited. Therefore, there is an urgent need to improve standardization and reproducibility of EV research. As a first step, the International Society on Extracellular Vesicles organized a biomarker workshop in Birmingham (UK) in November 2017, and during that workshop several working groups were created to focus on a particular body fluid. This report is the first output of the blood EV work group and is based on responses by work group members to a questionnaire in order to discover the contours of a roadmap. From the answers it is clear that most respondents are in favour of evidence-based research, education, quality control procedures, and physical models to improve our understanding and comparison of concentration, isolation and detection methods. Since blood is such a complex body fluid, we assume that the outcome of the survey may also be valuable for exploring body fluids other than blood.Non peer reviewe

Sepsis-related deaths in the at-risk population on the wards: attributable fraction of mortality in a large point-prevalence study

Objective Sepsis mortality is reported to be high worldwide, however recently the attributable fraction of mortality due to sepsis (AFsepsis) has been questioned. If improvements in treatment options are to be evaluated, it is important to know what proportion of deaths are potentially preventable or modifiable after a sepsis episode. The aim of the study was to establish the fraction of deaths directly related to the sepsis episode on the general wards and emergency departments. Results 839 patients were recruited over the two 24-h periods in 2016 and 2017. 521 patients fulfilled SEPSIS-3 criteria. 166 patients (32.4%) with sepsis and 56 patients (17.6%) without sepsis died within 90 days. Out of the 166 sepsis deaths 12 (7.2%) could have been directly related to sepsis, 28 (16.9%) possibly related and 96 (57.8%) were not related to sepsis. Overall AFsepsis was 24.1%. Upon analysis of the 40 deaths likely to be attributable to sepsis, we found that 31 patients (77.5%) had the Clinical Frailty Score ≥ 6, 28 (70%) had existing DNA-CPR order and 17 had limitations of care orders (42.5%)