Mind the gap: sentencing, rehabilitation and civic purgatory

This article discusses the relationships and tensions between the sentencing, statutory supervision and legal rehabilitation of lawbreakers under UK legislation. It does so with reference to both the Rehabilitation of Offenders Act 1974, which allows some criminal records to become ‘spent’ after a set period of time, and the Offender Rehabilitation Act 2014, which was designed to significantly expand statutory supervision arrangements. The article also demonstrates how, post-supervision, many former lawbreakers are cast into a state of ‘civic purgatory’, before suggesting that a more fully integrated approach to rehabilitation is required

Carcinoma of endocrine organs: results of the RARECARE project

The rarity or the asymptomatic character of endocrine tumours results in a lack of epidemiological studies on their incidence and survival patterns. The aim of this study was to describe the incidence, prevalence and survival of endocrine tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002, registered in 89 population-based cancer registries (CRs) with follow-up until 31st December 2003. These data give an unique overview of the burden of endocrine carcinomas in Europe. A list of tumour entities based on the third International Classification of Diseases for Oncology was provided by the project Surveillance of rare cancer in Europe (RARECARE) project. Over 33,594 cases of endocrine carcinomas were analysed in this study. Incidence rates increased with age and were highest in patients 65 years of age or older. In 2003, more than 315,000 persons in the EU (27 countries) were alive with a past diagnosis of a carcinoma of endocrine organs. The incidence of pituitary carcinoma equalled four per 1,000,000 person years and showed the strongest decline in survival with increasing age. Thyroid cancer showed the highest crude incidence rates (four per 100,000 person years) and was the only entity with a gender difference: (female-to-male ratio: 2:9). Parathyroid carcinoma was the rarest endocrine entity with two new cases per 10,000,000 person years. For adrenal carcinoma, the most remarkable observations were a higher survival for women compared to men (40% compared to 32%, respectively) and a particularly low relative survival of 24% in patients 65 years of age or older. More high quality studies on rare cancers, with additional information, e.g. on stage and therapeutic approach, are needed and may be of help in partly explaining the observed variation in survival

Prospective cost-effectiveness analysis of cetuximab in metastatic colorectal cancer: evaluation of National Cancer Institute of Canada Clinical Trials Group CO.17 trial

The National Cancer Institute of Canada Clinical Trials Group CO.17 study showed that patients with advanced colorectal cancer had improved overall survival when cetuximab, an epidermal growth factor receptor-targeting antibody, was given in addition to best supportive care. We conducted a cost-effectiveness analysis using prospectively collected resource utilization and health utility data for patients in the CO.17 study who received cetuximab plus best supportive care (N = 283) or best supportive care alone (N = 274).Direct medical resource utilization data were collected, including medications, physician visits, toxicity management, blood products, emergency department visits, and hospitalizations. Mean survival times for the study arms were calculated for the entire population and for the subset of patients with wild-type KRAS tumors over an 18- to 19-month period. All costs were presented in 2007 Canadian dollars. One-way and probabilistic sensitivity analysis was used to determine the robustness of the results. Cost-effectiveness acceptability curves were determined. The 95% confidence intervals (CIs) for the incremental cost-effectiveness ratios and the incremental cost-utility ratios were estimated by use of a nonparametric bootstrapping method (with 1000 iterations).For the entire study population, the mean improvement in overall and quality-adjusted survival with cetuximab was 0.12 years and 0.08 quality-adjusted life-years (QALYs), respectively. The incremental cost with cetuximab compared with best supportive care was $23,969. The incremental cost-effectiveness ratio was$199,742 per life-year gained (95% CI = $125,973 to$652,492 per life-year gained) and the incremental cost-utility ratio was $299,613 per QALY gained (95$187,440 to $898,201 per QALY gained). For patients with wild-type KRAS tumors, the incremental cost with cetuximab was$33,617 and mean gains in overall and quality-adjusted survival were 0.28 years and 0.18 QALYs, respectively. The incremental cost-effectiveness ratio was $120,061 per life-year gained (95$88,679 to $207,075 per life-year gained) and the incremental cost-utility ratio was$186,761 per QALY gained (95% CI = $130,326 to$334,940 per QALY gained). In a sensitivity analysis, cetuximab cost and patient survival were the only variables that influenced cost-effectiveness.The incremental cost-effectiveness ratio of cetuximab over best supportive care alone in unselected advanced colorectal cancer patients is high and sensitive to drug cost. Incremental cost-effectiveness ratios were lower when the analysis was limited to patients with wild-type KRAS tumors

‘Victims’ versus ‘offenders’ in British political discourse: The construction of a false dichotomy

This article evaluates the contemporary discursive status of victims and people convicted of criminal offences. The rhetoric used by British politicians to convey the meaning of ‘rights’ is explored within media output, parliamentary speech-making and other forms of political discourse. Our analysis details how victims’ rights are sometimes advocated for at the expense of ‘offenders’ ’ rights in public discourse. Examination of parliamentary debates illustrates that differentiating between ‘victims’ and ‘offenders’ elides consideration of more meaningful support for victims, worsens opportunities for the reintegration of ex-prisoners and constructs a false dichotomy between citizens who do not fall into mutually-exclusive categories

Quality of Service for Satellite IP Networks: A Survey

none2siS. KOTA; M. MARCHESES., Kota; Marchese, Mari