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Although cognitive remediation (CR) improves cognition and functioning, the key features that promote or inhibit its effectiveness, especially between cognitive domains, remain unknown. Discovering these key features will help to develop CR for more impact.
Aim
To identify interrelations between cognition, symptoms, and functioning, using a novel network analysis approach and how CR affects these recovery outcomes.
Methods
A secondary analysis of randomized controlled trial data (N = 165) of CR in early psychosis. Regularized partial correlation networks were estimated, including symptoms, cognition, and functioning, for pre-, post-treatment, and change over time. Pre- and post-CR networks were compared on global strength, structure, edge invariance, and centrality invariance.
Results
Cognition, negative, and positive symptoms were separable constructs, with symptoms showing independent relationships with cognition. Negative symptoms were central to the CR networks and most strongly associated with change in functioning. Verbal and visual learning improvement showed independent relationships to improved social functioning and negative symptoms. Only visual learning improvement was positively associated with personal goal achievement. Pre- and post-CR networks did not differ in structure (M = 0.20, p = 0.45) but differed in global strength, reflecting greater overall connectivity in the post-CR network (S = 0.91, p = 0.03).
Conclusions
Negative symptoms influenced network changes following therapy, and their reduction was linked to improvement in verbal and visual learning following CR. Independent relationships between visual and verbal learning and functioning suggest that they may be key intervention targets to enhance social and occupational functioning.
Early intervention in psychosis (EIP) services improve outcomes for young people, but approximately 30% disengage.
Aims
To test whether a new motivational engagement intervention would prolong engagement and whether it was cost-effective.
Method
We conducted a multicentre, single-blind, parallel-group, cluster randomised controlled trial involving 20 EIP teams at five UK National Health Service (NHS) sites. Teams were randomised using permuted blocks stratified by NHS trust. Participants were all young people (aged 14–35 years) presenting with a first episode of psychosis between May 2019 and July 2020 (N = 1027). We compared the novel Early Youth Engagement (EYE-2) intervention plus standardised EIP (sEIP) with sEIP alone. The primary outcome was time to disengagement over 12–26 months. Economic outcomes were mental health costs, societal costs and socio-occupational outcomes over 12 months. Assessors were masked to treatment allocation for primary disengagement and cost-effectiveness outcomes. Analysis followed intention-to-treat principles. The trial was registered at ISRCTN51629746.
Results
Disengagement was low at 15.9% overall in standardised stand-alone services. The adjusted hazard ratio for EYE-2 + sEIP (n = 652) versus sEIP alone (n = 375) was 1.07 (95% CI 0.76–1.49; P = 0.713). The health economic evaluation indicated lower mental healthcare costs linked to reductions in unplanned mental healthcare with no compromise of clinical outcomes, as well as some evidence for lower societal costs and more days in education, training, employment and stable accommodation in the EYE-2 group.
Conclusions
We found no evidence that EYE-2 increased time to disengagement, but there was some evidence for its cost-effectiveness. This is the largest study to date reporting positive engagement, health and cost outcomes in a total EIP population sample. Limitations included high loss to follow-up for secondary outcomes and low completion of societal and socio-occupational data. COVID-19 affected fidelity and implementation. Future engagement research should target engagement to those in greatest need, including in-patients and those with socio-occupational goals.
There follows the open discussion which took place at the IGS symposium on ‘The Edges of Glaciology’, in July 2023. The discussion was curated by Doug Benn. The time of speaking in minutes and seconds into the Panopto recording is given in bold figures. The recording itself is provided as electronic supplementary material. It has been transcribed and edited by Andrew Fowler, with much (and much-needed) assistance from the participants. Footnotes (mostly references) are editorial intrusions.
Contains 'The Shefford Beaker', by Cyril Fox. 'The Later Descent of Wingate of Harlington', by Joseph Hight Blundell. 'The Disseisins by Falk de Breaute at Luton', by G. Herbert Fowler and Michael W. Hughes. 'An Elizabethan Inquisition Concerning Bondmen', by S. Peyton. 'Roll of the Justices in Eyre, 1242', by G. Herbert Fowler. 'A list of Bedfordshire Apprentices, 1711-1720', by Mrs. Hilary Jenkinson. 'The Commune of Bedford', by Prof. F. M. Stenton. 'A Handlist of the Bedfordshire County Muniments', prepared by the County Records Committee.
Since the article which forms pp. 23-34 was printed, the writer noticed a surprising entry on the Close Roll of 1248, by which the Escheators in Hunts, and Cambs. are ordered “that, with regard to the revenue of Simon de sancto Licio in Huntindon’ from the third penny of the County, which the King caused to be taken into his own hand by reason that in these days there is no Earl of Huntindon’, they cause him again to have (rehabere) full seisin, provided that according to justice he answer for it in the King's Court to his summons.” This seems to be the only case as yet noticed of the allowance of the third penny of the County to one who had no claims on an Earldom. The nearest comparable case seems to be that of Hugh de Courtenay; he was a distant kinsman of the last of the family de Reviers, Earls of Devon, and succeeded to their estates about 1293; he claimed the third penny of Devon from the Sheriff, and it was allowed at the Exchequer till about 1325/6, when the Treasurer disallowed it on the ground that Hugh was not the Earl; Hugh protested, and finally was created Earl of Devon with full grant of the third penny, and was acquitted of the claims made by the Exchequer for what he had irregularly received in the last 8J years. A serious search of the Pipe Rolls of the period has not been possible, but no payment to Simon de St. Liz of the third penny appears in the Rolls for 1248, 1249, 1250; it might have been paid in some other way. Both in these three years and earlier is an allowance for ‘lands granted’ (terrae datae) “to the heirs of the Earl of Huntendon 40li in Brampton and Alemundebiri” (Brampton and Alconbury co. Hunts., royal lands at Domesday).
It seemed worth while to attempt to trace this highly favoured recipient, but as the eldest son of the family seems always to have been called Simon, the separation of successive generations is merely inferential.
It appears from a case reported by Bracton under 1220, that William Marshal duly received the manor of Luton with his wife, but that it was escheated in 1216 in consequence of his opposition to King John. At the conclusion of peace Falk (whether willingly or not) restored it to William, who re-granted it to him (on lease or farm) by charter. The transaction becomes thus somewhat clearer.
In another place Bracton reports an action for novel disseisin by Will, de Stanes against Falk for 2 carucates and a mill in Luton, under the year 1224. Falk does not appear, “and Robert de Lexinton and his fellows, who were Justices at Dunstaple to take that assise and before whom it was summoned, recall (recordantur) that that assise stood over for hearing because” etc. ; this seems to confirm the suggestion that the Rolls had been lost; if they had been accessible, the phrasing would probably have been different. A note to this case by Bracton's editor, Prof. Maitland, shows that he had detected the Inquisition by Martin de Pateshull which is dealt with on pp. 51-60 above, but that he regarded it (erroneously, as we think) as the record of the original Eyre of Martin de Pateshull and his fellows.—[G.H.F.].
The coronavirus pandemic sent shockwaves around the world, resulting in radical changes to how people in all sectors were expected to do their jobs. The probation service was no exception, with the National Probation Service (NPS) in England and Wales introducing the exceptional delivery model (EDM) following the announcement of the first lockdown on 23 March 2020. This chapter focuses on the impact these changes had on the service, staff and people under supervision. The EDM led to unpaid work (UPW) ceasing (temporarily at least), a pause to the delivery of accredited programmes for all but the highest-risk individuals (which were delivered on a one-to-one basis) and most court-related activities being suspended (Phillips, 2020). The EDM mandated the completion of assessments to review risk management actions and sentence plan objectives for all individuals subject to community supervision (House of Commons Justice Committee, 2020a; Napo, 2020) and determine the method and frequency of supervisory meetings under the new model of delivery (Napo, 2020). Face-to-face meetings with people on probation were reduced in frequency to enable people to adhere to the ‘stay at home’ message, and most probation practitioners quickly transitioned to working from home. Face-to-face meetings were limited to people assessed as posing a very high risk of harm, prison leavers reporting for their initial appointment, people managed in accordance with counterterrorism legislation and, finally, those without access to remote communication. Where face-to-face meetings were deemed necessary, these were conducted at a probation office and/or via doorstep visits at the client's home.
Remote communication thus became the primary method for delivering community supervision. Clients were contacted by telephone, WhatsApp and Skype, with video messaging to be used wherever possible (Napo, 2020). Remote supervision was considered inferior when compared to traditional face-to-face contact, so contact requirements were increased to twice the frequency (Napo, 2020). As the pandemic progressed, this requirement was relaxed to allow greater professional judgement, ameliorate logistical difficulties and respond to a perception that these additional reporting requirements were too onerous for people under supervision.
This chapter explores the ways in which students have experienced the Professional Qualification in Probation (PQiP) during the COVID-19 pandemic. It includes comments drawn from focus groups with students in a range of cohorts at various stages of the qualification when the pandemic occurred. The findings lead to reflections on the implications for probation education moving forward. The impact of the COVID-19 pandemic on probation has been documented by the House of Commons Justice Committee (2020) in their report Coronavirus (COVID-19): The impact on probation systems, which details the move to the exceptional delivery model that changed the way probation services were delivered. Unfortunately, there was no mention of PQiP students within the Justice Committee's report. We are interested in learning more about the students who transitioned from the workplace to working from home, and those students who started the qualification when already working from home. Given that the report states that staff ‘[m] orale and wellbeing are being affected’ (House of Commons Justice Select Committee, 2020) by the current circumstances, there is further support for research that explores the ‘wellness’ of probation trainees.
The aspiring probation officers were entering the service at a time of tumultuous change. During this period, the Justice Select Committee (2020) reported that probation practice adapted by using Skype, phone and messaging services for supervision, while people assessed as high risk received doorstep visits. Further to this, sentence requirements could not be completed where they involved unpaid work or offending behaviour programme interventions. In addition, an already-stretched workforce, with high caseloads and not enough staff, suffered the absence of 2,000 staff per day due to COVID-19. Moreover, Phillips (2020) flags a request from HM Prison & Probation Service (HMPPS) for the frequency of contact with people on probation at this time to be doubled. With 224,174 individuals on probation in the community in March 2021 (GOV.UK Justice Data, 2021), this was also a difficult time for people on probation and in prison experiencing supervision, exacerbating the ‘pains’ of supervision (McNeill 2019, 2020). This has all come at a time when probation services in England and Wales are undergoing significant reforms following the failure of Transforming Rehabilitation.
Traditional transect survey methods for forest antelopes often underestimate density for common species and do not provide sufficient data for rarer species. The use of camera trapping as a survey tool for medium and large terrestrial mammals has become increasingly common, especially in forest habitats. Here, we applied the distance sampling method to images generated from camera-trap surveys in Dja Faunal Reserve, Cameroon, and used an estimate of the proportion of time animals are active to correct for negative bias in the density estimates from the 24-hour camera-trap survey datasets. We also used multiple covariate distance sampling with body weight as a covariate to estimate detection probabilities and densities of rarer species. These methods provide an effective tool for monitoring the status of individual species or a community of forest antelope species, information urgently needed for conservation planning and action.
The coronavirus disease 2019 (COVID-19) has greatly impacted health-care systems worldwide, leading to an unprecedented rise in demand for health-care resources. In anticipation of an acute strain on established medical facilities in Dallas, Texas, federal officials worked in conjunction with local medical personnel to convert a convention center into a Federal Medical Station capable of caring for patients affected by COVID-19. A 200,000 square foot event space was designated as a direct patient care area, with surrounding spaces repurposed to house ancillary services. Given the highly transmissible nature of the novel coronavirus, the donning and doffing of personal protective equipment (PPE) was of particular importance for personnel staffing the facility. Furthermore, nationwide shortages in the availability of PPE necessitated the reuse of certain protective materials. This article seeks to delineate the procedures implemented regarding PPE in the setting of a COVID-19 disaster response shelter, including workspace flow, donning and doffing procedures, PPE conservation, and exposure event protocols.
In this chapter, we examine the performance of emotional labour by probation practitioners to uncover the complex use of emotion that underpins the development of the officer–offender relationship inherent to effective probation practice. We begin by mapping the way in which the use of emotion has been marginalised from policy over the past 30 years, making links to the rise of managerialism and the ‘what works’ movement, as well as more recent developments such as the Offender Engagement Programme and the Skills for Effective Engagement and Development (SEED) programme, which sought to pilot a practice-based model based on evidence of what works to reduce reoffending (NOMS, 2011; see also Chapter Ten of this volume). We then use data that were generated through interviews with probation practitioners to analyse one aspect of SEED – the development of the relationship. We do this through the lens of emotional labour. In doing so, we focus on the way in which practitioners engage in both deep and surface acting to get to know and understand their clients as well as create clear boundaries. These are the two elements of practice that are seen to be crucial in the creation of effective professional relationships in the SEED model. We conclude by arguing that the development of the relationship with the client as described in the SEED model requires considerable emotional labour that has, hitherto, been unacknowledged in probation policy, and reflect on what might need to be done, in light of our findings, were probation providers to consider reintroducing SEED following the implementation of the government's Transforming Rehabilitation reforms, which privatised around 60% of probation work.
Emotions as effective practice
It is necessary to offer some context to understand how this research sits in terms of literature on both emotional labour and effective probation practice. The relative importance attached to, or marginalisation of, the use of emotion in one-to-one supervision can be mapped against the ‘disappearance and appearance of the relationship’ as discussed by Burnett and McNeill (2005, p 222). While this literature review aims to trace the ebb and flow of the prominence attached to the role of emotion in effective practice, Garland (2001, p 22) cautions that ‘talk should not be mistaken for action’.
On August 25, 2017, Hurricane Harvey made landfall near Corpus Christi, Texas. The ensuing unprecedented flooding throughout the Texas coastal region affected millions of individuals.1 The statewide response in Texas included the sheltering of thousands of individuals at considerable distances from their homes. The Dallas area established large-scale general population sheltering as the number of evacuees to the area began to amass. Historically, the Dallas area is one familiar with “mega-sheltering,” beginning with the response to Hurricane Katrina in 2005.2 Through continued efforts and development, the Dallas area had been readying a plan for the largest general population shelter in Texas. (Disaster Med Public Health Preparedness. 2019;13:33–37)
The deformation of subglacial till is instrumental in causing certain glacier surges, the motion of rapid ice streams in ice sheets, and ice-sheet surges which are associated with Heinrich events, and consequent rapid climatic shifts, during the last ice age. It may also be the means whereby drumlins are formed, and these in turn may act as a brake on large-scale ice flow. It is therefore important in building models to understand the rate at which till deforms, and how this controls the basal ice velocity. In recent years, two paradigms have emerged. On the one hand, theoreticians have tended to use a viscous rheology, though this lacks quantitative support. On the other hand, field and laboratory studies suggest that till behaves plastically. In this paper I will examine some of the dynamic consequences of this latter assumption, and show how the dichotomy between viscous and plastic may be less clear-cut than previously thought.