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Exploring legal development requires more than simply examining the votes of judges because legal development embraces the actions of multiple actors. At a minimum, courts require lawyers to develop and present cases to them for adjudication. While courts need lawyers, lawyers need law; in other words, courts rely on lawyers to develop cases for their review, but the law provided by those courts shapes the actions of lawyers. This article examines the development of state constitutional law by exploring the interactions between lawyers and the Washington Supreme Court after the court required specific briefing practices for state constitutional arguments and the degree to which Washington lawyers responded. Utilizing legal briefs in Washington and some comparative data, I argue that the court was moderately successful at encouraging more thorough constitutional claims. This highlights the importance of considering how lawyers respond to court signals not only in the presence or absence of certain legal arguments but also in the content of those arguments.
Psychological therapy is core component of mental healthcare. However, many people with severe mental illnesses do not receive therapy, particularly in acute mental health settings.
Aims
This study identifies barriers to delivering and accessing psychological therapies in acute mental health settings, and is the first to recommend how services can increase access from the perspectives of different stakeholders (staff, patients and carers).
Method
Sixty participants with experiences of acute mental health wards (26 staff, 22 patients and 12 carers) were interviewed about barriers to accessing therapy in in-patient settings and how therapies should be delivered to maximise access.
Results
Four themes were identified: (a) ‘Models of care’, including the function of in-patient wards, beliefs about the causes of mental health problems and the importance of strong leadership to support psychosocial interventions; (b) ‘Integrated care’, including the importance of psychologists being ward-based, as well as having strong links with community teams; (c) ‘Acute levels of distress’, including factors that aggravate or ameliorate the impact of this on engagement in therapy; and (d) ‘Enhancing staff capability and motivation’, which is influenced by contextual issues.
Conclusions
It is possible to improve access to therapy through strong leadership (that is supportive of talking treatments), flexible delivery of therapy (that considers short admissions) and a whole-systems approach that promotes ward staff understanding of the psychosocial causes of mental illness and staff well-being. It is essential to ensure continuity between in-patient and community therapy services, and for wards to have physical space to carry out therapy.
Coronavirus disease 2019 (COVID-19) vaccination rates of a large health system reflected their respective service areas but varied by work role. Nurse vaccination rates were higher (56.9%) and rates among nursing support personnel were lower (38.6%) than those of their communities (51.7%; P < .001). Physician vaccination rates were highest (71.6%) and were not associated with community vaccination levels.
Research on international norms has yet to answer satisfactorily some of our own most important questions about the origins of norms and the conditions under which some norms win out over others. The authors argue that international relations (IR) theorists should engage more with research in moral psychology and neuroscience to advance theories of norm emergence and resonance. This Element first provides an overview of six areas of research in neuroscience and moral psychology that hold particular promise for norms theorists and international relations theory more generally. It next surveys existing literature in IR to see how literature from moral psychology is already being put to use, and then recommends a research agenda for norms researchers engaging with this literature. The authors do not believe that this exchange should be a one-way street, however, and they discuss various ways in which the IR literature on norms may be of interest and of use to moral psychologists, and of use to advocacy communities.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (
${\sim}60\%$
), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions.
Aims
To estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition.
Method
Surveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires.
Results
Questionnaire response was 79% at baseline and 82% at follow-up. For those aged 17–19, incident rate (range adjusted for non-response) of transition need was 202–511 per 100 000 people aged 17–19 per year, with successful transition of 38–96 per 100 000 people aged 17–19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria.
Conclusions
As inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences.
DURING the heyday of his fame, between 1905 and 1925, Cyril Scott enjoyed an international reputation as a musical modernist, to a greater extent than any of his English contemporaries. Throughout his lifetime he was probably better known, and certainly more highly esteemed, abroad, particularly in France and Germany, than in his own country. This situation arose in the first place from personal contacts. His composition teacher at Frankfurt, Iwan Knorr, was greatly respected, and continued to speak with admiration and affection for his one-time student. Scott also enjoyed the friendship and patronage of the poet Stefan George, a major figure in German literature, and to whose influence was due the premiere of Scott's First Symphony, at Darmstadt in 1900. Meanwhile, in Austria he benefited from the admiration of Alma Mahler (the wife, then widow, of the great composer), who greatly admired the Violin Sonata of 1908 and secured performances of some of his orchestral works in Vienna. Of Scott's friendship with his French contemporaries Debussy and Ravel I shall speak below.
In England, in contrast, his major works were largely forgotten after their not very frequent premieres. But this was balanced by the popularity of his short piano pieces among those who took an interest in the latest musical developments. These pieces had the great advantage that most of them were easy to play, while the piano pieces being written at this time by Debussy and Ravel were too difficult for amateur pianists. Scott's piano music is likely to have played a major role in popularising the ‘new harmony’ that (with the political help of World War 1) brought to an end the dominance of English musical life by nineteenth-century German Romanticism. But though this emphasis on Scott the modernist stimulated interest in his music while he was still a member of the avant-garde, it did his standing no good when, from the mid-1920s, musical fashions changed drastically. Scott's music now sounded dated. Those with an interest in modern music turned their gaze elsewhere, to newer gods.
Particularly damaging to Scott's reputation was the sobriquet he had acquired of the ‘English Debussy’. For one thing, Debussy's standing was not at all as high a century ago as it is today.
The Protoplanetary Discussions conference—held in Edinburgh, UK, from 2016 March 7th–11th—included several open sessions led by participants. This paper reports on the discussions collectively concerned with the multi-physics modelling of protoplanetary discs, including the self-consistent calculation of gas and dust dynamics, radiative transfer, and chemistry. After a short introduction to each of these disciplines in isolation, we identify a series of burning questions and grand challenges associated with their continuing development and integration. We then discuss potential pathways towards solving these challenges, grouped by strategical, technical, and collaborative developments. This paper is not intended to be a review, but rather to motivate and direct future research and collaboration across typically distinct fields based on community-driven input, to encourage further progress in our understanding of circumstellar and protoplanetary discs.
Objectives: Kids in Control OF Food (KICk-OFF) is a 5-day structured education program for 11- to 16-year-olds with type 1 diabetes mellitus (T1DM) who are using multiple daily insulin injections. This study evaluates the cost-effectiveness of the KICk-OFF education program compared with the usual care using data from the KICk-OFF trial.
Methods: The short-term within-trial analysis covers the 2-year postintervention period. Data on glycated hemoglobin (HbA1c), severe hypoglycemia, and diabetic ketoacidosis (DKA) were collected over a 2-year follow-up period. Sub-group analyses have been defined on the basis of baseline HbA1c being below 7.5 percent (58.5 mmol/mol) (low group), between 7.5 percent and 9.5 percent (80.3 mmol/mol) (medium group), and over 9.5 percent (high group). The long-term cost-effectiveness evaluation has been conducted by using The Sheffield Type 1 Diabetes Policy Model, which is a patient-level simulation model on T1DM. It includes long-term microvascular (retinopathy, neuropathy, and nephropathy) and macrovascular (myocardial infarction, stroke, revascularization, and angina) diabetes-related complications and acute adverse events (severe hypoglycemia and DKA).
Results: The most favorable within-trial scenario for the KICk-OFF arm led to an incremental cost-effectiveness ratio (ICER) of £23,688 (base year 2009) with a cost-effectiveness probability of 41.3 percent. Simulating the long-term complications using the full cohort data, the mean ICER for the base case was £28,813 (base year 2011) and the probability of the KICk-OFF intervention being cost-effective at £20,000/QALY threshold was 42.6 percent, with considerable variation due to treatment effect duration. For the high HbA1c sub-group, the KICk-OFF arm was “dominant” (meaning it provided better health gains at lower costs than usual care) over the usual care arm in each scenario considered.
Conclusions: For the whole study population, the cost-effectiveness of KICk-OFF depends on the assumption for treatment effect duration. For the high baseline HbA1c sub-group, KICk-OFF arm was estimated to be dominant over the usual care arm regardless of the assumption on the treatment effect duration.
Detractors have long criticized the use of courts to achieve social change because judicial victories tend to provoke counterproductive political backlashes. Backlash arguments typically assert or imply that if movement litigators had relied on democratic rather than judicial politics, their policy victories would have been better insulated from opposition. We argue that these accounts wrongly assume that the unilateral decision by a group of movement advocates to eschew litigation will lead to a reduced role for courts in resolving the relevant policy and political conflicts. To the contrary, such decisions will often result in a policy field with judges every bit as active, but with the legal challenges initiated and framed by the advocates' opponents. We document this claim and explore its implications for constitutional politics via a counterfactual thought experiment rooted in historical case studies of litigation involving abortion and the right to die.
This collection of essays has its origin in a conference held at Oxford in 2006 to mark the publication of the first English edition of the Acts of Chalcedon. Its aim is to place Chalcedon in a broader context, and bring out the importance of the acts of the early general councils from the fifth to the seventh century, documents that because of their bulk and relative inaccessibility have received only limited attention till recently. This volume is evidence that this situation is now rapidly changing, as historians of late antiquity as well as specialists in the history of the Christian Church discover the richness of this material for the exploration of common concerns and tensions across the provinces of the Later Roman Empire, language use, networks of influence and cultural exchange, and political manipulation at many different levels of society. The extent to which the acts were instruments of propaganda and should not be read as a pure verbatim record of proceedings is brought out in a number of the essays, which illustrate the fascinating literary problems raised by these texts.