‘Section 28’ and the pre-recording of cross-examination: What can advocates expect in 2018?

This article first appeared in Criminal Law and Justice weekly – (2018) 182 JPN 7-10. And can be found here: https://www.criminallawandjustice.co.uk/features/%E2%80%9CSection-28%E2%80%9D-and-Pre-Recording-Cross-ExaminationIn 2018, so long as the recently identified technological issues are remedied (rumoured to be about storage capacity for the recordings), pre-recorded cross-examination will be rolled out across Crown Courts in England and Wales. The process evaluation report (MoJ, 2016) for the pilot of section 28 Youth Justice and Criminal Evidence Act 1999 (YJCEA 1999) was encouraging as well as realistic; it acknowledged that findings might not be replicated on roll-out because courts in the study might not being representative of courts in general. The authors believe that the success of the scheme substantially rests in the hands of judges and practitioners. Here we briefly summarise the background to the roll-out, highlight some important aspects of the new guidance in the Criminal Practice Directions (CPD), illustrate practice with real case studies, and discuss the implications for professional development

Drawing to support vulnerable witnesses' and victims' episodic memory:increasing access to justice

Information provided by witnesses is fundamental to the investigation of criminal offences, and vulnerable people make up a large proportion of witnesses who enter the criminal justice system. Research concerning particularly vulnerable witnesses (i.e., children with autism) is still in its infancy. Further, research concerning typically developing children and adolescents, while vast, does not fully address the developmental and cognitive needs that this population present. Current best practice for eliciting information from vulnerable witnesses in England and Wales advocates the use of the Cognitive Interview (CI), which includes the Mental Reinstatement of Context (MRC) mnemonic. However, the benefits of MRC are unclear, both with typically developing children and children with autism. This thesis presents a series of studies that investigate how children might be better supported to recreate the context of an event using a developmentally appropriate drawing technique (Sketch-Reinstatement of Context; Sketch-RC). First, this thesis explores the interviewing practices of professionals who conduct or assist interviews with vulnerable witnesses, with a particular focus on the use of drawing. Following this, a series of studies examine the efficacy of Sketch-RC and MRC with both typically developing children and children with autism spectrum disorder. Findings demonstrate that practitioners make regular use of drawing during investigative interviews. Importantly, Sketch-RC was found to be most effective for all children, improving remembering without a concomitant increase in incorrect or confabulated recall. Further, Sketch-RC enabled children with autism to perform on par with their typically developing peers. These findings provide evidence for an empirically and theoretically supported retrieval tool that can be used by practitioners when interviewing vulnerable witnesses

Drawing the answers: Sketching to support free and probed recall by child witnesses and victims with autism spectrum disorder

The success of witness interviews in the criminal justice system depends on the accuracy of information obtained, which is a function of both amount and quality of information. Attempts to enhance witness retrieval such as mental reinstatement of context have been designed with typically developed adults in mind. In this paper, the relative benefits of mental and sketch reinstatement mnemonics are explored with both typically developing children and children with autism. Children watched a crime event video, and their retrieval of event information was examined in free and probed recall phases of a cognitive interview. As expected, typically developing children recalled more correct information of all types than children with autism during free and probed recall phases. Sketching during free recall was more beneficial for both groups in both phases in reducing the amount of incorrect items, but the relative effect of sketching on enhancing retrieval accuracy was greater for children with autism. The results indicate the benefits of choosing retrieval mnemonics that are sensitive to the specific impairments of autistic individuals, and suggest that retrieval accuracy during interviews can be enhanced, in some cases to the same level as that of typically developing individuals

Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND). a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension

Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. Methods: ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18–58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3·0–6·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3·0–5·5 vs 6·0–6·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Findings: Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0·86; 95% CI 0·66–1·13; p=0·287). No treatment effect was observed on the EDSS (OR 1·06, 95% CI 0·74–1·53; nominal p=0·753) or the T25FW (0·98, 0·74–1·30; nominal p=0·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0·56, 95% CI 0·40–0·80; nominal p=0·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108–221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Interpretation: Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Funding: Biogen

Exploring the similarities and differences amongst service users with and without learning disabilities attending Saint Marys Sexual Assault Referral Centre

From Wiley via Jisc Publications RouterHistory: received 2021-12-11, rev-recd 2023-02-23, accepted 2023-07-14, epub 2023-07-28Article version: VoRPublication status: PublishedFunder: NHS England Health and Justice Team; Grant(s): n/aBackground: People with learning disabilities are over‐represented amongst Sexual Assault Referral Centre service users. This work aims to explore the similarities and differences between service users with and without learning disabilities. Method: Medical notes of 52 service users likely to have a learning disability were compared with 52 service users not likely to have a learning disability (according to the Learning Disability Screening Questionnaire); all of whom attended Saint Marys SARC for a forensic medical examination during a 12‐month period. Results: Significant associations were found between the likelihood of learning disability and relationship to perpetrator; location of assault; alcohol use; time taken to present to SARC; domestic violence; self‐harm; suicide attempts and mental health service involvement. Conclusions: People with learning disabilities in the sexually assaulted population are more likely to present with intersecting vulnerabilities emphasising the need for timely, accessible and appropriate patient‐centred care for this group

Gender differences in the correlates of reactive aggression

The main aim of the present study was to examine the relationships between four psychopathy dimensions (Interpersonal Manipulation, Callous Affect, Erratic Lifestyle, and Antisocial Behaviour) as well as childhood exposure to violence and reactive aggression in men and women. Participants were a sample of working adults (N = 319) recruited from the University of Security in Poznan. Results indicated that reactive aggression among males formed significant associations with Erratic Lifestyle, Interpersonal Manipulation, and childhood exposure to violence. Only one variable, Erratic Lifestyle, was a significant correlate of reactive aggression in females. These findings are discussed in light of theory and previous research findings. © 2015 Polish Academy of Sciences, Committee for Psychological Sciences

Understanding the conditions that influence the roles of midwives in Ontario, Canada’s health system: an embedded single-case study

Abstract: Background: Despite the significant variability in the role and integration of midwifery across provincial and territorial health systems, there has been limited scholarly inquiry into whether, how and under what conditions midwifery has been assigned roles and integrated into Canada’s health systems. Methods: We use Yin’s (2014) embedded single-case study design, which allows for an in-depth exploration to qualitatively assess how, since the regulation of midwives in 1994, the Ontario health system has assigned roles to and integrated midwives as a service delivery option. Kingdon’s agenda setting and 3i + E theoretical frameworks are used to analyze two recent key policy directions (decision to fund freestanding midwifery-led birth centres and the Patients First primary care reform) that presented opportunities for the integration of midwives into the health system. Data were collected from key informant interviews and documents. Results: Nineteen key informant interviews were conducted, and 50 documents were reviewed in addition to field notes taken during the interviews. Our findings suggest that while midwifery was created as a self-regulated profession in 1994, health-system transformation initiatives have restricted the profession’s integration into Ontario’s health system. The policy legacies of how past decisions influence the decisions possible today have the most explanatory power to understand why midwives have had limited integration into interprofessional maternity care. The most important policy legacies to emerge from the analyses were related to payment mechanisms. In the medical model, payment mechanisms privilege physician-provided and hospital-based services, while payment mechanisms in the midwifery model have imposed unintended restrictions on the profession’s ability to practice in interprofessional environments. Conclusions: This is the first study to explain why midwives have not been fully integrated into the Ontario health system, as well as the limitations placed on their roles and scope of practice. The study also builds a theoretical understanding of the integration process of healthcare professions within health systems and how policy legacies shape service delivery options

A critical interpretive synthesis of the roles of midwives in health systems

Abstract: Please refer to full text to view abstract