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Research has shown that 20–30% of prisoners meet the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms, but effects in prisoners are uncertain because of comorbid mental health and substance use disorders.
To estimate the efficacy of an osmotic-release oral system methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD.
We conducted an 8-week parallel-arm, double-blind, randomised placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16–25 years) meeting the DSM-5 criteria for ADHD. Primary outcome was ADHD symptoms at 8 weeks, using the investigator-rated Connors Adult ADHD Rating Scale (CAARS-O). Thirteen secondary outcomes were measured, including emotional dysregulation, mind wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression.
In the OROS-methylphenidate arm, mean CAARS-O score at 8 weeks was estimated to be reduced by 0.57 points relative to the placebo arm (95% CI −2.41 to 3.56), and non-significant. The responder rate, defined as a 20% reduction in CAARS-O score, was 48.3% for the OROS-methylphenidate arm and 47.9% for the placebo arm. No statistically significant trial arm differences were detected for any of the secondary outcomes. Mean final titrated dose was 53.8 mg in the OROS-methylphenidate arm.
ADHD symptoms did not respond to OROS-methylphenidate in young adult prisoners. The findings do not support routine treatment with OROS-methylphenidate in this population. Further research is needed to evaluate effects of higher average dosing and adherence to treatment, multi-modal treatments and preventative interventions in the community.
International comparisons of the effectiveness of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) based on national case and mortality data are fraught with underestimated complexity. This article calls for stronger attention to just how extensive is the multifactorial nature of national case and mortality data, and argues that, unless a globally consistent benchmark of measurement can be devised, such comparisons are facile, if not misleading. This can lead to policy decisions and public support for the adoption of potentially harmful NPIs that are ineffective in combating the COVID-19 pandemic and damaging to mental health, social cohesion, human rights and economic development. The unscientific use of international comparisons of case and mortality data in public discourse, media reporting and policymaking on NPI effectiveness should be subject to greater scrutiny.
The law of judicial review in Scotland both resembles, and is distinctive from, its English counterpart. The grounds of review are largely aligned in the two jurisdictions, but there are substantial differences in the scope and availability of review. Scots judicial review is highly distinctive in being doctrinally centred on confinement to jurisdiction without overt resort to notions of public power. This is shown to result from the way in which judicial review has evolved in Scotland over several centuries. Related to those differences is distinctiveness in the remedies that are available, with no discrete class of public law remedies and no comparative system of prerogative orders or writs. Nevertheless, English law has served as a powerful force of convergence, and recent reforms have seen Scots judicial review increasingly aligned with its English counterpart on procedural matters. This occurred in relation to the rules on standing, and the introduction of both a time limit and a leave stage, neither of which had previously featured in Scots judicial review procedure. Reasons for both resemblance with, and distinctiveness from, English law are considered, it being concluded that neither convergence nor divergence should be adopted for their own sake.
This chapter examines unreasonableness and irrationality as grounds of judicial review. It begins with an examination of Wednesbury unreasonableness as a standard of review, before considering it as both a substantive and a procedural threshold. It is suggested that there may be a lowering of the Wednesbury threshold in Hong Kong, particularly as a standard of procedural review. The intensity of review under Wednesbury unreasonableness is then examined, both as a lower and as a higher intensity of review. It is argued that, and explained how, unreasonableness and irrationality are and should be treated as distinct concepts and grounds of review, before the role of reasons is considered in relation to unreasonableness and irrationality.
This chapter gives an overview of remedial mechanisms associated with administrative law other than those afforded by judicial review, administrative tribunals, the Ombudsman and the Legislative Council Redress System. It provides an introduction to Commissions of Inquiry, including a table of all Commissions of Inquiry conducted in Hong Kong since 1966. An overview is given of the role and work of the Independent Commission Against Corruption (ICAC), and the fight against corruption in Hong Kong. The Equal Opportunities Commission (EOC) is introduced and its main powers and functions set out. An overview is given of the role and powers of the Privacy Commissioner for Personal Data, and also of the Audit Commission.
This chapter gives a detailed discussion of the remedies that are available on an application for judicial review. It discusses the main procedural rules on remedies, before introducing the remedies of certiorari, prohibition, mandamus, declaration (including suspension of a declaration and orders of temporary validity), injunction (including interim injunction), and damages, restitution and recovery of a sum due. It discusses the discretionary nature of remedies, including their relationship with statutory appeals mechanisms, prematurity of application, delay, waiver, acquiescence, the undeserving applicant, futility, no prejudice and inevitability. The chapter concludes with a discussion of judicial review proceedings continued as though begun by writ.
This chapter considers the constitutional foundation of judicial review in Hong Kong. It begins with an overview of the constitutional foundation of judicial review under UK sovereignty, before turning to its foundation under PRC sovereignty. The PRC Constitution and the Basic Law are considered as potential constitutional foundations of review, along with a consideration of judicial review in the context of ‘one country, two systems’. The relationship between judicial review and both the common law and the rule of law is then explored, along with a brief consideration of whether and to what extent legislative supremacy might offer a potential constitutional foundation in Hong Kong. The chapter concludes with an overview of constitutional review, its relationship with administrative review, and human rights.
This chapter considers the taking into account of irrelevant considerations, and the failure to take into account relevant considerations, as grounds of judicial review. This includes a discussion of the intensity of review if a relevant consideration is taken into account.
This new text provides the most comprehensive and up-to-date coverage of administrative law in Hong Kong. It includes original commentary on judicial review, administrative tribunals, the Ombudsman, the Legislative Council Redress System, Commissions of Inquiry, the Independent Commission Against Corruption, the Equal Opportunities Commission, the Privacy Commissioner for Personal Data, the Audit Commission, subsidiary legislation and more. Drawing on law, policy and practice, it offers detailed analysis while maintaining accessibility, charting developments as Hong Kong continues to evolve as a Special Administrative Region of the People's Republic of China. Administrative Law in Hong Kong is essential reading for judges, practitioners, policymakers, academics, students and commentators with an interest in public law, governance and administration.
This chapter considers two grounds of judicial review which constitute insufficient retention of discretion, namely unlawful delegation, and divestiture and relinquishment. The discussion of unlawful delegation begins by introducing the Carltona principle and a consideration of the extent to which the principle is constitutionally apposite in Hong Kong. Factors such as the status of the delegator and the delegate, the nature of the delegated power and the relationship between agency and delegation, are also considered. The chapter then discusses divestiture and relinquishment of discretion.
This chapter considers breach of legitimate expectations as a ground of judicial review. After introducing the conceptual aspects of this ground, it explores the key requirements for successful establishment of the ground including those relating to the representation (if any) given by the public body, the role of knowledge and (detrimental) reliance, the legitimacy of the applicant’s expectation, legitimate expectation as a relevant consideration when exercising discretion, the role of overriding policy considerations, and both procedural and substantive protection of legitimate expectations by the courts. This includes a discussion of key cases such as Ng Siu Tung v Director of Immigration and R v North and East Devon Health Authority, ex parte Coughlan. Finally, the chapter considers whether and to what extent ultra vires representations can generate legitimate expectations.
This chapter gives a detailed discussion of delay arising as an issue at the leave stage in an application for judicial review. The relevant principles and rules are introduced, followed by an explanation of the requirement for promptness. The various reasons which may justify an extension of time are then explored, followed by a consideration of the rule that the court has discretion to refuse to grant leave or any relief sought on the application for judicial review if it considers that the granting of relief sought would be likely to cause substantial hardship to, or substantially prejudice the rights of, any person or would be detrimental to good administration.
This chapter begins with a detailed discussion of statutory exclusion of review, in particular by means of the statutory ouster clause. This is followed by considering statutory limitation of review, including both the time-limited ouster and the partial ouster. Non-justiciability is considered as a bar to judicial review proceedings. The chapter concludes with a discussion of the variable intensity of review, in particular deference seen in such contexts as the Chief Executive’s power to pardon criminal offenders or commute their penalties, and prosecutorial discretion.