Conference Items

Permanent URI for this collectionhttps://hdl.handle.net/2292/3398

Use the Deposit button on research output records in Te Waka Huia Rangahau | Research Outputs to archive conference proceedings, papers, abstracts, and slides.

Browse

Recent Submissions

Now showing 1 - 20 of 4455
  • Item
    Towards equitable access and outcomes for tamariki and whanau within early childhood ear and hearing services in South Auckland
    (2023-03-30) Holt, Elizabeth; Leung, Joan; Dickinson, Louise; Morton, Randall; Manuel, Alehandrea; Vandal, Alain; Purdy, Suzanne
    Background: purpose of the study/ the study’s objectives Our previous research has shown an unmet need to identify and manage hearing loss and middle ear disease in young children in South Auckland. A large study of >450 “asymptomatic” pre-schoolers showed over 20% with hearing loss. Pasifika and Māori children were especially at risk. A proposal was made to bridge the gap between newborn hearing screening and the four-year-old ‘before school’ hearing screening by conducting three ear and hearing tests on 3-year-olds within early childhood centres. The purpose of the research is to help facilitate earlier detection of significant ear and hearing problems to enable timely treatment and improve hearing and developmental outcomes. Approach: the methods, framework or approach used Of the 61 children in the pilot study, 23 were referred for formal audiology and/or Ear, Nose, Throat (ENT) review. The testing process in early childhood centres was efficient and feasible, but of the 23 children who were referred, 12 were lost to follow-up. A qualitative research study was undertaken to interview families of children who did not pass the hearing screening to learn more about the experiences of those whose children could attend audiology/ENT and those who did not receive follow-up services. Goals of this phase were to investigate barriers for families successfully navigating the current public health system. Results: a summary of the results or outcomes Preliminary data from the qualitative interviews will be presented. Families had a range of experiences, both positive and negative associated with their engagement with audiology and ENT services. A number of barriers to access were identified, including the location of the services and the challenges of the clinic being hospital-based. Conclusion: the significance of the findings or outcomes The next phase of this research will involve establishing a stake-holder group to discuss methods to identify and remove barriers to equitable hearing healthcare. Our group is committed to working alongside other Pasifika and Māori community-based groups in health equity, child health, and wellbeing.
  • Item
    Standing Tall to Design the Indigenous Ways of Being On/In Time: Clocktowers in the Colonial Universities ​
    (2024-12-13) Ahmad, Maria
    Public clock towers in the colonised lands can be viewed as a feature of colonial apparatus of disciplining and controlling the colonised societies (Thompson, 1967). A tall and central clock tower as a part of the architecture of the colonial universities in the colonised lands in addition to stamping the grandeur and supremacy of the empire also introduced a westernised universal linear view of time to the indigenous epistemic imaginary. For the colonised being it is also a reminder of its temporal positioning of being left behind as it reinstates the superior industrial morality of the colonising race as being punctual and industrious (Salamé, 2016). The temporal coloniality embodied in the western linear colonial imaginary of time makes being left behind the fault of the colonised self that is usually projected as being ‘lazy’ and ‘lethargic’ and make it run faster like the sweep hand of the clock that move faster but for rather insignificant gains as compared to the minutes and hour hands of the clock. Moreover, this colonial imaginary of time embodied in the object of the clock tower enables normalisation of the language of efficiency in relation to time in the modern higher education imaginary (Bennett & Burke, 2017). Adjunct with the language of efficiency, this imaginary also introduces the idea of utilisation and wastage of time in relation to certain academic activities; thus, enabling the disciplining of academic life. This western colonial imaginary of time being a universal quantifiable entity enables framing higher education qualifications in terms of spending a specific amount of time in doing specific activities to be a scholar. It underlines by the view that same amount of time invested in a learning activity would lead to same learning outcomes that can be demonstrated through another time bound activity. In this work, I argue that this imaginary of time that is in tension with the indigenous views of time is an important aspect of temporal coloniality shaping the onto-epistemic dynamics of the Westernised university in the colonial lands.
  • Item
    Disseminating findings from the Data Analysis with Privacy Protection for Epidemiological Research (DAPPER) workshop
    (Swansea University, 2017-04-19) Wilson, Rebecca; Burton, Paul; Asher, Innes; Carter, Kim; Castelli, Adriana; Cumin, David; Evelo, Chris; Stewart, Lesley; Tsoi, Kelvin; White, Emma
    ABSTRACT ObjectivesThe effective exploitation of what are often called big data is increasingly important. They provide the evidence in evidence-based health care and underpin scientific progress in many domains including social/economic policy. Typically, an optimal analysis involves working directly with microdata; i.e. the detailed data relating to each individual in the dataset. But there are many ethico-legal and other governance restrictions on physically sharing microdata. Furthermore, researchers or institutions may have an extensive intellectual property investment in complex microdata and although keen for other researchers to analyse their data they may not wish to give them a physical copy. These restrictions can discourage the use of optimum approaches to analysing pivotal data and slow scientific progress. Data science groups across the world are exploring privacy-protected approaches to analysing microdata without having to physically share the data. ApproachA two day international workshop was arranged focussing on privacy protected approaches to data analysis – particularly federated analysis where raw data remain at their original site of collection. The workshop considered the range of approaches that exist, and those that are currently being developed. It explored the strengths, weaknesses, opportunities and challenges associated with these methods and identified situations where specific approaches have a particularly important role. The workshop included a number of practical sessions where potential users could watch demonstrations of the various approaches in action and run analyses themselves. ResultsThe Data Analysis with Privacy Protection for Epidemiological Research (DAPPER) workshop was held 22-23rd August 2016, Bristol. We report back to the broader community on the outcomes of this workshop that focussed on exploring current approaches, tools and technical solutions that facilitate sensitive data to be shared and analysed. ConclusionsThe workshop has helped map out key opportunities and challenges and assisted potential users, developers and other stakeholders (e.g. funders/journals) to recognise the strengths and weaknesses of different privacy protected analytic approaches. The workshop will encourage further methodological work in this field and better informed application of existing methods.
  • Item
    Spectrum of injuries resulting from gunshot wounds in car hijacking: a South African experience
    (BMJ, 2018-01) Kong, Victor; Weale, Ross; Blodgett, Joanna; Bruce, John; Laing, Grant; Clarke, Damian

    Background

    Car hijacking, known as "carjacking", is a form of aggravated robbery of a vehicle from the driver frequently involving firearm and is common in South Africa. There is, however, little literature on the spectrum of injuries sustained by victims of car hijacking. The study aimed to describe the spectrum of gunshot wound-related (GSW) injuries and review our experience of management of victims of car hijacking in our trauma center based in South Africa.

    Methods

    A retrospective review was conducted during an 8-year period from January 2010 to January 2018 on all patients who presented with any form of GSW after a car hijacking incident.

    Results

    During the 8-year study period, a total of 101 patients were identified. Seventy-four percent were male (75 of 101) and the mean age was 34 years. The mean time from injury to arrival at our trauma center was 7 hours (rural district: 10 hours, urban district: 4 hours; p<0.001). Seventy-five percent (76 of 101) of all patients sustained GSWs to multiple body regions, whereas the remaining 25% (25 of 101) were confined to a single body region. The most common region involved was the chest (48 cases), followed by the abdomen (46 cases) and neck (34 cases). Sixty-three of the 101 (62%) patients required one or more operative interventions. The most common procedure was laparotomy (28 cases), followed by vascular (20 cases) and neck (14) exploration. Eighteen percent (18 of 101) of all patients required intensive care unit admission. The mean length of hospital stay was 7 days. The overall morbidity was 13% (16 of 101) and the overall mortality was 18% (18 of 101).

    Discussion

    The spectrum of injuries from GSW related to car hijacking commonly involves close range GSWs to multiple body regions. Torso trauma is common and a substantial proportion of victims require major operative interventions. The mortality from these injuries is significant.

    Level of evidence

    Level III.
  • Item
    Damage control or definitive repair? A retrospective review of abdominal trauma at a major trauma center in South Africa
    (BMJ, 2019-01) Weale, Ross; Kong, Victor; Buitendag, Johan; Ras, Abraham; Blodgett, Joanna; Laing, Grant; Bruce, John; Bekker, Wanda; Manchev, Vassil; Clarke, Damian

    Background

    This study set out to review a large series of trauma laparotomies from a single center and to compare those requiring damage control surgery (DCS) with those who did not, and then to interrogate a number of anatomic and physiologic scoring systems to see which best predicted the need for DCS.

    Methods

    All patients over the age of 15 years undergoing a laparotomy for trauma during the period from December 2012 to December 2017 were retrieved from the Hybrid Electronic Medical Registry (HEMR) at the Pietermaritzburg Metropolitan Trauma Service (PMTS), South Africa. They were divided into two cohorts, namely the DCS and non-DCS cohort, based on what was recorded in the operative note. These groups were then compared in terms of demographics and spectrum of injury, as well as clinical outcome. The following scores were worked out for each patient: Penetrating Abdominal Trauma Index (PATI), Injury Severity Score, Abbreviated Injury Scale-abdomen, and Abbreviated Injury Scale-chest.

    Results

    A total of 562 patients were included, and 99 of these (18%) had a DCS procedure versus 463 (82%) non-DCS. The mechanism was penetrating trauma in 81% of cases (453 of 562). A large proportion of trauma victims were male (503 of 562, 90%), with a mean age of 29.5±10.8. An overall mortality rate of 32% was recorded for DCS versus 4% for non-DCS (p<0.001). In general patients requiring DCS had higher lactate, and were more acidotic, hypotensive, tachycardic, and tachypneic, with a lower base excess and lower bicarbonate, than patients not requiring DCS. The most significant organ injuries associated with DCS were liver and intra-abdominal vascular injury. The only organ injury consistently predictive across all models of the need for DCS was liver injury. Regression analysis showed that only the PATI score is significantly predictive of the need for DCS (p=0.044). A final multiple logistic regression model demonstrated a pH <7.2 to be the most predictive (p=0.001) of the need for DCS.

    Conclusion

    DCS is indicated in a subset of severely injured trauma patients. A pH <7.2 is the best indicator of the need for DCS. Anatomic injuries in themselves are not predictive of the need for DCS.

    Levels of evidence

    Level III.
  • Item
    Disintegrated coastal zone management (DICZM): an example from Auckland, New Zealand
    (Copernicus Publications, 2020-03-23) Brook, Martin; Palma, Alex; Garill, Rosemary; Richards, Nick; Tunnicliffe, Jon
    &lt;p&gt;Typically, integrated coastal zone management (ICZM) uses the informed participation and cooperation of all stakeholders to assess the societal goals in a given coastal area. ICZM seeks, over the long term, to balance environmental, economic, social, cultural and recreational objectives, all within the limits set by natural dynamics. We outline coastal instability in the Auckland region of New Zealand, where the effects of natural coastal dynamics appear to have been underplayed, or even overlooked, during the residential land development process. Auckland is New Zealand&amp;#8217;s largest city, with the Auckland region encompassing c. 3,300 km of coastline, with a highly variable wave climate and coastal geomorphology. The sparsely inhabited high energy west coast records significant wave heights of 2-3 m for much of the year. In contrast, the eastern bay coastlines are lee coasts, protected by offshore islands in the Hauraki Gulf and the Coromandel Peninsula. Nevertheless, significant coastal cliff instability does occur along these eastern coasts, which are heavily populated, with houses often constructed within 10 m of the cliff edge. Coastal instability in the Beachlands area in particular, is part-conditioned by engineering properties of the cliff materials, which include soft, Pleistocene sediments. In particular, shear surfaces develop along clay-rich tephra layers, which are of low-permeability, leading to increased porewater pressure, and cliff failure.&amp;#160; Despite the clear failure mechanisms, coastal protection works and routing of domestic stormwater over the cliffs has led to further coastal instability.&lt;/p&gt;
  • Item
    Entity/Relationship Graphs: Principled Design, Modeling, and Data Integrity Management of Graph Databases
    (Association for Computing Machinery (ACM), 2025-02-10) Skavantzos, Philipp; Link, Sebastian
    Chen's Entity/Relationship (E/R) framework is a lingua franca for well-designed databases. We define E/R graphs as property graphs that are instances of E/R diagrams. As the latter are a subclass of PG-Schema, E/R modeling constitutes a methodology for designing graph databases that guarantee data integrity, the absence of data redundancy and update anomalies. In addition, E/R graphs provide the first graph semantics for E/R diagrams. Further to the unification of conceptual and graph data modeling, referential integrity for E/R graphs can be managed by directed edges, called E/R links, between nodes. As a consequence, redundancy and sources of potential inconsistency can be eliminated, minimizing update maintenance. This is achieved by E/R keys that use properties and E/R links to enforce entity integrity, in contrast to property keys that rely exclusively on properties to enforce entity integrity. We use the TPC-H benchmark as running example and for extensive experiments that quantify the effort for i) managing entity integrity using property keys or E/R keys, ii) managing referential integrity using property redundancy or E/R links, iii) query evaluation. In summary, E/R diagrams form a principled core of PG-Schema for well-designed property graphs, while E/R keys constitute an efficient core of PG-Key for data integrity management.
  • Item
    Evolving Atrial Fibrillation (AF) Care in New Zealand (NZ): A Nurse Specialist-Led Clinic Aiming to Improve Standardisation, Equity, Cost-Effectiveness, and Lifestyle Modification in AF Management
    (Elsevier, 2024-06) Hosking, A; Jameson, M; Stiles, M; Ryan, H; Joyson, P; Sugden, L; Tan, C
    Aim This study assesses the efficacy of a nurse specialist-led AF clinic in a large regional centre in New Zealand. We look specifically at the standardisation of care, lifestyle management, the impact on health equity, and the cost-effectiveness of these strategies. Method A retrospective analysis of the first year of the clinic’s establishment was conducted reviewing the outcomes, attendance, and adherence to management guidelines. The clinic follows up those presenting to the Emergency Department with a primary diagnosis of AF. After discharge, appointments are available within 48–72 hours of presentation. Results Over the first year, 247 appointments were made (Median age 66, interquartile range 58–76, 48% male, 75% NZ European). 168 patients were established on a rhythm control strategy, with 20 referred for ablation, 26 receiving cardioversions, and the remainder established on anti-arrhythmic medication. Lifestyle modifications were addressed with majority of these patients. Demographic data also highlighted, a need to focus on equity with only 17.4% of appointments attended by Māori and Pacific patients, lower than would be expected given relative disease burden. Conclusion The Nurse Specialist-led AF clinic is a positive step forward in AF management in this region of NZ. This clinic brings international standards to a local stage and throws a focus on our unique healthcare needs and an emphasis on equitable delivery of care. This clinic is scalable, effective, and an inclusive approach to AF care.
  • Item
    Evolving atrial fibrillation (AF) care in New Zealand (NZ): a nurse specialist-led clinic aiming to improve standardisation, equity, cost-effectiveness, and lifestyle modification in AF management
    (Oxford University Press (OUP), 2024-10-28) Hosking, A; Jameson, M; Stiles, M; Ryan, H; Sugden, L; Joyson, P; Tan, C
    Background: Management of atrial fibrillation (AF) in NZ is challenging and variable between regions. NZ has a diverse population with Māori and Pacific ethnic groups, in particular, facing significant difficulties with access to care and inequity in treatment. The integration of nurse specialists into the care of patients with AF is increasingly recognised and discussed in AF management, including the European Society of Cardiology (ESC) guidelines. This approach also allows emphasis on managing lifestyle factors, pivotal contributing factors in disease burden Objective: This study assesses the efficacy of a nurse specialist-led AF clinic in a large regional centre in New Zealand. We look specifically at the standardisation of care, lifestyle management, the impact on health equity in managing AF, and the cost-effectiveness of these strategies. Methods: A retrospective analysis of the first year of the clinic’s establishment was conducted reviewing the outcomes, attendance, and adherence to management guidelines. The clinic is running three days per week to follow up those presenting to the Emergency Department with a primary diagnosis of AF. After discharge, appointments are available within 48-72 hours of presentation. The clinics efficacy and ability to serve wider NZ populations will also be presented alongside a recently-published, similar initiative in Christchurch, NZ. Results: Over the first year, 247 appointments were made (Median age 66, interquartile range 58-76, 48% male, 75% NZ European). 168 patients were established on a rhythm control strategy, with 20 directly referred for ablation, 26 receiving cardioversions, and the remainder established on anti-arrhythmic medication strategies. Lifestyle modifications were addressed with majority of these patients. Demographic data also highlighted once more, a need to focus on equity with only 17.4% of appointments attended by Māori and Pacific patients, lower than would be expected given population data and relative disease burden. Conclusions: The Nurse Specialist-led AF clinic shows promising outcomes and is a positive step forward in AF management in this region of NZ. Incorporating ESC guidelines with emphasis on lifestyle factors and including rhythm control strategies to good effect. This clinic brings international standards to a local stage and throws a focus on our unique healthcare needs and an emphasis on equitable delivery of care. This clinic is scalable, effective, and an inclusive approach to AF care.
  • Item
    Sheep models of Alzheimer's Disease
    (2023-11-11) Mckean, Natasha; McMurray, Cara; Zetterberg, Henrik; Handley, Renee; Rudiger, Skye R; Mclaughlin, Clive; Bawden, Simon C; Verma, Paul J; Kelly, Jennifer M; Faull, Richard; Waldvogel, Henry; Reid, Suzanne; Pearson, John F; Hardy, John; Gusella, James F; Owen, Michael; Snell, Russell G
  • Item
    Navigating the places we now inhabit: Stories of migrant learning designers
    (2024-12-23) Schwenger, Bettina; Nguyen, Nhung; Carvalho, Lucila; Cochrane, T; Narayan, V; Bone, E
    Learning design involves creating educational opportunities that are engaging and effective. In many countries, this process must attune to indigenous ways of being and knowing. In the context of Aotearoa New Zealand, the learning design process requires the ability to create culturally inclusive learning opportunities that are respectful of Māori culture, but also beneficial to all learners - a process that calls for deeper reflection and understanding of tikanga Māori (Māori customs and practices). This paper highlights the experiences of migrant learning designers and teachers in Aotearoa New Zealand, who work at the intersection of Māori knowledge and Western educational practices. As non-indigenous immigrants, learning designers, teachers, and educational researchers, the authors drew on autoethnography as the methodology, to analyse and reflect on their role as allies of Māori, the indigenous people of Aotearoa New Zealand. This research aims to find and share ways of reconciling principles of learning design with different ways of knowing, whilst honouring the Māori culture. The paper contributes to wider debates in education that discuss how indigenous knowledge systems can enrich modern educational practices.
  • Item
    Spatial patterns of heat exposure and child hospital admissions in Aotearoa New Zealand
    (Environmental Health Perspectives, 2024-08-15) Lai, Hakkan; Lee, Jeong Eun; Hales, Simon; Health Research Council Grant Project Team
    BACKGROUND AND AIM: The influence of global climate change on temperature-related health outcomes, particularly among vulnerable populations, has been widely acknowledged. The spatial dimensions of these effects, related to population sensitivity by socio-demographic and environmental factors, remain underexplored. METHOD: We analysed data from 686,900 children under five years old, admitted to public hospitals between 2000 and 2019. We investigated associations between daily maximum temperatures (-6 to 40°C) and counts of child admissions, stratified by 2185 statistical areas, day-of-week and month of the year. We modelled temperature effect with a fixed effects quasi-Poisson distributed lag model with lag window of 0–21 days. Long term trends were modelled with a cubic spline of year with 2 degrees of freedom. We examined the modifying impact of socio-economic deprivation, housing factors, and ethnicities on the temperature-morbidity association. RESULTS: Preliminary findings suggest a non-linear exposure-response relationship. Significant elevations in relative risks (RR) were observed for temperatures below and above the 23°C threshold, with RRs ranging from 1.014 [95%CI: 1.011-1.017] to 1.423 [1.362-1.487] at lower temperatures and 1.004 [1.001-1.007] to 9.551 [7.393-12.340] at higher temperatures. Although the overall pattern of the exposure-response curve was consistent across different levels of deprivation and housing factors, there were significant disparities in RR below the reference temperature, with higher RR observed in more deprived areas compared to less deprived areas, and in areas with fewer homeowners compared to areas with more homeowners. Additionally, ethnic disparities in RR were evident above the reference temperature, with higher RR observed among Pacific Island, Asian and Māori children compared to European children. CONCLUSIONS: The findings suggest that child morbidity in Aotearoa New Zealand is highly sensitive to elevated temperatures. Further analyses are exploring the impact of interactions between urban heat islands and additional factors, with the goal of mapping the population attributable fractions under present and future climate conditions.
  • Item
    Unlocking The Potential of Pre-Eclampsia Self-Management System: Analysing Benefits, Challenges and Gaps
    (2025-01-06) Chung, Claris; Sreeprakash, Ashitha
    Pre-eclampsia is a severe hypertension condition that complicates approximately up to 10% of pregnancies. Timely diagnosis and treatment are essential since this condition poses serious threats to the health of the mother and fetus. Selfmanagement of blood pressure (SMBP) has become a viable approach to improving health outcomes and early diagnosis. Through a systematic literature review using PRISMA and applying the Technology Acceptance Model (TAM) as a lens, this research identifies key functionalities for developing Preeclampsia Self-Management Systems. Patients and health providers experienced improved patientprovider communication, real-time alerts, and integration with electronic health records as beneficial functionalities. However, they also expressed challenges such as financial barriers, technical literacy, and data privacy concerns. The results show the need for specialized functions to manage pre-eclampsia and emphasize the importance of considering the specific needs of patients and providers.
  • Item
    Numerical simulation of two large spheres moving in vertical turbulent pipe flow
    (2024-12-02) Sun, Deping; MacDonald, Michael; Liu, Haixiao
    This study investigates the dynamics of two large spheres in a vertical turbulent pipe flow using Reynolds-Averaged Navier–Stokes (RANS) simulations. We focus on axial, radial, and tangential velocities and the effects of initial separation distances between the spheres. The simulation domain features a 13-meter-long pipe with a 200 mm diameter. The model's validation against experimental data shows an average systematic error of 6.6%. The results reveal that the initial distance between two spheres has a minimal impact on their axial velocities but significantly affects radial velocities, particularly for smaller separations. The spheres reach terminal velocities similar to a single sphere, although interactions between the two spheres lead to increased energy dissipation, resulting in lower velocities. The study also shows that in upward turbulent flow, the axial distance between spheres generally increases over time, with higher mean fluid velocities leading to faster separation due to more pronounced wake effects. The typical "drafting, kissing, and tumbling" (DKT) behaviour is not observed, as the bottom sphere can act as a "windbreak", reducing the direct influence of the wake from the upper one. Radial velocities exhibit significant initial fluctuations due to strong interactions, which dissipate quickly at higher mean velocities. Tangential movements appear to be minimal.
  • Item
    Experimental Investigation on the Near-ground Flow Structure of Buoyancy Induced Vortices
    (2024-12-02) Wang, Dominic; Hawkes, NA; MacDonald, Michael; Cater, John E; Flay, Richard GJ
    This research focuses on the lower near-ground flow structure of buoyancy-induced vortices at laboratory scale for various swirl vane angles. The time-averaged velocity components are measured from both horizontal cross-sections and vertical planes above the ground plane using Particle Image Velocimetry (PIV) for one-cell, one to two-cell transition, and two-cell type vortices. The vortex wandering effect and a force balance analysis are also carried out based on the timeaveraged Navier-Stokes equations for different types of vortex structures. The results show that centripetal acceleration and radial pressure gradient are the primary contributors to the force balance near the ground. The results also reveal that vortices developed with 45° vane angle have the minimum wandering, corresponding to the minimum unsteady forces in both the radial and vertical directions.
  • Item
    Direct Numerical Simulation of Turbulent Radiation Fog
    (2024-12-02) Liu, Deng; Cater, John; Dunker, Christina; MacDonald, Michael
    This study investigates the interplay between turbulent and radiative effects in fog formation using Direct Numerical Simulation (DNS). The simulation is conducted in an open channel with a fixed total amount of cooling at a friction Reynolds Number of Re∗ = 590. Three cases are compared: GC, which only has a constant ground cooling, and GCR, which also incorporates radiative cooling effects with varying absorption coefficients of 100,000 and 600,000. The results reveal that turbulence promotes early fog growth by enhancing water vapour aggregation, while higher radiative absorption by fog results in more uniform liquid water potential temperature distributions. Both turbulence and radiation contribute to increased liquid water accumulation, revealing complex interactions in fog dynamics and offering insights into fog formation under different conditions.
  • Item
    Inner-layer turbulence of a vertical buoyancy layer
    (2024-12-01) Maryada, KR; Armfield, SW; MacDonald, M; Dhopade, P; Norris, Stuart
  • Item
    Policing the polycrisis: Liberal democratic state terror and other contradictions
    (2024-11-12) Rakete, Emmy
    The pleasant daydream of capitalist social democracy has now ended, taking with it the possibility of a negotiated class detente. Capitalism has spent the last 50 years repeatedly colliding with external limits, which it has had to convert into merely internal barriers to avert terminal crisis. The stagflation crisis, the global financial crisis, and the crisis of social reproduction are just a few of the potential apocalypses warded off by the ruling class. This process of deferral has saved capitalism’s skin so far, but only by introducing new internal contradictions into capitalism that it must again defer, resolve, or be killed by. For the duration of the neoliberal period, the bourgeoisie has increasingly relied upon the repressive state apparatus to manage these contradictions. Cops, courts, and cages provide the capitalist state with both the directly repressive violence and the indirectly ideological violence that it depends upon for its continued existence. The qualitative transformation of the prison systems of social democracy into the mass incarceration of neoliberalism is one index by which we can register the increasing illiberalism of liberalism. Capitalism must both immiserate on a massive scale and imprison anyone who behaves miserably. Activists and organisers who threaten this intolerable system, like the student Palestine solidarity encampments, are met with police terror. Far from banishing crisis, this dependence upon the ‘justice’ system to incapacitate opposition constitutes a new potentially fatal internal contradiction. Capitalism can live now only so long as it continues to incarcerate, and by so doing it creates an enormous wasteful, futile, loathsome prison regime that teeters constantly on the brink of collapse and on which its whole legitimacy is now staked. The struggle against mass incarceration should be an immediate tactical priority for the communist movement.