Reduction or discontinuation of antipsychotics for challenging behaviour in adults with intellectual disability: a systematic review

The use of antipsychotics to manage challenging behaviour in adults with intellectual disability is widespread but controversial, and evidence is scarce. There is a perception that antipsychotics used in this context can be reduced or discontinued, and this has been a major focus of recent national policy. However, such an intervention risks harm as well as having potential benefits. We reviewed the available evidence and found that antipsychotics can be reduced or discontinued in a substantial proportion of adults who use them for challenging behaviour, although not always without adverse effects. There is a group which displays behavioural deterioration on antipsychotic reduction that prevents discontinuation; predictors of poor response could not be reliably identified. In view of the relatively scarce data and methodological limitations of the available studies, we cannot draw firm conclusions to inform a population level approach to this issue. Antipsychotic medication used for behaviour should be reviewed regularly and an individualised approach taken to treatment

Kilometric radiation power flux dependence on area of discrete aurora

Kilometer wavelength radiation, measured from distant positions over the North Pole and over the Earth's equator, was compared to the area of discrete aurora imaged by several low-altitude spacecraft. Through correlative studies of auroral kilometric radiation (AKR) with about two thousand auroral images, a stereoscopic view of the average auroral acceleration region was obtained. A major result is that the total AKR power increases as the area of the discrete auroral oval increases. The implications are that the regions of parallel potentials or the auroral plasma cavities, in which AKR is generated, must possess the following attributes: (1) they are shallow in altitude and their radial position depends on wavelength, (2) they thread flux tubes of small cross section, (3) the generation mechanism in them reaches a saturation limit rapidly, and (4) their distribution over the discrete auroral oval is nearly uniform. The above statistical results are true for large samples collected over a long period of time (about six months). In the short term, AKR frequently exhibits temporal variations with scales as short as three minutes (the resolution of the averaged data used). These fluctuations are explainable by rapid quenchings as well as fast starts of the electron cyclotron maser mechanism. There were times when AKR was present at substantial power levels while optical emissions were below instrument thresholds. A recent theoretical result may account for this set of observations by predicting that suprathermal electrons, of energies as low as several hundred eV, can generate second harmonic AKR. The indirect observations of second harmonic AKR require that these electrons have mirror points high above the atmosphere so as to minimize auroral light emissions. The results provide evidence supporting the electron cyclotron maser mechanism

Digital mental health and intellectual disabilities: state of the evidence and future directions

The use of digital technologies in the management of mental illness, and more generally in the promotion of well-being and mental health, has received much recent attention and is a focus of current health policy. We conducted a narrative review to explore the opportunities and risks of digital technologies in mental healthcare specifically for people with intellectual disability, a sometimes marginalised and socially excluded group. The scope of digital mental health is vast and the promise of cheaper and more effective interventions delivered digitally is attractive. People with intellectual disability experience high rates of mental illness and could benefit from the development of novel therapies, yet seem to have been relatively neglected in the discourse around digital mental health and are often excluded from the development and implementation of new interventions. People with intellectual disability encounter several barriers to fully embracing digital technology, which may be overcome with appropriate support and adaptations. A small, but growing, literature attests to the value of incorporating digital technologies into the lives of people with intellectual disability, not only for promoting health but also for enhancing educational, vocational and leisure opportunities. Clearly further evidence is needed to establish the safety and clinical efficacy of digital mental health interventions for people with and without intellectual disability. A digital inclusion strategy that explicitly addresses the needs of people with intellectual disability would ensure that all can share the benefits of the digital world

The role of planets in shaping planetary nebulae

In 1997 Soker laid out a framework for understanding the formation and shaping of planetary nebulae (PN). Starting from the assumption that non-spherical PN cannot be formed by single stars, he linked PN morphologies to the binary mechanisms that may have formed them, basing these connections almost entirely on observational arguments. In light of the last decade of discovery in the field of PN, we revise this framework, which, although simplistic, can still serve as a benchmark against which to test theories of PN origin and shaping. Within the framework, we revisit the role of planets in shaping PN. Soker invoked a planetary role in shaping PN because there are not enough close binaries to shape the large fraction of non-spherical PN. In this paper we adopt a model whereby only ~20% of all 1-8 solar mass stars make a PN. This reduces the need for planetary shaping. Through a propagation of percentages argument, and starting from the assumption that planets can only shape mildly elliptical PN, we conclude, like in Soker, that ~20% of all PN were shaped via planetary and other substellar interactions but we add that this corresponds to only ~5% of all 1-8 solar mass stars. This may be in line with findings of planets around main sequence stars. PN shaping by planets is made plausible by the recent discovery of planets that have survived interactions with red giant branch (RGB) stars. Finally, we conclude that of the ~80% of 1-8 solar mass stars that do not make a PN, about one quarter do not even ascend the AGB due to interactions with stellar and substellar companions, while three quarters ascend the AGB but do not make a PN. Once these stars leave the AGB they evolve normally and can be confused with post-RGB, extreme horizontal branch stars. We propose tests to identify them.Comment: 23 pages, accepted by PAS

The psychological contract of knowledge workers

Purpose: This paper explores whether the concept of psychological contracts underpinned by relational/transactional exchanges provides an adequate description of knowledge workers’ contracts. Methodology: The research approach uses interviews with 10 scientists from within a pre-eminent Australian scientific research and development organisation, the Commonwealth Scientific & Industrial Research Organisation (CSIRO). Findings: The research strong evidence of an ideological currency within the psychological contract for this set of knowledge workers. Implications: The research raises questions over the role of normative occupation-specific beliefs about work, and the sharing of common currency elements by individuals in the same organization within the same occupation. The analysis lends support to calls in the literature for a reconsideration of the transactional/relational interpretative framework that underpins the psychological contract

J D Bernal: philosophy, politics and the science of science

This paper is an examination of the philosophical and political legacy of John Desmond Bernal. It addresses the evidence of an emerging consensus on Bernal based on the recent biography of Bernal by Andrew Brown and the reviews it has received. It takes issue with this view of Bernal, which tends to be admiring of his scientific contribution, bemused by his sexuality, condescending to his philosophy and hostile to his politics. This article is a critical defence of his philosophical and political position

J D Bernal: philosophy, politics and the science of science

This paper is an examination of the philosophical and political legacy of John Desmond Bernal. It addresses the evidence of an emerging consensus on Bernal based on the recent biography of Bernal by Andrew Brown and the reviews it has received. It takes issue with this view of Bernal, which tends to be admiring of his scientific contribution, bemused by his sexuality, condescending to his philosophy and hostile to his politics. This article is a critical defence of his philosophical and political position