Do people with intellectual disabilities understand their prescription medication? A scoping review

© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.Background: People with intellectual disabilities are more likely to experience poor health than the general population and are frequently prescribed multiple medications. Therefore, it is important that people with intellectual disabilities understand their medication and potential adverse effects. Method: A scoping review explored people with intellectual disabilities' knowledge of prescription medications, their risks and how medication understanding can be improved. Results: Ten journal articles were included. People with intellectual disabilities often lacked understanding of their medication, including its name, purpose and when and how to take it. Participants were often confused or unaware of adverse effects associated with their medication. Information was sometimes explained to carers rather than people with intellectual disabilities. Some interventions and accessible information helped to improve knowledge in people with intellectual disabilities. Conclusion: There is a need for accessible and tailored information about medication to be discussed with people with intellectual disabilities in order to meet legal and best practice standards.Peer reviewe

Initial ecological recovery post‐weir removal amidst catchment‐wide improvements, in a groundwater‐dominated chalk stream

Physical habitat modification is one of the main pressures affecting river environments, impacting their ecosystem health and compromising their ability to adapt to the effects of climate change. Addressing the impacts of physical modification through reinvigorating natural processes has become a globally established river restoration technique. Here, we appraised such an approach by assessing ecological responses to a weir removal project on an English groundwater‐dominated ‘chalk’ stream. Using a Before‐After‐Control‐Impact (BACI) approach, we found that 3 years post‐restoration the macroinvertebrate communities are moving towards those of the target community both in terms of structural complexity (e.g., taxonomic composition) and functional integrity (e.g., trait composition). The progress is ongoing and has occurred alongside wider catchment improvements. Our results indicate that ecological responses to passive restoration undertaken on low energy streams, such as chalk streams, may be gradual, and thus longer‐term assessment is needed to fully appraise ecological recovery. We highlight the importance of a BACI approach to understand the local responses to restoration in a catchment context. Our findings also provide further evidence highlighting complementary ecological information provided by assessing taxonomic and functional properties concurrently in post‐project appraisals. A better understanding of ecological recovery times should be incorporated into future restoration planning. Such evidence would help develop robust assessments over appropriate timescales, increasing the likelihood of accurately and effectively appraising restoration project success, and helping to build support to increase the scale and pace of restoration actions needed to address biodiversity loss

To be or not to be an auctioneer: Some thoughts on the legal nature of online eBay auctions and the protection of consumers

This paper discusses the legal classification of online “eBay” auctions. The discussion has key implications on the scope of consumer protection law as sale by auctions are, for example, excluded from the scope of the Consumer Protection (Distance Selling) Regulations 2000. The paper uncovers that online “eBay” auctions cannot always be considered as traditional auctions and that eBay, as an intermediary, is not to be considered as an auctioneer. This creates difficulties associated with a distributive application of consumer protection laws such as the Consumer Protection (Distance Selling) Regulations 2000. Another set of difficulties is associated with a lenient legal regime applicable to the liability of eBay under the Electronic Commerce (EC Directive) Regulations 2002 . The paper concludes that there is an urgent need to clarify the legal classification of online auctions and to rethink the liability of online auction sites to better protect consumers

Interfacing GHz-bandwidth heralded single photons with a room-temperature Raman quantum memory

Photonics is a promising platform for quantum technologies. However, photon sources and two-photon gates currently only operate probabilistically. Large-scale photonic processing will therefore be impossible without a multiplexing strategy to actively select successful events. High time-bandwidth-product quantum memories - devices that store and retrieve single photons on-demand - provide an efficient remedy via active synchronisation. Here we interface a GHz-bandwidth heralded single-photon source and a room-temperature Raman memory with a time-bandwidth product exceeding 1000. We store heralded single photons and observe a clear influence of the input photon statistics on the retrieved light, which agrees with our theoretical model. The preservation of the stored field's statistics is limited by four-wave-mixing noise, which we identify as the key remaining challenge in the development of practical memories for scalable photonic information processing

A Tale of Two Animats: What does it take to have goals?

What does it take for a system, biological or not, to have goals? Here, this question is approached in the context of in silico artificial evolution. By examining the informational and causal properties of artificial organisms ('animats') controlled by small, adaptive neural networks (Markov Brains), this essay discusses necessary requirements for intrinsic information, autonomy, and meaning. The focus lies on comparing two types of Markov Brains that evolved in the same simple environment: one with purely feedforward connections between its elements, the other with an integrated set of elements that causally constrain each other. While both types of brains 'process' information about their environment and are equally fit, only the integrated one forms a causally autonomous entity above a background of external influences. This suggests that to assess whether goals are meaningful for a system itself, it is important to understand what the system is, rather than what it does.Comment: This article is a contribution to the FQXi 2016-2017 essay contest "Wandering Towards a Goal

Great Expectations: Voluntary Sports Clubs and Their Role in Delivering National Policy for English Sport

“The original publication is available at www.springerlink.com”. Copyright International Society for Third-Sector Research and The Johns Hopkins University. DOI: 10.1007/s11266-009-9095-yVoluntary sports clubs (VSCs) account for about a quarter of all volunteering in England. The volunteers work in a mutual aid, self-production, self-consumption system whose main purpose is identifying and nurturing high-level performers. But the new HMG/Sport England strategies leading to London 2012 expects volunteers to make a major contribution to sustaining and extending participation. The study utilized six focus group sessions with a total of 36 officials and members of 36 clubs across the six counties of Eastern England to assess whether and to what extent government policy objectives can be delivered through the voluntary sector. The study focused on the perceptions and attitudes of club members about being expected to serve public policy and the current pressures they and their clubs face. The results lead the authors to question the appropriateness, sensitivity, and feasibility of current sport policy, particularly the emphasis on VSCs as policy implementers.Peer reviewe

Deep representation learning identifies associations between physical activity and sleep patterns during pregnancy and prematurity

Preterm birth (PTB) is the leading cause of infant mortality globally. Research has focused on developing predictive models for PTB without prioritizing cost-effective interventions. Physical activity and sleep present unique opportunities for interventions in low- and middle-income populations (LMICs). However, objective measurement of physical activity and sleep remains challenging and self-reported metrics suffer from low-resolution and accuracy. In this study, we use physical activity data collected using a wearable device comprising over 181,944 h of data across N = 1083 patients. Using a new state-of-the art deep learning time-series classification architecture, we develop a \u27clock\u27 of healthy dynamics during pregnancy by using gestational age (GA) as a surrogate for progression of pregnancy. We also develop novel interpretability algorithms that integrate unsupervised clustering, model error analysis, feature attribution, and automated actigraphy analysis, allowing for model interpretation with respect to sleep, activity, and clinical variables. Our model performs significantly better than 7 other machine learning and AI methods for modeling the progression of pregnancy. We found that deviations from a normal \u27clock\u27 of physical activity and sleep changes during pregnancy are strongly associated with pregnancy outcomes. When our model underestimates GA, there are 0.52 fewer preterm births than expected (P = 1.01e - 67, permutation test) and when our model overestimates GA, there are 1.44 times (P = 2.82e - 39, permutation test) more preterm births than expected. Model error is negatively correlated with interdaily stability (P = 0.043, Spearman\u27s), indicating that our model assigns a more advanced GA when an individual\u27s daily rhythms are less precise. Supporting this, our model attributes higher importance to sleep periods in predicting higher-than-actual GA, relative to lower-than-actual GA (P = 1.01e - 21, Mann-Whitney U). Combining prediction and interpretability allows us to signal when activity behaviors alter the likelihood of preterm birth and advocates for the development of clinical decision support through passive monitoring and exercise habit and sleep recommendations, which can be easily implemented in LMICs

The validity and reliability of the exposure index as a metric for estimating the radiation dose to the patient

Introduction With the introduction of digital radiography, the feedback between image quality and over-exposure has been partly lost which in some cases has led to a steady increase in dose. Over the years the introduction of exposure index (EI) has been used to resolve this phenomenon referred to as ‘dose creep’. Even though EI is often vendor specific it is always a related of the radiation exposure to the detector. Due to the nature of this relationship EI can also be used as a patient dose indicator, however this is not widely investigated in literature. Methods A total of 420 dose-area-product (DAP) and EI measurements were taken whilst varying kVp, mAs and body habitus on two different anthropomorphic phantoms (pelvis and chest). Using linear regression, the correlation between EI and DAP were examined. Additionally, two separate region of interest (ROI) placements/per phantom where examined in order to research any effect on EI. Results When dividing the data into subsets, a strong correlation between EI and DAP was shown with all R-squared values > 0.987. Comparison between the ROI placements showed a significant difference between EIs for both placements. Conclusion This research shows a clear relationship between EI and radiation dose which is dependent on a wide variety of factors such as ROI placement, body habitus. In addition, pathology and manufacturer specific EI’s are likely to be of influence as well. Implications for practice The combination of DAP and EI might be used as a patient dose indicator. However, the influencing factors as mentioned in the conclusion should be considered and examined before implementation