Establishing gold standard approaches to rapid tranquillisation: a review and discussion of the evidence on the safety and efficacy of medications currently used

Background: Rapid tranquillisation is used when control of agitation, aggression or excitement is required. Throughout the UK there is no consensus over the choice of drugs to be used as first line treatment. The NICE guideline on the management of violent behaviour involving psychiatric inpatients conducted a systematic examination of the literature relating to the effectiveness and safety of rapid tranquillisation (NICE, 2005). This paper presents the key findings from that review and key guideline recommendations generated, and discusses the implications for practice of more recent research and information. Aims: To examine the evidence on the efficacy and safety of medications used for rapid tranquillisation in inpatient psychiatric settings. Method: Systematic review of current guidelines and phase III randomised, controlled trials of medication used for rapid tranquillisation. Formal consensus methods were used to generate clinically relevant recommendations to support safe and effective prescribing of rapid tranquillisation in the development of a NICE guideline. Findings: There is a lack of high quality clinical trial evidence in the UK and therefore a ‘gold standard’ medication regime for rapid tranquillisation has not been established. Rapid tranquillisation and clinical practice: The NICE guideline produced 35 recommendations on rapid tranquillisation practice for the UK, with the primary aim of calming the service user to enable the use of psychosocial techniques. Conclusions and implications for clinical practice: Further UK specific research is urgently needed that provides the clinician with a hierarchy of options for the clinical practice of rapid tranquillisation

Letter from Louise Chandler Moulton, Boston, Massachusetts, to Anne Whitney, Boston, Massachusetts, 1895 February 11

https://repository.wellesley.edu/whitney_correspondence/1856/thumbnail.jp

Letter from Louise Chandler Moulton, Boston, Massachusetts, to Anne Whitney, 1882 April 17

https://repository.wellesley.edu/whitney_correspondence/1853/thumbnail.jp

Letter from Louise Chandler Moulton, Boston, Massachusetts, to Anne Whitney, 1882 April 27

https://repository.wellesley.edu/whitney_correspondence/1854/thumbnail.jp

Letter from Louise Chandler Moulton, Boston, Massachusetts, to Anne Whitney, Boston, Massachusetts, 1906 May 23

https://repository.wellesley.edu/whitney_correspondence/1857/thumbnail.jp

An Evaluation of the Altamont Community Unit #10 Gifted Program

Purpose The purpose of this field study was to research the entity of gifted education from an historical viewpoint, to review gifted education as it is today, and most importantly, to review evaluation procedures and studies connected with gifted education. A formal evaluation had never been done in the history of the Independent Study Program at Altamont Community Unit #10. The result of the evaluation procedure was to determine how to modify, revise, and re-evaluate the program in order to more effectively meet the needs of the gifted students in the school district. Procedure After the historical review of gifted education and research on current gifted programs was completed, many types of evaluation procedures were studied. It was decided that the evaluation design was to be formal, formative, a naturalistic inquiry, and use a qualitative questionnaire for instrumentation. Questionnaire evaluation designs were created by the researcher, and administered to the Independent Study Program parents, students, and teachers, school board members, and administrators of Altamont Community Unit #10. This was deemed to be the most effective way to meet the purpose of the study. Surveyed in this study were 92 students, 50 teachers, 79 parents, 3 administrators, and 7 school board members. The overall return rate was 85.2%. Data analysis of the survey questions, tables, results, conclusions, and recommendations for each group participating are presented in Chapter IV. Results The study found that there were several areas of agreement and disagreement among the four groups completing the survey. Most of the four groups felt that: the Independent Study Program (ISP) was a good program, liked the organization of the program, and the ISP program was more challenging than the regular classroom. Three of the evaluating groups -- parents, teachers and school board/administrators -- agreed that teachers working in the program can be communicated with comfortably. Parents and teachers indicated that the ISP program helped students learn new things. The school board and administrators gave a positive rating on several other items, as did the parents, teachers, and the students. The comments concerned good teachers in the program, good student attitudes, and over-all program effectiveness. Several areas of needed improvement were clearly indicated by negative responses. The results indicated that: more areas of study needed to be offered to the students, and more time needed to be allotted to the ISP program. Several surveyed questioned the availability of good and interesting materials. Many indicated that the materials the program had were good but that more were needed. Teachers also indicated that they needed more information relayed to them about the program. The field study evaluation revealed opinions on key factors of the effectiveness of the Independent Study Program. Opinions of the groups surveyed should serve as guidelines to plan future goals and objectives, to strengthen the program, to make it more effective, and to continue its success

Neurocognitive investigation of objectin-scene representations

Organisms are required to perceive, process and remember a wealth of visual information from the environment to guide behaviour during spatial navigation. However, our knowledge is limited regarding how the brain encodes and reconstructs in memory, spatial and non-spatial properties of objects in scenes. For example, how are object locations, arrangements and identities encoded and represented across core scene-selective regions? How does the identity of a focal entity influence memory for the spatial extent of a scene? This thesis used functional magnetic resonance imaging (fMRI) and behavioural approaches across 4 independent experiments to investigate these themes. Empirical Chapters 1 and 2 employed fMRI repetition suppression (RS) to examine how activation across scene-selective regions differed in response to spatial (object Locations and Arrangements) and non-spatial (object Identities) conditions. Results revealed no effect of RS in any ROI, considered to reflect the type of task used (inversion detection). The second fMRI experiment employed a novel task, where participants responded to multiple changes between scenes. Results showed a significant effect of RS in two regions, but no dissociable effects between conditions. In two behavioural chapters, we extended these themes by using boundary extension (BE),to investigate whether memory for the spatial extent of a scene is influenced by the type of entity (object/person). Results revealed that BE was observed in both experiments for objects in scenes (in line with previous research), but not for people in scenes. Further analyses demonstrated that this effect might reflect the increase in attention assigned to people compared to objects, possibly to predict their future actions/behaviours. Together, this body of research provides insight into the mechanisms that drive RS during scene encoding, and identifies that possible differences in saliency associated with people and objects may mediate how the spatial extent of a scene is encoded and subsequently remembered

The Greenland Ice Sheet as a hot spot of phosphorus weathering and export in the Arctic:THE GREENLAND ICE SHEET P CYCLE

The contribution of ice sheets to the global biogeochemical cycle of phosphorus is largely unknown, due to the lack of field data. Here we present the first comprehensive study of phosphorus export from two Greenland Ice Sheet glaciers. Our results indicate that the ice sheet is a hot spot of phosphorus export in the Arctic. Soluble reactive phosphorus (SRP) concentrations, up to 0.35?µM, are similar to those observed in Arctic rivers. Yields of SRP are among the highest in the literature, with denudation rates of 17–27?kg?P?km?2?yr?1. Particulate phases, as with nonglaciated catchments, dominate phosphorus export (>97% of total phosphorus flux). The labile particulate fraction differs between the two glaciers studied, with significantly higher yields found at the larger glacier (57.3 versus 8.3?kg?P?km?2?yr?1). Total phosphorus yields are an order of magnitude higher than riverine values reported in the literature. We estimate that the ice sheet contributes ~15% of total bioavailable phosphorus input to the Arctic oceans (~11?Gg?yr?1) and dominates total phosphorus input (408?Gg?yr?1), which is more than 3 times that estimated from Arctic rivers (126?Gg?yr?1). We predict that these fluxes will rise with increasing ice sheet freshwater discharge in the future

Researching complex interventions in health: the state of the art

CITATION: Craig, P., et al. 2016. Researching complex interventions in health : the state of the art. BMC Health Services Research, 16:101, doi:10.1186/s12913-016-1274-0.The original publication is available at https://bmchealthservres.biomedcentral.comENGLISH SUMMARY : Keynote presentationsPublishers' Versio