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The Mental Health Bill, 2025, proposes to remove autism and learning disability from the scope of Section 3 of the Mental Health Act, 1983 (MHA). The present article represents a professional and carer consensus statement that raises concerns and identifies probable unintended consequences if this proposal becomes law. Our concerns relate to the lack of clear mandate for such proposals, conceptual inconsistency when considering other conditions that might give rise to a need for detention and the inconsistency in applying such changes to Part II of the MHA but not Part III. If the proposed changes become law, we anticipate that detentions would instead occur under the less safeguarded Deprivation of Liberty Safeguards framework, and that unmanaged risks will eventuate in behavioural consequences that will lead to more autistic people or those with a learning disability being sent to prison. Additionally, there is a concern that the proposed definitional breadth of autism and learning disability gives rise to a risk that people with other conditions may unintentionally be unable to be detained. We strongly urge the UK Parliament to amend this portion of the Bill prior to it becoming law.
[For the government of Japan to act deliberately in defiance of international agreement, and to devote considerable diplomatic effort to securing the revision of that agreement by pressure, including the use of substantial financial inducements, on small countries, means that there has to be a substantial issue at stake.
It can hardly be science, since virtually no one accepts the claim that scientific purpose warrants the annual killing of over 900 whales. It can hardly be economic, since although the meat of the captured animals is widely sold, the revenue to the Japanese government is trivial and most likely outweighed by the costs. It can hardly be culture and tradition, since Japanese traditional culture, strongly Buddhist influenced, deplored the killing and consumption of animals and the practise was confined to a few, relatively remote villages. So, if scientific, economic and cultural rationale isruled out, what can the reason be?
This essay celebrates the BU Health Law Program upon its 70th anniversary, offering reflections on the founders of the program, Fran Miller, George Annas, and Wendy Mariner (“FGW,” endearingly), and their contributions to the field.
Current faculty offer reflections, including: Several speak to scholarly research, including Elizabeth McCuskey on health care finance, Aziza Ahmed on human rights, Dionne Lomax on antitrust, Christopher Robertson on trust, and Kathy Zeiler on the marketplace. Other contributors speak to the student experience, with Dianne McCarthy on mentorship, Laura Stephens on demanding excellence, Michael Ulrich on teaching, and Larry Vernaglia on merging law and public health. On FGW’s broader impacts, Nicole Huberfeld speaks to the translation of research to reach new audiences, and Kevin Outterson writes about FGW’s pivotal roles in establishing the health law field and the institutions that now define it.
Together these pieces testify to the astounding contributions of these scholar-teacher-leaders across many domains and dimensions of health law. While their contributions are countless and immeasurable, these reflections offer a start.
In this essay, I argue that Christophers’ description of asset-manager society is best characterized by a logic of ‘acquire and extract’. I build on his insights to delve into the less-explored world of emancipatory alternatives. I argue for radical transformations – what I term ‘democratic ruptures’ – that shift the investment logic of asset managers toward one of ‘build and nourish’. With insights from the failure to establish economic democracy over large pools of finance by unions in the postwar period, I argue that the crucial missing ingredient in the social and ecological disaster of asset-manager society today is democracy. I conclude with a radical reimagining of financial democracy for the twenty-first century.
This article describes a robot walker based on a new single degree-of-freedom six-bar leg mechanism that provides rectilinear, non-rotating, movement of the foot. The walker is statically stable and requires only two actuators, one for each side, to provide effective walking movement on a flat surface. We use Curvature Theory to design a four-bar linkage with a flat-sided coupler curve and then adds a translating link so that walker foot follows this coupler curve in rectilinear movement. A prototype walker was constructed that weighs 1.6 kg, is 180 mm tall, and travels at 162 mm/s. This is an innovative legged robot that has a simple reliable design.
An area of great interest in Depression and Mood Disorder research has been highlighted by the Mental Health Priority Area of the Wellcome Trust (UK), namely sleep and circadian rhythm disturbances (SCRD). Wellcome has set out the background logic for this focus and clear research priorities (Wellcome Trust, 2022), leading to the funding of a series of international projects. This focus is a particularly good fit with the international agenda for development of more effective and scalable strategies for prevention, early intervention and secondary prevention of illness relapse, progression and downstream physical illnesses for adolescent-onset anxiety, depressive and psychotic disorders (Hickie et al., 2019).
We aimed to establish cut-off scores to stage dementia on the Addenbrooke's Cognitive Examination-III (ACE-III) and the Mini-Addenbrooke's Cognitive Examination (M-ACE) compared with scores traditionally used with the Mini-Mental State Examination (MMSE). Our cross-sectional study recruited 80 patients and carers from secondary care services in the UK.
Results
A score ≤76 on the ACE-III and ≤19 on the M-ACE correlated well with MMSE cut-offs for mild dementia, with a good fit on the receiver operating characteristic analysis for both the ACE-III and M-ACE. The cut-off for moderate dementia had lower sensitivity and specificity. There were low to moderate correlations between the cognitive scales and scales for everyday functioning and behaviour.
Clinical implications
Our findings allow an objective interpretation of scores on the ACE-III and the M-ACE relative to the MMSE, which may be helpful for clinical services and research trials.
Response to lithium in patients with bipolar disorder is associated with clinical and transdiagnostic genetic factors. The predictive combination of these variables might help clinicians better predict which patients will respond to lithium treatment.
Aims
To use a combination of transdiagnostic genetic and clinical factors to predict lithium response in patients with bipolar disorder.
Method
This study utilised genetic and clinical data (n = 1034) collected as part of the International Consortium on Lithium Genetics (ConLi+Gen) project. Polygenic risk scores (PRS) were computed for schizophrenia and major depressive disorder, and then combined with clinical variables using a cross-validated machine-learning regression approach. Unimodal, multimodal and genetically stratified models were trained and validated using ridge, elastic net and random forest regression on 692 patients with bipolar disorder from ten study sites using leave-site-out cross-validation. All models were then tested on an independent test set of 342 patients. The best performing models were then tested in a classification framework.
Results
The best performing linear model explained 5.1% (P = 0.0001) of variance in lithium response and was composed of clinical variables, PRS variables and interaction terms between them. The best performing non-linear model used only clinical variables and explained 8.1% (P = 0.0001) of variance in lithium response. A priori genomic stratification improved non-linear model performance to 13.7% (P = 0.0001) and improved the binary classification of lithium response. This model stratified patients based on their meta-polygenic loadings for major depressive disorder and schizophrenia and was then trained using clinical data.
Conclusions
Using PRS to first stratify patients genetically and then train machine-learning models with clinical predictors led to large improvements in lithium response prediction. When used with other PRS and biological markers in the future this approach may help inform which patients are most likely to respond to lithium treatment.
The book makes the case that it is pedagogy, rather than technology, that should underpin the design of blended learning programmes. It is organised into five sections: Connecting Theories and Blended Learning; Implications for Teaching; Rethinking Learner Interaction; Case Studies; The Future of Blended Learning. With its research-informed and practitioner-focused approach, this book is ideal for language teachers and language centre managers looking to broaden their understanding of pedagogy and blended learning. It will also be of interest to anyone working on blended learning course design or delivering teacher training courses.
Most tobacco treatment efforts target healthcare settings, because about 75% of smokers in the United States visit a primary care provider annually. Yet, 25% of patients may be missed by such targeting.
Aims
To describe patients who smoke but infrequently visit primary care – their characteristics, rates of successful telephone contact, and acceptance of tobacco treatment.
Methods
Tobacco Cessation Outreach Specialists ‘cold-called’ those without a primary care visit in the past year, offering tobacco dependence treatment. Age, sex, insurance status, race, ethnicity, electronic health record (EHR) patient-portal status and outreach outcomes were reported.
Results
Of 3,407 patients identified as smokers in a health system registry, 565 (16.6%) had not seen any primary care provider in the past year. Among 271 of those called, 143 (53%) were successfully reached and 33 (23%) set a quit date. Those without visits tended to be younger, male, some-day versus every-day smokers (42 vs. 44 years, P = 0.004; 48% vs. 40% female, P = 0.0002, and 21% vs. 27% some-day, P = 0.003), and less active on the EHR patient portal (33% vs. 40%, P = 0.001).
Conclusions
A substantial proportion of patients who smoke are missed by traditional tobacco treatment interventions that require a primary care visit, yet many are receptive to quit smoking treatment offers.
Business English and academic English may perhaps be thought of as areas of language use requiring precision of expression and a quest for specific and unambiguous meaning. However, corpus evidence shows that both types of language, in their spoken contexts, exhibit noticeable use of the kinds of vague expressions found in everyday conversation. In this lecture, I focus on one type of vagueness: vague category marking (VGM). This feature involves mention of an example or examples of something followed by reference to a broad, ad hoc category of which the chosen examples are seen as typical. References to categories commonly involve expressions such as or whatever, and so on, or something (like that). In both business and academic English, vague category marking is an important projection of shared knowledge and shared identities. In business, vagueness is also a useful tool in delicate negotiations. In academic English, vague categories refer to bodies of assumed shared knowledge and are crucial in the pedagogic process of grafting new knowledge onto old. Subtle differences are drawn out by different types of vague category markers. I conclude with some implications for teaching in these specialised areas.
Carbon-rich Asymptotic Giant Branch (AGB) stars are major sources of gas and dust in the interstellar medium. During the brief (∼1000 yr) period in the evolution from AGB to the Planetary Nebula (PN) stage, the molecular composition evolves from mainly diatomic and small polyatomic species to more complex molecules. Using the Submillimeter Array (SMA), we have carried out a spectral line survey of CRL 618, covering a frequency range of 281.9 to 359.4 GHz. More than 1000 lines were detected in the ∼60 GHz range, most of them assigned to HC3N and c-C3H2, and their isotopologues. About 200 lines are unassigned. Lines of CO, HCO+, and CS show the fast outflow wings, while the majority of line emission arises from a compact region of ∼1” diameter. We have analyzed the lines of HC3N, c-C3H2, CH3CN, and their isotopologues with rotation temperature diagrams.
We can also add that practice is something which can be undertaken in a large variety of contexts: in classrooms, in a second language environment, online, in groups and independently. This book aims to investigate differnt forms of practice in differnt contexts to better inform teaching and research.
There is limited empirical information on service-level outcome domains and indicators for the large number of people with intellectual disabilities being treated in forensic psychiatric hospitals.
Aims
This study identified and developed the domains that should be used to measure treatment outcomes for this population.
Method
A systematic review of the literature highlighted 60 studies which met eligibility criteria; they were synthesised using content analysis. The findings were refined within a consultation and consensus exercises with carers, patients and experts.
Results
The final framework encompassed three a priori superordinate domains: (a) effectiveness, (b) patient safety and (c) patient and carer experience. Within each of these, further sub-domains emerged from our systematic review and consultation exercises. These included severity of clinical symptoms, offending behaviours, reactive and restrictive interventions, quality of life and patient satisfaction.
Conclusions
To index recovery, services need to measure treatment outcomes using this framework.
We describe methods for measuring crystal orientation fabric with sonic waves in an ice core borehole, with special attention paid to vertical-girdle fabrics that are prevalent at the WAIS Divide. The speed of vertically propagating compressional waves in ice is influenced by vertical clustering of the ice crystal c-axes. Shear-wave speeds – particularly the speed separation between fast and slow shear polarizations – are sensitive to azimuthal anisotropy. Sonic data from the WAIS Divide complement thin-section measurements of fabric. Thin sections show a steady transition to strong girdle fabrics in the upper 2000 m of ice, followed by a transition to vertical-pole fabrics below 2500 m depth. Compressional-wave sonic data are inconclusive in the upper ice, due to noise, as well as the method's inherent insensitivity to girdle fabrics. Compared with available thin sections, sonic data provide better resolution of the transition to pole fabrics below 2500 m, notably including an abrupt increase in vertical clustering near 3000 m. Our compressional-wave measurements resolve fabric changes occurring over depth ranges of a few meters that cannot be inferred from available thin sections, but are sensitive only to zenithal anisotropy. Future logging tools should be designed to measure shear waves in addition to compressional waves, especially for logging in regions where ice flow patterns favor the development of girdle fabrics.
Supraglacial debris thickness is a key control on the surface energy balance of debris-covered glaciers, yet debris thickness measurements are sparse due to difficulties of data collection. Here we use ground-penetrating radar (GPR) to measure debris thickness on the ablation zone of Lirung Glacier, Nepal. We observe a strong, continuous reflection, which we interpret as the ice surface, through debris layers of 0.1 to at least 2.3 m thick, provided that appropriate acquisition parameters were used while surveying. GPR measurements of debris thickness correlate well with pit measurements of debris thickness (r = 0.91, RMSE = 0.04 m) and two-way travel times are consistent at tie points (r = 0.97). 33% of measurements are <0.5 m, so sub-debris melting is likely important in terms of mass loss on the debris-covered tongue and debris thickness is highly variable over small spatial scales (of order 10 m), likely due to local slope processes. GPR can be used to make debris thickness measurements more quickly, over a wider debris thickness range, and at higher spatial resolution than any other means and is therefore a valuable tool with which to map debris thickness distribution on Himalayan glaciers.
Organisational restructuring is a pervasive strategy employed by organisations in Australia in response to changes in market competition and/or policy directives. Such restructuring often involves staff redundancies and increased demands on the remaining employees. This paper identifies important issues for workplace rehabilitation programs in response to this phenomenon of organisational restructuring. The paper notes the impact of organisational restructuring on clients in workplace rehabilitation programs and the types of issues rehabilitation professionals are likely to face at this time. A particular focus is the aspect of managerial behaviour during the process of change and the paper reports from a range of studies on employee well-being, managerial bullying and coercion in the context of organisational restructuring. Considerations for the rehabilitation professional include the need to understand communication issues, identify those at risk, and maintain the natural supports during the change program. Suggestions are given for convenors of workplace rehabilitation programs to actively collaborate with the human resource function of the organisation and disability management is outlined as a useful example of such strategies.
The Galway Granite Complex is unique among the British and Irish Caledonian granitoid terranes, as it records punctuated phases of magmatism from ∼425–380 Ma throughout the latest phase of the Caledonian Orogeny. Remapping of the Omey Pluton, the oldest member of this suite, has constrained the spatial distribution and contact relationships of the pluton's three main facies relative to the nature of the host rock structure. The external contacts of the pluton are mostly concordant to the limbs and hinge of the Connemara Antiform. New AMS data show that a subtle concentric outward dipping foliation is present, and this is interpreted to reflect pluton inflation during continued magma ingress. Combined field, petrographic and AMS data show that two sets of shear zones (NNW–SSE and ENE–WSW) cross-cut the concentric foliation, and that these structures were active during the construction of the pluton. We show that regional sinistral transpression at ∼420 Ma would have caused dilation along the intersection of these two fault sets, and suggest that this facilitated centralised magma ascent. Lateral emplacement was controlled by the symmetry of the Connemara Antiform to ultimately produce a discordant phacolith. We propose that regional sinistral transpression at ∼420 Ma influenced the siting of smaller intrusions over NNW–SSE faults, and that the later onset of regional transtension caused larger volumes of magma to intrude along the E–W Skird Rocks Fault at ∼400 Ma.