Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

The learning hospital is distinguished by ceaseless evolution of erudition, enhancement, and implementation of clinical best practices. We describe a model for the learning hospital within the framework of a hospital infection prevention program and argue that a critical assessment of safety practices is possible without significant grant funding. We reviewed 121 peer-reviewed manuscripts published by the VCU Hospital Infection Prevention Program over 16 years. Publications included quasi-experimental studies, observational studies, surveys, interrupted time series analyses, and editorials. We summarized the articles based on their infection prevention focus, and we provide a brief summary of the findings. We also summarized the involvement of nonfaculty learners in these manuscripts as well as the contributions of grant funding. Despite the absence of significant grant funding, infection prevention programs can critically assess safety strategies under the learning hospital framework by leveraging a diverse collaboration of motivated nonfaculty learners. This model is a valuable adjunct to traditional grant-funded efforts in infection prevention science and is part of a successful horizontal infection control program.

We assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.

Radio echo-soundings obtained during joint programmes of the US National Science Foundation (NSF), the Scott Polar Research Institute (SPRI), and the Technical University of Denmark (TUD) have provided sufficient data of good quality to map driving stress over approximately one half of the Antarctic ice sheet. Computerized averaging of data over 1 degree of latitude squares has largely eliminated local effects of longitudinal stress variations on surface slope. Methods of data handling are outlined. Variations in driving stresses between different regions are discussed in relation to the balancing restraining forces. These are primarily related to ice velocity and thickness, bedrock topography, the presence of basal water and possibly to the development of easy-glide fabric in the ice mass, to the temperature of basal ice layers, and to the excess hydrostatic pressure in areas where ice rests on bedrock well below sea-level.

Swedish noun-phrases of the form (Det) (Adj)* N are examined in the light of recent work in generalized phrase-structure grammar. It is argued that simple generalizations about the phrase-structure of these NPs are lost by trying to account for the precise morphological possibilities by using phrase-structure rules mentioning categories marked with morphological features. What could be accounted for by two rules must be broken down into subcases which need seven rules, thereby obscuring the overall syntactic structure of the NPs. An alternative is suggested which maintains the simple syntax which generates morphologically ill-formed NPs but only allows morphologically well-formed ones to be interpreted. It is suggested that this system can be constrained so as to generate only context-free languages.

This paper reports work in progress. It concerns the relationship in Germanic languages between the sentence initial constituent XP, and the rest of the sentence S, assuming a rule S → XP S. An informal proposal is presented, according to which that relationship is better characterized in terms of the notion of unification than that of predication. The author is currently working with Elisabet Engdahl on producing a precise grammar of some long distance dependency constructions which should be able to embody the ideas sketched here.

This special issue of the Nordic Journal of Linguistics is devoted to Comparative Nordic Semantics. Whereas much research has been carried out on comparative syntax, morphology and phonology in the Nordic languages, much less work has been done on the comparative semantics of these languages. But the fact that some of the Nordic languages, namely the Scandinavian ones, Danish, Faroese, Icelandic, Norwegian and Swedish, are historically, lexically and structurally very similar means that they provide an interesting target for semantic research. Are there systematic semantic differences between these languages? If so, are the formal semantic analytic tools that have been developed mainly for English and German sufficiently fine-grained to account for the differences among the Scandinavian languages? These were some of the questions asked in the research project Comparative Semantics for Nordic Languages (NORDSEM), which was funded by the Joint Committee of the Nordic Research Councils for the Humanities in 1998–2001 and which involved researchers at the Copenhagen Business School, Göteborg University and the University of Oslo. Two of the papers in this issue (by Carl Vikner and Kjell Johan Sæbø) derive directly from the NORDSEM project whereas the third paper, by Erich Round, pursues some issues investigated during the project by Joakim Nivre and published in Nordic Journal of Linguistics 25:1 (2002).

Objectives: There is a view that antipsychotic drugs can be successfully withdrawn from people with intellectual disabilities with resultant health gain. This study critically examines whether antipsychotic drug withdrawal is beneficial.

Methods: 119 adults with intellectual disabilities were included in a programme of antipsychotic drug withdrawal.

Results: The clinical outcomes of this programme are poor. Only 7.6% completely withdrew from antipsychotic drugs, and 48.7% experienced onset/deterioration in problem behaviours or mental ill-health. Significant drug side effects with the introduction of new drugs were experienced by 23.3%. Resultant mean antipsychotic drug doses were higher compared with those at the start of the programme. The cost to the intellectual disabilities psychiatric service (over and above that of routine psychiatric care) was £258,050 (€391,693), and the human cost was considered high. Primary care, social care and family costs were not calculated. The only specific factors found to be associated with poor outcome were increased severity of intellectual disabilities and female gender.

Conclusions: The successful role of antipsychotic drugs in the management of problem behaviours in people who do not have verbal communication skills may relate to the pathoplastic effect of intellectual disabilities on clinical presentation, with problem behaviours being markers of eg. psychosis and anxiety disorders. Our original findings challenge the view that routine withdrawal of antipsychotic drugs is good practice; we reinterpret the existing literature, and recommend caution and vigilance in pharmacotherapy.