This article is a concise refreshment for psychiatrists to update their knowledge and understanding of corticosteroid-induced psychiatric symptoms. It summarises the diverse presentation associated with this clinical phenomenon, how frequently it occurs and some pathophysiological considerations. There is a focus on early identification and management, highlighting the importance of an integrated multidisciplinary approach, withdrawal or reduction of the corticosteroid treatment and adjunctive psychotropic medication options for clinicians to consider.

A company with n geographically widely dispersed sites seeks an insurance policy that pays off if m out of the n sites experience rarely occurring catastrophes (e.g., earthquakes) during a year. This study compares three strategies for an insurance company wishing to offer such an m-out-of-n policy, assuming the existence of markets for insurance on the individual sites with coverage periods of various lengths of a year or less. Strategy A is static: at the beginning of the year it buys a reinsurance policy on each individual site covering the entire year and makes no later adjustments. By contrast, Strategies S and C are dynamic and adaptive, exploiting the availability of individual-site policies for shorter periods than a year to make changes in the coverage on individual sites as quakes occur during the year. Strategy S uses the payoff from reinsurance when a quake occurs at a particular site to increase coverage for the remainder of the year on the sites that have not yet had quakes. Strategy C buys individual-site policies covering successive time periods of fixed length, observing the system at the beginning of each period and using cash on hand plus cash obtained from a reinsurance payoff (if any) during the previous period to decide how much cash to retain and how much reinsurance to purchase for the current period. The study relies on expected utility to determine indifference premiums and compare the premiums and loss probabilities for the three strategies.

The NHS 2025 Health Plan aims for radical reform but overlooks people with intellectual disability. This editorial highlights critical omissions in policy, services, research and rights protections. Without intentional inclusion, digital and community shifts risk deepening inequality. True progress demands co-produced strategies to ensure equitable care for this vulnerable population.

Let $\Gamma$ be a Schottky subgroup of $\mathrm{SL}_2(\mathbb{Z})$ and let $X=\Gamma \backslash {\mathbb{H}}^2$ be the associated hyperbolic surface. We consider the family of Hecke congruence coverings of $X$, which we denote as usual by $ X_0(q) = \Gamma _0(q)\backslash {\mathbb{H}}^2$. Conditional on the Lindelöf Hypothesis for quadratic L-functions, we establish a uniform and explicit spectral gap for the Laplacian on $ X_0(q)$ for “almost” all prime levels $q$. Assuming the generalized Riemann hypothesis for quadratic $L$-functions, we obtain an even larger spectral gap.