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Psychiatrists play a critical role in identifying and supporting their patients on the autism spectrum in the UK, yet little is known about their knowledge, attitudes and experiences in this regard.
To understand psychiatrists' experiences of working with autistic individuals, their confidence in making diagnostic/management decisions and the factors that affect such decisions.
A total of 172 psychiatrists took part in an online self-report survey.
Most psychiatrists reported receiving useful training on autism and were knowledgeable about the condition, particularly those with a personal connection to autism. Higher confidence in working with autistic patients was linked to greater levels of autism knowledge, experience and training. Several systemic and autism-specific factors were highlighted by psychiatrists, which were felt to challenge their ability to provide effective care and support for their patients on the autism spectrum.
Psychiatrists' views corroborated previous research with the autism community, highlighting the need to co-design services that are accessible, respectful and person-centred.
Declaration of interest
I.D. is the Royal College of Psychiatrists' Autism Champion.
As multi-core computing is now standard, it seems irresponsible for constraints researchers to ignore the implications of it. Researchers need to address a number of issues to exploit parallelism, such as: investigating which constraint algorithms are amenable to parallelisation; whether to use shared memory or distributed computation; whether to use static or dynamic decomposition; and how to best exploit portfolios and cooperating search. We review the literature, and see that we can sometimes do quite well, some of the time, on some instances, but we are far from a general solution. Yet there seems to be little overall guidance that can be given on how best to exploit multi-core computers to speed up constraint solving. We hope at least that this survey will provide useful pointers to future researchers wishing to correct this situation.
Polls have had a number of high-profile misses in recent elections. We review the current polling environment, the performance of polls in a historical context, the mechanisms of polling error, and the causes of several recent misses in Britain and the US. Contrary to conventional wisdom, polling errors have been constant over time, although the level of error has always been substantially beyond that implied by stated margins of error. Generally, there is little evidence that voters lying about their vote intention (so-called ‘shy’ voters) is a substantial cause of polling error. Instead, polling errors have most commonly resulted from problems with representative samples and weighting, undecided voters breaking in one direction, and to a lesser extent late swings and turnout models. We conclude with a discussion of future directions for polling both in terms of fixing the problems identified and new approaches to understanding public opinion.
Mass transport deposits (MTDs), created by gravity-driven deformation of unlithified sediments, and tectonic mélanges produced by contractional deformation are characterized by a similar chaotic appearance. It follows that distinguishing structures formed by soft-sediment deformation during mass transport from those produced by contractional tectonics can be problematic. In fact, deformation occurring along detachment levels may completely obliterate the original sedimentary fabric. Although a number of advances have been made during recent decades, field criteria for discriminating structures within MTDs that are overprinted by later regional contraction are not readily applicable to all the exposed examples. We address some of these general issues through a detailed case study of the Monte Facito Formation in Italy. This Triassic unit was formed during the Africa–Europe continental separation and, since the Miocene, has been involved in contractional deformation during the construction of the Apennines. The Monte Facito Formation consists of a series of stratigraphically coherent units, separated by chaotic and often deformed intervals, whose origin has been previously attributed to either tectonic or sedimentary processes. An example is provided by a characteristic pebbly mudstone (or ‘paraconglomerate’) which has been interpreted as either a Triassic gravity-flow deposit, or alternatively, as a product of shearing along regional contractional detachments during the Miocene. This detailed field-based study allows us to recognize structures related to the depositional processes that created these chaotic intervals, and which can therefore be interpreted as MTDs. We also discriminate structures connected to later contractional tectonics that locally produced intense reworking of the MTDs.
The objective of this study was to measure the effects of varying doses of atropine on the concentration and composition of milk protein and on blood α-amino N levels. Four treatments were administered to each of 12 cows over 12 days in a replicated Latin square experiment. There were at least 2 days between each of 4 treatment days. Treatments were: control (C; saline); low dose (L; 30mg atropine/kg LWT); medium dose (M; 40mg atropine/kg LWT); and 2 x low dose (2L). All treatments were administered via subcutaneous injection immediately after the morning milking; the second dose of the 2L treatment was given two hours later. Milk was sampled from each cow at the morning milking (time 0 h). Cows were then milked again 2, 6 and 10 h after treatment, and milk samples again collected. Blood samples were drawn from the coccygeal vein of each cow after each milking. Atropine decreased milk secretion at 6 h for the 2L treatment and 10 h for all treatments. Atropine reduced concentrations of milk protein and casein at 2 h and 6 h, but not at 10 h. Concentrations of whey proteins and of α-casein were depressed by atropine only at 6 h post-treatment, while a reduction in α-lactalbumin due to atropine was observed at 6 and 10 h post-treatment. In contrast, atropine increased concentrations of IgG and BSA at 6 h and 10 h post-treatment. Atropine also increased the ratio of casein:total protein at 6 h after injection. There was no difference between the effects of the low and medium doses of atropine, but the double low dose induced effects which were greater than for the single doses. Effects of a single dose of atropine were greatest for most milk proteins at 6 h post treatment; thus this would be the most useful milk sampling time for future experiments. Atropine did not significantly affect α-amino N concentrations in whole blood, although there was a trend for a reduction for all treatments at 2 h after treatment. Atropine may be useful for reducing milk protein concentrations and circulating levels of certain blood amino acids to base levels, during studies designed to elucidate the effects of perturbations in the blood amino acid profile on milk protein composition.
This study assessed bioavailability and utilisation of vitamin D3 in two feeding trials using young, growing Sprague–Dawley male rats. Trial one fed animals standard AIN-93G diet (casein protein) containing no vitamin D3 and goat or cow skimmed milk supplemented with vitamin D3. Trial two fed animals modified dairy-free AIN-93G diet (egg albumin) containing no vitamin D3 and goat or cow skimmed or full-fat milk supplemented with vitamin D3. Control groups received AIN-93G diets with or without vitamin D, and water. At 8 weeks of age, blood samples were collected for vitamin and mineral analysis, and femurs and spines were collected for assessment of bone mineralisation and strength. In both trials, analyses showed differences in bioavailability of vitamin D3, with ratios of serum 25-hydroxyvitamin D3 to vitamin D3 intake more than 2-fold higher in groups drinking supplemented milk compared with groups fed supplemented solid food. Bone mineralisation was higher in groups drinking supplemented milk compared with groups fed supplemented solid food, for both trials (P<0·05). There was no difference in the parameters tested between skimmed milk and full-fat milk or between cow milk and goat milk. Comparison of the two trials suggested that dietary protein source promoted bone mineralisation in a growing rat model: modified AIN-93G with egg albumin produced lower bone mineralisation compared with standard AIN-93G with casein. Overall, this study showed that effects of vitamin D3 deficiency in solid diets were reversed by offering milk supplemented with vitamin D3, and suggests that using milk as a vehicle to deliver vitamin D is advantageous.
The dating of alluvial deposits is frequently hampered by a lack of good-quality charcoal or other material for radiocarbon samples. We have dated two sites in southeastern Australia using traditional radiometric methods with minimal pretreatment. Results yielded an inconsistent chronology, affected by contamination with younger humic materials. A more consistent and older chronology was achieved using AMS dating of rigorously pretreated samples of fine-grained charcoal. The results have important implications for the radiocarbon dating of many Late Quaternary stratigraphic sequences with low charcoal abundance.
Three-dimensional bluff body aerodynamics are pertinent across a broad range of engineering disciplines. In three-dimensional bluff body flows, shear layer behaviour has a primary influence on the surface pressure distributions and, therefore, the integrated forces and moments. There currently exists a significant gap in understanding of the flow around canonical three-dimensional bluff bodies such as rectangular prisms and short circular cylinders. High-fidelity numerical experiments using a hybrid turbulence closure that resolves large eddies in separated wakes close this gap and provide new insights into the unsteady behaviour of these bodies. A time-averaging technique that captures the mean shear layer behaviours in these unsteady turbulent flows is developed, and empirical characterizations are developed for important quantities, including the shear layer reattachment distance, the separation bubble pressure, the maximum reattachment pressure, and the stagnation point location. Many of these quantities are found to exhibit a universal behaviour that varies only with the incidence angle and face shape (flat or curved) when an appropriate normalization is applied.
RR Lyraes that have nearby visual companions may be examined to decide if they do indeed belong to a real binary system. Identification of RR Lyraes in binary systems could lead to the determination of physical characteristics of the variable and to an understanding of the history and evolution of such systems in the Galaxy. Where possible, proper motion analysis, using astrograph plates from the Lick Proper Motion Program, for some visual binaries has been done and has enabled the rejection of some variables from consideration. The variables which have been shown not to be physically associated with their visual companions are YZ Cap, V445 Oph, BH Peg, and TX Vir. EZ Lyr, RW Ari, and V494 Sco still remain possible cases requiring relative radial velocities between the variable and companion. Limited plate material has meant that one must resort to radial velocity measurements for the RR Lyrae and close companion in order to determine the nature of the pair.
Despite evidence for their comparable efficacy, psychotherapy faces a dramatic decline relative to pharmacotherapy in psychiatry. A deep ideological reason for this decline centres on the belief that psychotherapy is a psychosocial treatment whereas pharmacotherapy is a biological treatment. Modern cognitive neuroscience demonstrates that this distinction is a myth.
There exist many spatial discretization schemes that are well able to provide accurate and stable approximations for isothermal turbulent flows. Comparatively little analysis has been made of the performance of these schemes in the presence of temperature gradients driven by combustion. In this paper, the effects of temperature gradients on numerical stability are explored. A surprising result is that temperature gradients in the flow have a tendency to impinge on left half plane (LHP) stability of the spatial discretization scheme. Reasons for this tendency are explored and two remedies are proposed: one based on the particular class of finite difference schemes, and one based on an alternative method of boundary condition specification.
The incidence of recreational water-associated outbreaks in the United States has significantly increased, driven, at least in part, by outbreaks both caused by Cryptosporidium and associated with treated recreational water venues. Because of the parasite's extreme chlorine tolerance, transmission can occur even in well-maintained treated recreational water venues (e.g. pools) and a focal cryptosporidiosis outbreak can evolve into a community-wide outbreak associated with multiple recreational water venues and settings (e.g. childcare facilities). In August 2004 in Auglaize County, Ohio, multiple cryptosporidiosis cases were identified and anecdotally linked to pool A. Within 5 days of the first case being reported, pool A was hyperchlorinated to achieve 99·9% Cryptosporidium inactivition. A case-control study was launched to epidemiologically ascertain the outbreak source 11 days later. A total of 150 confirmed and probable cases were identified; the temporal distribution of illness onset was peaked, indicating a point-source exposure. Cryptosporidiosis was significantly associated with swimming in pool A (matched odds ratio 121·7, 95% confidence interval 27·4–∞) but not with another venue or setting. The findings of this investigation suggest that proactive implementation of control measures, when increased Cryptosporidium transmission is detected but before an outbreak source is epidemiologically ascertained, might prevent a focal cryptosporidiosis outbreak from evolving into a community-wide outbreak.
We describe two cases of infant botulism due to Clostridium butyricum producing botulinum type E neurotoxin (BoNT/E) and a previously unreported environmental source. The infants presented at age 11 days with poor feeding and lethargy, hypotonia, dilated pupils and absent reflexes. Faecal samples were positive for C. butyricum BoNT/E. The infants recovered after treatment including botulism immune globulin intravenous (BIG-IV). C. butyricum BoNT/E was isolated from water from tanks housing pet ‘yellow-bellied’ terrapins (Trachemys scripta scripta): in case A the terrapins were in the infant's home; in case B a relative fed the terrapin prior to holding and feeding the infant when both visited another relative. C. butyricum isolates from the infants and the respective terrapin tank waters were indistinguishable by molecular typing. Review of a case of C. butyricum BoNT/E botulism in the UK found that there was a pet terrapin where the infant was living. It is concluded that the C. butyricum-producing BoNT type E in these cases of infant botulism most likely originated from pet terrapins. These findings reinforce public health advice that reptiles, including terrapins, are not suitable pets for children aged <5 years, and highlight the importance of hand washing after handling these pets.
Carolin Kreber, Professor of Higher Education, University of Edinburgh,Charles Anderson, Senior Lecturer and Deputy Head of the Institute for Education, Community and Society, University of Edinburgh,Jan McArthur, Lecturer in Higher Education, University of Edinburgh,Noel Entwistle, Professor Emeritus of Education, University of Edinburgh
The relationship between assessment and student learning has been a major issue in education for a long time. The argument has been that what is assessed constitutes the curriculum for many students and how it is assessed constitutes the learning process. The ideas behind, and the relationship between, summative and formative aspects of assessment have been much discussed. More recently, the issue of feedback and its relationship to quality assurance (Williams and Kane 2008) and student learning (Hattie and Timperley 2007) have been at the forefront of these discussions.
Substantial and influential research on assessment and feedback in higher education has been carried out by Dai Hounsell. I first came across Dai's earlier work at a joint conference of the Society for Research into Higher Education and the Cognitive Psychology Section of the British Psychological Society in 1985. At that conference, Dai presented a paper on “Essay Writing and the Quality of Feedback” (Hounsell 1987). Since then, Dai has written extensively on assessment and feedback, recently culminating in a six-step model for feedback (Hounsell et al. 2008). In much of this work, Dai has focused on the processes of feedback and on the criteria of assessment and feedback in relation to those criteria. The quality, quantity, frequency and timeliness of feedback have all been considerations at the forefront of his work, although the issues of standards of assessment, students' understanding of standards and how that understanding relates to the quality of student learning have not been central for him.
In this chapter, I wish to draw upon some of Royce Sadler's ideas of, and, in particular, his focus on, standards and students' understanding of standards of assessment, which complement many of the ideas to which Dai has also referred. I should point out, however, that Royce may not agree with all of the ideas presented here. In his recent work, he has made a strong case that the concepts of ‘criteria’ and ‘standards’ are often confused in the assessment literature in higher education, with criteria often equated with standards; as a result of this, he has made a clear distinction between criteria and standards (Sadler 2005).
The safety and nutritional adequacy of goat milk infant formulas have been questioned. The primary aim of the present study was to compare the growth and nutritional status of infants fed a goat milk infant formula with those of infants fed a typical whey-based cow milk infant formula. The secondary aim was to examine a range of health- and allergy-related outcomes. A double-blind, randomised controlled trial with 200 formula-fed term infants randomly assigned to receive either goat or cow milk formula from 2 weeks to at least 4 months of age was conducted. A cohort of 101 breast-fed infants was included for comparison. Weight, length and head circumference were measured at 2 weeks and 1, 2, 3, 4, 6 and 12 months of age. Nutritional status was assessed from serum albumin, urea, creatinine, Hb, ferritin, and folate and plasma amino acid concentrations at 4 months. Z-scores for weight, length, head circumference and weight for length were not different between the two formula-fed groups. There were differences in the values of some amino acids and blood biomarkers between the formula-fed groups, but the mean values for biomarkers were within the normal reference range. There were no differences in the occurrence of serious adverse events, general health, and incidence of dermatitis or medically diagnosed food allergy. The incidence of parentally reported blood-stained stools was higher in the goat milk formula-fed group, although this was a secondary outcome and its importance is unclear. Goat milk formula provided growth and nutritional outcomes in infants that did not differ from those provided by a standard whey-based cow milk formula.