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Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.
To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.
Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.
Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.
The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.
This paper agrees with Friedrich August Hayek’s assertion in his 1945 Dublin lecture that the importance of Dutch physician Bernard Mandeville’s role in the history of economics had been overlooked and with his 1966 London lecture’s assertion that Mandeville’s important contribution qualified him as a master mind. Paul Sakmann’s and Albert Schatz’s studies of Mandeville’s eighteenth-century allegorical Fable of the Bees satire were acknowledged by Hayek as having influenced his formulation and development of the theory of spontaneous order extended from Scottish Enlightenment thinkers. Each of these two writers’ contribution to Mandeville and spontaneous order theory is considered as well as proposing a new source for the term “spontaneous order”—Schatz’s 1907‘le principe d’ordre spontané.’
There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney.
A convenience sample of 206 caregiver–patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Significance of results:
Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.
Interrogating the concepts of allegiance and identity in a globalised world involves renewing our understanding of membership and participation within and beyond the nation-state. Allegiance can be used to define a singular national identity and common connection to a nation-state. In a global context, however, we need more dynamic conceptions to understand the importance of maintaining diversity and building allegiance with others outside borders. Understanding how allegiance and identity are being reconfigured today provides valuable insights into important contemporary debates around citizenship. This book reveals how public and international law understand allegiance and identity. Each involves viewing the nation-state as fundamental to concepts of allegiance and identity, but they also see the world slightly differently. With contributions from philosophers, political scientists and social psychologists, the result is a thorough appraisal of allegiance and identity in a range of socio-legal contexts.
The record of events that describe the petroleum industry (Yergin 1991; Parra 2004) and the analysis of these events (Jacoby 1974; Kobrin 1984b; Adelman 1995) provide a context from which to draw observations about the drivers and evolution of the structure of the industry. Private operating companies are seen to have been employed in the great majority of instances for the exploration and early development of a new “frontier” petroleum province, yet governments have often revisited those choices in favor of nationalization and the transfer of petroleum assets to a state operating company. Most notably, in the early 1970s, nationalizations in a host of countries, including all of the major developing world oil producers, left three-quarters of the world’s oil reserves in the hands of state-owned companies. Control of a major part of the oil industry – decisions on oil price, production, and investment in reserves replacement – passed from private enterprise to a small group of producer countries.
Conventional wisdom holds that nationalizations are rooted in political motives of the petroleum states, which perceive value in the direct control of resource development though a state enterprise. State motives are inarguably important and are considered in detail throughout this book, including in the introductory and concluding chapters, in Chapter 2 by Chris Warshaw on drivers of states’ expropriation and privatization behavior, and in all of the individual NOC case studies. At the same time, the argument presented in this chapter is that this motive to nationalize, whatever its cause, is in fact severely constrained by both the significant risks associated with the creation of petroleum reserves and the capacity of the petroleum state to take these risks.