Northampton Community College

About: Northampton Community College is a education organization based out in Bethlehem, Pennsylvania, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 3410 authors who have published 4582 publications receiving 130398 citations. The organization is also known as: Northampton County Area Community College.

A survey of off-label prescribing for inpatients with mild intellectual disability and mental illness

Abstract: Background The term ‘off-label prescribing’ refers to the use of a drug outside the terms of its Marketing Authorisation, including prescribing for an unlicensed indication. There have been few reports about off-label prescribing in psychiatry. The aims of the study were to determine the frequency of off-label prescribing of psychotropics for inpatients with mild intellectual disability (ID) and mental illness resident in a large psychiatric hospital, the nature of the off-label clinical indications and details about patient consent and case note documentation of the off-label usage. Methods Cross-sectional survey of inpatients of the ID division of a charitable hospital was carried out. Interviews with consultant psychiatrists about off-label use of psychotropics were also made. Results Of the 56 patients studied, 38 (67.9%) were receiving one or more psychotropic drugs and 26 (46.4%) were receiving at least one off-label psychotropic. The most frequently cited off-label indications were: reduction of aggression, arousal and behavioural disturbance (14 cases) and mood stabilization of affective disturbance (13). The principle psychotropics involved were atypical antipsychotics (17 cases) and mood stabilizers (13). Although in most instances the psychiatrist was aware the drug was being used off-label and had consulted other professionals, in only two (6%) instances had the patient been informed of the off-label usage, largely because the psychiatrist felt they lacked the capacity to understand the off-label concept. In most cases the off-label usage had not been documented in the case notes. Conclusions Off-label prescribing is common in patients with comorbid ID and mental disorder. When prescribing off-label, psychiatrists need to consider the evidence that the drug is likely to be effective for the unlicensed indication and any risks involved. Where there is limited evidence of benefit a trial of the drug, with clinical monitoring may be indicated. Patients should be fully informed about their medication. However, many patients with ID cannot understand the off-label concept. In some circumstances psychiatrists may find it helpful to consult other professionals before prescribing off-label. Good case note documentation of the process is important and supports the prescriber.

Voices of Experience: Talk, Identity and Membership in Reminiscence Groups

Abstract: This paper presents a discourse analysis of talk in reminiscence groups. Two main issues are addressed. First, we examine how speakers' identities are accomplished through the way they position themselves in social relationships and social practices of ‘remembered pasts’. Particular analytical attention is given to how people claim entitlements to the significance and consequences of their lived experience. Second, issues of membership are examined through the way people index their engagement in the narrative environment accomplished in reminiscence group talk. Finally, we are concerned with how these narratives contribute to a ‘reconstitution’ of understandings in common about cultural and moral orders of remembered pasts and the historical era in which the reported events, experiences and practices took place. Our analysis aims to demonstrate how reminiscence work affords a context for ‘re-membering’ where older people on their own behalf can work entitlements to voice the consequences of their experiences of life.

Modelling the Effects of Dispersal and Landscape Configuration on Population Distribution and Viability in Fragmented Habitat

Abstract: Landscape configuration and dispersal characteristics are major determinants of population distribution and persistence in fragmented habitat. An individual-based spatially explicit population model was developed to investigate these factors using the distribution of nuthatches in an area of eastern England as an example. The effects of immigration and increasing the area of breeding quality habitat were explored. Predictions were compared with observed population sizes in the study area. Our model combined a nuthatch population simulator based on individual behaviour with a grid-based representation of the landscape; nuthatch life cycle and immigration parameters were user selectable. A novel aspect of the model is user-selection of habitat perceptual range. Using a realistic set of parameters, the number of breeding pairs predicted by the model matched observed numbers. According to model simulations, the main cause of nuthatch scarcity in the study area was the inability of patches to support viable populations without immigration from elsewhere. Modelled habitat management, which increased breeding quality habitat in existing woods, lowered the threshold above which the study area population became self-sustaining. The existence of a large core habitat area was critical in producing a self-sustaining population in this landscape, the same area in dispersed small woods failed to sustain populations.

Aggressive behaviour observed within a neurobehavioural rehabilitation service: utility of the OAS-MNR in clinical audit and applied research

Abstract: The Overt Aggression Scale-Modified for Neurorehabilitation (OAS-MNR) has been proposed as a means of standardizing descriptions of post-acute aggressive behaviour disorders amongst people with acquired brain injury. Single cases in the literature have illustrated its clinical utility. In this paper, its contribution to clinical audit and applied research is explored. The scale was used to record all aggressive behaviour exhibited by 46 patients participating in a neurobehavioural programme during a 14 day period. Data for 3914 acts of aggression were captured. Whilst most was verbal, 443 comprised physical assaults on others. Results suggest the OAS-MNR can be usefully employed to audit practice, and has a role to play in resource allocation: however, efficacy remains best judged at the single case level. Regarding clinical research, it was found that patients with low language function were more likely to physically assault others in the absence of identifiable antecedents. Furthermore, this was more severe and required more intrusive interventions to manage it than aggression shown by the same patients which had identifiable antecedents, or any aggression exhibited by patients whose language was better preserved. It is argued that poor language function creates significant barriers to the treatment of aggression, and, whilst intervention methods with good outcome have previously been described, these are no longer routinely available in the UK. An appeal to reverse this is made.

A twenty‐one‐year record of surface change on a Namib linear dune

Abstract: Repeated surveying of two sites on a Namib linear dune between 1980 and 2001 provides a 21-year record of dune surface change. The surveys confirm the view that the dunes are not inactive relics but are responding to the present-day wind regime. They also provide no evidence that the dunes are migrating laterally. Examination of wind data for the survey period provides some evidence that the form of the crest of the dunes is actively responding to the natural year-by-year climate variability, such that an increase in the frequency of easterly winds leads to the development of a double-crested form while fewer easterly winds lead to a single-crested form. Copyright © 2003 John Wiley & Sons, Ltd.