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Introduction: Adults with intellectual disabilities have an increased vulnerability to mental health problems and challenging behaviour. In addition to psychotherapeutic or psychoeducational methods, off-label pharmacotherapy, is a commonly used treatment modality. Objective: The aim of this study was to establish evidence-based guideline recommendations for the responsible prescription of off-label psychotropic drugs, in relation to Quality of Life (QoL). Method: A list of guidelines was selected, and principles were established based on international literature, guideline review and expert evaluation. The Delphi method was used to achieve consensus about guideline recommendations among a 58-member international multidisciplinary expert Delphi panel. Thirty-three statements were rated on a 5-point Likert-scale, ranging from totally disagree to totally agree, in consecutive Delphi rounds. When at least 70% of the participants agreed (score equal or higher than 4), a statement was accepted . Statements without a consensus were adjusted between consecutive Delphi rounds based on feedback from the Delphi panel. Results: Consensus was reached on 4 general:the importance of non-pharmaceutical treatments, comprehensive diagnostics and multidisciplinary treatment. Consensus was reached in 4 rounds on 29 statements. No consensus was reached on 4 statements concerning: freedom-restricting measures, the treatment plan, the evaluation of the treatment plan, and the informed consent. Conclusion: The study led to recommendations and principles for the responsible prescription -- aligned with the QoL perspective -- of off-label psychotropic drugs for adults with intellectual disabilities and challenging behaviour. Extensive discussion is needed regarding the issues on which there was no consensus to furthering the ongoing development of this guideline.

Background: This article reports on the results of a study conducted in Belgium on family quality of life situated within a larger project focusing on the development of support strategies for young and adolescent siblings of persons with intellectual disabilities. The objectives of this article are twofold: (1) to present the results of the measures contained in the nine domains of the "Family Quality of Life Survey-2006" ("FQOLS-2006") from the perspective of parents (quantitative analysis); and (2) to come to a more in-depth understanding of two important domains of the "FQOLS-2006" by exploring and comparing the quantitative and qualitative data from open-ended interviews with parents. Method: The "FQOLS-2006" was completed by the main caregivers of 25 families living in one typical Belgian province. Subsequently, semi-structured interviews with one or both parents were conducted within the same families. Content analysis was carried out on the transcribed interviews using the qualitative software package MaxQDA. Results: A detailed analysis of the quantitative data together with data from the content analysis of the interviews revealed important issues with regard to two family quality of life domains, "support from others and support from services." In general, parents were satisfied with the professional support they received, whereas they were more critical of support from others. Conclusions: The quantitative data from the "FQOLS-2006" were supported and further explained by the qualitative data. These findings highlight the importance of adequate professional support, which is a flexible and capable answer to each family's individual needs. The authors warn of the dangers of "handicapism" and plea for a family-centred support approach that takes the whole family into account. Finally, they indicate the benefits of increased practical-pedagogical support.

Background: Despite various reliability studies on the Supports Intensity Scale (SIS), to date there has not been an evaluation of the reliability of client vs. staff judgments. Such determination is important, given the increasing consumer-driven approach to services. Additionally, there has not been an evaluation of the instrument's construct validity on a non-English speaking sample. This is important as the SIS is currently translated into 13 languages. Method: Data were collected in two different samples, using the Dutch translation of the SIS and the Vineland-Z. Results: There was a significant correlation between ratings of staff and consumers on the SIS; however, the relationship between the mean scores of consumer and staff responses indicated significant differences in staff and consumer scores. All correlations between the Vineland-Z domains and the SIS subscales were significant and negative, ranging from -0.37 to -0.89. Conclusions: Analyses of the inter-respondent reliability suggest that one needs to consider the source of information regarding needed supports carefully. The significant negative correlations between SIS and Vineland-Z reflect that the SIS is measuring a different construct (needed support) than the Vineland-Z (adaptive behaviour). The results of the two studies provide additional support for the etic (universal) properties of the SIS, as both hypotheses were confirmed. In conclusion, SIS users are provided with a wealth of information that can be used for multiple purposes.

The article presents a research study on young siblings of people with intellectual disabilities (ID). During the study, some siblings were interviewed, in which they expressed their feelings and experiences of living with a brother or sister with ID. Some revealed that they miss playing with their brother or sister, whereas, some stated that they feel more caring towards them.

Good research should be relevant and useful, it may even be enlightening or symbolic, but it can also be emancipatory. Qualitative research can be useful in challenging structures, policies and practices that disempower and marginalize segments of the population. However, could it be that the empowerment of the participant ends where the weakness of the researcher begins? In qualitative studies the researcher seems to have a number of favourite interviews. In a study on the relational and sexual experiences of 46 people with learning disabilities, 12 interviews were withdrawn from the general data on the basis of lack of relevance. It is important to re-examine why the voice of some people fell out of the in-depth analysis and whether this was justified. In this article some methodological opportunities and pitfalls to re-grant identity to these silenced narratives are considered and discussed. [ABSTRACT FROM AUTHOR]

Children can develop post-traumatic stress disorder (PTSD) and mental health symptoms after traumatic events. This meta-analysis evaluated the influence of moderators of cognitive behavioural trauma treatment (CBTT) with caregiver involvement in traumatized children. A total of 28 studies were included, with 23 independent samples and 332 effect sizes, representing the data of 1931 children (M age = 11.10 years, SD = 2.36). Results showed a significant medium overall effect (d = 0.55, t = 2.478, p = 0.014), indicating CBTT with caregiver involvement was effective in treating PTSD (d = 0.70), with somewhat smaller effect sizes for internalizing, externalizing, social, cognitive and total problems (0.35 < d > 0.48). The positive treatment effect was robust; we found somewhat smaller effect sizes at follow-up (d = 0.49) compared to post-test (d = 0.57) assessments. Furthermore, several sample (i.e. child's age, gender, and trauma event), programme (i.e. the duration of treatment, number of sessions), study (i.e. control condition, type of instrument, informant, type of sample), and publication (i.e. publication year and impact factor) characteristics moderated the treatment outcomes of the child. In sum, the results of our meta-analysis might help to improve the effectiveness of cognitive behavioural trauma treatment for youth with PTSD, and guide the development of innovative trauma interventions that involve caregivers. Implications for theory and practice are discussed., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Available research emphasizes the importance of getting a systematic overview of inpatient aggression in forensic psychiatric care. However, the same research does not focus on how systematic aggression registration should be introduced in clinical practice. To facilitate the use of systematic aggression registration instruments, it is very relevant to gain insight into the perspective of staff members on the introduction of these instruments in daily clinical practice. Additionally, preconditions for achieving a successful implementation can be considered. Therefore, this study aims to gain insight into the perspective of the staff members on the implementation of a systematic aggression registration instrument-that is, the MOAS-in a forensic psychiatric unit. Interviews ( n  = 8) and a focus group with staff members were carried out. Three main themes: (1) creating the most appropriate context for introduction, (2) choice for the MOAS as relevant instrument, and (3) perpetuating the use of the MOAS in clinical practice are scrutinized. The mentioned preconditions can be used as guidelines when implementing systematic aggression registration in clinical practice. We hope that this paper can inspire other forensic psychiatric facilities to introduce systematic registration of aggressive incidents., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In recent years, a growing trend to consider strengths and protective factors in studies on desistance from crime has emerged. The present study explores three formerly detained adolescents' narratives, aiming to tease out how Quality of Life (QoL) and desistance interact in pathways towards a "better life." The narratives suggest that the journey towards a better life is highly individual, and may unfold via multiple pathways characterized by an ambivalent relationship between QoL and desistance. Alongside the importance of individual aspects and social support, societal barriers and opportunities play a significant role in creating new chances to re-build a life and prosocial identities. This reflects earlier findings that desistance is not an individual responsibility. It is essential to support young people to overcome societal barriers that impede participation in society and living a good life. This research adds to growing evidence of strengths-based approaches to rehabilitation, such as the Good Lives Model (GLM).

Charcoal and micro-layers of soot trapped in speleothems from the inner galleries of Nerja Cave were analysed through an interdisciplinary study. The absolute dating of the prehistoric subterranean activity of the cave and the identification of different phases of visits to the deep parts are presented and discussed. The charcoal analysis includes anthracological analysis and SEM-EDX. The soot analysis includes optical microscopy, Raman spectroscopy and TEM-EDX, and the microcounting of soot microlayers. The 14 C dating of 53 charcoals identified 12 phases of prehistoric visits to the cave between 41,218 and 3299 cal. BP, putting back the origin of human occupation of this emblematic cave by 10,000 years. The interdisciplinary analysis of the soot microlayers allowed us to perform a high-precision zoom on the last three visitation phases identified by Bayesian analysis (8003-2998 cal. BP.), demonstrating that these phases contain at least 64 distinct incursions, with an average of one visit every 35 years for the Neolithic period. Spatial analysis showed that not all areas of the cave were used in the same periods, highlighting the repetition of visits to certain specific sectors of the Lower Galleries of the cave. Lastly, the anthracological data indicate a cross-cultural and unique use of Pinus tp. sylvestris-nigra wood for lighting activities over an extended period between the Gravettian and Upper Magdalenian., (© 2023. The Author(s).)

Background: The recovery processes of persons with complex mental health needs take a slow and unpredictable course. Despite the fact that a number of essential building blocks of recovery in this population have been identified (e.g. social relationships, treatment, personal beliefs), the actual process of recovery in persons with complex mental health needs largely remains a black box. The aim of this study was to gain insight into how the recovery processes of persons with complex mental health needs take place, by applying a relational geographical approach and scrutinizing the place-making dynamics of one low-threshold meeting place in Belgium engaging with this group., Methods: Data collection took place during the height of the COVID-19 pandemic by means of 11 in-depth interviews with different involved actors (service users, staff members, volunteers) and analyzed thematically., Results: Results showed how the daily practice of the meeting place is continuously reproduced through place-making rituals that create an inclusive space of hospitality, are fueled by creative processes and form an indispensable counterweight for service users' mental health needs., Conclusions: To further open up the 'black box' of recovery in persons with complex mental health needs, it is vital to focus our analytic gaze onto recovery as a dynamic and relational practice., (© 2022. The Author(s).)

Determining the extent of overlap between modern humans and other hominins in Eurasia, such as Neanderthals and Denisovans, is fundamental to understanding the nature of their interactions and what led to the disappearance of archaic hominins. Apart from a possible sporadic pulse recorded in Greece during the Middle Pleistocene, the first settlements of modern humans in Europe have been constrained to ~45,000 to 43,000 years ago. Here, we report hominin fossils from Grotte Mandrin in France that reveal the earliest known presence of modern humans in Europe between 56,800 and 51,700 years ago. This early modern human incursion in the Rhône Valley is associated with technologies unknown in any industry of that age outside Africa or the Levant. Mandrin documents the first alternating occupation of Neanderthals and modern humans, with a modern human fossil and associated Neronian lithic industry found stratigraphically between layers containing Neanderthal remains associated with Mousterian industries.

The impact of food taboos-often because of religion-is understudied. In Ethiopia, religious fasting by Orthodox Christians is assumed to be an important impediment for the sustainable development of a competitive dairy sector and desired higher milk consumption, especially by children. However, evidence is limited. Relying on unique data, we shed light on three major issues. First, we observe that the average annual number of fasting days that Orthodox adults are effectively adhering to is 140, less than commonly cited averages. Using this as an estimate for extrapolation, fasting is estimated to reduce annual dairy consumption by approximately 12 percent nationally. Second, farms adapt to declining milk demand during fasting by increased processing of milk into storable products-fasting contributes to larger price swings for these products. We further note continued sales of milk by non-remote farmers and reduced production-by adjusting lactation times for dairy animals-for remote farmers. Third, fasting is mostly associated with increased milk consumption by the children of dairy farmers, seemingly because of excess milk availability during fasting periods. Our results suggest that fasting habits are not a major explanation for the observed poor performance of Ethiopia's dairy sector nor low milk consumption by children. To reduce the impact of fasting on the dairy sector in Ethiopia further, investment is called for in improved milk processing, storage, and infrastructure facilities., Competing Interests: The authors have declared that no competing interests exist.

Detained female adolescents constitute a vulnerable, challenging, and understudied minority. Interventions for DFA are still dominated by risk management approaches with less focus on strength-based approaches such as the Good Lives Model (GLM). This study explored the functionality of DFA's behaviour prior to and four years after release from detention, using the GLM as the guiding theoretical framework. A theory-driven thematic analysis was conducted of 30 in-depth interviews with former DFA ( M age = 20.80), exploring the fulfilment of their basic human needs (e.g., relatedness, independence) before and after detention. Before detention, the young women experienced multiple problems trying to fulfil multiple human needs, often contributing to poor balance in their lives and their antisocial behaviour. Although external and internal obstacles to fulfilling human needs were still present at follow-up, important improvements were noted, e.g., in the scope of their human needs and the resources available to fulfil their needs. The findings provide additional insights into the issues experienced by young women in detention and indicate there are opportunities to assist these young women, through the development of appropriate resources and capacities which provide them with appropriate means for fulfilling their needs and moving towards a personally meaningful and prosocial life.

Background: In accordance with recommendations from The United Nations' Chief Executives Board of Coordination, several countries are in the process of reforming their punitive drug policies towards health-based approaches - from punishment to help. The Portuguese model of decriminalisation is generally seen as a good model for other countries and has been scientifically described in favourable terms, and not much scrutinised., Method: This article draws on foucauldian archaeological and genealogical approaches in order to understand and compare governance logics of the 19th century Norwegian sobriety boards and 21st century Portuguese commissions. In doing this, we problematize contemporary drug policy reform discussions that point to the "Portuguese model", which aims to stop punishing and start helping drug-dependent people, are problematised., Findings: The Portuguese commissions investigate whether drug-using people are dependent or not. Dependency, circumstances of consumption and their economy are considered when the commission decides on penalising, assisting, or treating the person, or a combination of all this. This model was studied alongside the Norwegian sobriety boards mandated by the Sobriety Act that was implemented in 1932. Sobriety boards governed poor alcoholics. Authorities from the sobriety movement were central in creating sobriety policies that culminated in sobriety boards. The Portuguese commissions have similarities to Norwegian sobriety boards. They make use of sanctions and treatment to govern people who use illicit substances to make them abstain, with the view that this is emancipatory for these people. The different apparatuses have distinct and different ways of making up, and governing their subjects., Conclusion: This article contributes to debates on drug policy reforms and aims to investigate whether they might produce biopower effects of governance masked by an emancipatory language. There is a need for critical studies on drug policy reforms to avoid policies that maintain divisions and control marginalised populations., Competing Interests: Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)