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Research and anecdotal clinical work indicate that complex post-traumatic stress disorder (CPTSD) in families that have children and adults who have a learning disability and/or are autistic may be prevalent. This paper aims to provide a preliminary formulation of complex trauma in families.

This report is based on a review of clinical psychotherapeutic work with six families. The themes are derived from the assessment period through examining the assessment reports and clinical supervision notes for thematic patterns.

This report suggests that the prevalence of CPTSD in families of people who have a learning disability and/or are autistic needs to be researched across the family lifecycle and that there are specific factors that mediate complex trauma symptomatology.

CPTSD symptomatology in these families is inadequately conceptualised and this is one of the first papers suggesting this as a potentially helpful framework to consider the experiences of families.

This paper aims to evaluate the social validity of the Aberrant Behavior Checklist - Communit y (ABC-C).

Thirty-six participants completed a questionnaire in which they identified and commented on items of the ABC-C they saw as problematic. Thematic analysis was conducted on the comments made.

All participants identified at least one item of the ABC-C as problematic with six items being so identified by over half the participants. A number of themes were identified in participant comments including ambiguity, judgemental language, child-focussed language, lack of attention to behavioural function and repetition.

More research is required using empirically based methodologies on measures used to assess people with learning disabilities. This should involve ascertaining the social validity of such measures by soliciting the views of both those being assessed and those assessing.

This study is the first of its kind to evaluate the social validity of one of the most widely used measures of challenging behaviour for people with learning disabilities.

Care pathways are being increasingly used in the national health service to outline an anticipated programme of care in relation to a particular illness, condition or set of symptoms. The purpose of this paper is to inform those using the service of what they might expect within what time frame. They are designed to reduce variation in practice and allow optimal quality of care across a variety of care settings. Care pathways map out a patient’s journey, providing coordination of services for users. They aim to have: “the right people, doing the right things, in the right order, at the right time, in the right place, with the right outcome”.

This paper outlines care pathways in relation to people with intellectual disabilities who present with behaviour that challenges.

It is likely that many people will have a lifelong need for support, so discharge from clinical services should only be considered if it is genuinely appropriate. Reductions in a person’s behaviours that challenge are likely to be a consequence of changes that have been made to the person’s environment and supports. Therefore, any reductions in the level or type of support that the person receives may lead to an escalation of the behaviour again.

Standards in relation to care pathways are presented.

There is an established literature supporting the idea that families who have children and adults who have a learning disability and/or autism have a greater vulnerability to mental health problems or poor psychological health. There are shortcomings in this literature in that there is a little consideration of the impact the families interaction with services has on their well-being. It is argued that complex post-traumatic stress disorder (CPTSD), with its focus on prolonged chronic exposure to trauma experiences and the recognition that this can occur in adulthood, may well be an appropriate framework to enable a better understanding of the experiences of families.

A total of 214 family members completed a co-produced online survey in relation to potential traumatic events, impacts and support.

The experiences of family carers of children and adults with a learning disability and/or who are autistic would appear to be multi-layered and complex, with many experiencing a wide range of traumatic events with the associated emotional and personal sequela. The reported responses are consistent with CPTSD with 10% of having received a diagnosis of PTSD. Their experience was that the system failed not only to provide support but also created additional trauma.

A trauma-informed approach needs to be adopted by agencies and professionals that serve families to ensure they understand their potential contribution to the trauma families experience.

To the best of the authors’ knowledge, this is the first study that has attempted to examine the experience of families using the framework of CPTSD.

Computer projects in Warwickshire County Library from 1974 led to separate system development for cataloguing, ordering and circulation. Problems with both the reliability and increasing costs of the circulation system led to a major evaluation of integrated library systems. CLSI LIBS100 system based on DEC PDP mini computers was selected and implementation began in November 1985. The paper describes the stages in selecting the CLSI system as well as the problems faced in converting diverse existing computer‐based systems to an integrated system.

Recent developments in neuroscience have generated great expectations in the education world globally. However, building a bridge between brain science and education has been hard. Educational researchers and practitioners more often than not hold unrealistic images of neuroscience, some naively positive and others blindly negative. Neuroscientist looking at how the brain reacts and changes during mental tasks involving reading or mathematics usually discuss education as some constant and undifferentiated “social environment” of the brain, either assuming it to be a “black box” or evoking an image of perfect schooling and full access to it. In this review, we claim that a more productive and realistic relationship between neuroscience and the comparative study of education can be thought about in terms of the hypothesis that formal education is having a significant role in the cognitive and neurological development of human populations around the world. We review research that supports this hypothesis and implications for future studies.

Understanding of the effects of formal education on HIV/AIDS infection in South Saharan Africa (SSA) has been a complex task because consecutive waves of research offer different, seemingly contradictory results and explanations of what exactly are the schooling effects on HIV/AIDS and the causal mechanisms driving those effects. This chapter concentrates on the narrative and implications of the key substantive findings from a multidisciplinary scientific team that was formed to explore the precise nature of the relationship between population education and the HIV/AIDS pandemic in SSA and to determine the main causal mechanisms behind the association. As members of this team, this chapter reviews and synthesizes our technical demographic, epidemiological, and health research. This, and other relevant research, suggests that, like in other cases of education and health risk, because of a historical change in the public health and information environment during the pandemic there was a shift in which outcomes of education dominated individual's sexual and disease prevention behavior. The SSA HIV/AIDS case is thoroughly examined, and then used to bridge to a general discussion of the effects of educational development on population health.

This chapter attempts to answer some of the questions raised in this volume, in particular: (1) provide a concise but precise definition of multi-level governance; (2) prove that it is a theoretical and not just a descriptive concept and (3) dispel some of the misconceptions associated with it, for example, that (a) multi-level governance underplays and conceals the exercise of power or (b) it is incompatible with democracy.

The chapter is correspondingly organized in four sections, preceded and followed by short introductory and concluding sections. The four sections address, respectively: (1) the definition of multi-level governance (MLG) (‘Solving the dependent variable problem’); (2) the causes that explain the emergence and diffusion of MLG arrangements (‘The contextual causes of MLG’); (3) the changes that it triggers in the manner in which power is deployed (‘The institutional consequences of MLG’); (4) the democratic implications of the diffusion of MLG arrangements (‘Are MLG arrangements democratic?’).

The methodology employed is mainly that of ‘conceptual analysis’ (Sartori, 1984), which implies that the connotational features (those features which minimally allow us to identify cases of MLG) of the concept are identified so that we can delimit the denotational extension of the concept (the universe of phenomena which can be identified as cases of MLG). This chapter contains a highly abridged version of this conceptual analysis, which is fully developed in Piattoni (2010a).

MLG denotes a growing class of policymaking arrangements characterized by the simultaneous activation of governmental and non-governmental actors at various jurisdictional levels. These arrangements have identifiable contextual causes, even if the precise contours of MLG arrangements depend on the capacity of the actors to mobilize arguments and people on behalf of their specific ideas, values and interest. The precise shape that these arrangements will take, therefore, depends on the mobilization capacity of the actors (and on the capacity of other actors to contain or delimit such mobilization). The causes of mobilization are mainly contextual, having to do with the increased complexity and overload of state activities and with the growing request for direct involvement on the part of civil society organizations. Both these trends induce states to seek joint solutions to common problems, hence MLG dynamics occur on three axes: a centre-periphery axis, a state-society axis, and a national-international axis which challenge, respectively, the centrality, the distinctiveness and the sovereignty of the state.

This conceptualization of MLG allows us to analyse the extent to which different policymaking arrangements respond to MLG logics and to understand which actors and which levels are mostly responsible for the particular configuration that obtains. This conceptualization of MLG, although here deployed in a purely discursive manner, could enable us to ‘measure’ the degree of institutional and political empowerment of subjects, other than central state actors, in various policy realms.

The most important social implication is the impact that MLG arrangements have on how democratic decision-making occurs, on what we mean by democracy, and on the societal perception of how contemporary democracies work. The chapter argues that trying to apply to MLG arrangements democratic criteria and standards that were developed for the unitary, distinctive and sovereign state is misleading and that we must rather develop an updated notion of democracy appropriate for the interconnected, multi-level context in which we live. The concept of ‘transnational democracy’ is cursorily offered as a promising direction for further reflection.

The chapter is wholly based on the long-term work and reflection of the author on MLG and on the scholarly contributions of the other authors of the volume.