So, You Think You Know What an Architect Does

An architect is a licensed professional who organizes space. The art world may define space differently than the scientific world (where does space begin?), but the architecture profession has always been a combination of art and science. Architects design houses, office buildings, skyscrapers, landscapes, ships, and even entire cities. The services offered by a licensed architect depend on the type of project being developed. Complicated commercial projects are accomplished with a team of architects. Sole proprietor architects—especially architects just starting out on their own—will specialize and experiment with smaller, residential projects. For example, before Shigeru Ban won the coveted Pritzker Architecture Prize in 2014, he spent the 1990s designing houses for wealthy Japanese patrons. Architectural fees are based on the complexity of the project and, for custom homes, may range from 10% to 12% of the total construction costs. Space Design Architects organize different types of spaces. For example, architect Maya Lin is known for sculpted landscapes and the Vietnam Veterans Memorial Wall, but she has also designed houses. Likewise, Japanese architect Sou Fujimoto has designed houses in addition to the 2013 Serpentine Pavilion in London. Large spaces, like cities and entire neighborhoods within cities, are also designed by architects. In the early 20th century, Daniel H. Burnham created several urban plans, including for Chicago. In the early 21st century, architect Daniel Libeskind created what is called the master plan for redeveloping the World Trade Center area. Professional Responsibilities Like most professionals, architects also take on other duties and special projects. Many architects teach at colleges and universities. Architects organize and run their professional organizations, like the American Institute of Architects (AIA) and the Royal Institute of British Architects (RIBA). Architects have also taken the lead in stopping climate change and global warming, moving toward the goal of new buildings, developments, and major renovations being carbon-neutral by the year 2030. Both the AIA and the work of Edward Mazria, founder of Architecture  2030, work toward this goal. What Do Architects Do? Architects design and plan spaces (structures and cities), with consideration for looks (aesthetics), safety and accessibility, functionality for the client, cost, and specifying (the specs) construction materials and processes that do not destroy the environment. They manage the building project (large projects will have both a design architect and a project manager architect), and most importantly they communicate ideas. The architects role is to turn ideas (a mental activity) into reality (the built environment). Examining the sketch history behind a structure often indicates the difficulty in communicating design ideas. A complex building like the Sydney Opera House began with an idea and a sketch. The Statue of Liberty sat in pieces in a local park before Richard Morris Hunts pedestal design was realized. Communicating architectural ideas is an important part of an architects job—Maya Lins Entry Number 1026 for the Vietnam Memorial wall was a mystery to some of the judges; Michael Arads competition entry for the National 9/11 Memorial was able to communicate a vision to the judges. A licensed architect is the only designer who can rightfully be called an architect. As a professional, the architect is ethically bound by codes of conduct and should be trusted to abide by all rules and regulations associated with a building project. Throughout their careers, architects participate in continuing education and professional development, similar to medical doctors and licensed attorneys. And You Call Yourself an Architect? Only licensed architects should call themselves architects. Architecture was not always a licensed profession. Any educated person could take on the role. Todays architects have completed university programs and lengthy internships. Like doctors and lawyers, architects must pass a series of rigorous exams in order be licensed. In North America, the initials RA designate a registered, or licensed, architect. When you hire a designer, know what the letters after your architects name mean. Kinds of Architects Architects are trained and specialize in many areas, from historic preservation to structural engineering and from computer programming to environmental biology. This training can lead to a wide variety of careers. Many opportunities are available to the college graduate with a major in architecture. An information architect is a person who plans the flow of information on Web pages. This use of the word architect is not related to building design or what is known as the built environment, although computer-aided design and 3D printing may be specialties within the field of architecture. Architects often design buildings, but a Building Designer is not usually a licensed architect. Historically, architects are chief carpenters. The word architect comes from the Greek word architekton meaning chief (archi-) carpenter or builder (tekton). We often use the word architect to describe the artists and engineers who designed historic buildings or iconic towers and domes. However, it was only in the twentieth century that architects were required to pass tests and be licensed. Today, the word architect refers to a licensed professional. Landscape architects often work closely with a buildings architects. Landscape architects analyze, plan, design, manage, and nurture the built and natural environments, according to their professional organization, The American Society of Landscape Architects (ASLA). Landscape architects have a different educational tract and licensing requirements than other registered architects of the built environment. Other Definitions of Architect Architects are licensed professionals trained in the art and science of the design and construction of buildings and structures that primarily provide shelter. Additionally, architects may be involved with designing the total built environment—from how a building integrates with its surrounding landscape to architectural or construction details that involve the interior of the building to designing and creating furniture to be used in a specific space.—National Council of Architectural Registration Boards (NCARB) The most basic definition of an architect is a professional who is qualified to design and provide advice—both aesthetic and technical—on built objects in our public and private landscapes. But this definition barely scratches the surface of an architects role. Architects serve as trusted advisors, their role is holistic, blending diverse requirements and disciplines in a creative process, while serving the public interest and addressing health and safety matters.—Royal Architectural Institute of Canada (RAIC) Sources: Commercial Architectural Fees at architecturalfees.com; Becoming an Architect, National Council of Architectural Registration Boards (NCARB); What is an Architect, Architecture Architects, Royal Architectural Institute of Canada (RAIC); About Landscape Architecture, The American Society of Landscape Architects [accessed September 26, 2016]

History of Capital Punishment Essay - 997 Words

History of Capital Punishment In the history of the world, the punishment for murder, or homicide, has generally been â€Å"the death penalty†. This seems to be the most logical punishment. If someone intentionally kills an innocent human being, why should he be able to live? Or should he? Should he be forced to suffer for the remainder of his life for this terrible crime? There are many arguments and opinions on this topic; many reasons why we should sentence murderers to death, but many reasons we should not. One main reason we should not sentence these people to death is the cost. It simply costs too much to put people on death row. A gentleman in Texas quoted estimates in two counties near his home. They both estimated the†¦show more content†¦(Duke University, May 1993/ www.essential.ura.ldpic) The cost in California is $90 million annually. The State of Florida has spent an estimated $57 million on the death penalty from 1973-1988 to achieve only 18 executions. This is an average of $3.2 million per execution. (www.essentialorg.ldpic). In Indiana, $2 million has been spent for only defense costs. (www. Esseneial.org). The problem with spending so much money on this is when the county needs things for different areas such as roadway improvements, educational improvements, there is no money because it was all used on some psychopath who killed an innocent person. One example of this is in Washington, employee pay increases were placed on hold, its $300,000 contigency fund was depleted, and all capital improvements were placed on hold because all funds had been used on capital punishment trials. Sometimes, we sentence people to death row for killing someone, they get sick, and we spend more money for medical treatment. This was also a case in Washington: Mitchell Rope was sentenced to death for murder, and after budgeting $346,000 for his3rd death sentence, money was being spent to treat his liver disease. Much money was being spent to fix his medical problem, then, he was to be executed. Many attorneys are now asking for a death sentence to be post-pone until adequate funding for attorney’s fees are available. InShow MoreRelatedThe History of Capital Punishment1239 Words   |  5 Pagesstatements, and there was no DNA evidence or murder weapon found (Pilkington). How can a man’s life be taken in such an unfair and cruel way? The world should make capital punishment illegal, recognizing it as a moral and ethical mistake, a cruel and misguided injustice, and an impractical and wasteful act. Capital punishment has a complicated history, both worldwide and particularly in the United States. Due to the efforts of human rights groups and evolutions in society, the world has many fewer executionsRead MoreHistory of Capital Punishment in America779 Words   |  3 PagesCapital Punishment, the process by which the government takes the life of an offender for crimes committed against humanity. Capital Punishment also referred to as the â€Å"death penalty† has played a role in the correctional process dating back to 1608 in Jamestown. Over the years the use of Capital Punishment has fluctuated. Like most areas of corrections the death penalty has become reformed and altered to needs of modern day society. Like most controversial issues the majority of people haveRead More The History of Capital Punishment Essay2004 Words   |  9 PagesThe History of Capital Punishment   Ã‚  Ã‚  Ã‚  Ã‚  Crime has been a plague on society from ancient times to present. In response to this plague, society has formed structured rules to deal with the perpetrators of crime. A crime can be defined as act that society’s government deems as illegal. Different societies have formed various methods and standards for evaluating crime and assigning corresponding punishment. What constitutes a crime has changed throughout the course of history. In ancient timesRead MoreHistory of THe Capital Punishment Essay714 Words   |  3 PagesThe capital punishment, known as the death penalty has been a widely debated topic in America over its constitutionality after being reinstated in 1976. There are two distinct sides in the debate over whether the death penalty is an unjust punishment. The debate spreads over to whether mentally ill and juveniles should be tried as adults and receive the death penalty or if their mental capacity restrains the government from issuing the punishment. Not only that, but the methods used to administerRead More The History and Public Opinion of Capital Punishment Essay4449 Words   |  18 PagesThe History and Public Opinion of Capital Punishment The history of the death penalty goes back to the earliest civilizations where it was used to punish all sorts of crimes from robbery, to murder, to different forms of heresy. In the United States it evolved to just punish murder, treason, and some cases of rape. It has been an issue that has sparked a never ending debate that goes back to colonial times. The general public traditionally supported the death penalty in a majorityRead MoreThe History of Capital Punishment as a Deterrent to Crime Essay2614 Words   |  11 Pagesconcerning capital punishment, or the death penalty. Through the passing of time, our society castigates transgressors with the death penalty. Many nations through time have decided to enact this harsh treatment. In the United States alone, the federal government has persevered to reinforce people to death (Marzillo 10). According to Wikipedia Encyclopedia, â€Å"Capital Punishment is the execution of a person by judicial process as a punishment for an off ense.† Over the centuries capital punishment has beenRead MoreThe Effects Of Capital Punishment On Society1516 Words   |  7 Pages Capital Punishment Tyra L. Ferguson SYP4514: Patterns of Violence in Society University of Central Florida Introduction Capital punishment was first noted in America in the early 1600’s (â€Å"Part I: History of†, 2014). Much like most of the laws in America, capital punishment was brought here and influenced by European settlers (â€Å"Part I: History of†, 2014). Many crimes that were punishable by death in its infancy in America ranged from stealing fruit to murder. Capital punishmentRead MoreBureau Of Justice Statistics : The United States Primary Source For Criminal Justice1439 Words   |  6 PagesCapital Punishment. Bureau of Justice Statistics (BJS). U.S. Department of Justice. 25 Nov. 2014. Web. Web. 25 Nov. 2014. Bureau of Justice Statistics is the United States primary source for criminal justice statistics. The website has published information on crime, criminal offenders, victims of crime, and the operation of justice systems at all levels of government. According to Bureau of Justice Statistics, â€Å"The Bureau of Justice Statistics (BJS) is a component of the OfficeRead MoreThe Death Penalty Throughout History1074 Words   |  5 Pagesdevelopment of the death penalty throughout history. It begins with a brief explanation of the origins of capital punishment, referencing the first known documentation of actions punishable by death. The paper goes on to explore different methods of execution and how they have progressed and changed over the years. Documented cases at different points of history are referenced to show the relationship of time periods and beliefs to the implementation of capital punishment. Finally, the development of differentRead MoreThe Death Penalt y Of Capital Punishment1480 Words   |  6 Pagessystem, such as the death penalty. Capital punishment has been used many times in history all around the world, and it was quite popular. Many people argue that capital punishment is useful in deterring crime and that it is only fair that criminals receive death as punishment for a heinous crime. On the contrary, others see the death penalty as a violation of the 8th amendment. It restricts excessive fines, and it also does not allow cruel and unusual punishment to be inflicted upon criminals. Although

Alzheimer s Disease A Common Neurodegenerative Disease

Alzheimer’s disease is a common neurodegenerative disease. It is the most common form of dementia which is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life (Alzheimer’s Disease Dementia). Dementia and Alzheimer’s have been around for centuries, but Alzheimer’s disease wasn’t first described until 1906 by Dr. Aloysius Alzheimer. In the past, there was a stigma for elderly people with the disease. People with dementia and Alzheimer’s were seen as a burden on society. Society has only recently accepted and cared for people with the disorder because more information is known about the disease. There wasn’t much treatment in the past accept for locking those away in institutions or just being kept hidden by family members (Batsch). There are now treatments and research being done for dementia and Alzheimer’s, but no cure remains and many individuals still suffer from the dis ease. Future treatments for the disease include taking aim at significant aspects of the disease like fighting beta-amyloid plaques, recruiting the immune system, reducing brain cell inflammation, and studying the heart-head connection (Alzheimer’s Treatments: What’s on the Horizon?). There are other ways to possibly treat the disease in the future as well. Hopefully from looking at the history of the disease, how the disease affects the brain and body, and future treatments, Alzheimer’s disease and dementia will be a thing of the past. In the past,Show MoreRelatedAlzheimers Disease1334 Words   |  6 PagesAlzheimer’s Disease Brittany Mathis HCS/245 July 14,2013 Tynan Weed Abstract Alzheimer’s has many causes and affects each patient differently. There have been studies done that have found that older African American’s are more likely to develop Alzheimer’s than older whites. A cause of Alzheimer’s has not been completely identified yet, but genetic and environmental factors are known to increase the risk. While we all know that Alzheimer’s is a complicated disease there areRead MoreAlzheimer s Disease Is The Most Significant Risk Factor1074 Words   |  5 PagesAlzheimer s Disease Abstract Alzheimer’s disease currently represents the second leading cause of death in people older than 65 years residing in the modern world. (1) Census records attest to this assertion, which has prompted medical researchers to further investigate the etiology and course of development of the disease in order to better treat the debilitating condition. This paper investigates how Alzheimer’s entered the medical lexicon and how its definition has shifted over the past centuryRead MoreThe Disease Of Alzheimer s Disease Essay1482 Words   |  6 PagesAlzheimer’s disease is a degenerative brain disease that is seen in the elderly. It is the most common form of dementia, which is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life (Alzheimer’s Disease Dementia). Alzheimer’s is one of the leading causes of death in America. Dementia and Alzheimer’s have been around for centuries, but Alzheimerâ₠¬â„¢s disease wasn’t first described until 1906 by Dr. Aloysius Alzheimer. In the past, there was aRead MoreGenetic Interaction Between Lsd1 And Hyperphosphorylated Tau1470 Words   |  6 PagesInvestigating a Genetic Interaction Between LSD1 and Hyperphosphorylated Tau in a P301S Mouse Model Background Alzheimer’s disease is the most common form of dementia and is characterized by the degeneration and death of brain cells that causes a loss of mental function. Although neuronal loss is not considered a normal part of aging, age is a significant risk factor for Alzheimer’s disease (AD) (Lindsay et al., 2002). Hallmarks of AD include tau tangles and Amyloid-ÃŽ ² plaques, whose interaction is thoughtRead MoreHealth Care and Stage Dementia Support Essay example1302 Words   |  6 Pagesaffect individual ¡Ã‚ ¯s ability to work and therefore they are not able to complete the tasks. In an aetiology view, dementia is commonly caused by advanced age, family history, neurodegenerative conditions and vascular. (Brown Edwards, 2005) Neurodegenerative conditions are those diseases of the brain such as infectious diseases tend to strike people in very old age. (Brown Edward, 2005) Up to now, the most common type of neurodegenerative diseases is known as Alzheimer ¡Ã‚ ¯s dise ase. (Stewart, PrinceRead MoreAlzheimer s And Alzheimer Dementia991 Words   |  4 PagesSome alternate names for Alzeheimer s include Alzheimer dementia (AD), Alzheimer dementiia, syndrome, and sclerosis. The name of the disease was chosen after Dr. Aloysius Alzheimer was credited with discovering the first case of presenile dementia. This would later be called Alzheimer s disease in honor of Dr. Alzheimer s discovery. In the year of 1901, Dr. Alzheimer was studying a 51-year-old patient named Auguste Deter. The patient was suffering from strage behavioral patterns of symptoms. OneRead MoreAlzheimer s Disease : A Progressive Disease925 Words   |  4 PagesAlzheimer s disease is a progressive disease that destroys memory and other vital mental functions. Alzheimer s disease is the most common cause of dementia, a group of brain disorders that cause the loss of intellectual and social skills. AD can eventually render a person unable to function in society and to even care for them selves. Since the disease is the 6th leading cause of death in the United States constant research is being done to try to prevent it and to find a cure. 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Alzheimer’s disease (AD) is one of the most well-known and familiar diseases in the modern societies AD was first reported by Alois Alzheimer in 1907.The AD is the most common type of dementia and a neurodegenerative disease characterized by the damage of nerve cells in theRead MoreAlzheimer s Disease And Disease935 Words   |  4 Pageswith Alzheimer’s disease. This disease is commonly found in the elderly. This explains why people assume older people have a bad memory. Alzheimer’s does not occur in a short period of time, it typically takes months to develop. It involves gradual memory loss due to two specific protein fragments that spread to different parts of the brain killing brain cells as they go. As mentioned in the article Alzheimer’s Disease Fact Sheet (2015), Dr. Alois Alzheime r first discovered the disease by noticing something

Learning Disability and Challenging Behaviour

Question: Discuss about the Learning Disability and Challenging Behaviour. Answer: Introduction: Challenging Behavior is the reoccurrence of outbursts for duration of time that the physical safety of the person or others is placed in serious danger and what the person is capable of is unpredictable (Emmerson, 2009). Challenging behavior is Aggression towards others or themselves such as Self-injurious behavior, Property destruction, non-compliant behavior, socially inappropriate behavior (Emmerson, 2009). My first four weeks of clinical placement was in a challenging behavior unit. There was eight clients with moderate intellectual disabilities and two those were is living independently with supervision and minimal assistance I am going to focus this assignment on a woman in this unit named as Katie this name is fictional due to privacy and confidentiality (Chandler and Dahlquist 2014). Katie is a 58 year old woman who has been in this service since the age of 16 she has mild to moderate intellectual disability she also has personality disorder on my first day of placement on the unit Katie was screaming and shouting at staff and was very aggressive there was other residents present and I noticed they were scared and shook so I decided to ask them to come with me to a quite side of the unit till the nurse in charge tried to deescalated the situation and to ensure their safety I brought them to a quite visitors room and reassured them everything was fine and we will go back up for breakfast shortly (Bromley and Emerson 2015). I informed the care staff where we were just in case they needed to get to us quickly I felt a little useless but I done what I thought I was capable of doing at the time as I did not know Katie and the regular staff did I thought I will leave the staff to deal with it as they should know how to calm her down (Holden and Gitlesen 2010). Behavior management is crucial when dealing with people with behaviors that challenge this refers to a set of techniques that are used to manage behaviors that challenge (CudrMauroux, A. 2009).These techniques are usually based on the topography of the behavior for example what the behavior looks like or the physical manifestation of the behavior (Grey, McClean and Barnes-Holmes 2012). On this placement I learned how nurses and care staff intervene. I observed Katie as my weeks here progressed she would scream, cry, and bang on the window attempt to strike at staff and clients around her. I had a discussion with my preceptor about management and nursing interventions for Katie. I was made aware of the incident and prevention plan in place for her. This plan was to identify the specific behavior, setting goals, being aware of early warning signs, triggers, preventative strategies, environmental accommodation. In the event of an early warning sign for example when Katie is observed to begun to be disruptive and raise her voice the response is usually supportive that is speaking to her in a low tone, reassuring her. In the event of an escalation for example when she starts screaming the response is to redirect them to her bedroom room to lie down (Holden and Gitlesen 2013). Reassurance is offered if the behavior continues PRN medication such as diazepam will be given to relax and calm her down and to control the situation and to ensure Katie dose not harm herself or others . It is vital to record the time a client has an episode of behavior that challenge to see a pattern. On my placement we use ABC recording forms: A (antecedent): where did the incident occur. B (Behavior) describes the behavior we observed and C (consequence) how did staff and others react to the behavior (Ager and OMay 2011). We also used scatter plot recording forms to describe the physical aggression we observed for example was the person crying, kicking, punching, screaming, throwing objects please find copy of both forms attached (Hastings, Remington and Hopper 2012). When a person has an episode of behavior that challenges this may mean they are in pain or distress. As nurses we must get to know clients and understand each ones communication style via their facial expressions and hand gestures. Here on my placement the staff understood the clients very well this is crucial in all their daily needs and nursing interventions (Lowe et al. 2014). Causes of Challenging Behaviors individuals with intellectual disabilities have a very high chance of also haven difficulties with behaviors that challenge and this can lead to them feeling sad after their outburst the Effects of Challenging Behavior on an individual is Danger to their self and others. It also upsets other residents and can leave the person alone and in Social isolation and impact on their social, domestic and/or employment opportunities. Individuals with intellectual disabilities will also have other health conditions and this may also impact on their behavior (Moss et al. 2010). According to Arnautovska (2016) Assessment and recording clients who are aggressive and who suffer from multiple behavior problems require a careful assessment for management of the behavior and for the safety of the client, staff and other service users a person who bites, punches, and throws objects requires an assessment called an ABC chart us as nurses must record all to ensure good communication between all staff and that all staff are aware of the clients status when they arrive on duty (Bateman and Fonagy 2012). The ABC chart records what exactly was the clients behavior like what were they doing and what intervention was put in place to reduce the frequency of the behavior. Other forms of assessment must be carried out to see is the client in pain is this why they are haven behavioral issues people with intellectual disabilities may not be capable of describing discomfort and pain (Feeley and Jones 2011). A complete mental status examination is required to exclude depression, mania, psychosis, anxiety, or delirium. Nurses should do a complete review of all medications and assess routine functions such as frequency of bowel movement, oral intake, and ensure best outcomes and interventions are put in place to enhance and improve the quality of life for the client. As a nurse it is a duty to ensure we provide the best care for our clients (Arnautovska 2016). Reference List Ager, A. and OMay, F., 2011. Issues in the definition and implementation of best practice for staff delivery of interventions for challenging behaviour. Journal of Intellectual and Developmental Disability, 26(3), pp.243-256. Arnautovska, U., Robleda, S., Jackson, J. and Pachana, N.A. (2016) the knowledge and skills assessment (KASA) tool in the Australian dementia behavior management advisory service: Development and initial testing, International Psychogeriatrics, 28(05), pp. 833 844. Bateman, A. and Fonagy, P., 2012. Psychotherapy for borderline personality disorder. Oxford: Oxford University Press. Bromley, J. and Emerson, E., 2015. Beliefs and emotional reactions of care staff working with people with challenging behaviour. Journal of Intellectual Disability Research, 39(4), pp.341-352. Chandler, L.K. and Dahlquist, C.M., 2014. Functional assessment: Strategies to prevent and remediate challenging behavior in school settings. Pearson Higher Cudr-Mauroux, A. (2009) Staff attributions about challenging behaviors of people with intellectual disabilities and transactional stress process: A qualitative study, Journal of Intellectual Disability Research, 54(1), pp. 2639. Dunlap, G., Strain, P.S., Fox, L., Carta, J.J., Conroy, M., Smith, B.J., Kern, L., Hemmeter, M.L., Timm, M.A., McCart, A. and Sailor, W., 2006. Prevention and intervention with young children's challenging behavior: Perspectives regarding current knowledge. Behavioral Disorders, pp.29-45. Emerson, E. (2009) Challenging behavior: Analysis and intervention in people with severe intellectual disabilities. 2nd edn. Cambridge: Cambridge University Press (Virtual Publishing). Feeley, K. and Jones, E., 2011. Addressing challenging behaviour in children with Down syndrome: The use of applied behaviour analysis for assessment and intervention. Down Syndrome Research and Practice, 11(2), pp.64-77. Grey, I.M., McClean, B. and Barnes-Holmes, D., 2012. Staff attributions about the causes of challenging behaviours effects of longitudinal training in multi-element behaviour support. Journal of Intellectual Disabilities, 6(3), pp.297-312. Hastings, R.P., Remington, B. and Hopper, G.M., 2012. Experienced and inexperienced health care workers beliefs about challenging behaviours. Journal of Intellectual Disability Research, 39(6), pp.474-483. Holden, B. and Gitlesen, J.P., 2010. A total population study of challenging behaviour in the county of Hedmark, Norway: Prevalence, and risk markers. Research in developmental disabilities, 27(4), pp.456-465. Holden, B. and Gitlesen, J.P., 2013. Prevalence of psychiatric symptoms in adults with mental retardation and challenging behaviour. Research in developmental disabilities, 24(5), pp.323-332. Kaiser, B. and Rasminsky, J.S., 2007. Challenging behavior in young children. Boston, MA: Pearson. Lowe, K., Allen, D., Jones, E., Brophy, S., Moore, K. and James, W., 2014. Challenging behaviours: Prevalence and topographies. Journal of Intellectual Disability Research, 51(8), pp.625-636. Moss, S., Emerson, E., Kiernan, C., Turner, S., Hatton, C. and Alborz, A., 2010. Psychiatric symptoms in adults with learning disability and challenging behaviour. The British Journal of Psychiatry, 177(5), pp.452-456.