Premeditated assaults on young boys by a man with spina bifida and hydrocephalus--a cognitive-behavioural approach to treatment.

This paper describes the case of a 25-year-old man with spina bifida and hydrocephalus, who had at least a ten-year history of physically assaulting young boys. Anti-social behaviour is reported as comparatively rare in people with this disability, and the case study illustrates how psychological assessment and treatment techniques were successfully applied. Information from his personal history plus a functional analysis of the assaults suggested that a combination of existing psychological difficulties and learning experiences contributed to the development of his behaviour. A behavioural model of the psychological mechanisms underlying the behaviour was suggested and treatment objectives defined. Cognitive and behavioural treatment techniques were adapted where necessary, with a good outcome. A gap in services for physically handicapped people with behavioural problems is noted and briefly discussed.

1,25 dihydroxyvitamin D3 increases plasma magnesium and calcium in sheep fed liquid diets low in calcium and magnesium.

Sheep given a liquid diet low in calcium and magnesium by infusion directly into the abomasum developed concurrent hypocalcaemia and hypomagnesaemia, with plasma concentrations of calcium and magnesium decreasing to 2.0 and 0.4 mmol/l respectively. Treatment of these hypomagnesaemic sheep with 1,25 dihydroxyvitamin D3 (1,25(OH)2 D3) increased the plasma calcium, magnesium and phosphorus concentrations with plasma calcium increasing to 2.5 mmol/l and plasma magnesium to 0.6 mmol/l. Plasma magnesium increased despite a small but significant increase in the daily excretion of magnesium in the urine, and the amount of magnesium derived from either bone and/or intestine must have been greater than the amount lost in the urine. Since in other experiments we have demonstrated that plasma calcium remains within the normal range when a liquid diet adequate in magnesium but low in calcium is infused, these results imply that either synthesis of and/or end organ response to 1,25(OH2) D3 is impaired in magnesium deficient sheep.