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Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar.

This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured.

This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices.

This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.

Border environments differ as foci for conflict discourse. While classic realist theories are used to account for mechanisms of securitized borders, socially oriented theories are often invoked to characterize relaxed borders. This distinguishing pattern regarding securitization reflects a deeply rooted focus on idealized borders, based on implicit expectations that relaxed borders are a viable option and goal for all. This orientation is prone to mistaken assumptions regarding local, national and regional interests and ultimately threatens delicately balanced states of stability. This paper aims to question this somewhat simplified categorization and posit that securitized borders are longstanding realities which warrant more complex theoretical conceptualization.

The analysis is based on documentary study and qualitative field research, mapping and evaluating Israel–Jordan cross-border interactions conducted during 2006-2014. Local civilian interactions were studied using three tools: interviews, non-participant observations and a sector-based analysis of original and secondary sources. In the course of research, many tours and observations of the border region were conducted, and key actors in Israel and Jordan were interviewed: entrepreneurs, local residents, local and national government officials, security personnel and representatives of non-governmental organizations involved in the administration and funding of normalization-promoting initiatives.

In light of internal and external security threats which challenge states and border regions in conflict environments and in normalized settings, there is increasing value in recognizing multi-level power relations (“bringing the state back in”) that design, inhibit and ultimately control the inevitability, circumstance and social–political effectivity of any cross-border interaction. Cross-border cooperation (CBC), which evolves gradually, monitored by the border regime and reflecting actual levels of inter-state political dialogue, is a slower yet safer option and a more realistic expectation for CBC, especially in regions of minimal communication between cross-border neighbors. In the backdrop of the Middle East turmoil, Israel and Jordan mark 20 years of peaceful relations, enjoying stability based on shared political and security interests, yet displaying no apparent tendency toward increased cross-border interaction. Given the stark differences in regimes and ongoing regional unrest, this securitized border fulfills local and regional needs and is far from a temporary “second-best” reality.

The analysis is based on original fieldwork and documentary study, mapping and evaluating Israel–Jordan cross-border interactions conducted during 2006-2014.