Autistic doctors: leveraging insider perspectives to improve healthcare for autistic people

oai:openresearch.lsbu.ac.uk:99098Autistic people experience poor healthcare outcomes and reduced life expectancy compared to non-autistic people. Recognition that doctors can be autistic is recent. This thesis presents the first ever series of publications by openly autistic medical doctors, with the intention being to explore the experiences of autistic doctors, and to improve healthcare and quality of life for autistic people. Alongside four original research papers relating to autism, healthcare, and autistic healthcare providers, I present an educational framework which offers a potential solution to the problems identified in my research. Utilising our insider positioning as both autistic people and medical doctors, we leverage our knowledge and perspectives on medicine and medical education to pitch this Autistic SPACE framework to be as accessible as possible to non-specialist medical colleagues. • Doherty M, Neilson S, O’Sullivan J, Carravallah L, Johnson M, Cullen W, Shaw SCK. Barriers to healthcare and self-reported adverse outcomes for autistic adults: a cross-sectional study. BMJOpen. 2022;12:e056904. • Shaw SCK, Carravallah L, Johnson M, O’Sullivan J, Chown N, Neilson S, Doherty M. Barriers to healthcare and a ‘triple empathy problem’ may lead to adverse outcomes for autistic adults: a qualitative study. Autism. 2024;28(7):1746-57. • Doherty M, McCowan S, Shaw SCK. Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings. British Journal of Hospital Medicine. 2023;84(4):1-9. • Shaw SCK, Fossi A, Carravallah LA, Rabenstein K, Ross W, Doherty M. The experiences of autistic doctors: a cross-sectional study. Frontiers in Psychiatry. 2023;14:1160994 • Doherty M, Chown N, Martin N, Shaw SCK. Autistic psychiatrists’ experiences of recognising themselves and others as autistic: qualitative study. BJPsych Open. 2024;DOI: 10.1192/bjo.2024.756). The overarching goal of my work is to increase awareness of neurodiversity in medicine and improve healthcare provision and outcomes for autistic people

Social and Emotional Skills in at-Risk Adolescents through Participation in Sports

(1) Background: Adolescents who are under the care of child and youth institutions are vulnerable due to factors that can include disruption to family structure or education and adverse experiences. They often experience poor or unstable support systems, leaving them at risk of delinquency. In this context, sports engagement may provide a stable structure and have positive effects in this population. Therefore, the purpose of this study was to explore the perceptions, knowledge, beliefs, and behaviors regarding social and emotional skills among at-risk adolescents, with a specific focus on their engagement in sports. (2) Methods: Ninety-six adolescents aged 12 to 17 years (66 female, 30 male), residing in child and youth care institutions across Italy, Portugal, the UK, and Turkey, participated in this study. The participants were divided into 14 focus groups, each with six to eight participants of similar ages. (3) Results: Thematic analysis revealed four main themes: Emotional causes of behavioral problems; Emotional skills to regain control; Social support makes sports worthwhile; Sport as a socio-emotional resource. (4) Conclusions: The study findings highlight that although sports create many challenging emotional situations for these adolescents, they also provides resources that may help them cope with their emotions within and beyond sports

Change in vaping, smoking and dual use identities predicts quit success and cigarette usage: A prospective study of people quitting smoking with electronic cigarette support

OBJECTIVE: Electronic cigarettes (ECs) are an efficacious support for some but not all people wishing to stop using tobacco. While advice and practical support have been identified as increasing quit success, little research has explored the role of changes in smoking and EC-related social identities. METHODS: A prospective study following 573 people attempting to quit smoking with EC support. Self-report measures of identification with being a smoker, non-smoker, vaper, and dual user (people using ECs and tobacco products) were taken prior to the quit attempt and at a 12-week follow-up. RESULTS: Baseline identifications with being a smoker, non-smoker or dual user were not associated with smoking outcomes. Baseline vaper identity baseline was linked to more frequent tobacco abstinence at follow-up and lower levels of cigarette smoking. Levels of social identification at follow-up were consistently linked with outcomes, with vaper identity and non-smoking identities being protective, and dual user identity being related to lower abstinence rates but decreased tobacco usage. Changes in identity over time were the most consistent predictor of outcomes. CONCLUSIONS: Findings have implications for smoking cessation practice, informing how and when identity-based interventions may be effective and our understanding of how identity transitions occur

Work-life Balance in Architecture

This book examines work-life balance in architecture to enhance the lives and wellbeing of architects. It seeks to improve the work lives of architects of diverse demographics who do not fit, or want to replicate, the traditional white-male architect lifestyle of working a 24-7 work life. It is written to support changing work life for an assorted range of architectural students, educators and practitioners of different gender, race/ethnicity, class, and age to enable them to sustain and flourish in their professional life by offering their design and practice voice to enhance a built environment for all

Evaluation of Web-Based Digital Intervention to Change Individual’s Drinking Behaviours

Alcohol Use Disorder is a complex and broad condition with multiple pathways to resolution. Only a small proportion of people with AUD seek formal treatment or support, whilst lower severity AUD is particularly under-addressed. In part, this reflects common misconceptions about AUD as an always severe condition requiring lifelong abstinence. The present study sought to investigate the impact of an online programme focused on supporting participants (n = 928) looking to change their drinking behaviors on outcomes of self-reported happiness with drinking and other well-being outcomes. Results showed that post-intervention, all participants reported significantly increased happiness with their drinking, greater drink-refusal self-efficacy, and improvements in how drinking impacted multiple well-being domains such as sleep and emotions. Importantly, it was found that all participants were happier with their drinking regardless of whether their goal was to abstain from drinking or to reduce their drinking. These results add to evidence highlighting the need to broaden the accessibility and range of options available to support a wider range of people with AUD, particularly via increasing understanding and acceptance of non-abstinent routes to AUD resolution

"Not as simple as right or wrong": A themed report on social care and support for disabled people in the UK

For disabled people to have fair social care and support, we need to understand disabled people’s experiences of these services. In this project, we studied the lived experiences of disabled people in the UK when they used social care and support. We wrote a report based on a catalogue of articles, books and reports that were published between 2010 and 2021. For this catalogue, we selected hundred and thirty-two articles, books and reports for our report. We found three main themes which were “Experience of social care and support”, “Experience of access to social care” and “Experience of care relationships”. The theme of “Experience of social care and support” describes how disabled people have different experiences of social care and support. Many disabled people want to be independent, enjoy meeting people for activities and manage their own finances. The next theme was “Experience of access to social care” and this theme talks about how it is difficult for disabled people to get information, especially when their circumstances change. This information is also difficult to find because it can come from many sources, such as healthcare professionals, carers and the internet. This theme also found that disabled people like help when they make important decisions. The theme of “Experience of care relationships” describes how disabled people find it even more difficult to have social care and support when they do not speak English as a first language. This theme also considers how many disabled people build meaningful relationships with personal assistants and other disabled people in support groups. These relationships help disabled people deal with what they feel when they are treated badly in everyday life. Overall, social care and support is more than just meeting health needs, but helping disabled people to build meaningful lives

Experiments and modelling of soil biocementation using the carbonic anhydrase metabolic pathway

Biocementation, i.e., the soil cementation using cements produced biomimetically, has recently been introduced as a method of ground improvement, which is potentially more eco-friendly than conventional ground improvement methods. To date, the vast majority of researchers have used the urea hydrolysis metabolic pathway to biocement soils. We present instead work focusing on a less researched and potentially more interesting pathway, the carbonic anhydrase route, which produces biocement while sequestering CO2. In this paper we present experimental results of bioprecipitate analysis and biocementation using CA producing bacteria; indicative results using the same bacteria though the ureolytic pathway are also shown; their modelling is then discussed instructed by studies on the ureolytic pathway. The results of this study based on bioprecipitate characterisation prove the precipitation of calcium carbonate using the CA pathway. The biocementation by biostimulation of the soil using the CA pathway was also proven, based on the unconfined compressive strengths of the treated soil ranging 0.5-1 MPa depending on cementing solution molarity vs the zero unconfined compressive strength of the untreated soil

The Gender Agenda: Transphobia and the Perceived Erasure of Women

The aim of this chapter is to contribute to the discussion about gender politics which focuses on women's oppression and trans liberation. It examines the claim by some that acknowledging transwomen would lead to the erasure of woman as a unique social category. Because transgender and gender fluidity are not new issues, this chapter looks at firstly, how concepts such as cis, transgender, gender fluidity, non-binary and gender dysphoria have emerged in our vocabulary. The second part of the chapter concerns Judith Butler's work Gender Trouble which uses concepts such as performativity and examines whether they are useful in an analysis of gender / transgender issues and erasure of women. Butler argues that gender as a set of binary categories is outdated and interrogates the social constructionist view of gender to move towards the possibility of agency and transformation. This is followed by a discussion on UK policy and legislation which can serve to make trans people visible or invisible and how this is vulnerable to pressure from outside government. The chapter also discusses the controversy surrounding trans exclusionary radical feminist thought regarding who can claim to be a woman and the perceived erasure of women. It includes the voices of feminist thinkers who have commented that there are many ways of being female and male, with trans people widening the spectrum of gender expression which includes the global south

Troubling French Feminist Diplomacy with the National Context

Feminist Foreign Policy is increasingly a strategic tool for states to (re)brand themselves as ‘feminist’ actors and norm-setters on the international stage. In the FFP story, states claim the intellectual foundation of feminism and construct themselves as bastions of gender equality. Yet, by imagining feminism and gender equality to be ‘homed’ in these states, FFP obscures real and potential gendered tensions that occur at the domestic level. This chapter illustrates this problem with ‘French feminist diplomacy’, a priority in Macron’s presidency since 2018, and draws on a narrative conceptual framework to trouble the narrative that France is entirely and unequivocally a feminist state. I focus on four domestic issues which reveal France’s internal struggles with gender and feminism: the ‘modèle Républicain’, the democratisation of sexual politics, the racialisation of gender equality, and the rise of (state-sponsored) anti-genderism since the 2000s. By shedding light on a complex politics of gender in the French national context, this chapter constitutes a contribution to postcolonial scholarship on Feminist Foreign Policy, a growing body of literature that challenges the idea that feminism and gender equality belongs to the Global North

Economic keywords in political communications and financial markets

This paper investigates the interplay between the use of economically significant keywords in political speeches—indicative of their economic content—and observed trends in financial markets. To this end, we implement a statistical/bibliometric study on the speeches stated by the US Presidents and the Standard and Poor’s 500 index (S &P 500). The corpus covers 1951-2017, including 376 discourses. The S &P 500 daily returns, prices, and volumes are considered in the same period. Our analysis utilises Kendall’s correlation to assess the relationship between S &P 500 variables and the frequency of economic terms in the speeches. Additionally, four distance measures are applied to evaluate the similarities among these time series. Lastly, we compare Shannon entropies computed for each variable. The values of the index are observed the day before, the same day, and the day after the Presidents conducted their speeches. The joint evaluation of the results shows that the speeches’ economic content and the S &P 500 volume have the most meaningful relationship. In particular, the volume shows some changes interrelated to the speeches before and after the days of the talks. The price has similar behaviour but with a lighter magnitude than volume. The daily returns are poorly responsive to the speeches’ economic content, but entropy suggests that they present some distributional similarities