A stakeholder approach to sexual assault prevention programming in the Halton Board of Education

There are few examples of sexual assault education interventions within the high schools. Research about programmes delivered at universities indicates that the programmes do not change the rape-supportive beliefs of participants (Lenihan, Rawlins, Eberly, Buckley, & Masters, 1992). A criticism of these programmes is that students do not participate in their own learning. A curriculum-writing team at the I-Ialton Board or Education developed two lessons on sexual assault as part of the grade nine “Healthy Sexuality curriculum. The sexual assault lessons were then piloted with three grade nine classes. After delivery, six to eight students from each class participated in focus groups in which they were asked what they liked and disliked about the units. They were also asked what they envisioned for a senior course on sexual assault prevention. For both curricula, students recommended the need to emphasize the sensitive nature of the material; the relevance of employing experiential learning techniques (role plays, small group activities); and, the use of positive male role models in sexual assault scenarios. Additionally, for the senior course, students indicated they wanted more statistical facts associated ‘with this crime; information about the link between societal pressures (e.g., media, socialization) and sexual assault; knowledge about what to do after an assault; and, information about sexually assaulted men. Teachers and community health workers were also asked for their input into the curricula and most of their recommendations were adopted. This thesis reflects the process of creating sexual assault prevention curricula and explores the issues of community participation, imbalance of power, value discrepancies, and the lack of support for the participants experiencing the curricula. Recommendations concerning curriculum development are discussed

A Puzzle Involving Galactic Bulge Microlensing Events

We study a sample of 16 microlensed Galactic bulge main sequence turnoff region stars for which high dispersion spectra have been obtained with detailed abundance analyses. We demonstrate that there is a very strong and highly statistically significant correlation between the maximum magnification of the microlensed bulge star and the value of the [Fe/H] deduced from the high resolution spectrum of each object. Physics demands that this correlation, assuming it to be real, be the result of some sample bias. We suggest several possible explanations, but are forced to reject them all,and are left puzzled. To obtain a reliable metallicity distribution in the Galactic bulge based on microlensed dwarf stars it will be necessary to resolve this issue through the course of additional observations.Comment: Submitted to ApJL, table 2 (quite long) will only appear in the on-line version of ApJ

Identifying features of ‘pathological demand avoidance’ using the Diagnostic Interview for Social and Communication Disorders (DISCO)

The term ‘pathological demand avoidance’ (PDA) was coined by Elizabeth Newson to describe children within the autism spectrum who exhibit obsessive resistance to everyday demands and requests (Newson et al., Arch Dis Child 88:595–600, 2003). Clinical accounts describe avoidance strategies including apparently strategic use of distraction or socially shocking behaviour, and obsessive need for control, reflected in domineering behaviour to peers and adults. Educational and management approaches effective for PDA reportedly differ from those for ‘typical’ autism spectrum disorders (ASD), and include novelty, humour and flexibility. Identification of PDA in individuals with ASD may have important implications for management (Eaton and Banting, J Learn Disabil Offending Behav 3:150–157, 2012). Despite increasing interest, no clinician-rated instrument for PDA has been developed. Here, items relevant to PDA were identified from the Diagnostic Interview for Social and Communication Disorder (DISCO) (Wing et al., J Child Psychol Psychiatry 43:307–325, 2002). The most PDA-specific subset of relevant DISCO items was selected, based on low endorsement in general across a sample of 153 individuals assessed for possible ASD using the DISCO. Having selected 11 DISCO PDA items for the measure, a subset of individuals with a high number of these features was identified (N = 27). Consistent with Newson’s descriptions, this high scoring group was characterised by lack of co-operation, use of apparently manipulative behaviour, socially shocking behaviour, difficulties with other people, anxiety and sudden behavioural changes from loving to aggression. All but one case met criteria for an ASD. This study brings the field a step closer to a clinician-rated measure of PDA features and highlights the need for further elucidation of the PDA phenotype

Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme/‘pathological’ demand avoidance

A subset of individuals with autism spectrum disorder (ASD) resemble descriptions of extreme/‘pathological’ demand avoidance, displaying obsessive avoidance of everyday demands and requests, strategic or ‘socially manipulative’ behaviour and sudden changes in mood. Investigating challenging presentations using dimensional description may prove preferable to identifying subgroups. However, there remains an imperative to explore which behavioural traits appear most problematic to inform quantitative investigation. This study provides an in‐depth exploration of parent perspectives on maladaptive behaviour in children reported to have an autism spectrum diagnosis and features of extreme/‘pathological’ demand avoidance

Returning to Work after the Death of a Baby or Child – Video for Supporting Healthcare Staff

Introduction - The death of a baby or child at any age or gestation is devastating. Returning to work in health care following the death of a baby or child can be hugely challenging. This may be due to the demands of the role and the emotions and feelings triggered by being back in a health care environment. Highlighting these challenges and the support health care professionals may need when returning to work after the death of a child or baby is important for staff: both the individual and the team around them. Methods – A collaborative multi-professional approach was used to design and produce a short audio-visual recording. This involved the input of two health professionals with lived experience of returning to work in a health care environment after the death of a child, a child mortality nurse, and a clinical psychologist. The aim of the video was to use lived experiences to highlight what had helped and also hindered the professionals' return to work. The video was produced using Canva software and relevant permissions were sought prior to sharing the recording. Results - The results of this project are far-reaching. For the professionals involved, the opportunity to tell their stories whilst helping others has been deeply cathartic. Feedback from fellow healthcare professionals has been positive with people keen to share the recording more widely. Conclusion - This project is aimed at staff who themselves have had a baby or child die to reassure them that they are not alone. We also hope to empower managers and colleagues to feel more confident in supporting the member of staff upon their return to work

Signposting for diagnosis of Autism Spectrum Disorder using the Diagnostic Interview for Social and Communication Disorders (DISCO)

Recent research has investigated the capability of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) descriptions to identify individuals who should receive a diagnosis of Autism Spectrum Disorder (ASD) using standardised diagnostic instruments. Building on previous research investigating behaviours essential for the diagnosis of DSM-5 ASD, the current study investigated the sensitivity and specificity of a set of 14 items derived from the Diagnostic Interview for Social and Communication Disorders (DISCO Signposting set) that have potential for signposting the diagnosis of autism according to both the new DSM-5 criteria for ASD and ICD-10 criteria for Childhood Autism. An algorithm threshold for the Signposting set was calculated in Sample 1 (n = 67), tested in an independent validation sample (Sample 2; n = 78), and applied across age and ability sub-groups in Sample 3 (n = 190). The algorithm had excellent predictive validity according to best estimate clinical diagnosis (Samples 1 and 2) and excellent agreement with established algorithms for both DSM-5 and ICD-10 (all samples). The signposting set has potential to inform our understanding of the profile of ASD in relation to other neurodevelopmental disorders and to form the basis of a Signposting Interview for use in clinical practice

A fresh look at preoperative body washing

National guidelines do not support preoperative body washing to reduce surgical site infections, instead recommending bathing or showering with soap. Yet preoperative body washing continues to be widely used in many hospitals across Europe. This paper suggests that existing trials of preoperative body washing, upon which guidelines are based, are dated and proposes a new investigation of preoperative body washing using modern definitions of surgical site infection with standardised patient follow up, modern surgical techniques and well designed trials. This paper provides a critique of existing guidelines and describes a randomised trial with 60 participants to compare the effect of soap and two antiseptic washing products on colony forming units (CFUs) for up to six hours. Chlorhexidine gluconate and octenidine were significantly more effective than soap in reducing CFUs in the underarm, and chlorhexidine was significantly more effective than soap in reducing CFUs in the groin

DSM-5 Autism Spectrum Disorder:in search of essential behaviours for diagnosis

The objective of this study was to identify a set of 'essential' behaviours sufficient for diagnosis of DSM-5 Autism Spectrum Disorder (ASD). Highly discriminating, 'essential' behaviours were identified from the published DSM-5 algorithm developed for the Diagnostic Interview for Social and Communication Disorders (DISCO). Study 1 identified a reduced item set (48 items) with good predictive validity (as measured using receiver operating characteristic curves) that represented all symptom sub-domains described in the DSM-5 ASD criteria but lacked sensitivity for individuals with higher ability. An adjusted essential item set (54 items; Study 2) had good sensitivity when applied to individuals with higher ability and performance was comparable to the published full DISCO DSM-5 algorithm. Investigation at the item level revealed that the most highly discriminating items predominantly measured social-communication behaviours. This work represents a first attempt to derive a reduced set of behaviours for DSM-5 directly from an existing standardised ASD developmental history interview and has implications for the use of DSM-5 criteria for clinical and research practice