Collective futures: cultivating creative collectives.

Collective Futures was a partnership project between three highly regarded institutions operating in the creative industries: Gray's School of Art, University of The West of Scotland (UWS) and the Glasgow School of Art. The partners undertook a unique exploration of creative collectives as a route to economic success and talent development for designer-makers. The collaborative nature of the partnership working throughout the project was recognised by the partners as a form of Creative Academic Collective. The aims of the project were consistent with Creative Scotland's strategic intention to support talent hubs for creative practitioners, and also aligned with recent reports (EKOS) and initiatives such as the South of Scotland Social Enterprise Initiative (SOSCEI), Creative Arts Business Network (CABN) and Emergents, that reinforced the importance of scale, networking, collaboration and the notion of creative places around the country to support creative industries. Central to the success of the project was a meaningful connection and engagement of designer/maker communities and creative practitioners in several parts of Scotland. This project sought to explore effective models of collective working that support designer/makers in the development of their own talent and to sustain and grow their creative businesses

The neurodiversity concept viewed through an autistic lens

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Vive la difference! Celebrating and supporting autistic psychiatrists with autistic doctors international

Aims We aim to raise awareness of the existence and value of autistic doctors in psychiatry and to also signpost psychiatrists who are or suspect they might be autistic towards peer support. Method Autism refers to a lifelong difference in how people communicate and interact with the world. These differences lead to strengths and challenges with individual profiles which include special interests, hyper-focus, and often sensory differences and anxiety. Autism has an estimated prevalence of 1-2%, which is likely an underestimate. It was noted that there was little in the way of advocacy for autistic doctors around the world. Anecdotal evidence also suggested possible issues of misunderstanding and stigmatisation of autistic doctors. As such, there was a need to tackle this to promote positive change. MD founded the group Autistic Doctors International (ADI) in 2019 to foster camaraderie, advocacy and support. ADI has flourished with 250+ members currently. In a recent member poll, 24 of 180 respondents identified themselves as psychiatrists – second only to general practice (n = 54). Several other consultant psychiatrists are known to self-identify as autistic but have not formally joined due to the fear of disclosure. The group has additionally supported multiple doctors to tackle prejudice and discrimination in the workplace / training environment. It has also brought together autistic doctors with academic interests and has generated multiple academic outputs in the form of publications, research grants and conference posters/papers regarding autism. Result Psychiatrists, and doctors in general, are a self-selecting group for many autistic strengths such as hyper-focus, curiosity, self-motivation, a desire to study social communication, attention to detail, pattern recognition, problem solving and empathy, which, contrary to prevailing stereotypes, can be marked in autism. The increasing numbers of doctors joining ADI supports the assumption that autistic individuals are safe and effective clinicians. It is worth noting that many members are not ‘doctors in difficulty’. Those who have been able to achieve suitable accommodations, often without realising why they were needed, have flourished. Such accommodations and outcomes are in line with the neurodiversity movement, which promotes a view of autism as difference, rather than pure disability or disorder. This aims to challenge stereotypes and the tragedy narrative surrounding autism. Conclusion Autism awareness is increasing amongst doctors but more open discussion is still needed in order to facilitate appropriate peer and workplace support. This is likely to improve mental wellbeing and resilience for autistic psychiatrists

Phenotypic and pharmacogenetic evaluation of patients with thiazide-induced hyponatremia.

Thiazide diuretics are among the most widely used treatments for hypertension, but thiazide-induced hyponatremia (TIH), a clinically significant adverse effect, is poorly understood. Here, we have studied the phenotypic and genetic characteristics of patients hospitalized with TIH. In a cohort of 109 TIH patients, those with severe TIH displayed an extended phenotype of intravascular volume expansion, increased free water reabsorption, urinary prostaglandin E2 excretion, and reduced excretion of serum chloride, magnesium, zinc, and antidiuretic hormone. GWAS in a separate cohort of 48 TIH patients and 2,922 controls from the 1958 British birth cohort identified an additional 14 regions associated with TIH. We identified a suggestive association with a variant in SLCO2A1, which encodes a prostaglandin transporter in the distal nephron. Resequencing of SLCO2A1 revealed a nonsynonymous variant, rs34550074 (p.A396T), and association with this SNP was replicated in a second cohort of TIH cases. TIH patients with the p.A396T variant demonstrated increased urinary excretion of prostaglandin E2 and metabolites. Moreover, the SLCO2A1 phospho-mimic p.A396E showed loss of transporter function in vitro. These findings indicate that the phenotype of TIH involves a more extensive metabolic derangement than previously recognized. We propose one mechanism underlying TIH development in a subgroup of patients in which SLCO2A1 regulation is altered.This work was supported by an Academy of Medical Sciences grant for clinical lecturers (to JSW and MG), British Heart Foundation grant PG/09/089 (to KMO), the National Institute for Health Research (NIHR) Royal Brompton Cardiovascular Biomedical Research Unit (to JSW and SC), the Fondation Leducq (to JSW and SC), and the British Heart Foundation (to JSW and SC). MDT holds a Medical Research Council Senior Clinical Fellowship (G0902313). This work was supported by the Medical Research Council (grant numbers G510364 and G1000861). This research used the ALICE and SPECTRE High Performance Computing Facilities at the University of Leicester

A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions.

BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions. METHODS: Literature searches, completed in September 2015, were carried out in fourteen databases between years 1995 and 2015. The search results were independently screened by two reviewers. For the purpose of this manuscript, only randomized controlled trials which examined interventions using orthotic or prosthetic devices were selected for data extraction and synthesis. RESULTS: A total of 342 randomised controlled trials were identified (319 English language and 23 non-English language). Only 4 of these randomised controlled trials examined prosthetic interventions and the rest examined orthotic interventions. These orthotic interventions were categorised based on the medical conditions/injuries of the participants. From these studies, this review focused on the medical condition/injuries with the highest number of randomised controlled trials (osteoarthritis, fracture, stroke, carpal tunnel syndrome, plantar fasciitis, anterior cruciate ligament, diabetic foot, rheumatoid and juvenile idiopathic arthritis, ankle sprain, cerebral palsy, lateral epicondylitis and low back pain). The included articles were assessed for risk of bias using the Cochrane Risk of Bias tool. Details of the clinical population examined, the type of orthotic/prosthetic intervention, the comparator/s and the outcome measures were extracted. Effect sizes and odds ratios were calculated for all outcome measures, where possible. CONCLUSIONS: At present, for prosthetic and orthotic interventions, the scientific literature does not provide sufficient high quality research to allow strong conclusions on their effectiveness and cost-effectiveness

Setting assumptions aside, exploring identity development in interracial/intercultural individuals growing up in Japan

grantor: University of TorontoThis research attempts to understand the experience of interracial/intercultural individuals growing up in Japan. Their experiences do not fit current minority identity development models. Much of the tension in their experience appears to be between the individual's own experience and the stereotypical experience he or she is supposed to undergo as a mixed individual. Identity was not a question of either/or, but took shape from dialogues that reflected a complex relationship between community, individual, language, and culture. One factor determining the tenor of the dialogue is its grounding in commonalities or in differences. The experience was profoundly different for individuals who attended international schools or Japanese schools. The difficulty that the international school attendees articulated, in contrast to those attending Japanese schools, appears as a clash of boundaries, not values. This is reflected particularly where "Japaneseness" fits in the hierarchy and the degree of rigidity or permeability of those boundaries.M.A

Autistic role modelling in medical education

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[Correspondence] Welcome signs of the road ahead for autistic doctors and patients

We wholeheartedly thank and congratulate the authors and the Royal College of Psychiatrists on this response to our editorial piece. Not only for autistic psychiatrists, but for all of our colleagues who are neurodivergent and those with other disabilities. We welcome the publication of the three vitally important priority areas for the disability section of the College Equality Action Plan. These priorities clearly and firmly signal a move to improve inclusion and support reasonable accommodations and are in line with the positions of the General Medical Council and Medical Schools Council. An accessible and inclusive College fosters retention of the existing workforce and supports ongoing recruitment – a priority of the inspiring Choose Psychiatry campaign. We have received messages of support and thanks from autistic and other neurodivergent doctors, who now feel that there is hope of being valued and supported with reasonable accommodations where needed and may now consider disclosing autism or other neurodivergence. The College is in a strong position to lead in this area and neurodivergent colleagues from other specialties hope that their Royal Colleges will also act. There have also been messages of congratulation and hope from those outside the medical profession who have seen our editorial with its clear message of common autistic strengths on offer alongside the request for reasonable support. They understand, like us, that the College response is a very significant and welcome change that ripples outwards in our approaches to autistic patients and into society. We are grateful to the College for actively listening and meeting with us and our neurodivergent colleagues, and we look forward to collaborating further to effect change as soon as possible. We continue to bring much to the profession and are proud to work alongside all of our colleagues in a full CIRCLE

A full CIRCLE: inclusion of autistic doctors in the Royal College of Psychiatrists’ values and equality action plan

Autistic psychiatrists bring strengths and values to the workforce and ask to be acknowledged and supported as part of the Royal College of Psychiatrists’ CIRCLE values and Equality Action Plan. Courage and collaboration are required to jointly learn and innovate, promoting well-being, resilience and excellence for autistic doctors