What children on the autism spectrum have to ‘say’ about using high-tech voice output communication aids (VOCAs) in an educational setting

This paper focuses on accessing the experiences of three boys who are on the autism spectrum to identify what using a voice output communication aid (VOCA), within a classroom setting, means to them. The methods used to identify the boys' perspectives are described and evaluated. Establishing these through direct methods of engagement proved problematic but working with parents and school staff as ‘expert guides’ provided a rich insight into what using a VOCA appeared to mean to the boys. The findings suggest that using a computer-based VOCA can be viewed by children with autism as a pleasurable and motivating activity. This technology also seems to offer the potential for a much broader developmental impact for these children than that currently recognised within the research literature

'Is this inclusive?'; teachers' perspectives on inclusion for children labelled with autism

This dissertation is an account of a phenomenological investigation which was undertaken with a group of teachers working in primary schools in one locality in England. It examines their perspectives of the process of inclusion for children with the label of autism, as for many of these children inclusion into mainstream schools can be a problematic process. The study has as a central focus the impact of the individual and social models of disability on how these teachers conceive of their practice. The teachers were participants on a module on a university based professional development programme. Data were gathered from discussions between the teachers and from weekly reflective logs which were written by the teachers as part of their participation on the module. The teachers engaged in a process of reflection on their practice and the discussions in the module sessions were constructed as ‘conversation research communities’ (Dadds 2005). Teachers find themselves affected by existing political developments, pulled between the competing agendas of performativity and inclusion which have conflicting relationships with the individual and the social models of disability. It emerged that for the teachers in this study, the agenda of performativity has a limiting effect on inclusive practice, affecting as it does the formation of a teacher’s professional identity and also their ability to act as an agent of change. In addition, the fact that these teachers did not readily name or identify the social model of disability as an influence on their practice, despite evidence that it does have an impact, illustrates the need for more overt debate about educational inclusion in a wider social and political context. It is argued in this study that there should be wider opportunities for teachers to engage with debate about the social model of disability as a platform for them to be able to interrogate educational policy development and to explore their own professional identities. In this way teachers may be better enabled to develop inclusive professional identities and to act as agents of change. It is also argued that one way towards articulating a model of inclusive education is for teachers and education researchers to work together in conceptualising practice

“Black white zebra orange orange”: How children with autism make use of computer-based voice output communication aids in their language and communication at school.

Purpose - This naturalistic study adapted exploratory school practice in order to support empirically-informed decision making in the provision of augmentative and alternative communication (AAC) technologies for children with autism. Design - Research was conducted with three boys with autism and little speech, as part of a curricular literacy lesson. A mixed method approach, involving observational coding and staff diaries, identified how the boys used computer-based voice output communication aids (VOCAs), also called speech generating devices (SGDs) and how the technology impacted on their communication and language. The boys were observed in initial lessons (‘baseline’ sessions), without the VOCA present and in sessions in which the VOCA was available (‘intervention’ sessions). Findings - VOCAs were used for two main communicative purposes; naming and giving information; with aids being used primarily to support curricular, task-related communication. Existing modes of communication continued to be used when access to the VOCA was available. In addition, all three boys showed an increase in Mean Length of Utterance (MLU) after the VOCA was introduced. The findings suggest that computer-based VOCA technology can augment children’s communicative participation in lesson activities. Specific patterns of change were also recorded in the boys’ communication, suggesting individualised responses to this technology. Originality - This paper extends the empirical base for clinical decision making by reporting the use of high tech VOCAs by school age children with autism for additional forms of communication, beyond those described elsewhere. It adds to the evidence that interventions which include access to a computer VOCA can have a positive impact on the language complexity of children with autism. It describes the potential of VOCAs to provide an enabling and inclusive technology in a classroom setting. </p

Leptin-dependent differential remodelling of visceral and pericardial adipose tissue following chronic exercise and psychosocial stress

Obesity is driven by an imbalance between caloric intake and energy expenditure, causing excessive storage of triglycerides in adipose tissue at different sites around the body. Increased visceral adipose tissue (VAT) is associated with diabetes, whilst pericardial adipose tissue (PAT) is associated with cardiac pathology. Adipose tissue can expand either through cellular hypertrophy or hyperplasia, with the former correlating with decreased metabolic health in obesity. The aim of this study was to determine how VAT and PAT remodel in response to obesity, stress, and exercise. Here we have used the male obese Zucker rats, which carries two recessive fa alleles that result in the development of hyperphagia with reduced energy expenditure, resulting in morbid obesity and leptin resistance. At 9 weeks of age, a group of lean (Fa/Fa or Fa/fa) Zucker rats (LZR) and obese (fa/fa) Zucker rats (OZR) were treated with unpredictable chronic mild stress or exercise for 8 weeks. To determine the phenotype for PAT and VAT, tissue cellularity and gene expression were analysed. Finally, leptin signalling was investigated further using cultured 3T3-derived adipocytes. Tissue cellularity was determined following haematoxylin and eosin (H&E) staining, whilst qPCR was used to examine gene expression. PAT adipocytes were significantly smaller than those from VAT and had a more beige-like appearance in both LZR and OZR. In the OZR group, VAT adipocyte cell size increased significantly compared with LZR, whilst PAT showed no difference. Exercise and stress resulted in a significant reduction in VAT cellularity in OZR, whilst PAT showed no change. This suggests that PAT cellularity does not remodel significantly compared with VAT. This data indicates that the extracellular matrix of PAT is able to remodel more readily than in VAT. In the LZR group, exercise increased insulin receptor substrate 1 (IRS1) in PAT but was decreased in the OZR group. In VAT, exercise decreased IRS1 in LZR, whilst increasing it in OZR. This suggests that in obesity, VAT is more responsive to exercise and subsequently becomes less insulin resistant compared with PAT. Stress increased PPAR-γ expression in the VAT but decreased it in the PAT in the OZR group. This suggests that in obesity, stress increases adipogenesis more significantly in the VAT compared with PAT. To understand the role of leptin signalling in adipose tissue remodelling mechanistically, JAK2 autophosphorylation was inhibited using 5μM 1,2,3,4,5,6-Hexabromocyclohexane (Hex) in cultured 3T3-derived adipocytes. Palmitate treatment was used to induce cellular hypertrophy. Hex blocked adipocyte hypertrophy in response to palmitate treatment but not the increase in lipid droplet size. These data suggest that leptin signalling is necessary for adipocyte cell remodelling and its absence induces whitening. Taken together, our data suggest that leptin signalling is necessary for adipocyte remodelling in response to obesity, exercise and psychosocial stress

The mental health experiences of ethnic minorities in the UK during the Coronavirus pandemic: A qualitative exploration.

BACKGROUND: Worldwide, the Coronavirus pandemic has had a major impact on people's health, lives, and livelihoods. However, this impact has not been felt equally across various population groups. People from ethnic minority backgrounds in the UK have been more adversely affected by the pandemic, especially in terms of their physical health. Their mental health, on the other hand, has received less attention. This study aimed to explore the mental health experiences of UK adults from ethnic minorities during the Coronavirus pandemic. This work forms part of our wider long-term UK population study "Mental Health in the Pandemic." METHODS: We conducted an exploratory qualitative study with people from ethnic minority communities across the UK. A series of in-depth interviews were conducted with 15 women, 14 men and 1 non-binary person from ethnic minority backgrounds, aged between 18 and 65 years old (mean age = 40). We utilized purposefully selected maximum variation sampling in order to capture as wide a variety of views, perceptions and experiences as possible. Inclusion criteria: adults (18+) from ethnic minorities across the UK; able to provide full consent to participate; able to participate in a video- or phone-call interview. All interviews took place via MS Teams or Zoom. The gathered data were transcribed verbatim and underwent thematic analysis following Braun and Clarke carried out using NVivo 12 software. RESULTS: The qualitative data analysis yielded seven overarching themes: (1) pandemic-specific mental health and wellbeing experiences; (2) issues relating to the media; (3) coping mechanisms; (4) worries around and attitudes toward vaccination; (5) suggestions for support in moving forward; (6) best and worst experiences during pandemic and lockdowns; (7) biggest areas of change in personal life. Generally, participants' mental health experiences varied with some not being affected by the pandemic in a way related to their ethnicity, some sharing positive experiences and coping strategies (exercising more, spending more time with family, community cohesion), and some expressing negative experiences (eating or drinking more, feeling more isolated, or even racism and abuse, especially toward Asian communities). Concerns were raised around trust issues in relation to the media, the inadequate representation of ethnic minorities, and the spread of fake news especially on social media. Attitudes toward vaccinations varied too, with some people more willing to have the vaccine than others. CONCLUSION: This study's findings highlight the diversity in the pandemic mental health experiences of ethnic minorities in the UK and has implications for policy, practice and further research. To enable moving forward beyond the pandemic, our study surfaced the need for culturally appropriate mental health support, financial support (as a key mental health determinant), accurate media representation, and clear communication messaging from the Governments of the UK