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Autistic people have high levels of mental ill-health and an increased risk of suicide across the lifespan. Yet autistic people report difficulties communicating with healthcare professionals and accessing a range of healthcare services. At the same time, mental healthcare workers in other countries are reporting links between confidence when working with autistic patients and the degree of autism knowledge and training they can access.
Methods:
We sought to examine what factors helped or hindered Irish mental healthcare colleagues when working with autistic healthcare service users. An online survey using quantitative and qualitative metrics was circulated among psychiatrists who are members of the College of Psychiatrists of Ireland, both in training and at consultant level, from April 2021 to April 2022.
Results:
Knowledge of autism was high among psychiatrists (n = 140), but self-efficacy scores were variable, particularly in relation to care pathways. Self-efficacy was better among psychiatrists with caseloads of children and youth or individuals with co-occurring intellectual disabilities. Three key qualitative themes emerged relating to capacity and training of mental health professionals, ways to improve mental health services provision for autistic individuals and also the critical need for co-creation and neurodiversity affirmative care.
Conclusions:
The study highlighted critical systemic and professional challenges in providing mental health care to autistic people in Ireland. We provide recommendations for reducing these challenges and for enabling the development of inclusive, evidenced-based care to autistic individuals.
Received wisdom in political science holds that informed citizens are better able to develop coherent, stable policy preferences. However, past research fails to differentiate between the effects of information and cognitive ability. I show that, for people with low levels of ability, consuming more political information predicts lower levels of ideological constraint and response stability. This effect is driven by relatively technical issues, suggesting that attempts to inform the electorate may backfire by overwhelming some voters. More broadly, these results suggest that an increasingly saturated information environment may exacerbate, rather than ameliorate, differences in political sophistication.
The hugely discrepant valuations of the alterities of opera and racial slavery – differing additionally between the period under consideration and our own – would seem to preclude their being addressed in the same article. The former has been lauded as the ne plus ultra of human artistic expression. The latter was embraced as an essential economic driver, and morally, spiritually and legally sanctioned by the finest Anglo philosophical, religious and legal minds of the time. That the enslaved decried and rejected their capture and enforced labour – through suicide, rebellion, flight, sabotage and cultural separation – has long been clear. The use of the profits, obtained through the sale of commodities that slave labour produced, to fund musical activities, including opera, has remained hidden. By using the published lists of subscribers (issued as books and fans) for the King’s Theatre, Haymarket, and combining that information with what can gleaned from demographic, genealogical and slavery sources, the extent to which the opera was dependent upon families whose wealth lay in plantation ownership or other forms of profit allied to it is established. The proportion is higher than might be supposed. Three families – Lewis, Young and the Heywood sisters – are spotlighted in case studies of box subscribers.
The process by which “common knowledge” is created via chains of communicative activities is now well understood, especially due to the work of linguistic anthropologists. This paper draws upon this work to examine how “common knowledge” about the causes of tidal flooding in Kendal Regency is created in communiques’ published on Kendal’s municipal government website over a period of seven years. We argue that there are five particular processes at play in the creation of “common knowledge” about flooding in general and tidal flooding in particular as a “natural disaster” in this social domain. We end by pondering why dire predictions about the impact of future tidal flooding events on hundreds of thousands of Indonesians have not yet produced any sustainable solutions within different levels of the Indonesian government.
In the Hellenistic era, there was widespread convergence to the Attic standard and a similar narrowing of coin types in terms of aesthetics. The competition between issuers resulted in an equilibrium in which improvements to the consistency and quality of money were sought after. This institutional foundation resulted in the creation of an incentive structure that fortified adherence to international monetary standards and discouraged entropy due to debasement and the pursuit of short-sighted fiscal gains. This paper explores the role of reputational incentives faced by issuers when determining coinage standards and aesthetic types, as well as the benefits that the attainment of reputational value conferred to both the issuers and users of coinage. I argue that the economic openness and competitive nature of coin issuance in the period created a framework in which the imputation of fiduciary value to coinage stemmed from the generation of reputational quality.
Existing research argues that malapportionment primarily favours rural areas, resulting in conservative biases of electoral systems. In this paper, we provide a new perspective on the study of apportionment processes by identifying the institutional design under which malapportionment may favour other regions. Because of the geographical sorting of non-citizen residents, we argue that regions with high shares of non-citizen residents benefit from population-based apportionment, whereas the spatial sorting of non-citizens does not affect malapportionment in the case of citizen-based apportionment. Empirically, we use sub-national data from ten advanced democracies to forward evidence that differences in apportionment mechanisms and district-level shares of non-citizen residents systematically influence malapportionment. Our findings suggest that the impact of malapportionment on political representation and public policies may be more heterogeneous than previously thought.
The dominant understandings of space that inform International Relations (IR) theories struggle to account for the material dynamism of the natural environment. From neo-realism through to constructivism and post-structuralist IR perspectives, the natural environment is relegated to the background of analysis as the seemingly stable backdrop against which humans do global politics. Supporting this relegation is an associated tendency among IR theorists to view nature abstractly, rather than materially, in alignment with the cartographic imagination. Meanwhile, realist scholars adhering to the tenets of classical geopolitics foreground the natural environment as a factor in global politics yet view it as ontologically static and materially deterministic in its effects. In an era of unprecedented spatial flux amid human-induced climate change, this article seeks to contribute to ongoing efforts in IR and political geography to develop alternative spatial frameworks that can account for the natural environment’s material dynamism and instability. To do so, the article adopts a post-humanist framework that centres matter’s ontological fluidity and mobility. By affording primacy to matter-in-motion, it is argued, a richer understanding of space as performatively produced through relational processes can be developed, where attention is attuned not only to what matter ‘does’, but also how it moves.
We investigate the effects of thermal boundary conditions and Mach number on turbulence close to walls. In particular, we study the near-wall asymptotic behaviour for adiabatic and pseudo-adiabatic walls, and compare to the asymptotic behaviour recently found near isothermal cold walls (Baranwal et al. 2022. J. Fluid Mech.933, A28). This is done by analysing a new large database of highly-resolved direct numerical simulations of turbulent channels with different wall thermal conditions and centreline Mach numbers. We observe that the asymptotic power-law behaviour of Reynolds stresses as well as heat fluxes does change with both centreline Mach number and thermal condition at the wall. Power-law exponents transition from their analytical expansion for solenoidal fields to those for non-solenoidal field as the Mach number is increased, though this transition is found to be dependent on the thermal boundary conditions. The correlation coefficients between velocity and temperature are also found to be affected by these factors. Consistent with recent proposals on universal behaviour of compressible turbulence, we find that dilatation at the wall is the key scaling parameter for these power-law exponents, providing a universal functional law that can provide a basis for general models of near-wall behaviour.
Explicit and implicit incentives and opportunities for mutually beneficial voluntary cooperation coexist in many economic relationships. In a series of eight laboratory gift-exchange experiments, we show that incentives can lead to crowding out of voluntary cooperation even after they have been abolished. This crowding-out also occurs in repeated relationships, which otherwise strongly increase effort compared to one-shot interactions. Using a unified econometric framework, we unpack these results as a function of positive and negative reciprocity, as well as the principals’ wage offer and the incentive compatibility of the contract. Crowding-out occurs mostly due to reduced wages and not a change in reciprocal wage–effort relationships. Our systematic analysis also replicates established results on gift exchange, incentives, and crowding out of voluntary cooperation while being exposed to incentives. Overall, our findings show that the behavioral consequences of explicit incentives strongly depend on the features of the situation in which they are embedded.
High-fat food intake is associated with atopic dermatitis (AD), but the role of habitual dietary habits related to the frequency of high-fat food intake remains unclear. To address this, we developed a frequency-based dietary index, Diet Quality based on Dietary Fat Score, to assess high-fat food intake and examined its association with AD in 13 561 young Chinese adults (mean age = 22·51 years, (sd 5·90)) from Singapore and Malaysia. Using an investigator-administered questionnaire aligned with the validated International Study of Asthma and Allergies in Childhood protocol, we conducted multivariable logistic regression analysis, adjusting for demographics, body mass index, genetic predisposition and lifestyle factors, with false discovery rate correction for multiple comparisons. Frequent high-fat food intake was associated with higher odds of AD (adjusted OR (AOR): 1·53; 95 % CI: 1·31, 1·77; P< 0·001). The association remained significant regardless of total fat intake (AOR: 1·45; 95 % CI: 1·05, 1·80; P< 0·001) and among individuals with high fruit and vegetable intake (AOR: 1·49; 95 % CI: 1·19, 1·86; P< 0·001) or low energy intake (AOR: 1·40; 95 % CI: 1·05, 1·86; P< 0·05). No synergistic effects were observed between dietary factors. These findings highlight that frequent intake of high-fat foods is independently associated with AD, emphasising the potential of dietary moderation in AD risk management.
Information about the consequences of our consumption choices can be unwelcome, and people sometimes avoid it. Thus, when people possess information that is inconvenient for another person, they may face a dilemma about whether to inform them. We introduce a simple and portable experimental game to analyze the transmission of inconvenient information. In this game, a Sender can, at a small cost, inform a Receiver about a negative externality associated with a tempting and profitable action for the Receiver. The results from our online experiment (N = 1,512) show that Senders transmit more information when negative externalities are larger and that Senders’ decisions are largely driven by their own preferences towards the charity and their own use of information. We do not find evidence that Senders take the Receiver’s preferences into account, as they largely ignore explicit requests for information, or ignorance, even if Receivers have the option to punish the Sender.
Dietary intervention is a key strategy for preventing and managing chronic kidney disease (CKD). However, evidence on specific foods’ effects on CKD is limited. This study aims to clarify the impact of various foods on CKD risk. We used two-sample Mendelian randomisation to analyse the causal relationships between the intake of eighteen foods (e.g., cheese, processed meat, poultry, beef and non-oily fish) and CKD risk, as well as estimated glomerular filtration rate (eGFR)cr and eGFRcys levels. The inverse variance weighting method, weighted median method, MR-Egger regression, simple mode and weighted mode were employed. The sensitivity analysis included Cochran’s Q test and the Egger intercept test. According to the main method, the IVM results indicated that frequent alcohol intake was linked to higher CKD risk (P= 0·007, 0·048). Protective factors included cheese (OR = 0·71, (95 % CI: 0·53, 0·94), P= 0·017), tea (OR = 0·66, (95 % CI: 0·43, 1·00), P= 0·048) and dried fruit (OR = 0·78, (95 % CI: 0·63, 0·98), P= 0·033). Oily fish (β = 0·051, (95 % CI: 0·001, 0·102), P= 0·046) and dried fruit (β = 0·082, (95 % CI: 0·016, 0·149), P= 0·014) were associated with elevated eGFRcys. Salad/raw vegetables (β = 0·024, (95 % CI: 0·003, 0·045), P= 0·028) and dried fruit (β = 0·013, (95 % CI: 0·001, 0·031), P= 0·014) were linked to higher eGFRcr, while cereal intake (β = –0·021, (95 % CI: −0·033, −0·010), P < 0·001) was associated with lower eGFRcr. These findings provide insights for optimising dietary strategies for CKD patients.
Effective communication is central to the majority of activities in care settings. In many English-speaking countries, carers working in care settings are increasingly from multilingual and multicultural backgrounds, with many growing up in countries where English is not the primary language. Communication difficulties may impede carers creating meaningful relationships with residents or successful working relationships with colleagues. Misunderstanding may also result in safety issues. To date, however, few studies have investigated what aspects of communication carers from culturally and linguistically diverse (CALD) backgrounds find difficult; nor have these difficulties been modelled theoretically.
This article presents the findings of an interview-based study exploring communication difficulties in care settings in Australia. Three groups of participants were interviewed: (1) 30 personal care assistants (PCAs) from CALD backgrounds, (2) 20 supervisors of PCAs and (3) 18 older people who were receiving care and/or nominated support people who participated on behalf of an older person. The data were thematically analysed. The findings show that the communicative challenges facing new PCAs from CALD backgrounds are numerous, ranging from specific linguistic challenges to more workplace-specific problems. Based on the findings, the article proposes a model of communicative competence of personal care workers. The study has implications for the training of personal care workers from CALD backgrounds.
Politicians appear to overestimate how conservative public opinion is in the U.S. and other Western democracies. Whether this “conservative bias” extends to voters remains unclear but has important implications for belief formation and behavior. I examine this in the context of abortion access after the Dobbs decision. Despite the salience of the topic, original survey data collected post-Dobbs reveal consistent underestimation of public support for abortion access. Individuals identifying as “pro-life” drive most of this underestimation, suggesting the presence of egocentric biases in which “pro-life” Americans overestimate the commonality of their views. Conservative biases among voters may contribute to a skewed information environment for politicians, potentially providing leverage for further restrictions on abortion access.
What factors explain Latino support for conspiracy theories? Contemporary scholarship offers valuable insights on how psychological, social, and political factors shape support for conspiracy theories. At the same time, scholarly understanding of the dynamics that foster conspiracy beliefs among racial and ethnic minorities is much more limited. Utilizing survey responses from more than 1,000 Latinos, we theorize explicitly about the factors that explain their support for conspiracies. Consistent with the scholarship highlighting in-group diversity among Latinos, we reveal significant differences among Latinos in their propensity to harbor conspiracy beliefs. Some of the factors that influence their support for conspiratorial statements align with the broader literature, other results appear unique to Latino Americans. Religiosity, lack of trust in institutions, and conservative political ideology are associated with higher levels of conspiracy beliefs among Latinos. We also find that Latinos from later generations, those who consume Spanish media, and who disagree that Latinos face discrimination and White privilege exists are more likely to believe in certain conspiracy theories.
With coastal populations rising at three times the global average, sustainable ways of safeguarding human needs around access and use of the coast alongside lasting ecosystem health of coastal environments must be developed. At the same time, human populations are facing the challenge of managing coastal access on the back of a legacy of human interventions that have already altered – and have often had unintended or unforeseen impacts on – the coastal system and its functioning.
We chart the history of the evolution of North Bull Island in Dublin Bay as an example of major unforeseen sedimentation in a coastal estuarine bay following the construction of river mouth training walls. We investigate the impact of a constructed causeway on the evolved ‘naturescape’ by comparing accretion and elevation change on the mid-marsh either side of the access road over a 32-month period (autumn 2021 to summer 2024) and measuring water levels either side of the causeway on six spring tides on consecutive days characterised by varying meteorological conditions in early September 2023. The results allow us to consider the potential implications a lack of physical connectivity may cause for the future of the two artificially separated back-barrier lagoon environments.
INCUS (INvestigation of Convective UpdraftS) is a NASA Earth Science mission scheduled to launch in 2026. The goal of the mission is to study in detail how water vapor and droplets move inside tropical storms and thunderstorms and understand their effects on weather and climate models. To carry out this study, the mission will use three almost identical SmallSats, each equipped with a Raincube-heritage Ka-band radar. The deployable mesh reflector antenna is a new 1.6 m design provided by Tendeg, which is fed using a seven-horn feed assembly to generate overlapping secondary beams. This paper discusses the approach used to design and fabricate the feed assembly and presents the measured and calculated RF performance parameters.
Many people with rheumatoid arthritis (RA) believe that certain foods may influence disease activity. Elimination reintroduction diets and oral food challenges are dietary strategies used to identify foods that may exacerbate symptoms. This review summarises and appraises the literature on elimination diet interventions that include food reintroductions or oral food challenges in adults with RA. It describes study design, measures used to assess the effects of food exclusion and challenge, foods identified that may affect RA symptoms, and the measures used to assess the outcome of excluding those foods. A search of five databases, two thesis repositories and Open Grey was conducted to identify records published from inception to January 2025, using terms related to RA, elimination diets and food sensitivity. Eligible records were screened independently by two reviewers, and data extraction followed Joanna Briggs Institute guidelines. Data are presented using a narrative synthesis approach with descriptive data analysis. In total, forty-eight records met inclusion criteria comprising twenty intervention studies (sample sizes 4–94) and seventeen case studies, conducted across twelve countries (1949–2024). Interventions included single-food exclusions, few-food diets, low-allergen meal replacements and fasting protocols. Reintroduction methods varied from a single-food challenge to multiple reintroductions, with five studies using blinded challenges. Outcome measures included physician- or participant-observed symptom changes, clinical assessments and laboratory measures, though these were heterogeneous. Findings reveal a lack of standardised protocols, dated methodologies and limited contemporary research. Controlled studies are needed to establish evidence-based protocols, investigate mechanisms, and guide dietary strategies as adjuncts to RA pharmacological treatment.
We investigate how sexism and harassment affect political candidates’ preferences for political positions by deploying a conjoint experiment among political candidates in the 2021 Danish local elections. We find that, compared to men candidates, women candidates experience far more sexism and harassment, and assess their risk of victimization as being far higher. Correspondingly, the conjoint experiment reveals that women candidates state stronger preferences for equal working environments in politics than men, while holding similar preferences for formal working conditions like political positions, remuneration, and workload. Substantively, women’s willingness to lower their remuneration and increase their workload to avoid sexism in politics is more than double the size of men’s willingness. Our approach provides us with highly accurate descriptions of candidates’ preferences for political jobs, which are often assumed rather than measured directly. This lets us quantify the magnitude of an important working condition in politics with significant repercussions for women.
This contribution aims to relate an important topic of the Hegelian philosophy, that of second nature, to the gender question developed by Simone de Beauvoir. The core of the emancipation process described in The Second Sex lies in Beauvoir’s revolutionary idea of the artificial character of gender: the latter belongs to the culturally constructed sphere of social norms and not to mere fixed nature. In this assumption the French philosopher seems to recover the Hegelian theory of second nature: Hegel believes that through an individual and social Bildungsprozess, subjects liberate themselves from the immediate level of natural necessity and reach the free horizon of spiritual existence, in which they become self-conscious actors. Beauvoir accepts in her own existentialist view this extra-natural becoming and realizes that also gender participates in it: women are not by nature ‘immanent’ creatures that lack ‘transcendence’. Hegel, however, does not recognize the second nature of gender and falls into that same essentialism, denounced by Beauvoir, which relegates the woman to the biological plane, thus excluding her from the dialectic of second nature and self-consciousness. For this reason, Hegel’s understanding of freedom through second nature will initially be introduced, and then, employing this concept against Hegel himself, the path of emancipation from gender essentialism in Beauvoir’s account of biology and culture will be addressed. In the second part of the paper it will be shown how gender, in acting as a second nature, replays the same ambiguity of Hegel’s theory: are second nature and gender something that we individuals freely shape or are we victims of an externally imposed necessity just like in first nature? A dialectical solution will be presented in both thinkers, whose work aims to conciliate spirit and nature beyond any Cartesian dualism.