Panning for Gold: The Standardizing Work of Filling “Autistic” Shells – Using institutional ethnography to explore textually mediated health relations in the diagnostic process of autism.

Health reform practices in Canada and elsewhere have restructured the purpose and use of diagnostic labels and the processes of naming such labels. Diagnoses are no longer only a means to tell doctors and patients what may be wrong and indicate potential courses of treatment; some diagnoses activate specialized services and supports for persons with a disability and those who provide care for them. In British Columbia, a standardized process of diagnosis with the outcome of an autism spectrum disorder gives access to government provided health care and educational services and supports. Such processes enter individuals into a complex of text mediated relations, regulated by the principles of evidence-based medicine. However, the diagnosis of autism in children is notoriously uncertain. Because of this ambiguity, standardizing the diagnostic process creates a hurdle in gaining help and support for parents who have children with problems that could lead to a diagnosis on the autism spectrum. Such processes and their organizing relations are problematized, explored and explicated below. Grounded in the epistemological and ontological shift offered by Dorothy E. Smith (1987; 1990a; 1999; 2005), this article reports on the findings of an institutional ethnographic study that explored the diagnostic process of autism in British Columbia. More specifically, this article focuses on the processes involved in going from mothers talking from their experience about their childrens problems to the formalized and standardized, and thus “virtually” produced, diagnoses that may or may not give access to services and supports in different systems of care. Two psychologists, a developmental pediatrician, a social worker – members of a specialized multidisciplinary assessment team – and several mothers of children with a diagnosis on the autism spectrum were interviewed. The implications of standardizing the diagnosis process of a disability that is not clear-cut and has funding attached are discussed. This ethnography also provides a glimpse of the implications of current and ongoing reforms in the state-supported health care system in British Columbia, and more generally in Canada, for people’s everyday doings.

An aggregated fridge-freezer peak shaving and valley filling control strategy for enhanced grid operations

The need for fast response demand side participation (DSP) has never been greater due to increased wind power penetration. White domestic goods suppliers are currently developing a `smart' chip for a range of domestic appliances (e.g. refrigeration units, tumble dryers and storage heaters) to support the home as a DSP unit in future power systems. This paper presents an aggregated population-based model of a single compressor fridge-freezer. Two scenarios (i.e. energy efficiency class and size) for valley filling and peak shaving are examined to quantify and value DSP savings in 2020. The analysis shows potential peak reductions of 40 MW to 55 MW are achievable in the Single wholesale Electricity Market of Ireland (i.e. the test system), and valley demand increases of up to 30 MW. The study also shows the importance of the control strategy start time and the staggering of the devices to obtain the desired filling or shaving effect.