Queer Spaces, Sexual Violence and the Desire for Safety

Queer politics and spaces have historically been associated with ideals of sexual liberation. They are conceptualised as spaces where sex, and its intersections with intimacy, friendship and love can be explored outside of normative frameworks which value monogamous reproductive heterosexuality at the expense of other non-normative sexual expressions. In recent years, however, autonomous queer spaces such as the global Queeruption gatherings and other queer community spaces in Australia have become increasingly concerned with the presence and danger of sexual violence in queer communities. Almost without exception, this danger has been responded to through the creation of ‘safe(r) spaces’ policies, generally consisting of a set of guidelines and proscribed behaviours which individuals must agree to in order to participate in or attend the event or space. The guidelines themselves tend to privilege of sexual politics of affirmative verbal consent, insisting that such consent should be sought prior to any physical or sexual contact, inferring that a failure to do so is ethically unacceptable within. This chapter reflects on the attempts to construct queer communities as ‘safer spaces,’ arguing that the concepts of consent and safety are inadequate to develop a queer response to sexual violence. Such a response, it argues, must be based on the openness to possibilities and refusal of sexual restrictions and regulations that have always been central elements of queer theory and politics.

Prevalence, phenomenology, aetiology and predictors of challenging behaviour in Smith-Magenis syndrome

Background

The prevalence, phenomenology aetiology and correlates of four forms of challenging behaviour in 32 children and adults with Smith-Magenis syndrome (SMS) were investigated.

Methods

Cognitive assessments, questionnaires and semi-structured interviews were used to gather data on intellectual disability, verbal and physical aggression, destructive behaviour and self-injury and on characteristics known to be associated with aggression.

Results

Aggression in SMS was more prevalent (87%), but not more severe than aggression in contrast groups. Aggressive behaviour was more frequently associated with environmental contingencies (e.g. attention, escape and access to tangibles) than self-injury and destructive behaviours. Severity of challenging behaviours was associated with high impulsivity.

Conclusion

Aggression is seen in the majority of people with SMS. Results suggest that behavioural disinhibition and operant social reinforcement are associated with the manifestation of aggression.

Helping the most vulnerable out of the poverty trap and reducing inequality: Policies, strategies, and services for individuals with Autism Spectrum Disorder, including intellectual and neurodevelopmental disabilities: BASE Project Report (Volume 2) NILT Survey Autism Module

The primary purpose of the BASE Project was to establish how to help individuals with Autism Spectrum Disorder out of poverty by promoting social inclusion. In order to achieve this, a range of methodologies were utilised that aimed to provide a baseline against which the effect of the Autism Act (NI) 2011 and the associated Autism Strategy (2013-2020) and Action Plans can be measured. The BASE Project is reported in 5 volumes. Volume 2 reports on the analysis of the autism module of the Northern Ireland Life and Times (NILT) Survey that assessed public awareness, attitudes, knowledge, and projected behaviours with regard to individuals with ASD (all primary data and technical reports are available at www.ark.ac.uk/nilt/).

The NILT (2012) survey first ever autism module (n=1204) offered a baseline against which the impact of new autism legislation, policies, and strategies can be measured. Key findings:

• 82% awareness: Most people in Northern Ireland are aware of autism (n=989).
• 50% of all participants knew someone with autism personally (n=606).

Of those who were aware of autism:
• 19% had a close family member with autism (n=186), and/or a friends/acquaintance (n=296), and/or a work colleague (n=79) with autism.
• Autism awareness was particularly low for those from ethnic minorities and those with no internet access.
• Awareness of autism specific legislation was low (20%).
• Good levels of knowledge about autism strengths and challenges, slight tendency to overestimate the occurrence of special talents.
• Prevalence of autism was underestimated (62% thought autism was much less prevalent than official figures or did not know).
• Fairly accurate perception about causes of autism, i.e., not caused by poor parenting (84%).
• Strong support for evidence-based behavioural interventions (77%), but confusion about interventions that are not evidence-based (64%).
• Strong positive attitudes towards children and adults in social, educational and employment settings.
• Autism not viewed as necessarily ‘lifelong’ (58%); support for independent living (78%), e.g., driving a car (83%).
• More business for employers who employ people with autism (12%).
• Strong support for families caring rather than residential care (64%).
• Confusion about service responsibility: education (26%) health (33%) or both (28%).

Given increasing prevalence rates of ASD it is important that the general population is aware of autism and able to respond responsibly to the associated strengths and challenges. The results of the NILT (2012) first ever autism module show that the general public was well aware of autism, had positive attitudes, and was relatively knowledgeable about the issues faced by individuals and families affected directly. However, there was a lack of clarity about responsibility for effective service delivery. The NILT results show that a shift in focus is necessary from ‘awareness raising campaigns’ to an approach that delivers clarity with regard to intervention and accountability.

A function-based treatment package aiming at decreasing self-injurious behaviour and tantrums.

Self-injurious and aggressive behaviours have often been identified as the cause for students’ lack of academic progress, parental distress, health risks and teachers´ low satisfaction levels. Functional analysis has been identified in the research literature as the benchmark of effective treatments for disruptive and/or inappropriate behaviours. The present study was completed with a girl diagnosed with ASD. An experimental functional analysis was conducted identifying the function of self-injurious behaviours and tantrums to be escaping from tasks. A treatment package was consequently put in place integrating several components that aimed at reducing overall levels of inappropriate behaviours. Results showed a clear and meaningful improvement in the student´s overall health and academic progress, as well as in parental involvement, teachers’ satisfaction and school inclusion. These outcomes are discussed in the light of evidence-based experimental procedures based on applied behaviour analysis and more specifically on the functional-analytic literature, which, if put in place consistently, can bring valuable positive changes in the quality of life of individuals with ASD.

Evidence-based management and intervention for autism spectrum disorders

Autism Spectrum Disorder (ASD) is diagnosed along a continuum of behavioural variants in social communication and repetitive behaviours [96]. Most individuals on the autism spectrum also experience differences in sensory perception. Some individuals on the spectrum are ‘high-functioning’ and able to cope in every day environments, while others are severely affected, non-verbal, and may have co-occurring diagnoses, such as intellectual disability, epilepsy, and/or obsessional, conduct, or mental health disorders. These individuals require substantial support, caring and careful management, and evidence-based, effective interventions.

Autism and ABA: Best Practice in America and the Way Forward for Europe.

According to recent estimates, 1 in each 68 new-borns will be diagnosed with an Autism Spectrum Disorder (ASD) in the USA (Centers for Disease Control and Prevention, 2014), while 1 in every 29 children will be diagnosed with ASD in the UK (Dillenburger, Jordan, McKerr, & Keenan, 2015). Individuals diagnosed with ASD share a set of characteristics at varying levels of severity: impairments in social communication skills and presence of restricted interests and repetitive behaviours (American Psychiatric Association, 2013).Notwithstanding these figures, little effort has been placed in European countries’ policies for reaching an early diagnosis. This has a detrimental effect on future prognosis for children with ASD, since research has clearly shown that when evidence-based interventions are accessed early in life, they can lead to great improvements on the overall functioning of children with ASD, including significant gains in social communication and reduction of inappropriate behaviours (Dawson, Rogers, Munson, Smith, Winter, Greenson, Donaldson, & Varley, 2009).Additionally, when looking at the services available for children with ASD and their families in Europe, it seems that not much improvement has been made in the last decades. Traditional eclectic approaches and a wealth of non-scientific methods seem to be available and often recommended by public bodies, while state-funded evidence-based interventions are not offered as part of the education or health system. Given that there is a wealth of evidence on the effectiveness of interventions based on the science of ABA, it seems that specific action is required to correct the situation, respecting children’s right to effective treatment and inclusion.In the present paper, these issues are fully discussed and recommendations for best practice are offered.

Defining the content and delivery of an intervention to Change AdhereNce to treatment in BonchiEctasis (CAN-BE): a qualitative approach incorporating the Theoretical Domains Framework, behavioural change techniques and stakeholder expert panels

Background
Low patient adherence to treatment is associated with poorer health outcomes in bronchiectasis. We sought to use the Theoretical Domains Framework (TDF) (a framework derived from 33 psychological theories) and behavioural change techniques (BCTs) to define the content of an intervention to change patients’ adherence in bronchiectasis (Stage 1 and 2) and stakeholder expert panels to define its delivery (Stage 3).

Methods
We conducted semi-structured interviews with patients with bronchiectasis about barriers and motivators to adherence to treatment and focus groups or interviews with bronchiectasis healthcare professionals (HCPs) about their ability to change patients’ adherence to treatment. We coded these data to the 12 domain TDF to identify relevant domains for patients and HCPs (Stage 1). Three researchers independently mapped relevant domains for patients and HCPs to a list of 35 BCTs to identify two lists (patient and HCP) of potential BCTs for inclusion (Stage 2). We presented these lists to three expert panels (two with patients and one with HCPs/academics from across the UK). We asked panels who the intervention should target, who should deliver it, at what intensity, in what format and setting, and using which outcome measures (Stage 3).

Results
Eight TDF domains were perceived to influence patients’ and HCPs’ behaviours: Knowledge, Skills, Beliefs about capability, Beliefs about consequences, Motivation, Social influences, Behavioural regulation and Nature of behaviours (Stage 1). Twelve BCTs common to patients and HCPs were included in the intervention: Monitoring, Self-monitoring, Feedback, Action planning, Problem solving, Persuasive communication, Goal/target specified:behaviour/outcome, Information regarding behaviour/outcome, Role play, Social support and Cognitive restructuring (Stage 2). Participants thought that an individualised combination of these BCTs should be delivered to all patients, by a member of staff, over several one-to-one and/or group visits in secondary care. Efficacy should be measured using pulmonary exacerbations, hospital admissions and quality of life (Stage 3).

Conclusions
Twelve BCTs form the intervention content. An individualised selection from these 12 BCTs will be delivered to all patients over several face-to-face visits in secondary care. Future research should focus on developing physical materials to aid delivery of the intervention prior to feasibility and pilot testing. If effective, this intervention may improve adherence and health outcomes for those with bronchiectasis in the future.

The stability of alcohol consumption between age 16 and 26: Evidence from a National Birth Cohort Study

This study examined the association between moderate drinking at age 16 (adolescence) and alcohol consumption at age 26 (young adulthood), whilst controlling for possible confounding effects at the individual and family level (assessed at birth and age 10). Using the British Cohort Study (BCS70), 6515 respondents provided data on their adolescent alcohol consumption and other behaviours. Of these, 4392 also completed the survey at age 26. Consumption patterns established in adolescence persisted, to a large degree, into early adulthood. Those adolescents who drank moderately in adolescence drank significantly less in adulthood than those adolescents who drank to heavy or hazardous levels. Implications for health promotion strategies and guidance are discussed.

Socio-economic status and lifestyle factors are associated with achalasia risk: a population-based case-control study.

AIM: To evaluate the association between various lifestyle factors and achalasia risk.

METHODS: A population-based case-control study was conducted in Northern Ireland, including n= 151 achalasia cases and n = 117 age- and sex-matched controls. Lifestyle factors were assessed via a face-to-face structured interview. The association between achalasia and lifestyle factors was assessed by unconditional logistic regression, to produce odds ratios (OR) and 95% confidence interval (CI).

RESULTS: Individuals who had low-class occupations were at the highest risk of achalasia (OR = 1.88, 95%CI: 1.02-3.45), inferring that high-class occupation holders have a reduced risk of achalasia. A history of foreign travel, a lifestyle factor linked to upper socio-economic class, was also associated with a reduced risk of achalasia (OR = 0.59, 95%CI: 0.35-0.99). Smoking and alcohol consumption carried significantly reduced risks of achalasia, even after adjustment for socio-economic status. The presence of pets in the house was associated with a two-fold increased risk of achalasia (OR = 2.00, 95%CI: 1.17-3.42). No childhood household factors were associated with achalasia risk.

CONCLUSION: Achalasia is a disease of inequality, and individuals from low socio-economic backgrounds are at highest risk. This does not appear to be due to corresponding alcohol and smoking behaviours. An observed positive association between pet ownership and achalasia risk suggests an interaction between endotoxin and viral infection exposure in achalasia aetiology.

Protestantism, Spectacle, Motherhood and Vice: Dublin's New Pleasure Gardens

In 1748, Bartholomew Mosse, a curious combination of surgeon, obstetrician and entertainment impresario, established a pleasure garden on the northern fringes of Dublin. Ostensibly designed to fund the construction of a maternity hospital to be located adjacently, Mosse’s New Pleasure Gardens became one of the premier leisure resorts in Dublin. This was to have a profound effect on the city’s urban form. Within a few years the gardens became an epicentre of speculative development as the upper classes jostled to build their houses in the vicinity. Meanwhile, the creation nearby of Sackville Mall, a wide and generous strolling ground, established a whole section of the city dedicated to haute spectacle, display and leisure. Like other pleasure gardens in the British Isles, Mosse’s venture introduced new, commodified forms of entertainment. In the colonial context of eighteenth-century Ireland, however, ‘a land only recently won and insecurely held’ (Foster, 1988) by the Protestant Anglo-Irish settler class, the production of culture and spectacle was perhaps more significant than elsewhere. Indeed, the form of Mosse’s gardens echoed the private city gardens of a key figure in the Anglo-Irish aristocracy, while the hospital itself was constructed in a style of a Palladian country house, symbol of colonial presence in the countryside. However, like other pleasure gardens, the mix of music and alcohol, the heterogeneous crowd culled from across social and gender boundaries, and a landscape punctuated with secluded corners, meant that it also acquired a dubious reputation as a haunt of louche and illicit behaviours. The curious juxtaposition between a maternity hospital and pleasure garden, therefore, begins to assume other, hitherto hidden complexities. These are borne out by a closer examination of the architecture of the hospital, the shape of its landscape and the records of its patrons and patients.

Integrated approach to teaching English in primary and preschool

O presente trabalho de investigação apresenta um estudo que procurou observar comportamentos de literacia emergente numa língua estrangeira (Inglês) em contexto da educação pré-escolar. Procedeu-se à conceção e implementação de uma abordagem integrada ao ensino da língua inglesa, através numa abordagem metodológica inspirada no paradigma investigação-ação, percecionada como oportunidade de inovação pedagógica e de formação de professores. O estudo foi desenvolvido em simultâneo no 1ºCEB, tendo como principal objetivo comparar os comportamentos e atitudes dos alunos de outra faixa etária relativamente aos comportamentos de literacia em língua estrangeira. Os dados foram recolhidos através da observação, gravação de aulas, posteriormente transcritas, diários do investigador, questionários, portfolios dos alunos e entrevistas semi-estruturadas a especialistas na área da pedagogia de línguas estrangeiras, analisados através da aplicação de técnicas de análise de conteúdo como procedimento de análise do corpus. Os resultados demonstram a relevância de abordagens integradas de cariz lúdico na promoção de comportamentos de leitura e escrita emergente, estimulando assim motivação intrínseca nas crianças pela aprendizagem da língua e cultura-alvo. Por conseguinte, os comportamentos observados de literacia emergente em língua estrangeira permitem estabelecer uma analogia com as crianças bilingues, na medida em que ao aprenderem uma outra língua desenvolvem em sincronia a sua flexibilidade mental e estratégias de auto-regulação em diversas áreas de conhecimento. Os resultados permitem ainda concluir que estratégias promotoras de motivação intrínseca como o lúdico e o storytelling são vitais na sensibilização à diversidade linguística e cultural, por oposição aos resultados evidenciados pela estratégia nacional para o ensino de línguas estrangeiras no 1.ºCEB. As principais implicações deste estudo sugerem a possibilidade de generalização da língua estrangeira na educação pré-escolar, sendo esta etapa compreendida como um período privilegiado na prevenção de insucesso na leitura e escrita na aprendizagem de uma língua estrangeira. Deste modo, a educação pré-escolar pode ser considerada como um tempo fundador do futuro linguístico das crianças, numa perspetiva de educação linguística ao longo da vida.

Improving health and wellbeing independently of GDP: dividends of greener and prosoical economies

Increases in gross domestic product (GDP) beyond a threshold of basic needs do not lead to further increases in well-being. An explanation is that material consumption (MC) also results in negative health externalities. We assess how these externalities influence six factors critical for well-being: (i) healthy food; (ii) active body; (iii) healthy mind; (iv) community links; (v) contact with nature; and (vi) attachment to possessions. If environmentally sustainable consumption (ESC) were increasingly substituted for MC, thus improving well-being and stocks of natural and social capital, and sustainable behaviours involving non-material consumption (SBs-NMC) became more prevalent, then well-being would increase regardless of levels of GDP. In the UK, the individualised annual health costs of negative consumption externalities (NCEs) currently amount to £62 billion for the National Health Service, and £184 billion for the economy (for mental ill-health, dementia, obesity, physical inactivity, diabetes, loneliness and cardiovascular disease). A dividend is available if substitution by ESC and SBs-NMC could limit the prevalence of these conditions.

Antecedents, psychiatric characteristics and follow-up of adolescents hospitalized for suicide attempt of overwhelming suicidal ideation.

To evaluate the socio-demographic as well as the health and psychiatric profiles of adolescents hospitalised for suicide attempt or overwhelming suicide ideation and to assess repetition of suicide attempt over a period of 18 months. Between April 2000 and September 2001, all patients aged 16 to 21 years admitted to the University Hospitals of Geneva and Lausanne for suicide attempt or ideation were included in the study. At this time (T0) semi-structured face to face interviews were conducted to identify socio-demographic data, mental health and antecedents regarding suicidal conducts. Current psychiatric status was assessed with the MINI (Mini International Neuropsychiatric Instrument). At T1 and T2, reassessments included psychiatric status (MINI) as well as lifestyles, socio-professional situation and suicidal behaviours. At T0, 269 subjects met the study criteria, among whom 83 subjects (56 girls and 27 boys) left the hospital too quickly to be involved or refused to participate in the study (final sample at T0: 149 girls; 37 boys). The participation rate at T1 and T2 was respectively 66% and 62% of the original sample. The percentage of adolescents meeting the criteria for psychiatric diagnoses (91%) was high: affective disorder (78%); anxiety disorder (64%); substance use disorder (39%); eating disorder (9%); psychotic disorder (11%); antisocial personality (7%) with most subjects (85%) having more than one disorder. Around 90% of the subjects interviewed at T1, and/or T2, had received follow-up care after their hospitalisation, either by a primary care physician or a psychotherapist or both. Two subjects died of violent death and 18% made a further suicide attempt. Most adolescents hospitalised for suicidal episodes suffer from psychiatric problems which should be addressed by a careful psychiatric assessment, followed up if needed by a structured after care plan.

The role of self-presentation in adolescent health risk behaviours

Self-presentation has been identified as playing a key role in the perfonnance of various potentially hazardous health behaviours such as substance abuse, eating disorders and reckless behaviours (Leary, Tchividjian, & Kraxberger, 1994; Martin & Leary, 2001; Martin, Leary, & O'Brien, 2001). The present study investigated the role of selfpresentation on adolescent health-risk behaviours. Specifically, this study examined the prevalence of adolescent identified health-risk behaviours rooted in self-presentational motives in youths aged 13-18 years. The current study also identified the specific images associated with these behaviours desired by youth, and the targets of these behaviours. Also, the relationship between these behaviours, and several trait measures (social physique anxiety, public-self consciousness, fear of negative evaluations, selfpresentational efficacy) of self-presentation were examined. Finally, the gender differences in health risk behaviours and self-presentational concerns were examined. Participants in the present study were 96 adolescent students, 34 male and 62 female, recruited from various private schools across Southern Ontario. Students ranged in age from 13 to 18 years for both males (M age = 15.81 years, SD = 1.49) and females (M age = 14.89 years, SD = 1.17) and ranged from grades 8 through 13. Results of the current study suggested that Canadian adolescents between the ages of 13 and 18 years participated in health risk behaviours for self-presentational purposes. Drinking alcohol, skipping school, and performing stunts and dares were identified as the most common health risk behaviours performed for self-presentational purposes by both males and females. Appearing fun and cool were the most commonly reported desired images while appearing brave and mature were the least reported. The most desired target group cited was same sex friends, followed by other sex friends. Trait measures of self-presentational concerns identified females as being higher in public self-consciousness, and social physique anxiety than males. Males were found to be higher in self-presentational efficacy than females. The total number of health risk behaviours was predicted by selfpresentational efficacy and social physique anxiety for males, and social physique anxiety for females. Findings of the current study suggest that Canadian adolescents' health risk behaviours are rooted, in part, in self-presentational motives. Thus far, an educational approach to health interventions has been favoured and/or adopted by teachers, health promoters, and educators (Jessor, 1992). Implications of the current study suggest that although educational interventions are beneficial in presenting the associated risks with certain activities and/or behaviours, one reason this type of approach may be ineffective in changing adolescent behaviour over the long run is that it does not address the strong and prominent influences of interpersonal motives on health damaging behaviour. It is evident that social acceptance and public image are of importance to adolescents, and the desire to make the "right" impression and to achieve peer approval and acceptance often override health and safety concerns (Jessor, 1992). Thus, a self-presentational approach focusing on changing the images associated with the behaviours may be more successful at deterring adolescent health risk behaviours.

The influence of investigator disturbance on aggressive behaviour and breeding success of ring-billed gulls (Larus delawarensis) /

Increased losses of eggs and chicks resulting from human intrusion (investigator or other) into seabird colonies has been well documented. In 1990/91, I studied the effects of investigator disturbance on aggressive behaviour and breeding success of individual pairs of ring-billed gulls nesting at two colonies near Port Colborne, Ontario. The insular colony was on an artificial breakwall, associated with the Welland Ship Canal, approximately 1 km off the north shore of Lake Erie. The mainland colony was adjacent to the canal approximately 1 km east of the breakwall. The frequencies of adult threat and assault behaviours, chick movement and adult attacks on chicks were recorded by continuous scan sampling 30 min prior to, 30 min during and 60 (2 X 30) min after investigator disturbance. The frequency of threat and assault behaviours increased during the period of investigator activity in the colony while the duration of wingpulls and beakpulls decreased. Significantly more chicks ran ("runners") from their natal territories during disturbances and "runners" were more frequently attacked than "territorial" chicks. No chicks were fatally attacked during disturbance and "runners" returned to their natal territories quickly after disturbance. Breeding success was determined for pairs nesting in study plots subjected to two levels of disturbance (normal and moderate). The disturbance level of each plot differed in visitation frequency and activities performed on each visit. Investigator disturbance had no effect on the hatching success or fledging success (taken as 21 days of age) of ring-billed gull study pairs at either colony.