"I am afraid of being treated badly if I show it": A cross-sectional study of healthcare accessibility and Autism Health Passports among UK Autistic adults.

BACKGROUND: Autistic people are more likely to experience stigma, communication barriers and anxiety during healthcare. Autism Health Passports (AHPs) are a communication tool that aim to provide information about healthcare needs in a standardised way. They are recommended in research and policy to improve healthcare quality. AIM: To explore views and experiences of AHPs among Autistic people from the UK who have been pregnant. METHODS: We developed an online survey using a combination of open and closed questions focused on healthcare impairments and views and experiences of AHPs. Data were anlaysed using descriptive statistics, Kruskal-Wallis tests, and content analysis. FINDINGS: Of 193 Autistic respondents (54% diagnosed, 22% undergoing diagnosis and 24% self-identifying), over 80% reported anxiety and masking during healthcare always or most of the time. Some significant differences were identified in healthcare (in)accessibility by diagnostic status. Only 4% of participants knew a lot about AHPs, with 1.5% of participants using one at least half of the time. Almost three quarters of respondents had not previously seen an AHP. Open text responses indicated that the biggest barrier to using an AHP was a belief that health professionals would discriminate against Autistic patients. Additional barriers included staff lack of familiarity with AHPs and respondents expecting a negative response to producing an AHP. CONCLUSIONS: Our findings suggest that AHPs are not reducing health inequalities for Autistic adults who have been pregnant. Alternative solutions are needed to reduce health inequalities for Autistic people.

Life Interference Due to Gambling in Three Canadian Provinces.

The gambling landscape among provinces in Canada is diverse. Yet, few studies have investigated provincial differences related to life interference due to gambling. The objectives of the current study were to examine: (1) provincial differences with regard to gambling types and (2) if gender, family history of gambling, and alcohol or drug use while gambling were related to an increased likelihood of life interference in three Canadian provinces. Data were drawn from the 2013 and 2014 cycles of the Canadian Community Health Survey from Manitoba, Saskatchewan, and British Columbia (n = 30,150). Analyses were conducted stratified by provinces and also combined using logistic regression models. Provincial differences were noted with individuals from British Columbia compared to Manitoba being less likely to play VLTs outside of casinos, play live horse racing at a track or off track, and participate in sports gambling. Those in Saskatchewan compared to Manitoba were more likely to play VLTs inside a casino. When examining all provinces combined, family history of gambling was associated with increased odds of life interference. Gender was not associated with life interference. Provincial differences were noted, which may be in part related to differences in gambling landscapes. Family history of gambling may have clinical relevance for understanding which individuals may be more likely to experience life interference due to gambling. Further research is needed to clarify the link between alcohol and drug use while gambling and life interference due to gambling as the models in the current research were likely underpowered.

Challenges and dilemmas: fieldwork with upland minorities in socialist Vietnam, Laos and southwest China.

The Chinese, Vietnamese and Lao spaces within the upland Southeast Asian massif, sheltering over 80 million people belonging to geographically dispersed and politically fragmented minority populations, have only recently reopened to overseas academic endeavours. Undertaking social sciences research there among ethnic minority groups is underscored by a specific set of challenges, dilemmas, and negotiations. This special issue brings together Western academics and post-fieldwork doctoral students from the realms of social anthropology and human geography, who have conducted in-depth fieldwork among ethnic minorities in upland southwest China, northern Vietnam, and southern Laos. The articles provide insights into the struggles and constraints they faced in the field, set against an understanding of the historical context of field research in these locales. In this unique context that nowadays interweaves economic liberalisation with centralised and authoritarian political structures, the authors explore how they have negotiated and manoeuvred access to ethnic minority voices in complex cultural configurations. The ethical challenges raised and methodological reflections offered will be insightful for others conducting fieldwork in the socialist margins of the Southeast Asian massif and beyond. This specific context is introduced here, followed by a critique of the literature on the core themes that contributors raise.

The changing face of voluntary welfare provision in New Zealand.

This paper contributes a micro-level analysis of voluntary welfare providers, an under explored avenue of geographical research. It analyses the localised social impacts of the macroeconomic restructuring of the Welfare State in New Zealand in the 1980s and 1990s on the work of voluntary service organisations (VSOs) and drop-in centres (DICs) as spaces of care in Dunedin, a small South Island city. We document differences among VSOs and DICs in terms of funding, clientele, and adjustments to service provision to satisfy increasing numbers of patrons and the changing composition of demand. Our findings suggest policy recommendations which, we believe, would do much to enhance the ability of both DICs and smaller VSOs to meet client needs.