Category Archives: Interventions

Car-free Cork in 15 minutes, walking and cycling

Cork City centre is within 15 minutes walk (green) for 22,000 residents, within 30 minutes walk (cyan) for 53,000 residents and 45 minutes walk, or 20 minutes cycling (pink) for 106,000 residents.

Cork City centre is compact, varied and contains all the amenities for most people’s everyday needs. The City centre shops and facilities are within 15 minutes walk (green) for 22,530 residents, within 30 minutes walk (cyan) for 53,481 residents and 45 minutes walk, or 20 minutes cycling (pink) for 106,200 residents.

These residents are, equally, the consumer base of many of the businesses within Cork City centre, and the audience for appeals on footfall and invigorating activity in Cork.

I use the boundaries of Cork City, as defined at the time of the 2016 census, to count and plot how many can (and do!) walk, cycle, use public transport and live without cars or private motorised vehicles in Cork City. Links to the full CSO Small Area Population Statistics (SAPS) are included (and repeated in full at the end), as well as some excellent sources of information about the City, including the Pedestrian Cork Survey 2020.

(See also “Conserving accesible urban space” for a discussion on accessibility and sensory overload in Cork City).

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Modelling an epidemic

Two contrasting approaches to predicting (guessing) the outcome of an epidemic are 1) projecting data from similar situations observed in the past; and 2) modelling from varying degrees of first principles. Models must match reality for any reasonable usefulness, but are often extremely sensitive to intitial (unknown) conditions and the slightest variation in input parameters.

Here are both approaches, in broad outline, to generate boundaries around expected outcome.

NB1: Code in R (requires population and death or case time series)

NB: My thesis “Mathematical modelling of inherent susceptibility to fatal diseases” has some relevance, but not to epidemic modelling.

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How I (sometimes) cope with anxiety

Ian Dury wryly noted that anxiety crippled (his word) him more than polio and in his wonderful song “Crippled with Nerves”, anxiety is both disabling and a potential loss of social opportunity – but it’s a pain worth enduring for a sufficiently rewarding end result (marriage and two children, in his case). I’d like to emphasise the role of choice and (social) reward.

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Autism and identity in the DSM

The DSM (autism section) alluvial plotThe Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, is a definitive document for many professionals assessing, diagnosing and providing services related to autism. The DSM has been slow to recognise of Hans Asperger’s work (see also Historical context of Asperger’s first (1938) autism paper), of Asperger syndrome and Lorna Wing’s contribution to the wider autism/autistic spectrum .

Professionals inform parents, carers, teachers and others about the meaning of ‘autism’ and are often held in awe. The identity of autistic people has been impacted by the ebb and flow of ideas and consensus in the DSM.

This is a description of some images I have been creating of the definition of autism in the full text of every version of the DSM, from 1952 to the present.

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Autism and dual diagnosis in a psychiatric dystopia

"I ain’t broke ... and you bastards ain’t never gonna break me." (Bitch Planet #3, by writer Kelly Sue DeConnick and artist Valentine De Landro, 2015).
“I ain’t broke … and you bastards ain’t never gonna break me.” (Bitch Planet #3, by writer Kelly Sue DeConnick and artist Valentine De Landro, 2015).

As someone with both an autism spectrum diagnosis and a history of mental illness, I fall into that intersectionality politely called ’dual diagnosis’, although it often feels more like ’falling between two stools’ than eligibility for duplicated supports. I am lucky to have won the postcode lottery and live in Cork City, the base of the only HSE-funded community support service in the country for adults with Asperger syndrome, where I get excellent social and other supports from Aspect, part of the Cork Association for Autism. I am unlucky to live in a country that otherwise has no services whatsoever for autistic adults (post 18 years) and where ’dual diagnosis’ means being shuffled between mental health services (as and when mental health is impacted) and social or disability support services. About 70-80% of people with Asperger syndrome also experience depression, anxiety and emotional difficulties. Suicidal thoughts are common and often difficult to identify. I want to share a particularly difficult recent encounter with psychiatric care that others in a similar position may find helpful to talk about.

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Illness and absence

I have had some serious illness over the past year, which I will write about in a post shortly. As a result I have been saving my energy for a number of important projects that I needed to keep on track, and I have missed my goal of posting here about once a week.

As a result I have built up a little pile of completed work that I hope to write up quite swiftly and you may see a small deluge of posts, if I have the energy to get them all written up.

Historical context of Asperger’s first (1938) autism paper

Hans Asperger published his first paper on autism in 1938 in German in the journal Wiener Klinische Wochenschrift [The Vienna Clinical Weekly], five years before Leo Kanner’s first publication in 1943 in English. These were by no means the first papers about “autism“, because the term was already used in the description of schizophrenia by Eugen Bleuler in German in 1913. Four strands of work – about autism and schizophrenia, in German and English – continued to both enhance and confuse the understanding of autism for decades. Most notably Asperger’s 1938 contribution was ignored as the pre-war prominence of Viennese medicine gave way to post-war shame and disgrace.

The transformation of “autism” from a predominantly German term in schizophrenia, to the predominantly English term we undersatnd is summarised well in the word-frequency plot of the publication sequence.

Word frequency of "autism" in German and English, 1900-1960
Word frequency of “autism” in German and English, 1900-1960

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Coleridge and sensory dreams

I recently went on a charming little journey through time to track down a quote attributed to the poet Samuel Taylor Coleridge (1772-1834), “we do not feel horror because we are haunted by a sphinx, we dream a sphinx in order to explain the horror that we feel”. The context and the journey through references adds beautifully to my earlier post about dreams and nightmares. Coleridge was disturbed by his nightmares throughout his life and shared his thoughts about their origins.

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Medical communication barriers

I have been spending a little more time than I would like investigating health clinics, diagnostic procedures and hospital. A recurring theme for me is inadequate, conflicting or confusing communication of potentially important medical information. My own position is that I have a wide vocabulary and good verbal fluency, but my listening comprehension is sometimes over-ridden by my own preconceptions or overwhelmed by sensory and emotional overload. At my worst I babble very fast, repetitively ask for confirmation of the same answer or simply become mute. This confuses people.

I am currently in-between two abdominal surgeries, the first involving 3 nights recovery in Intensive Care and a further 4 in a ward; the second will follow 6 weeks of recuperation at home (in which I am barred from lifting anything heavier than a jug of water). Needless to say the delivery of a diagnosis of major surgery at 53 requires some emotional processing (which I don’t think I have really started) and a great deal of exposure to beeping monitors, machinery and over-lapping conversation.

The staff have been absolutely fantastic and extremely accommodating. There are some areas of procedure and infrastructure that I found confusing.

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Fitness tracking the quality of my life

Fitness and other tracking systems have the potential to measure some aspects of quality of life and possibly suggest changes that will improve future quality of life. I have worn a simple fitness tracker (a pedometer-style step-counting watch) for almost two years and have now combined the fitness tracker data with other sources – my real-life and online social activity – to look at how quality of life might be assessed.

The fitness tracker tells me my total steps and primitive measures of sleep. The real-life activities are social and work activities from my diary and photographs from my camera (which fill in gaps about where I was). The online activity is taken from the number of email and Twitter messages that I have sent per day. Some of the data is noisy and I have averaged over a week.

The take-home message is that physical activity improves quality of life. Twitter (or at least the way I have been using Twitter) has a negative impact. Doing more to be outside the house, even simply taking my activity to another place, would improve my fitness and happiness.
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