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A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

The purpose of this paper is to provide information for non-specialists on identifying the characteristics, assessment and support needs of people with intellectual disabilities (ID) accessing mainstream services.

A review of relevant policy and research literature is supplemented with observations from the authors’ own experience of working in mental health services for people with ID.

With change in provision of services the likelihood of mainstream staff encountering someone with ID will increase. However, information on whether a person has ID or their level of ID is not always available to professionals in acute mental health services meeting an individual for the first time. Reliance on observational and interview-based assessments can leave people with ID vulnerable to a range of over- and under-diagnosis issues. This is as a result of difficulties with communication and emotional introspection, psychosocial masking, suggestibility, confabulation and acquiescence. For people with poor communication, carers will be the primary source of information and their contribution has to be taken into account.

Knowing or suspecting an individual has ID allows staff to take into account the various assessment, diagnosis and formulation issues that complicate a valid and reliable understanding of their mental health needs. Awareness about an individual’s ID also allows professionals to be vigilant to their own biases, where issues of diagnostic overshadowing or cognitive disintegration may be important considerations. However, understanding some of the practical and conceptual issues should ensure a cautious and critical approach to diagnosing, formulating and addressing this population’s mental health needs.

This synthesis of a review of the literature and observations from the authors’ experience of working in mental health services for people with ID provides an informed and practical briefing for those encountering people with ID accessing mainstream services.

“Case-complexity” is a widely used but under-explored concept across health and social care. A region’s Intensive Support Teams (ISTs) had been reporting an increase in “case-complexity”, but had not tested this hypothesis against data. This study aims to investigate this question through a pragmatic mixed-methods approach as part of a wider service evaluation.

Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) scores were used (n = 1,766) to estimate average “case-complexity” of referrals over an eight-year sample period. Two focus groups for IST staff (n = 18) explored why “case-complexity” appears to be increasing. Participant perspectives were subjected to thematic analysis.

Average HoNOS-LD scores have steadily increased over the sample period, suggestive of increasing “case-complexity”. Focus groups identified three broad themes to potentially explain the increased complexity: effects of Transforming Care; people’s changing and unchanging support systems; and issues related to mild and borderline intellectual disability. Many perspectives are grounded in or supported by evidence.

Implications and limitations of findings are discussed, including areas for further consideration and research. The well-designed “short-cut” is promoted as a strategy for busy professionals in need of practice-based evidence but with limited research time and resources.

The findings and discussion will be of value to anyone involved in the design, commissioning and delivery of mental health and challenging behaviour services to people with intellectual and developmental disabilities (IDD) under Transforming Care. Study methodology is easily replicable to build broader picture about “case-complexity” among UK’s IDD population.

This paper aims to provide a commentary response to “Stakeholder experiences of deprescribing psychotropic medicines for challenging behaviour in people with intellectual disabilities”.

The commentary provides some evidence-based perspectives on the risks and challenges of psychiatric drug-withdrawal, emphasising the importance of the patient experience in deprescribing decisions. It also makes the case for clinical clarity and carer-engagement in optimising deprescribing outcomes for individuals. Some clinical reflections are provided.

Whilst efforts to reduce the overmedication of people with learning disabilities are welcomed, there is lacking evidence around this population’s experience of adverse effects from psychiatric deprescribing decisions, including differentiating between withdrawal and relapse effects. Clinical clarity and carer engagement are key to safe and effective prescribing, although in reality, this can be challenging.

This paper will be of value to all professionals with a role in the effective deprescribing of psychiatric medications with and/or for people with intellectual disability. It provides perspectives on aspects of stakeholder experience that warrant further consideration and research.

IF we count the University of Strathclyde School of Librarianship as a “new” school—rather than simply an old school transferred from a College of Commerce to a university—then four “new” schools were established between 1963 and 1964, three of the four in universities and the other closely linked with a university, though remaining independent. All four schools have their special features but I consider the more significant of Belfast's features to be its right, from the outset, to conduct all its own examinations for graduates and non‐graduates. Queen's was also the first British university to provide non‐graduates with courses in librarianship. (Strathclyde is the second.) All successful students are eligible for admission to the Register of Chartered Librarians (ALA) after they have completed the prescribed period of practical experience.

The purpose of this paper is to examine the knowledge public procurement professionals perceive as important for performing their duties.

Using secondary data generated from a job analysis study commissioned by the Universal Public Procurement Certification Council [UPPCC], this paper examined the knowledge sets that procurement officials recognize as necessary and sufficient for daily operations and professional development.

Principal Component Analysis is used to validate the six domains of knowledge covered on the survey. This paper identifies sets of core knowledge domains that are essential for procurement administration, including sourcing, negotiation process, contract administration, supply management and strategic procurement planning.

Furthermore, the authors incorporated anecdotal commentary information from the same survey to determine what additional professional development and continuing education opportunities procurement officials are seeking to improve performance in their current and future work roles.

Zoos are important urban tourism attractions. The challenge for zoos is finding a balance between attracting visitors and enhancing education and conservation management. This research contributes to a greater understanding of the conservation intentions of zoo visitors and how zoos can emphasise conservation management principles sustainably. This study aims to identify the variables that encourage conservation intentions among visitors to a South African zoo.

A destination-based survey was conducted in 2019 at the Johannesburg Zoo, and 445 questionnaires were administered through convenience sampling.

Exploratory factor analyses identified visitors’ conservation awareness because of zoos (pre-conscious, conscious and unconscious), behavioural intentions (advocating and supporting), motives (engagement, edutainment and escapism) and satisfaction (interaction and facility quality, and service and interpretation quality). The behavioural intentions were the dependent variables. Advocating conservation intentions (ACI) is an active role where zoo visitors feel a strong responsibility towards conservation and encourage others to the conservation cause. Supporting conservation intentions (SCI) relates more to loyalty towards visiting the zoo and subsequently supporting conservation. Stepwise linear regression analyses revealed that enhancing ACI relies on SCI, edutainment, conscious awareness, service and interpretation quality and total spending. However, enhancing SCI relies on ACI, interaction and facility quality and the motive, escapism, while engagement revealed a negative relationship.

The results show that zoos can encourage SCI to ACI by using interactive and entertaining interpretations to teach visitors about the zoo’s mandate and the importance of conservation while balancing their need to escape.

This paper examines the nature of propaganda and its use by corporations, particularly in the USA, over a period of nearly 100 years. It emphasises the invisibility of much of this activity and propaganda’s importance for shaping acquiescence in corporate hegemony. The role played by corporate propaganda in the development of different forms of capitalism is addressed. The inculcation of accounting and finance students with values that serve corporate interests is considered: in this context propaganda is inferred in both the longstanding misrepresentation of Adam Smith, and the sustained illusion of competitive “free markets”. The role and language of the business media as a form of propaganda is considered, particularly regarding colonisation of social market economies by Anglo‐Saxon capitalism, which takes as incontestable the maximisation of shareholder value as the proper and necessary aim of corporate activity. It is argued that corporate propaganda has contributed to the accounting measure of business success being justified as an end in itself at the explicit expense of wider societal considerations.

The paper's aim is to develop a closed‐loop supply chain orientation as a strategic alternative available to supply chain organizations seeking competitive advantage in a setting that puts a premium on socially responsible decisions.

The literature describing the concepts of supply chain orientation and supply chain leadership is used to develop a framework for achieving a competitive advantage.

Creating a closed‐loop supply chain orientation may be facilitated when the supply chain leader demonstrates a transformational leadership style, and when socially important environmental issues are present.

The paper presents a synthesis of previously unconnected concepts in a conceptual framework that sets a stage for future research in this area.

The paper highlights the strategic importance of developing a closed‐loop supply chain orientation in the presence of environmental factors, and a supply chain leadership style that may enhance the transformation to such an orientation.

The paper extends the strategic concept of supply chain orientation to include forward and reverse flows in a holistic, closed‐loop view of the supply chain.