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Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

Distinguishing between autism characteristics and trauma-related symptoms may be clinically challenging, particularly in individuals who have experienced early traumatisation. Previous studies have described a risk that trauma-related symptoms are misinterpreted and/or misattributed to autism. This study aims to describe and explore assessment strategies to distinguish autism and early traumatisation in the case of a young woman with mild intellectual disability.

A clinical case study outlining assessment strategies, diagnostic decision-making and initial intervention.

A multi-informant interdisciplinary assessment using multiple assessment tools, together with a comprehensive review of records from previous assessments and contacts with various services, was helpful in distinguishing between autism and trauma. This included specific assessment tools for autism and trauma. Autism characteristics and trauma-related symptoms appeared to interact, not merely co-occur.

The current case demonstrates that diagnostic overshadowing may occur for autism in the context of early trauma. The case further highlights the importance of not ascribing trauma-related symptoms to autism, as service provision and treatment need to take account of both. Overlooking autism in individuals who have experienced early traumatisation may result in a risk that intervention and care are not appropriately adapted, which may involve a risk of exacerbating trauma symptoms.

Autistic individuals are at increased risk of trauma exposure and post-traumatic stress disorder (PTSD). Diagnostic overshadowing, however, often results in PTSD symptoms being mislabelled as autistic traits. This study aims to develop professional consensus on the identification and assessment of co-occurring PTSD in autistic adults.

An online modified Delphi design was used to gather professionals’ perspectives on key aspects of the identification and assessment of PTSD in autistic adults. Data were gathered qualitatively in Round 1 and then synthesised using content analysis into a list of statements that were rated in Round 2. Statements reaching 60–79% consensus and additional suggestions were sent out for rating in Round 3. Consensus for the final statement list was set at 80% agreement.

Overall, 108 statements reached consensus. These form the basis of professional-informed recommendations to facilitate the identification and assessment of PTSD symptoms in autistic adults.

The final Delphi statements provide a framework to assist with the assessment and recognition of traumatic stress reactions in autistic adults presenting to mental health, diagnostic or social services.

To the best of the authors’ knowledge, this is the first study to explore the presentation and identification of PTSD in autistic adults (with and without intellectual disability), using a bottom-up approach informed by professional consensus.

Operation and maintenance (O&M) processes projects such as identification, assessment, planning and execution, embody a variety of standards such as technical (method of statement), environmental, economic (campus development) and social (health and wellbeing). Because these standards have proven to be challenging to integrate, local governments are increasingly experimenting with social innovation (SI) as a bottom-up form of standard integration. This study aims to apply the concept of SI to the O&M processes of facilities management at polytechnics in Malaysia to identify problems with conventional working practices in this area and to recommend potential solutions.

The paper reviews evidence that conventional working methods generate significant problems related to paper-based forms, improper database management and flawed decision-making processes. Because of the lack knowledge about different ways of how standard integration is achieved, the comparison of three polytechnic institutions which are Rensselaer Polytechnic Institute (RPI) and Southern Polytechnic College of Engineering and Engineering Technology (SPCEET) in USA as well as Seberang Perai Polytechnic, Pulau Pinang (PSP) in Malaysia shares the ambition to realise standard integration of O&M through SI.

The findings reveal that SI leads to four ways of standard integration: computerised maintenance management system, online customer complaint, electronic form and relational database. Application of the concept of SI reveals the need for more sophisticated management solutions in the O&M processes of facilities management.

These standard integration arrangements unfortunately seem to mainly contribute to greater alignment between standard rather than true standard integration. The concept of SI will guide future improvements and developments in maintenance management systems to fulfil requirements in this area.

This paper focuses on knowledge sharing in health care. The aim of the paper is to further understand how digital applications can facilitate knowledge sharing between different care providers and health-care professionals.

The paper is based on a qualitative action case study, performed as a formative intervention study as a Change Laboratory, where a digital application concerning wound support was used. The Change Laboratory was used for knowledge sharing in the assessment and treatment process of wounds. The collected data was then thematically analyzed.

The findings show how digital applications can facilitate knowledge sharing, but also the need for complementary collaborative sessions. The main contribution is the rich description of how digital applications together with these sessions can facilitate knowledge sharing.

This paper shows that activities as collaborative sessions performed on the organizational level prove to support knowledge sharing and learning when a new digital application has been implemented in the work process. It also shows that these sessions contributed to identifying new knowledge that has potential for being included in the application and hence are important to keeping the application updated and relevant over time.

Alzheimer’s disease (AD) is the primary cause of dementia in elderly people and needs extensive professional care. The aim of our study was to assess the level of knowledge among primary health-care providers, primarily Family Physicians (FPs) and community pharmacists (CPs), about AD and its treatment.

A cross-sectional study using Google Forms sent by email or message to FPs and CPs in Istanbul in June–July 2023. Turkish modified the Alzheimer’s Disease Knowledge Scale (ADKS) and Alzheimer’s Medicines Knowledge Level Questionnaire (AMKLQ) were used in this study.

A total of 63 FPs with a mean age of 35.3 ± 7.8 and 138 CPs with a mean age of 38.6 ± 12.6 enrolled in the study. There was no statistically significant difference between FPs and CPs in terms of total ADKS score (19.82 ± 2.30 vs 19.23 ± 3.08, p = 0.136), but there was a significant difference in terms of total AMKLQ score (4.31 ± 1.40 vs 3.81 ± 1.49, p = 0.020). Health-care providers with Alzheimer’s training had a higher total AMKLQ score (OR =1.08 CI 95% [1.03–1.14], p = 0.012).

FPs’ knowledge of AD is on par with that of CPs. Nevertheless, it has been observed that FPs have more proficiency in delivering accurate responses to the AMKLQ and ADKS inquiries, which encompass crucial details regarding the treatment of AD. The sole determinant of the highest mean AMKLQ score was found to be professional education. Collectively, these arguments emphasize the need for primary health-care practitioners to obtain comprehensive and ongoing education regarding AD and its treatment.

The system of higher education in the Russian Federation due to the high share of fundamental training is focused on ensuring the foundation of permanent stability of the graduate, while the system of additional professional education is obliged to take into account the current state of the educational services market, which is characterised by globalisation, diversification, digitalisation and international integration. Therefore, the main focus of the modern system of additional professional education of teachers is the creation of favourable organisational, content, procedural and other conditions that contribute to the professional development and creative self-realisation of teachers, taking into account their individual needs and abilities. In this section, based on the analysis of normative documents and innovative experience of professional development and retraining of education specialists, the goals and objectives, structure and content, main development trends and modern training technologies, features of the internal system of quality assessment of additional professional education of teachers in Russia are disclosed.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

This paper on the prevalence of attention deficit hyperactive disorder (ADHD) in schools holds immense significance due to its unique contribution to the existing body of knowledge. This study stands out as one of the few conducted in Uganda and the entire African continent. The purpose of this study is to establish the prevalence of ADHD symptoms in government primary schools in Wakiso District, Uganda. And also inform educational policies and interventions tailored to address the needs of children with ADHD in Uganda and globally.

The research paradigm adopted was pragmatism, an explanatory sequential mixed methods approach was used, with a quantitative sample of 1,067 participants (learners), 64 teachers who underwent a series of training to equip them with the necessary knowledge about ADHD filled questionnaires for the 1,067 learners, four teachers selected in each school, one teacher per class and a qualitative sample of 32 teachers and one key informant from 16 primary schools. Random and purposive sampling was used. The strengths and weaknesses of ADHD symptoms and normal behavior scale questionnaire was used for quantitative data collection, while qualitative data was gathered through interviews, observations and focus group discussion.

The results revealed an overall prevalence of ADHD symptoms of 11.60%, with inattention symptoms being more dominant than hyperactive/impulsivity symptoms (8.82%). There was no significant difference in prevalence between boys and girls, with primary one pupils having the highest prevalence of symptoms and primary four pupils having the lowest. Pupils aged 10–13 may be less susceptible to ADHD symptoms. The most prevalent symptoms were linked to interrupting or intruding behavior, failure to give attention to detail and inability to play quietly. Qualitative data from the key informant’s observations and teacher focus groups supported these findings.

Limited geographic scope: The study was conducted in only one district, Wakiso, in Uganda. However, this district is very densely populated with people from different cultural and economic background, making it representative of the entire country Uganda. While the response rates for both the quantitative and qualitative components were relatively high (95% and 84%, respectively), there is a possibility that those who chose to participate may have different experiences. But the response rate provided sufficient data for analysis according to the researcher.

The researcher recommends that further research is needed in other districts; also, there is a need to develop early intervention strategies for teachers and parents with ADHD children. More research is needed to better understand the primary causes and risk factors associated with ADHD in primary school children.

This study stands out as one of the few conducted in Uganda and the entire African continent on ADHD. By addressing this research gap, the paper adds valuable insights to the field of ADHD research, shedding light on the prevalence of ADHD symptoms, which can be used to investigate the impact of ADHD on academic performance within the Ugandan education system further. The findings of this study have the potential to inform educational policies and interventions tailored to address the needs of children with ADHD in Africa and beyond.