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This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.

Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).

Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).

Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.

To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).

The aim of this paper is to explore the stakeholder exclusion practices of responsible leaders.

An interpretive multiple case analyses of seven responsibly led organisations was employed. Twenty-two qualitative interviews were undertaken to investigate and understand perceptions and practice of responsible leaders and their approach to stakeholder inclusion and exclusion.

The findings revealed new and surprising insights where responsible leaders compromised their espoused values of inclusivity through the application of a personal bias, resulting in the exclusion of certain stakeholders. This exclusivity practice focused on the informal evaluation of potential stakeholders’ values, and where they did not align with those of the responsible leader, these stakeholders were excluded from participation with the organisation. This resulted in the creation and continuity of a culture of shared moral purpose across the organisation.

This study focussed on responsible leader-led organisations, so the next stage of the research will include mainstream organisations (i.e. without explicit responsible leadership) to examine how personal values bias affects stakeholder selection in a wider setting.

The findings suggest that reflexive practice and critically appraising management methods in normative leadership approaches may lead to improvements in diversity management.

This paper presents original empirical data challenging current perceptions of responsible leader inclusivity practices and indicates areas of leadership development that may need to be addressed.