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Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

The over-reliance on psychotropic medication for the management of patients with learning disabilities with behaviour that challenges is well documented.This paper aims to discuss the application of the methodology of clinical audit within community learning disability mental health services to adapt interventions including optimising prescribing practice and behavioural interventions aiming to reduce behaviour that challenges in people with learning disabilities.

Questionnaire-based review of documentation in electronic patient records, covering relevant audit standards in line with NICE and Royal College of Psychiatrists, was carried out in the North Essex Community Learning Disability Service, Hertfordshire Partnership NHS Foundation Trust. The audit included patients on the caseload of consultant psychiatrists.

The audit demonstrated that the prescribing of psychotropic medication was within BNF maximum limits for all patients, evidence of “consent” procedures was being followed in the majority, and there was some evidence of deprescribing attempts.Improvement was required in several areas e.g. undocumented off label prescribing in a significant proportion of patients. Objective measures to record the severity of behaviours and the effects of the medication were being used by clinicians in only a small proportion of patients. A significant proportion of patients have prescribed medication in the absence of appropriate psychological or environmental interventions.

As a result of the audit findings, the action plan made recommendations such as the development of a database for tracking the prescribing of psychotropic medicines and routine use of standardised measures. This action has been supported by the pharmacy team. Positive developments include a clinical psychologist taking on the role of leading the development of behavioural intervention strategies.

Emergency evacuation plans are often developed under the assumption that evacuees will use wayfinding strategies such as taking the shortest distance route to their nearest exit. The purpose of this paper is to analyze empirical data from a wildfire evacuation analyzed to determine whether evacuees took a shortest distance route to their nearest exit and to identify any alternate wayfinding strategies that they may have used.

The wildfire evacuation analysis presented in this paper is the outcome of a natural experiment. A post-fire online survey was conducted, which included an interactive map interface that allowed evacuees to identify the route that they took. The survey results were integrated with several additional data sets using a GIS. Network analysis was used to compare the routes selected by evacuees to their shortest distance routes, and statistical hypothesis testing was employed to identify the wayfinding strategies that may have been used.

The network analysis revealed that 31 percent of evacuees took a shortest distance route to their nearest exit. Hypothesis testing showed that evacuees selected routes that had significantly longer distances and travel times than the shortest distance routes, and indicated that factors such as the downhill slope percentage of routes and the elevation of exits may have impacted the wayfinding process.

This research is best regarded as a spatiotemporal snapshot of wayfinding behavior during a single wildfire evacuation, but could inspire additional research to establish more generalizable results.

This research may help emergency managers develop more effective wildfire evacuation plans.

This research presents an analysis of an original data set that contributes to the broader body of scientific knowledge on wayfinding and spatial behavior during emergency evacuations.

Purpose: We critically examine the idea of neurodiversity, or the uniqueness of all brains, as the foundation for the neurodiversity movement, which began as an autism rights movement. We explore the neurodiversity movement's potential to support cross-disability alliances that can transform cultures.

Methods/Approach: A neurodiverse team reviewed literature about the history of the neurodiversity movement and associated participatory research methodologies and drew from our experiences guiding programs led, to varying degrees, by neurodivergent people. We highlight two programs for autistic university students, one started by and for autistics and one developed in collaboration with autistic and nonautistic students. These programs are contrasted with a national self-help group started by and for stutterers that is inclusive of “neurotypicals.”

Findings: Neurodiversity-aligned practices have emerged in diverse communities. Similar benefits and challenges of alliance building within versus across neurotypes were apparent in communities that had not been in close contact. Neurodiversity provides a framework that people with diverse conditions can use to identify and work together to challenge shared forms of oppression. However, people interpret the neurodiversity movement in diverse ways. By honing in on core aspects of the neurodiversity paradigm, we can foster alliances across diverse perspectives.

Implications/ Values: Becoming aware of power imbalances and working to rectify them is essential for building effective alliances across neurotypes. Sufficient space and time are needed to create healthy alliances. Participatory approaches, and approaches solely led by neurodivergent people, can begin to address concerns about power and representation within the neurodiversity movement while shifting public understanding.

This chapter uses findings derived from interviews with 13 Ontario (Canada) secondary school principals to identify conditions that contribute to emotional labor, experienced in their work. Five workplace conditions that heighten participating principals' emotional labor emerged from the interviews, including advocating for students, work intensification, navigating their local policy context, managing workplace conflict and crises or tragedies in the school community. The findings suggest a need to clarify legislated expectations and responsibilities placed on principals to accurately reflect their work and counter the impact of work intensification. Principals could benefit from additional supports to deal with the impact(s) of work intensification, shepherding the school through crises or navigating shifting policy contexts and conflicts in the workplace. Rather than treating the symptoms that result from emotional labor, concrete efforts are needed to change the culture of the principalship in order to maximize the impact of leadership on student achievement.

We bring together the institutional theory literature on institutional logics and the information systems (IS) literature that conceptualizes a relational view of affordances to explore the digital changes unfolding in the delivery of professional services. Through a qualitative inductive study of the development of an app led by a clinician manager in an Australian hospital, we investigate how multiple institutional logics shape the design of affordances when an organization develops new digital technologies for frontline professional work. Our findings show how a billing function was designed into the app by the development team over four episodes to afford potential physician users with billing usability, billing acceptability, billing authority and billing discretion. These affordances emerged as different elements of professional, state, managerial and market logics became activated, interpreted, evaluated, negotiated and designed into the digital technology through the team’s interactions with the clinician manager, a hybrid professional, during the app development process. Our findings contribute new insight to the affordance-based logics perspective by deepening understanding of the process through which multiple institutional logics play out in the design of affordances of digital technology. We also highlight the role of hybrid professionals in this digital transformation of frontline professional work.

Although research regarding socialization processes recognizes the importance of organizational identification for newcomer adjustment outcomes, it has less frequently considered the impact of newcomer identification with targets external to the organization. This study aims to investigate whether relational identification with identities external to the organization can be beneficial for socialization outcomes, a relationship the authors describe through the conservation of resources theory. At a time when newcomers are expending resources and may not have a support system inside the organization, important identities may foster success through building a resource base of support available to the newcomer.

Two studies were conducted with newcomers, both groups responded to multi-wave surveys. The authors conducted an initial study with undergraduate students (n = 45) in their first semester of college and a second study with working individuals employed full time in their first year in a new organization (n = 148).

Relational identification with identities external to the organization is positively related to job engagement through the dual mediation of social support and psychological well-being. The results indicate that these external resources encourage well-being and free newcomers to invest in becoming physically, emotionally and cognitively engaged with their new jobs.

The results suggest that organizations may wish to take care in helping newcomers maintain strong relational identities outside the organization while becoming connected with their new organization.

The findings suggest that external relational identities are a neglected and important element influencing the socialization process.

The purpose of this paper is to examine how young women understand and make meaning of their status as early-career women (ECW) in the creative communication industry, which is typically dominated by male leadership. It explores how professional relationships influence their transition into full-time employment and influences their career trajectories.

Interviews with 31 women in the first five years of their communication careers provided insights into how they experience professional relationships in the workplace in relation to leadership advancement. Inductive coding, a feminist organizational communication lens and literature on mentorship and role modeling was used to explore the standpoint of these young women.

Young women understand that professional relationships are necessary for acclimation and professional development. Our analysis revealed an intersection of three distinct ways these relationships help young women cultivate a strong career foundation, positioning themselves for leadership opportunities.

This study provides insight into the experiences of ECW, a group significantly overlooked by industry and research as a way to increase career equity. Findings from this study guide programmatic and socialization practices to help young women overcome barriers.

Developing a deeper understanding of women worker’s realities, this research encourages industries to regard the entire career path, emphasizing the importance of beginning socialization experiences in the workplace. It offers actionable managerial practices, and it drives a new scholarly focus on a demographic critical to closing the leadership gender gap.

The purpose of this article is to propose an overall framework for brand community formation that separates antecedents that lead to the formation of a brand community from those outcomes that are associated with established communities.

The authors approached this review through an interdisciplinary literature review that delineated psychological, structural and behavioral processes that underline the formation of the brand community, often illustrated by contemporary cases in the sport industry.

The findings outline 18 different constructs, categorized in three overarching dimensions, separating structural, behavioral and psychological constructs. The authors posit these 18 constructs are at the heart of brand community formation. These constructs provide managers with a guide to inform their efforts to form a new brand community.

It is emphasized that brand community formation is a complex process that is paradoxical in nature and requires organizations to balance a non-interventionist approach that would allow for consumer empowerment, with a pro-active approach that creates conditions for a successful brand community formation process.

The Personal Responsibility Work Opportunity and Reconciliation Act of 1996, better known as Welfare Reform, implemented, in addition to many other features, a 60-month lifetime limit for welfare receipt. Research to date primarily documents individual-level barriers, characteristics, and outcomes of those who time out. Very little scholarly work considers experiences of mothering or carework after timing out. In this chapter, I ask, what kinds of carework strategies are used by women who have met their lifetime limits to welfare? What do the ways mothers talk about these strategies tell us about the discursive forces they are resisting and/or engaging? Using in-depth interviews at two points in time with women who have timed out of welfare (n = 32 and 23), this analysis shows how mothers’ strategies and the ways they discuss them reveal covert material and symbolic resistance to key discourses – negative assumptions about welfare mothers and a culture of work enforcement – and the conditions shaping their lives (Hollander & Einwohner, 2004). Mothers use carework strategies very similar to those identified in many other studies (e.g., London, Scott, Edin, & Hunter, 2004; Morgen, Acker, & Weigt, 2010; Scott, Edin, London, & Mazelis, 2001), but they provide us with an understanding of carework in a new context. The three groups of strategies explored here – structuring employment and non-employment, protecting children, and securing resources – reveal raced, classed, and gendered labor in which women engage to care for children in circumstances marked by limited employment opportunities and limited state support. The policy implications of mothers’ strategies are also discussed.