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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.

This study compared different types of full-time caregiver (e.g., children, older adults, COVID-19 patients) and subgroups (e.g., disability, race/ethnicity, sexual orientation) in the United States during the COVID-19 pandemic for potentially meaningful distinctions.

Data from the 9,854 full-time caregivers identified in Phase 3.2 (July 21–October 11, 2021) of the US Census Household Pulse Survey (HPS) were analyzed in this study using multinomial logistic regression to examine relationships between caregiver types, marginalized subgroups, generation, and vaccination status.

The prevalence of caregiving was low, but the type of full-time caregiving performed varied by demographic group (i.e., disability, race/ethnicity, sexual orientation, gender, generation, and vaccination status). The relative risk of being a COVID-19 caregiver remained significant for being a member of each of the marginalized groups examined after all adjustments.

To date, the HPS has not been analyzed to predict the type of full-time informal caregiving performed during the COVID-19 pandemic or their characteristics. Research limitations of this analysis include the cross-sectional, experimental dataset employed, as well as some variable measurement issues.

Prior informal caregiver research has often focused on the experiences of those caring for older adults or children with special healthcare needs. It may be instructive to learn whether and how informal caregivers excluded from paid employment during infectious disease outbreaks vary in meaningful ways from those engaged in other full-time caregiving. Because COVID-19 magnified equity concerns, examining demographic differences may also facilitate customization of pathways to post-caregiving workforce integration.

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

The statistics show that older adults have been major fire victims in high-rise buildings. However, the fire safety building codes in most countries are not inclusive and do not reflect provisions for older adults. The research aims to develop a fire risk assessment index system for older adults living in high-rise residential buildings in India. The study further develops a fire rating system to improve fire safety provisions in high-rise buildings in India.

The paper employs Delphi, analytic hierarchy process (AHP) and fuzzy comprehensive risk evaluation techniques. It considers 18 in-depth interviews and group discussions with builders, developers, architects, policymakers, and fire safety experts and consultants to develop a fire risk assessment system for older occupants living in high-rise residential buildings in India.

The fire protection systems and fire management systems are not as per the needs of older adults. The egress system components need improvisation considering the challenges of older adults.

The study is limited to older adults living in high-rise residential buildings in the capital city of Gujarat, Ahmedabad.

This study will assist policymakers in developing fire safety standards that are targeted to the needs of older persons living in high-rise residential buildings during a fire evacuation.

While several approaches for measuring fire risk in high-rise residential buildings exist, no such system has been developed specifically for older adults in India.

The purpose of this paper is to consider the role of the Mental Health Act (MHA) 1983 in safeguarding adults at risk of abuse and neglect. The author has undertaken a thematic review of Safeguarding Adults Reviews (SARs) commissioned in England and Adult Practice Reviews (APRs) commissioned in Wales where the MHA 1983 was a central aspect to the review.

Reviews were included based on specific determinants, following analysis of SARs, APRs and executive summaries. This should not affect the credibility of the research, as themes were identified in conjunction with analysis of literature regarding use of the MHA in the context of adult safeguarding. Consequently, this review has been underpinned by evidence-based research in the area of study.

The interaction between statutes, such as the MHA 1983 and Care Act 2014, signify challenges to professionals, with variable application of mental health legislation in practice.

Lack of a complete national repository for review reports means that it is likely that the data set analysis is incomplete. It was noted that limitations to this research include the fact that Safeguarding Adults Boards in England may not publish SAR reports or may choose to publish an executive summary or practice brief instead of the full SAR report, therefore limiting the scope of disseminating learning from SARs, as this is difficult to achieve where the full report has not been published. The author aimed to mitigate this by undertaking comprehensive searches of Local Authority and SAB websites, in addition to submitting Information requests to ensure that this research encompassed as many relevant review reports as possible.

This is an important and timely topic for debate, given that the UK Government is proposing reform of the MHA 1983. In addition, existing thematic reviews of SARS tend to be generalised, rather than specifically focused on the MHA.

The majority of emerging adults in the United States spend time in cohabiting unions. Prior research has suggested that higher levels of sexual non-exclusivity may exist among those in cohabiting relationships compared to marital unions. Although these basic patterns have been explored in prior work, research examining the potential reasons why levels of sexual non-exclusivity differ by union status has been limited. Drawing on a relational perspective and using the fifth wave of data from the Toledo Adolescent Relationships Study (TARS), the present study found that higher levels of sexual non-exclusivity in cohabiting relationships were explained by intimate relationship characteristics and sexual histories rather than sociodemographic factors, partner heterogamy, or partner- and couple-level drug use. These findings highlighted that understanding the higher rates of sexually non-exclusive experiences in cohabiting relationships, compared to marital relationships, requires attention to specific dynamics of the intimate partnership and prior relational experiences of both partners. The study concluded that cohabitation has a unique place in emerging adults’ relationship landscape and may set the groundwork for future relationship functioning.

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.

We take Cumulative Prospect Theory (CPT) seriously by rigorously estimating structural models using the full set of CPT parameters. Much of the literature only estimates a subset of CPT parameters, or more simply assumes CPT parameter values from prior studies. Our data are from laboratory experiments with undergraduate students and MBA students facing substantial real incentives and losses. We also estimate structural models from Expected Utility Theory (EUT), Dual Theory (DT), Rank-Dependent Utility (RDU), and Disappointment Aversion (DA) for comparison. Our major finding is that a majority of individuals in our sample locally asset integrate. That is, they see a loss frame for what it is, a frame, and behave as if they evaluate the net payment rather than the gross loss when one is presented to them. This finding is devastating to the direct application of CPT to these data for those subjects. Support for CPT is greater when losses are covered out of an earned endowment rather than house money, but RDU is still the best single characterization of individual and pooled choices. Defenders of the CPT model claim, correctly, that the CPT model exists “because the data says it should.” In other words, the CPT model was borne from a wide range of stylized facts culled from parts of the cognitive psychology literature. If one is to take the CPT model seriously and rigorously then it needs to do a much better job of explaining the data than we see here.

The main purpose of this study is to test for the interaction effect of digital literacy in the relationship between financial technologies (FinTechs) of biometrics and mobile money and digital financial inclusion among the unbanked poor women, youth and persons with disabilities (PWDs) in rural Uganda.

Covariance-based structural equation modeling was used to construct the interaction effect using data collected from the unbanked poor women, youth and PWDs located in the four regions in Uganda as prescribed by Hair et al. (2022).

The findings from this study are threefold: first; the results revealed a positive interaction effect of digital literacy between FinTechs of biometrics and mobile money and digital financial inclusion. Second; the results also confirmed that biometrics identification positively promotes digital financial inclusion. Lastly; the results showed that mobile money positively promotes digital financial inclusion. A combination of FinTechs of biometrics and mobile money together with digital literacy explain 29% variation in digital financial inclusion among the unbanked poor women, youth and PWDs in rural Uganda.

The data for this study were collected mainly from the unbanked poor women, youth and PWDs. Further studies may look at data from other sections of the vulnerable population in under developed financial markets. Additionally, the data for this study were collected only from Uganda as a developing country. Thus, more data may be obtained from other developing countries to draw conclusive and generalized empirical evidence. Besides, the current study used cross sectional design to collect the data. Therefore, future studies may adopt longitudinal research design to investigate the impact of FinTechs on digital financial inclusion in the presence of digital literacy across different time range.

The governments in developing countries like Uganda should support women, youth, PWDs and other equally vulnerable groups, especially in the rural communities to understand and use FinTechs. This can be achieved through digital literacy that can help them to embrace digital financial services and competently navigate and perform digital transactions over digital platforms like mobile money without making errors. Besides, governments in developing countries like Uganda can use this finding to advocate for the design of appropriate digital infrastructures to reach remote areas and ensure “last mile connectivity for digital financial services' users.” The use of off-line solutions can complement the absence or loss of on-line network connectivity for biometrics and mobile money to close the huge digital divide gap in rural areas. This can scale-up access to and use of financial services by the unbanked rural population.

This paper sheds more light on the importance of digital literacy in the ever complex and dynamic global FinTech ecosystem in the presence of rampant cyber risks. To the best of the authors' knowledge, limited studies currently exist that integrate digital literacy as a moderator in the relationship between FinTechs and digital financial inclusion, especially among vulnerable groups in under-developed digital financial markets in developing countries. This is the novelty of the paper with data obtained from the unbanked poor women, youth and PWDs in rural Uganda.

The health costs associated with obesity are increasing in developed and emerging economies. Particularly important, though remaining underexplored, is the overall impact of health risks associated with being obese and overweight on the productivity of firms in a cross-country setting. The purpose of this paper is to address these issues.

This paper exploits the natural variation in the percentage of obese males in the population as an exogenous health risk randomly distributed across firms in each country.

Investigating this link for a sample of around 80 emerging countries, the evidence suggests a significant negative effect of health risks on productivity.

The identification assumptions are checked using different approaches to establish the robustness of the empirical link.

This study helps us understand the microlevel effects of the rising average obesity rate. This knowledge is rare in emerging economies which are facing the highest risks of obesity and cardiovascular diseases associated with it.