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The purpose of this paper is to illustrate how often survivors are dismissed and unsupported in response to actively reaching out for help with distress. The author hopes the vignettes written about in this piece will serve to support and contribute to a body of work, which will educate professionals how to better support. The author shares various experiences when opportunities to help were denied and the impact this had on recovery. It is also noted that the responses of some health professionals mirror the original trauma suffered and therefore add to distress unnecessarily.

The author has written about various experiences in different settings in which the support offered fell below professional standards and contributed to further unnecessary distress. The writing is evocative and rich in descriptive detail of the event and then implications of the event on recovery.

The author concludes that it is helpful to use experiences of being dismissed and unsupported by various professionals to contribute to a body of work, which will hopefully educate and support those in caring professions to support survivors better. The author notes that responses to requests for help can unintentionally and intentionally further exacerbate the distress already experienced by those living with traumatic early life experiences and relational abruptions.

This is the author’s unique and first-hand lived experience of reaching out for help in relation to the distress experienced as a result of early life traumatic and adversarial experiences. The author notes that it is helpful to write about these difficult experiences with the hope that they will inform educational programmes to support health professionals in how they respond to people experiencing trauma. This has helped the author regain a sense of agency in contributing to the prevention of further unhelpful responses from various health professionals to those in distress. The vignettes are rich, deeply evocative and moving. The writing process also helped the author make sense of these further difficulties and how they impacted the recovery process.

In early 2014, recent Stanford University graduate Tyler Shultz was in a quandary. He had been working at Theranos, a blood-diagnostic company founded by Elizabeth Holmes, a Stanford-dropout wunderkind, for almost a year. Shultz had learned enough about the company to realize that its practices and the efficacy of its much-touted finger-prick blood-testing technology were questionable and that the company was going to great lengths to hide this fact from the public and from regulators.

Theranos and Holmes were Silicon Valley darlings, enjoying positive press and lavish attention from potential investors and technology titans alike. Just as companies like PayPal had revolutionized the stagnant payments industry and Uber had upended the for-hire transportation sector, Theranos had been positioned as the latest technology firm to substantially disrupt yet another mature sector: the medical laboratory business. By the start of 2014, the company had raised more than $400 million in funding, and had an estimated market valuation of $9 billion.

Shultz's situation was exacerbated by the fact that his grandfather, the highly respected former US Secretary of State George Shultz, was on the Theranos board and was one of Elizabeth Holmes's biggest supporters.

But Tyler Shultz worried about the customers he was convinced were receiving highly unreliable and often inaccurate blood-test results. With so much at stake, Shultz wondered how he should proceed. Should he raise his concerns with the firm's investors? Blow the whistle externally? Report to industry regulators? Go away quietly?

This case and its subsequent four brief follow-up cases are based largely on interviews with Tyler Shultz, and outline the dilemma he faced and the various steps he would take both to extricate himself from his unsavory position and let the public know the full extent of the deception at Theranos.

Five optional handouts are available to instructors to further discussion after the case has been debriefed. The handouts serve as additional decision points for the students if your class time permits.

Gender-diverse people experience unique cultural and interpersonal stigma in mainstream society and sometimes within their own communities; they face allegations of inauthenticity based on their nonconformity to either cisnormative or transnormative gender regimes. Based on 21 in-depth life history interviews, we unveil the intricate interactional process of negotiating identity and authenticity in the biographical work of gender-diverse individuals. In this study, gender-diverse people engaged in a “gender audit” with their gender-diverse interviewer. Gender audits yield verbal performances of gender with oneself and others. Ambiguity was “accounted for” or “embraced and created” in their biographical work to organize their life stories and undermine binary essentialism – a discourse that was “discursively constraining.” Gender audits took place in participants' day-to-day lives, either through self-audits, questioning from others, or both. In the final analysis, we assert that we all engage in gender auditing. Gender audits are intersubjective sites of domination, subordination, resistance, and social change. Gender diversity, then, can be viewed as a product of gender in flux.

This study aimed to propose a performance-oriented approach of automatically generative design and optimization of hospital building layouts in consideration of public health emergency, which intended to conduct reasonable layout design of hospital building to meet different performance requirements for both high efficiency during normal periods and low risk in the pandemic.

The research design follows a sequential mixed methodology. First, key points and parameters of hospital building layout design (HBLD) are analyzed. Then, to meet the requirements of high efficiency and low risk, adjacent preference score and infection risk coefficient are constructed as constraints. On this basis, automatic generative design is conducted to generate building layout schemes. Finally, multi-objective deviation analysis is carried out to obtain the optimal scheme of hospital building layouts.

Automatic generative design of building layouts that integrates adjacent preferences and infection risks enables hospitals to achieve rapid transitions between normal (high efficiency) and pandemic (low risk) periods, which can effectively respond to public health emergencies. The proposed approach has been verified in an actual project, which can help systematically explore the solution for better decision-making.

The form of building layouts is limited to rectangles, and future work can explore conducting irregular layouts into optimization for the framework of generative design.

The contribution of this paper is the developed approach that can quickly and effectively generate more hospital layout alternatives satisfying high operational efficiency and low infection risk by formulating space design rules, which is of great significance in response to public health emergency.

This paper investigates the change talk (CT) strategies of the motivational interviewing (MI) technique and their relevance in achieving change goals within communities of practice (CoP), focusing on addressing real-world problems in today's complex world.

We employ a literature review and conceptual analysis to study the interactions and potential areas of complement between CT, MI and CoP theories.

This paper combines CT, MI and CoP theories to develop an integrated model called Facilitative Change Talk Leadership (FCTL).

This paper provides an innovative model (FCTL) to inform leadership educators about facilitating communities of practice. We provide a hypothetical case study to suggest how FCTL might foster collaborative inquiry and resilience amidst complex challenges. This case study illustrates a practical pathway for leadership educators and community practitioners to use this model in their own contexts.

The purpose of this study is to explore the support needs surrounding intimate relationships and sexuality of autistic adults accessing funded social care in England.

Semi-structured interviews with 15 autistic adults who were accessing funded social care examined their support needs surrounding intimate relationships and sexuality, with subsequent data analysis using reflexive thematic analysis.

Four themes were generated: Help at hand, but not too close for comfort, No “cookie-cutter rules”: personalised, inclusive approaches, Playing it safe, not leaving it too late, and Autism-informed education and support.

The authors produced an online learning module for social care staff in England on best practice in supporting autistic adults without learning disabilities with relationships and sexuality.

To the best of the authors' knowledge, there has been no other UK-based research published to date on the social care support needs of autistic adults without learning disabilities surrounding relationships, gender and sexuality.

Employee burnout is increasingly coming under attention due to its negative impact on employee well-being and organisational effectiveness. This study, a systematic review, aims to evaluate the role of servant leadership and its mediators in preventing and mitigating against burnout experiences in organisations.

A preferred reporting items for systematic review and meta-analyses (PRISMA) was conducted using three databases, Academic search Complete, Embase and Scopus, in addition to bibliography searches. Articles were included if they reported on primary data, in English from inception to 2023. The mixed methods critical appraisal tool was used to assess the quality of articles, and a narrative synthesis was used to report results.

The search strategy yielded 4,045 articles, of which (N = 17), with total sample size of (N = 10,444) are included. Findings suggest that servant leadership is predictive of burnout, and that several mediators impact this relationship. Most studies were conducted in health care (n = 8) and banking (n = 3), and while the quality of the studies was mostly high (64%), the methods used were mainly descriptive and cross-sectional, which limits the extent to which causality can be inferred. A theory of change is provided based on the findings from this review and integrated with the extant literature on servant leadership theory, and can be used by organisations to support the policy, training and practice of servant leadership to reduce burnout.

Servant leadership is predictive of burnout; however, further research needs to be undertaken in this important emerging area.