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Research indicates that the diagnostic label of Bipolar Disorder is being both over and under-used in mental health services. Disagreement between clinicians in how the diagnosis of Bipolar Disorder is perceived and how the label is used can make it difficult to establish and uphold consistent care. This may lead to the experience of negative emotions for service users and poor engagement with intervention. Therefore, the purpose of this paper is to explore whether clinicians do hold different perceptions of the diagnosis of Bipolar Disorder, with the view of providing insight into how this may impact service provision.

Q-methodology was used to investigate the subjective viewpoints of 19 clinicians from mental health community teams supporting individuals with a diagnosis of Bipolar Disorder. The completed Q-sorts were subject to analysis using Q-methodology analysis software.

Three main factors representing the viewpoints of participants were identified: seeing the person and their experience, promoting quality through standardised processes and understanding the function of diagnostic labels. All three factors agreed that more than one assessment appointment should be required before a diagnosis of Bipolar Disorder was given and that the focus should be on the difficulties experienced rather than the diagnostic label.

These three viewpoints provide different perspectives of the diagnosis of Bipolar Disorder, which are likely to impact on service provision. Services may benefit from a better integration of the viewpoints, noting the important functions of each viewpoint and being guided by individuals’ needs.

Although No Secrets suggests that adult protection practices should seek to prevent abuse, it can be argued that such practice predominately focuses on pursuing effective responses to abuse that has already happened, rather than preventing the onset of abuse. This research sought to contribute to the prevention of abuse, through the identification of ‘early indicators’. Early indicators were identified, and this knowledge has been applied to equip families and practitioners to report concerns at an early stage and seek protective responses.

The purpose of this paper is to reflect on the response to the scandal of abuse in services for people with intellectual disabilities in the light of research evidence and analysis.

Critical reflection and review of literature. In particular, recent research into possible indicators that a service is at risk of becoming abusive is used to test the hypotheses and implied solutions that are currently being adopted.

That some of the responses to recent scandals are necessary but not sufficient to prevent future harm. Furthermore, some of the proposed solutions may actually increase the likelihood of further abuse. Prevention of abuse requires a broader and more evidence-based response.

The synthesis of research and analysis presented here has not been presented previously in the published literature.

The purpose of this paper is to describe a project reporting the evaluation of an adapted form of the thinking skills programme (TSP) with prisoners with intellectual disabilities. In particular, the utility of realistic evaluation is explored as a response to the difficulties in applying research-based interventions in practice and rolling out pilot projects that have been evaluated under specific conditions.

Realistic evaluation involves the identification of context, mechanism and outcome as a structure for programme evaluation and this was applied to the development and implementation of adapted TSP (ATSP) in three English prisons.

Findings are reported in respect of the three aspects of context, mechanism and outcome to demonstrate the utility of realistic evaluation. Contextual findings suggested that ATSP is effective with male prisoners representing a range of intellectual disabilities, who would otherwise be excluded from mainstream programmes. The programme did not establish effectiveness with women or in community settings. The prisons involved were of different levels of security, but all three prisons were actively involved in positive approaches to difference and diversity and support for people with intellectual disabilities. For mechanism it was noted that all involved in the pilot sites were highly motivated to participate in the project and they were also achieving high scores for general quality in programme delivery. The realistic evaluation framework suggests that, where these factors are not present, some caution about possible effectiveness should be exercised. The evaluation approach proved to be helpful in identifying relevant factors to be considered in the wider implementation of ATSP.

This is a novel approach to programme evaluation in psychological therapies that was shown to be of value in identifying conditions under which pilot schemes can be extended to other parts of a service, and research on interventions for offenders with intellectual disabilities applied in practice.

The purpose of this paper is to contribute to the prevention of the abuse of older people in residential and nursing homes, through the identification of “early indicators of concern”. Such indicators support practitioners in identifying services in which older people are at risk of abuse, neglect and ill treatment.

Semi-structured interviews were conducted with health and social care practitioners in two local authorities (in England and Scotland), who had visited services in which abuse or neglect had occurred. Practitioners were asked about the things that they had seen within the service which had caused them to become concerned.

Over 90 early indicators of concern were identified. These indicators were grouped within six themes which identify key manifestations of service cultures which may promote the abuse of older people.

Information and guidance has been developed to enable practitioners to recognise early indicators and identify services in which older people are at risk and in which actions are required to help prevent the onset of abuse.

A range of studies have highlighted the importance of organisational cultures in promoting the abuse of older people. The early indicators identified through this research represent visible signs of such poor service cultures which can be observed by practitioners, enabling them to recognise services in which older people are at greater risk.

The purpose of this chapter is to determine whether graduate classes in deep democracy and social justice can actually effect change in educators’ leadership practice.

This chapter draws on a survey of all doctoral students in educational leadership from a major research university who were concurrently school principals. From those willing to engage in follow-up, surveys were conducted of their teachers, and follow-up interviews and observations were conducted with the principals themselves.

We identified six main themes; courses related to deep democracy and social justice brought about deeper understanding of the topics, helped leaders acquire language and “new paradigms,” sometimes caused confusion and a sense of being overwhelmed by the challenges, assisted leaders to engage staff in dialogue, and prompted action related to social justice. Leaders also sometimes experienced a sense of being alone as they engaged in a difficult struggle.

The findings highlighted the need for instructors to walk “alongside” their students as they tried to change their practices, to become critical friends and to offer on-site support.

Findings also highlight the importance of teaching both theory and practical applications together. Further research about the pedagogies that make this possible is needed.

If graduate coursework can impact leaders’ practice, it can effect changes in schools so they become more welcoming and inclusive of all students so that those who come from minoritized or disadvantaged backgrounds may experience greater school success.

Demonstrating a link between graduate coursework and the ability of school leaders to emphasize social justice, equity and deep democracy in their practice is not only original but extremely important.

The case depicts Krispy Kreme's franchise system growth and decline as a lesson to entrepreneurs running a company as a franchisor. Burton D. Cohen, retired senior vice president and chief franchise officer for McDonald's Corporation from 1980 to 1999, explains the strengths and weaknesses in Krispy Kreme's franchising strategy during the period from 1997 to 2006. Areas examined in the case include: franchisee agreements, accounting practices, volatility in stock valuation, franchise system growth, franchise ownership structure, product distribution strategy, and commissary growth. The case depicts how Krispy Kreme started and how it ended up in a low point.

Students learn: 1.