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Research highlights that antipsychotic medications are prescribed more in people with Intellectual Disability (ID) without a diagnosis of severe mental illness. Despite non-pharmacological interventions recommended as alternatives, their application can be challenging due to heterogeneity of the patient group. The purpose of this paper is to discuss application of quality improvement (QI) methodology in adapting interventions, aiming to reduce challenging behaviour of people with ID, thereby reducing use of antipsychotic medication.

Two interventions were introduced as “tests of change”; an “Attention-Deficit Hyperactivity Disorder (ADHD) clinic” and “Positive Behaviour Support (PBS) clinic”. Process (Clinical Global Impression (CGI) and Modified Overt Aggression Scale (MOAS)) and outcome measures (total antipsychotic use) were used to assess the interventions, with each being reviewed as per QI methodology guidelines.

There was an improvement in CGI scores for both interventions. MOAS scores reduced for those attending the ADHD clinic, resulting in reductions of antipsychotic medication. MOAS scores did not reduce for the PBS clinic, so there was no reduction in medication for this group.

Based on the introduction of pilot clinics, this paper provides a commentary on how QI interventions can be used to evaluate and adapt evidence-based interventions, in managing the needs of patients with ID. It further highlights the importance of the diagnosis of ADHD in patients with ID and challenging behaviour. Although PBS is recommended to manage challenging behaviour, this paper demonstrates the importance of continuous evaluation of behavioural interventions. There is currently no existing literature investigating use of QI methodology to reduce challenging behaviour in ID populations, emphasising scope for future research and service evaluation.

Developing resilience is vital for firefighters and other practitioners exposed to trauma as part of their day-to-day work in maintaining physical and mental resilience. However, further understanding of what factors facilitate and hinder the development of firefighter resilience and why is needed. The current study evaluates efficacy of support mechanisms currently in place and develops an evidence base for interventions to support development of firefighter resilience.

Semi-structured interviews were conducted with 12 firefighters from across two regions in the United Kingdom, the Northwest and Southeast of England. Thematic analysis was used to analyse transcripts, highlighting themes within, and across, services to identify what factors affect development of firefighter resilience and why.

Thematic analysis highlighted four key themes shared by firefighters across regions: “informal support”, “formal support”, “basic welfare measures” and “trust”. Importantly, how effective formal measures are perceived to be and the willingness for firefighters to access these resources was dependent upon the level of trust held in senior management. Firefighters across locations highlighted levels of trust were affected by industrial actions which created divides. Accordingly, one way firefighter resilience may be further promoted is by altering how formal support mechanisms are accessed.

Although existing research has found factors which promote resilience of firefighters, evaluation of specific services is lacking. The current research highlights areas among two UK services where resilience is effectively being promoted and areas for potential improvement.

The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides:

In order to succeed in an action under the Equal Pay Act 1970, should the woman and the man be employed by the same employer on like work at the same time or would the woman still be covered by the Act if she were employed on like work in succession to the man? This is the question which had to be solved in Macarthys Ltd v. Smith. Unfortunately it was not. Their Lordships interpreted the relevant section in different ways and since Article 119 of the Treaty of Rome was also subject to different interpretations, the case has been referred to the European Court of Justice.

The purpose of this paper is to explore the impact of three components of the psychological contract (i.e. obligations, fulfillment and breach) and the individual characteristic negative affectivity (NA) onto three key outcomes, namely, job satisfaction, organizational identification and psychological distress.

Questionnaires were completed by 222 Australian nurses and midwives from a medium-sized metropolitan Australian hospital. The response rate for the study was 39 percent.

Structural equation modeling revealed that perceptions of psychological contract fulfillment were positively linked to organizational identification and job satisfaction, while psychological contract breach was negatively linked to these outcomes. NA was negatively linked to job satisfaction and positively linked to psychological distress. Psychological contract obligations were not associated with any of the employee outcomes.

Psychological contract fulfillment is an important driver of employee satisfaction and organizational identification and the findings highlight the importance of including NA in psychological contract research. The occupation and context, being in-demand employees, appeared to neutralize the impact of one dimension of the psychological contract, employer promises and obligations.

Explicitly managing employees’ psychological contracts by focussing on fulfilling realistic promises will enable managers to improve employee outcomes and facilitate employees embracing their organization.

This study is one of the first to explore all three components of the psychological contract. These results may assist in the development of strategies to retain in-demand employees such as nurses, particularly highlighting the need to make and fulfill realistic promises.

Children are the primary group most affected by all sorts of social and political developments in a society, whether negative or positive. The disintegration of the social fabric, the destabilisation of a country and the breakdown of political and social security pose a greater threat to children and expose them to greater harm compared to other social strata. Children, whose family integrity in cities, villages and towns has been reduced to dust by the civil war that has raged in Afghanistan for over 40 years, are the most exposed to this violence. Millions of Afghan children have been deprived of modern educational opportunities. On the other hand, the children have been forced to bear the economic burden of the household due to the loss of the source of income for the families as the fathers died in terror attacks. Add to this the psychological problems suffered by the children, as well as the physical abuse of boys, a bitter and archaic picture emerges. In addition, girls are forced to be married off to influential older men, sometimes the age of their grandfathers, and boys are given weapons at an early age, only to be offered to unlawful organisations as fighters to be deployed in conflict zones after harsh and difficult training. This threatens the very nature of what human and children's rights stand for. In this study, using the figures and statistics from UNICEF, Afghanistan Independent Human Rights Commission and other institutions such situations of human rights and children's rights in this country are analysed.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.

Although private health care is regarded as providing a premium quality experience for both patients and staff alike, it is not without its daily challenges for health professionals. This study aims to explore the psychological contract of nurses to develop a greater understanding of how employee–employer interaction impacts motivation levels.

Data were gathered through semi-structured interviews with thirteen nurses at a private hospital in South Africa. Five nursing managers were interviewed to provide a management perspective. Thematic analysis was used to identify the salient elements of the psychological contract and to establish connections with motivational features.

The psychological contract of nurses was balanced in nature, contained predominantly relational elements and was characterized by the need for manager support, leadership and autonomy. Motivation was a by-product of fulfilment and was enhanced by a combination of tangible and intangible rewards.

Nursing managers should recognize their role in caring for the wellbeing of their staff and should be trained accordingly. Equipping nurses with the necessary tools to work autonomously, as well as acknowledging their skills, will stimulate confidence and improve motivation.

This study makes an important contribution to the existing literature on the psychological contract of nurses within the health-care system. It provides insight into relationship-based mechanisms that can be used to improve the motivation of nurses and thus impact the overall quality of patient care.

This research aims to demonstrate that coupons with short durations for redemption can backfire, lowering consumers’ attitudes toward the company.

Two experimental studies in the restaurant context demonstrate the backfire effect. A boundary condition of the effect as well as the underlying psychological process are identified.

Consumers respond adversely to coupons with restrictive requirements for redemption – in particular, a short duration. Study 1 indicates that while a short-duration (vs long-duration) coupon may backfire when its face value is low, this backfire effect is attenuated when the coupon’s face value is high. Furthermore, Studies 1 and 2 provide evidence that psychological reactance is the process underlying this backfire effect.

Consumers respond negatively to coupons with restrictive requirements for redemption because they perceive them as a company’s attempt to limit their freedom of choice. Companies should take measures, including careful target marketing, to avoid rousing this reaction from their consumers.