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Internal employees of firms are a reliable source of information for potential job seekers. However, few studies have focused on why internal employees actively recommend their firms. Based on the social exchange theory, this study aims to construct a chain mediation model using perceived challenge stress and employee experience as mediators to explore how leadership empowerment behavior affects employee referrals.

Bootstrap repeated sampling analysis was conducted on a sample of 307 employees collected through two-time points.

Leadership empowerment behavior is positively related to employee referrals; perceived challenge stress and employee experience mediate the effect of leadership empowerment behavior on employee referrals, respectively; in addition, perceived challenge stress and employee experience play a chain mediating role between leadership empowerment behavior and employee referrals.

The findings can help provide insight into the drivers of employee referrals and can effectively guide organization reputation management.

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.

Customer referral programs (CRPs) are popular; however, they often generate low referral rates. The authors propose that certain CRP referral tasks may hinder consumers’ referral likelihood. This study aims to explore the effects of referral tasks (communication content and approach) on customers’ referral likelihood on social platforms and the role of self-construal.

This study establishes a theoretical model based on online social platforms and conducts three scenario-based experiments. The authors obtain data from consumers on Sojump platform and test the hypotheses using analysis of variance (ANOVA) analysis and mediation analysis in SPSS. The valid sample sizes for these three experiments are 288, 203 and 214, respectively.

Three experimental studies indicate that communication content and approach have a significant effect on referral likelihood. Furthermore, the effect of communication content on referral likelihood depends on the communication approach. Self-construal plays a moderating role in the effect of communication content and approach on perceived social costs.

CRPs typically involve tasks and rewards; consumers are asked to complete a referral task and then receive a reward. Both tasks and rewards can affect an individual’s willingness to participate; however, existing studies on CRP focus primarily on the reward component. To the best of the authors’ knowledge, this is the first study to systematically investigate the role of referral tasks (communication content and approach) in CRPs. The authors extend the related research by examining the impact of referral tasks on consumers’ willingness to recommend. In addition, this study introduces self-construal into CRPs research.

Addressing the significant differences between referral programs and traditional promotional marketing, this paper aims to investigate and examine the impact of how reward-related information is presented within referral programs and how it interacts with reward size and reward allocation.

This study adopts framing effect and equity theory to build the relationship between reward presentation, reward size and reward allocation. Then, two scenario-based experimental studies are designed and conducted on Amazon Mechanical Turk.

The results show that there is no direct impact of reward presentation on referral likelihood, while the effect relies on reward size. As the levels of reward size increase, the referral likelihood gradually shifts from percentage form to dollar form as perceived size mediates the interaction effect on referral likelihood. Further, adding information about reward allocation also indicate the different impacts of equity and inequity on influencing the above findings.

The study contributes to the literature by introducing reward presentation and emphasizes its impact on individual’s behavior decisions in the context of referral programs. This study extends and broadens the scope and effectiveness of the framing effect on traditional promotional marketing strategies, while also bridging the gap in the literature by examining the combined role of information about rewards.

Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.

Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.

Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.

Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.

This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.

Transference-based trust (TBT) via referral sources is a cognitive process where trust in third-party information about an individual transfers to trust in the individual. TBT via referral sources can have significant effects on early trust development in a virtual team (VT). This study aims to examine the potential influence of Hofstede’s (1980) cultural variables and two proposed combinations of these cultural variables on early trust development in VT, including the effects of referral source.

This study adopted multigroup analysis partial least squares structural modeling to examine potential cultural differences in the responses of 357 university students from 51 different countries to understand early trust development in VT.

TBT via referral sources as in interpersonal construct has a positive, direct impact on early trust development. TBT mediated the individual and organizational model constructs. There were significant differences in the high/low values of 3 of the 56 tested cultural dimensions.

Reaffirmed the validity of cognitive-based trust models in understanding early trust development in VTs TBT as an interpersonal construct and has a significant influence on early trust development in VTs. TBT via referral sources mediated the individual and organizational constructs of the model. There were significant differences in the high/low measures of three cultural dimensions (i.e. IV, M and the combination of IV-M-LT) in the relationship of early trusting beliefs to early trusting intensions.

To positively influence interpersonal and organizational aspects of trust development, managers should ensure that the early phases of VTs, before actual implementation begins, are well organized. Managers could make VT members fully aware of how referral sources can influence early trust development. Managers could encourage individuals to have open access to relevant social media accounts for other VT members and encourage individuals to research referral sources on other VTs members. The implication for managers of culturally diverse VT is that the development of early trust is largely by individual choice, rather than differences in national culture.

People need to maintain and actively manage their online presence, ensuring that online information about them is accurate and updated. Referral sources could help VT members learn about one another, which might in turn help foster early trust in their online teams.

Although some studies have found significant cultural differences in early trust development, other studies, including a meta-analysis of 43 studies, found no significant cultural differences in early trust development. This study confirmed the results of the meta-analysis.

The dermatology service on the islands of Orkney, with a population of approximately 22,500, was taken over by National Health Service (NHS) Tayside in August 2018. This paper aims to provide an overview of the planning and review of a highly efficient and effective dermatology service for a rural island population.

The service includes visiting dermatology consultants, enhanced electronic referral vetting, skin surgery services, a General Practice (GP) with extended role (GPwER) in dermatology, specialist virtual clinics, urgent advice for inpatients at the local district general hospital and remote systemic therapy monitoring. A new phototherapy service has been set up in an island GP practice.

Local GPs and consultant dermatologists find the enhanced vetting service useable, efficient and educational. Between August 2018 and November 2022, there have been 1,749 referrals. Of these referrals, 60% were seen in clinic or a GPwER surgery, with 40% managed remotely by providing advice back to the referring GP. The number of consultations performed by the GPwER has grown over the past 3 years, and in the last year, it accounted for more than 50% of patient appointments. The waiting time has been significantly reduced using this model.

This remote service uses an integrated approach of teledermatology (TD) whilst offering continual in-person services using local capabilities including a GPwER and island general surgeons. New treatment facilities are provided to the island population. Continual educational feedback to the primary care referrer is provided, and it enhances relationships that greatly aid the high-quality dermatology service provided.

This study aims to improve the efficiency of the assessment process within a Step4 Psychological Therapies Service by identifying factors related to assessment non-attendance and service suitability for referred clients.

Referral and assessment information was accessed between October 2019 and March 2020 from Step4 routine service data, electronic client records where necessary and Step4 staff self-report questionnaires.

All clients offered an assessment during this time attended. Findings indicated several factors could influence service suitability in meeting client need. These included individual differences such as readiness to change, which was not necessarily identified at referral or prior to assessment, and potential systemic factors, such as the opt-in procedure, which possibly impeded access. Though the necessity for assessment in clarifying client needs and treatment was indicated, an assessment (from referral to assessment appointment) that led to discharge could take an excess of one working day of service time, associated with considerable opportunity cost to other clients awaiting assessment. Recommendations are made for improving assessment efficiency.

With a high prevalence of poor mental health in the UK, efforts must be made to identify and reduce additional demand upon service time and resources within mental health services to effectively meet people’s needs. Recommendations to improve assessment process efficiency include the use of a standardised referral form, offer of follow-up support procedures, increased client involvement, a streamlined opt-in battery and ongoing monitoring to ensure shared practice between clinicians. These are transferable to other mental health services, with implications for subsequent quality and timeliness of care.

This study aims to investigate the prevalence and characteristics of dysphagia among adults with intellectual disabilities (ID) referred to speech and language therapy for swallow assessment, providing information on the demographic characteristics, referral trends, co-occurring health conditions and reasons for referrals highlighting the complex health-care needs of this population.

This study used a standardised patient data extraction method over a six-month period involving 74 adults with ID referred to speech and language therapy for swallow assessment.

This study revealed a high prevalence of dysphagia among adults with ID referred to speech and language therapy for swallow assessment. Increasing age and severity of ID were associated with an increased likelihood of swallowing difficulties. Co-occurring health conditions such as mobility difficulties, epilepsy and gastrointestinal conditions were prevalent, suggesting that adults with ID and swallowing difficulties are often living with complex health conditions. Choking incidents and hospital admissions were primary reasons for referral.

This study stresses the pressing need for strategies to mitigate risks associated with choking incidents and hospital admission among this vulnerable population. Possible limitations include a reliance on referral and the focus being on a single service over a short period which may limit generalisation to the wider ID population.

This study emphasises the need to understand each person’s unique profile of health needs and the value of a specialised speech and language therapy service.

The importance of increasing awareness among caregivers and medical experts is highlighted.

The findings underscore the importance of tailored assessment, caregiver involvement and heightened interdisciplinary awareness to effectively manage dysphagia in individuals with ID.

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process.

Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software.

This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process.

This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.