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This chapter demonstrates the ways in which digital inclusion functions as a super social determinant of health, particularly within the arena of family carework and healthcare for vulnerable disabled US communities. The focus on vulnerable populations, including the elderly, chronically ill, young disabled, neurodivergent, and/or medically complex children and the families that care for them, is a useful case to present a compelling argument for the need to take seriously digital inclusion to maximize health, safety, and well-being for growing populations of Americans today. The authors argue that digital inclusion is an increasingly influential social determinant of health and a key dimension of health equity that offers important benefits and potentials, especially for vulnerable patient populations, for whom in-home and family-centered care are necessary parts of health maintenance, prevention, and well-being. The chapter ends with a discussion of ways that the US government can mitigate digital barriers and facilitate equitable access to broadband internet and e-health resources that address the intersections of digital, health, and care inequalities, with significant impacts in all three dimensions.

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.

The purpose of this study is to systematically review the recent empirical literature on job stress and burnout among prison staff with a focus on predictors, outcomes of stress and burnout and the mediating role that stress and burnout can play between its predictors and outcomes.

The authors followed systematic literature review (SLR) protocols for the social sciences, and searches were done on two large research databases: SCOPUS and Web of Science. Articles included in the study were from January 2015 to March 2020. After the screening and eligibility processes, 48 articles met the inclusion/exclusion criteria, and 33 articles were included in the full-text qualitative analysis.

Characteristics of the samples, main authors and journals and measures used to assess stress and burnout are presented, showing that most research was done in the USA, with cross-sectional studies using similar measures of stress and burnout. Results from the qualitative analysis were organised around the main research questions. Most studies explored the antecedents of stress and burnout in the context of the job demands – resources model. Common predictors that consistently increase stress and burnout among different samples include perceived dangerousness of the job and work–family conflict. Participation in decision-making and social support consistently decrease job stress.

This paper presents a SLR on stress and burnout among prison officers in a pre-COVID-19 pandemic era, providing an important picture of the published scientific research on the topic as well as implications for theory and practice.

Although educators would likely agree that values and ethics are important in all disciplines, they have particular importance for practice-oriented fields. These applied professionals need to solve complex social problems that require the application of ethical standards and value perspectives. While the importance of value-engaged practice is known to the applied field, there is little research and conversation about how values can be integrated into teaching. This chapter synthesizes values-education approaches in various practice-based disciplines such as public administration (PA), program evaluation, social work, and public health. This chapter draws from empirical and theoretical works as well as the authors' experiences developing, participating in, and conducting values-based research on professionals and professional education.

The evolution and trends of special education and educational leadership are evident, especially in recent years. The former has strived to provide equitable educational opportunities to students with disabilities. The latter has dealt with how people in positions of authority in K-12 schools create policy, use resources, and influence other people to achieve educational goals. Together, these notions constitute an idea that school leaders and administrators can provide insight, oversight, assistance, and guidance toward creating educational environments for students with and without disabilities. This chapter examines the current state of special education and educational leadership by exploring the evolution of special education, relevant legal cases, and the enactment of inclusive education. Furthermore, this chapter addresses contemporary issues for leaders, such as the influence of the COVID-19 pandemic, while dealing with special education and the increasing pressure from families for equity for students with disabilities.

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.

At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of introducing AA as a potential intervention to the OT community, this study aims to investigate the extent to which participation in a two-day AA training could contribute to increasing confidence and inspire changes in practice for Irish occupational therapists (OTs) supporting autistic children.

A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of a two-day AA training on six OTs. The OTs support autistic children throughout Ireland across public, private and voluntary sectors. They completed brief, non-standardised questionnaires 2 weeks before the training (Time 1) and again 12 weeks post (Time 2) training session. At Time 2, additional exploratory questions were answered by OTs regarding their use of AA in practice.

This explorative study’s quantitative findings presented percentage change increases within three areas of confidence for all OTs. These include establishing attention, motivating and developing functional skill goals with autistic children. One of the participants did not score any change in confidence in a fourth area, building rapport, however, the five other participants scored percentage change increases. Qualitative data provided by participants showed that they were implementing AA in practice since attending the training. Five of the participants reported positive experiences of using AA and one participant reported the programme was not suitable for her caseload because of their level of understanding and need.

This was a small, exploratory, practice-based study. As this is the first study exploring this area of practice for OTs, to the best of the authors’ knowledge, there were no standardised methods of assessment available, therefore a self-designed survey was used by the author which had a limited number of open-ended questions and four Likert scale questions. This study was also limited in that there was one main researcher who also delivered the two-day AA training. The sample data set was small which resulted in the limitation of the choice of methods used to analyse the quantitative data. Percentage changes were used as the only available and reliable method for a small data set.

Findings of this study, despite their preliminary nature, indicate that AA training may be a useful professional development consideration for OTs who provide a service for autistic children. Further AA research in OT is required including larger and more rigorous studies. An alternative training option of The Curiosity Programme may be considered for OTs supporting children who may not yet be ready to participate in AA.

Globally “non-urgent” health care services were ceased in response to the 2020 outbreak of COVID-19, until 2021, when restrictions were lifted. In the UK, this included speech and language therapy services. The implications of COVID-19 restrictions have not been explored. This study aimed to examine the impact of the UK’s COVID-19 response on speech and language therapy services.

An online survey of the practice of speech and language therapists (SLTs) in the UK was undertaken. This explored SLTs’ perceptions of the demand for their services at a time when COVID-19 restrictions had been lifted, compared with before the onset of the pandemic. The analysis was completed using descriptive statistics and content analysis.

Respondents were mostly employed by the UK’s National Health Service (NHS) or the private sector. Many participants reported that demands on their service had increased compared with before the onset of the pandemic. The need to address the backlog of cases arising from shutdowns was the main reason for this. Contributing factors included staffing issues and redeployment. Service users were consequently waiting longer for NHS therapy. Private therapy providers reported increased demand, which they directly attributed to these NHS challenges.

This presents the only focused account of the impact of the national response to COVID-19 on speech and language therapy services in the UK. It has been identified that services continue to face significant challenges, which indicate a two-tier system is emerging. Healthcare system leaders must work with service managers and clinicians to create solutions and prevent the system from being overwhelmed.

Individual Placement and Support (IPS) is an evidence-based employment model, effective in supporting individuals with severe mental health difficulties to gain competitive employment. Irish mental health policy recognises its value and IPS is being rolled out in a national programme. Employment is recognised an important contributor to mental health recovery and social inclusion. However, research on IPS has tended to focus on competitive job outcomes. The purpose of this study was to explore the non-vocational outcomes of IPS in an Irish context.

A qualitative research approach was used to interview participants taking part in IPS within community mental health teams. Twelve interviews were included in the data analysis process which was informed by a thematic analysis approach.

Participants experienced increased confidence and positivity, both within a work context and whilst job seeking. More purposeful time use, participation in activities and engagement with society were also experienced by those employed and those at the job search stage of IPS.

This study contributes to the literature about the non-vocational benefits of IPS within an Irish context, highlights the mental health recovery benefits of taking part in IPS and supports the need for ongoing development of IPS throughout mental health services in Ireland.

Telepresence robots have gained prominence as a novel technological modality for mobile videoconferencing. Although the technology has mass appeal in the realm of telehealth and patient–health provider communication, its integration in community living settings for older adults has not been extensively studied. The aim of this study was to gather the perspectives of residents, trainers and staff at a retirement facility on their experience with a telepresence robot during and following a five-week wellness program.

The study employed semi-structured interviews with ten stakeholders who were involved in the wellness program followed by a qualitative content analysis of the data. The Unified Theory of Acceptance and Use of Technology served as the interview framework to explore the facilitators and barriers to the implementation of the robot.

Independent coding of the data by the study investigators identified discrete as well as interconnected categories among the stakeholders. Residents expressed their changing ideation of the robot, affinity toward the technology, preference for human connection and future value. Perspectives of the trainers, the fellow residents (ambassadors) and staff pertained to their need for increased engagement, growing comfort with the technology, usability challenges and importance of coordination and training.

Older adults' outlook and comfort with telepresence robots improve with continuing exposure to the technology for healthcare and social connectivity needs. However, in-person care is also preferred initially and periodically to engage with their health providers meaningfully and effectively via the robot. To address long term feasibility and usability, the authors propose a hierarchical approach when integrating telepresence robots in community living facilities for older adults. Information technology education, staff training and reliable internet connectivity are the precursors to optimizing the value and perceived usefulness of the technology.