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The purpose of this paper is to investigate if positive behavioural support (PBS) can be an effective alternative to medication, and can aid medication reduction in people with a learning disability, autism or both who are prescribed psychotropic medication for behaviour thought to be challenging. STOMP is an initiative supported by NHS England which aims to reduce inappropriate prescribing of psychotropic medication, i.e. antipsychotics used for challenging behaviour in the absence of a documented mental health diagnosis. PBS has been described as the first line of intervention for behaviours which challenge, (NICE, 2015) and has been highlighted as a non-pharmacological alternative to, medication.

A two-group, experimental design was utilised. Both groups were considered for medication reduction. The experimental group of 25 people received input from a specialist PBS team, while the control group of 29 people underwent unsupported medication challenge.

There was a significantly higher success rate for medication reduction and discontinuation when PBS assessment and intervention was provided as an alternative to medication.

This study indicates that providing PBS is associated with decreased medication and if replicated should be become standard practice for specialist teams.

This is the first study to investigate the effect of PBS on medication reduction in patients prescribed psychotropic medication for behaviour thought to be challenging.

The purpose of this paper is to demonstrate how Positive Behavioural Support (PBS) can be used as an alternative to psychotropic medication to improve the quality of life of an individual with a learning disability and behaviour described as challenging.

A single case design was utilised. A unique PBS stopping over medication of people with a learning disability, autism or both (STOMP) clinic model was developed and PBS was used in line with National Institute for Health and Care Excellence (NICE) guidance. This included functional behavioural assessment, to support understanding of the reasons behind behaviour described as challenging, and a gradual medication reduction.

This case study found that antipsychotic medication used to manage behaviour that challenges could be safely reduced and individual quality of life increased when PBS was used as an alternative.

STOMP is a project supported by NHS England aimed at reducing the inappropriate prescribing of psychotropic medication to manage behaviour that challenges. NICE guidance recommends that behaviour should be more appropriately understood through PBS. More research is needed to demonstrate how the two work together for safe medication reduction and improved quality of life.

Active support (AS) influences the way staff support people with intellectual disabilities to take part in everyday activities. Changes in work practices may affect job satisfaction. The impact of AS on job satisfaction has not, however, been widely studied. Job satisfaction is linked with levels of staff turnover and the overall quality of services provided to people with intellectual disabilities (Coomber & Barriball, 2007; Hatton et al., 2001). The purpose of this paper is to describe an evaluation of job satisfaction amongst 38 direct care staff working in intellectual disability services before and after AS was implemented.

A single group, repeated-measures design was used. In total, 38 members of direct care staff received AS training. Data on job satisfaction were collected before, and after, AS was implemented. In total, 19 members of staff took part in a follow-up 12 weeks later.

There was a significant increase in reported job satisfaction following the implementation of AS. Subscale analysis revealed that the most significant increases in job satisfaction were related to areas directly targeted by AS, including satisfaction with skill level and satisfaction with amount of time spent with service users.

Implementing AS may provide an added benefit for direct care staff, who feel more satisfied at work. While a significant number of papers have been published focusing on the benefits of AS, no papers have specifically looked at the impact that the intervention can have on job satisfaction.

The purpose of this paper is to develop a clear answer to the question “how is leadership developed?” This research utilized the knowledge of leadership development experts and their collective expertise to identify the critical elements required for a high-quality leadership development program.

The Lockean Inquiring System approach to the Delphi technique was used to solicit the views of experts in leadership and leadership development from around the world. Experts for Round 1 of the Delphi were drawn from a random sampling of 100 people, comprising leadership researchers, coaches, and organizational leaders, not personally known to the lead researcher of this project, but in his LinkedIn network. A response rate of 13 percent (n=13) yielded a rich range of qualitative data. Responses from the first round of the Delphi were analyzed using open coding and categorized into four themes, representing four sets of competencies required of leaders.

The four themes were labeled as contextual, human capital, social capital, and structural capital, all of which were seen by participants as being central to the development of collective leadership. Based on these themes, this paper identifies a useful list of key leadership development tactics from which those wishing to develop a leadership program can work.

As the first round of a Delphi study, the authors are limited to presenting only the key elementary empirical judgments. Subsequent study with an expanded sample size and a refined set of questions rooted in the current data will contribute further to the development of factual propositions related to leadership development for the twenty-first century. The Delphi survey is a “snapshot” approach and presents a holographic-type image of the complex whole. The authors plan to triangulate the data by significantly expanding the pool of Delphi experts and conducting the Round 1 survey a second time with a larger international group of respondents that fit the criteria of expert.

This paper presents four dimensions of an effective leadership development strategy.

Core elements of the best methods for leadership development have been identified by leadership development experts, which serve as a basis for developing leadership as a collective, and for further research.

Research on human trafficking largely focuses on large, urban areas, yet it is a problem in small, rural areas. Police in these areas must have the training to identify human trafficking and resources to combat the issue – both of which may be lacking in small, rural areas. The purpose of this project is to explore police chiefs' perspectives on human trafficking in small, rural areas.

A mixed-methods approach was used to assess Pennsylvania police chiefs' understanding of human trafficking and their perspective of the extent of the problem in their area. First, 349 police chiefs completed an online survey during the summer of 2020. Follow-up in-depth interviews were conducted with 52 police chiefs.

Most chiefs believed human trafficking is a problem in Pennsylvania (81%) or in their local area (12%). Logistic regression analysis indicated chief experience, department budget and the number of employees affect small and rural police chief perceptions of human trafficking. Qualitative analyses identified three themes of police chief perceptions of human trafficking: conflation with prostitution, definitional debates and competing beliefs about prevalence. Training on identifying human trafficking would benefit small and rural police departments. Chiefs recommended outside assistance investigating human trafficking cases and other state-level resources would be helpful.

Scant research exists on small and rural police departments in the United States, especially in regards to human trafficking. This study contributes to the literature by addressing this gap with a mixed-methods approach.

This chapter considers how higher education has enticed and interacted with corporations. This chapter explores how higher education behaves, in the aggregate, with a set of external partners, including businesses. It concludes with a discussion of how higher education should behave, given its external partners, in the modern context in which it finds itself. Discussion topics in this chapter include expectations of external partners; tactics to attract and retain business engagement and support; and internal organization by higher education to address corporate relations, ethics, and effective strategic planning. The Network of Academic Corporate Relations Officers' (NACRO) ideas and models are discussed. A set of guiding principles focused on Strategic Corporate Alliances by the American Association of University Professors (AAUP) is highlighted.

The purpose of this paper is to explore how school principals influenced or controlled leadership coaches working with assistant principals in urban secondary schools.

This longitudinal qualitative case study drew upon semi-structured interviews and program documents obtained from participants in a university-based leadership coaching program across three academic years. The study included 22 total participants, including ten assistant principals, nine leadership coaches, and three program staff.

A thematic analysis of the data produced three themes. First, principals controlled coaches’ work with assistant principals both directly and indirectly. Second, the extent of principal control influenced how coaches developed a confidential relationship with the assistant principals and what strategies they used to preserve the confidential nature of the coaching relationship. Third, the focus of the coaching support evolved in response to the assignment of responsibilities and duties to the assistant principals, which were largely outside the assistant principal and leadership coach’s control. The absence of alignment between coaching priorities and leadership responsibilities frustrated coaches.

The findings from this study make two significant empirical contributions to the literature. First, the study provides critical new insights about the extent to which politics generated by principals and administrative teams may influence the work of leadership coaches. Second, the study contributes to the sparse literature about leadership coaching for assistant principals, particularly those working in secondary school settings in the USA.

Most teachers in the Gulf would agree that Arab learners struggle more with reading and writing than listening and speaking. One little considered possible influence on this is the particular visual processing requirements of English. This article suggests why visual processing or visual cognition might be a particular difficulty for Arab students reading English. It offers a simple classroom checklist that may assist teachers to notice if visual processing strain could be effecting their student’s attention, motivation and performance.

The COVID-19 pandemic created a broad array of challenges for hospitals. These challenges included restrictions on admissions and procedures, patient surges, rising costs of labor and supplies, and a disparate impact on already disadvantaged populations. Many of these intersecting challenges put pressure on hospitals' finances. There was concern that financial pressure would be particularly acute for hospitals serving vulnerable populations, including safety-net (SN) hospitals and critical access hospitals (CAHs). Using data from hospitals in Washington State, we examined changes in operating margins for SN hospitals, CAHs, and other acute care hospitals in 2020 and 2021. We found that the operating margins for all three categories of hospitals fell from 2019 to 2020, with SNs and CAHs sustaining the largest declines. During 2021, operating margins improved for all three hospital categories but SN operating margins still remained negative. Both changes in revenue and changes in expenses contributed to observed changes in operating margins. Our study is one of the first to describe how the financial effects of COVID-19 differed for SNs, CAHs, and other acute care hospitals over the first two years of the pandemic. Our results highlight the continuing financial vulnerability of SNs and demonstrate how the factors that contribute to profitability can shift over time.