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Rebecca Rose Conway, Bhathika Perera, Ken Courtenay, Spyros Tsolakidis and Sheetal Gopal
Research highlights that antipsychotic medications are prescribed more in people with Intellectual Disability (ID) without a diagnosis of severe mental illness. Despite…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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Laura Korb, Bhathika Perera and Ken Courtenay
The purpose of this paper is to illustrate the possible basis of challenging behaviour (CB) can lie in a treatable neurodevelopmental disorder.
Abstract
Purpose
The purpose of this paper is to illustrate the possible basis of challenging behaviour (CB) can lie in a treatable neurodevelopmental disorder.
Design/methodology/approach
Two case studies were used to illustrate the clinical characteristics of attention deficit hyperactivity disorder (ADHD) presenting as CB in people with intellectual disability (ID).
Findings
The findings of this paper show that the appropriate use of drug therapy for ADHD effectively reduced the behavioural challenges.
Research limitations/implications
Limited by two cases. Application of the findings of this paper is limited given it is a case study. This paper highlights an important clinical implications which need to be studied in a larger scale to make clinical recommendations.
Practical implications
Findings from the two case studies may be used when making decisions in clinical practice.
Originality/value
The paper explores the possibility of ADHD presenting as CB in people with ID.
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Bhathika Perera and Ken Courtenay
Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these…
Abstract
Purpose
Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues.
Design/methodology/approach
Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure.
Findings
The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care.
Practical implications
This paper helps the reader to understand how ID mental health services are organised in the UK.
Originality/value
This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.
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Eddie Chaplin, Amina Rawat, Bhathika Perera, Jane McCarthy, Ken Courtenay, Andrew Forrester, Susan Young, Hannah Hayward, Jess Sabet, Lisa Underwood, Richard Mills, Philip Asherson and Declan Murphy
This paper aims to examine effective diagnostic and treatment pathways for attention deficit hyperactivity disorder (ADHD) in prison settings given the high prevalence of ADHD and…
Abstract
Purpose
This paper aims to examine effective diagnostic and treatment pathways for attention deficit hyperactivity disorder (ADHD) in prison settings given the high prevalence of ADHD and comorbidities in the prison population.
Design/methodology/approach
Two studies were carried out in two separate prisons in London. Firstly, data were collected to understand the prevalence of ADHD and the comorbidities. The second study used quality improvement (QI) methodology to assess the impact of a diagnostic and treatment pathway for prisoners with ADHD.
Findings
Of the prisoners, 22.5% met the diagnostic criteria for ADHD. Nearly half of them were screened positive for autistic traits, with a higher prevalence of mental disorders among prisoners with ADHD compared to those without. The QI project led to a significant increase in the number of prisoners identified as requiring ADHD assessment but a modest increase in the number of prisoners diagnosed or treated for ADHD.
Originality/value
Despite various challenges, an ADHD diagnostic and treatment pathway was set up in a prison using adapted QI methodology. Further research is needed to explore the feasibility of routine screening for ADHD in prison and examine at a national level the effectiveness of current ADHD prison pathways.
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This paper aims to examine the nature and extent of forward-looking disclosures in early examples of integrated reporting and to investigate the determinants of those disclosures.
Abstract
Purpose
This paper aims to examine the nature and extent of forward-looking disclosures in early examples of integrated reporting and to investigate the determinants of those disclosures.
Design/methodology/approach
The sample for research involved 55 non-financial companies whose reports are available in the Integrated Reporting Examples Database for the year 2014. The authors used content analysis to investigate the quantitative and qualitative forward-looking disclosures among early adopters of integrated reporting. The forward-looking disclosure index (FLDI) was categorized into two main groups, quantitative and qualitative, including 30 items in total. Multivariate ordinary least squares regression was used to investigate the associations proposed in the research hypotheses.
Findings
The authors determined that the majority of the entities tended to provide qualitative forward-looking disclosures rather than quantitative. Further, the findings showed that gender diversity and firm size are positively related to forward-looking disclosures, whereas leverage is negatively related to forward-looking disclosures. Contrary to expectations, the authors did not find a significant impact created by board size, board composition, profitability or industry on forward-looking disclosures.
Originality/value
The research contributes to the current integrated reporting and forward-looking disclosure literature. To the best of the authors’ knowledge, there is no prior study that has investigated forward-looking disclosures in integrated reports. This study contributes to the current literature by examining the determinants of forward-looking disclosures by categorizing them as quantitative and qualitative. Further, this research adds empirical findings to the literature on the association found between female directors and forward-looking disclosures.
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Prihatnolo Gandhi Amidjaya and Ari Kuncara Widagdo
The purpose of this paper is to find empirical evidence of ownership structure and corporate governance (CG) effect on sustainability reporting in Indonesian listed banks. The…
Abstract
Purpose
The purpose of this paper is to find empirical evidence of ownership structure and corporate governance (CG) effect on sustainability reporting in Indonesian listed banks. The study also tries to describe sustainability reporting disclosure practice.
Design/methodology/approach
The authors analyze balanced panel data with a total of 155 observations from 2012 to 2016 using panel data regression.
Findings
The findings present empirical evidence that sustainability reporting in Indonesian listed banks is still low. CG, foreign ownership and family ownership positively influence sustainability reporting. Further, the authors find that family ownership weakens the effect of CG while foreign ownership has no significant moderating role. Digital banking is not a significant determinant and OJK sustainable finance roadmap is evidenced to have no impression on bank intention to produce sustainability report.
Research limitations/implications
The use of content analysis method for variable measurement may contain subjectivity substance from the researcher’s perspective. Further research works need confirmation from independent parties with expertise in this subject. Further research works can also implement the mixed method by combining quantitative and qualitative approach to gain better quality.
Practical implications
The result of this study underlines the need for sustainability reporting improvement, followed by suggestions for Indonesian banking regulator.
Originality/value
This paper provides a description of Indonesian banks sustainability reporting and evidence of CG and controlling owner’s role in its practice. The research presents a novelty, examining the role of digital banking as determinant.
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Spyros Missiakoulis, R.E. Pahl and Peter Taylor‐Gooby
Cross‐class affiliation and unpaid work in and around the home are important in affecting the propensity of an individual to vote Conservative, as are elements of patterns of…
Abstract
Cross‐class affiliation and unpaid work in and around the home are important in affecting the propensity of an individual to vote Conservative, as are elements of patterns of domestic interaction. Regardless of whether occupational status is a relatively transitory phenomenon in a woman's life it seems to influence her voting behaviour and that of her husband. Political consciousness as evidenced by the propensity to vote Conservative in the 1979 election is explored as to how women's occupational class “makes a difference”. Elements for determining political consciousness include the production relation of both men and women in the household, the relations to the means of consumption of household members and the social interaction of men and women engaged in a variety of other forms of work in and around the house. A very complex set of data is required to study these three spheres. The Sheppey survey explores the relative significance of households' relationships to production and consumption as well as the interactions of men and women inside the dwelling. In 1981 a survey of 526 household couples on the island gave detailed information about their social and economic behaviour inside and outside the house. No previous study of voting behaviour, or the determinants of political consciousness has had access to such material: 403 respondents actually voted — 52 per cent Conservative and 48 per cent for the other parties. Factors associated with voting Conservative are explored. The island was representative of the situation for Great Britain as a whole.
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Roshima Said, Corina Joseph and Noor Zahirah Mohd Sidek
The principles of sustainable development argue that organizations should make decisions not only based on economic or financial factors but also based on the long-term social and…
Abstract
The principles of sustainable development argue that organizations should make decisions not only based on economic or financial factors but also based on the long-term social and environmental consequences. The Code on Corporate Governance is one of the drivers for corporate social responsibility (CSR) reporting in Malaysia. Additionally, the way managers execute their responsibilities may be affected by their own tradition, beliefs, values, and culture. Thus, this chapter aims to examine the relationship between corporate governance characteristics and CSR disclosure and to investigate the influence of cultural values (Board’s Culture Domination) on the relationship between corporate governance and corporate social responsibility. A sample of 150 companies from the main board of Bursa Malaysia for year ended 2006 are chosen for the purpose of this study due to the year of the introduction of Bursa Malaysia CSR Framework. Based on available data, a CSR index is constructed. Hierarchical regression analysis is used to examine the relationship between the CSR disclosure index and the independent variables and also the moderating effect of Board’s Culture Domination. Results show that government ownership and audit committees have a positive and significant influence on CSR disclosure. Furthermore, the findings show that the Board’s Culture Domination moderate the relationship between audit committee, number of shareholders, foreign ownership, and CSR disclosure.
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