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Worldwide, there is significant growth in the cost of (and demand for) healthcare, which often clashes with a requirement to contain expenditure. This duality leads to an increasing need for a systematic approach to disinvestment in health technologies. The purpose of this paper is to consider the challenges and opportunities for disinvestment policy decisions in Australia. It discusses the implementation of the Choosing Wisely campaign and the need for rigorous evaluation of such campaigns in the Australian healthcare system.

The authors highlight characteristics of disinvestment: what it is and what it is not and discuss international examples of identifying low value care, including the recent Choosing Wisely initiative. The authors discuss the barriers to implementing initiatives such as Choosing Wisely and the complexities in evaluating their effectiveness.

While the primary purpose of the Choosing Wisely campaign is improved decision making through clinical engagement, it is expected that implementation could lead to resource savings alongside improvements in patient safety and service quality. While there is research looking to understand the barriers and facilitators to the implementation of initiatives such as Choosing Wisely, little is known about broader patient impacts, and more attention on the quantification of their effect on both patient outcomes and resource use is needed.

This work highlights the limited knowledge around implementation of disinvestment strategies and the paucity of research around the impact of strategies such as Choosing Wisely in the Australian public hospital system. This is important as future research in this area will give greater certainty about the benefits and consequences of Choosing Wisely leading to improved opportunities for resource savings and patient safety and quality.

Recent research has proposed a specific female phenotype within autism spectrum disorder (ASD). It suggests females exhibit differences in social communication styles with higher levels of camouflaging and compensatory strategies, as well as variance in restrictive repetitive behaviours (RRBs); however, many existing studies have been based on either small, disproportionate or child and adolescent samples, leaving questions about the specific phenotype. This study aims to explore the sex difference and phenotype in a clinic sample of individuals diagnosed with autism.

A service evaluation of sex/ gender differences on 150 historical ASD assessment reports (75 males, 75 females) using a 103-item questionnaire developed from a quantitative review of existing literature was undertaken.

Females camouflaged more significantly than males in five different areas (thinking how to act next, preparing conversation in advance, making lists of prompts/social responses, wearing a mask/acting, less monotone voice); however, these were not maintained in post-analysis correction.

This study points the evidence towards a different phenotype of Autism that is more common in women than men rather than a unique female phenotype.

Distinguishing between autism characteristics and trauma-related symptoms may be clinically challenging, particularly in individuals who have experienced early traumatisation. Previous studies have described a risk that trauma-related symptoms are misinterpreted and/or misattributed to autism. This study aims to describe and explore assessment strategies to distinguish autism and early traumatisation in the case of a young woman with mild intellectual disability.

A clinical case study outlining assessment strategies, diagnostic decision-making and initial intervention.

A multi-informant interdisciplinary assessment using multiple assessment tools, together with a comprehensive review of records from previous assessments and contacts with various services, was helpful in distinguishing between autism and trauma. This included specific assessment tools for autism and trauma. Autism characteristics and trauma-related symptoms appeared to interact, not merely co-occur.

The current case demonstrates that diagnostic overshadowing may occur for autism in the context of early trauma. The case further highlights the importance of not ascribing trauma-related symptoms to autism, as service provision and treatment need to take account of both. Overlooking autism in individuals who have experienced early traumatisation may result in a risk that intervention and care are not appropriately adapted, which may involve a risk of exacerbating trauma symptoms.

The purpose of this paper is to link theories on the meaning of work with the meanings participants in a public work scheme attribute to work, in a context of high national and local unemployment and precarious employment.

This study followed a qualitative strategy to allow participants to express their own meanings of work through a work-life history approach. Findings from eight interviews are substantiated by two focus groups and thematically analysed.

Analysis of the findings revealed a high correlation with Kaplan and Tausky’s typology of the meanings of work (1974). The implication of this grounded approach is that this study expands the typology from six to eight factors. In this manner, work in a public work scheme not only has meaning as an economic activity, a structured routine, intrinsic satisfaction, interpersonal experiences, social status and a morally correct activity, but is also gendered and an opportunity for training.

Apart from expanding Kaplan and Tausky’s typology on the meanings of work (1974), this study highlights the added-value of public work schemes, in that, by providing the unemployed with the opportunity to work, they also improve their quality of life in a number of aspects.

The voluntary and not‐for‐profit sector accounts for an important and growing proportion of employment in the UK though it remains highly under‐researched. Rates of pay are often relatively low, necessitating forms of human resource management that emphasise non‐financial means of eliciting employee motivation and commitment. This paper examines HRM in a major charity that provides services to adults with learning disabilities. It finds that the intrinsic commitment to the job held by employees – which the organisation is trying to tap – can form a competing commitment towards different entities of the organisation. This competing commitment is difficult to reconcile to organizational objectives because it reflects ambivalences in existing power structures and group dynamics. The results have wider relevance to the management of employee commitment in other service sectors.

The purpose of this article is to set out the ways in which pharmaceutical company Boehringer Ingelheim embedded a strengths-based approach to the assessment and development of field-based staff during a period of structural and culture change. It provides an overview of how strengths-based methodologies were implemented and embedded through this period. It offers a case study example of how Capp partnered with Boehringer Ingelheim to deliver and cascade its assessment and development solutions. It also provides early evaluation data.

Boehringer Ingelheim introduced strengths through recruitment and development. It built on Capp's strengths methodology and Realise2 tool and model. To aid implementation, cross functional teams were also set up to cascade knowledge and skills across the organizational system.

The initial findings from this program include quantitative and qualitative data from candidates and assessors demonstrating their positive perception of the assessment and development process.

This article provides case study material, client learning and tips for how other organizations could introduce strengths-based solutions into similar culture change, team and personal development projects.

Boehringer Ingelheim is one of the first UK based organizations explicitly to take a strengths-based approach to aid culture change.

Transformational learning outcomes of short-term faculty-led international service-learning experiences can by stymied by cultural shock and improperly facilitated programs. Moreover, dissonance in dimensions of the self in contrast to foreign traditions and social interactions can be especially salient in American student encounters in India. How students resolve and make meaning of their own emotional entropy is traced across two institutional programs, two courses (1 undergraduate and 1 graduate), and multiple India community partner sites. An evidence-based pedagogical model and strategies for preparation, praxis, and processing are offered in supporting student reflection of themselves as global beings and in development of global agency which is manifested as intrapersonal, interpersonal, intercultural, academic, and professional competencies.

A thematic focus on identity has for years been a mainstay of secondary school literature curricula. Typical curricular units engage students in questions related to what it means to come of age and to develop an integrated sense of individual identity in the face of societal pressures toward conformity. This common thematic focus relies on conventional theories of identity as static, located in the individual, and linked to an autonomous self. Further, this focus positions adolescents as incomplete people, lacking fully formed identities. Current sociocultural theories of identity, however, understand identity as multiple, fluid, performed, and shaped by cultural histories and social contexts. Identity, in this view is always in process. Adolescents are fully formed people with identities that are no more or less complete than those of anyone else. Such a view of identity requires a more complex and nuanced conceptualization of adolescents, their capabilities, and their interactions with texts than does an individual view of identity. In this chapter, we outline a framework for identity focused literature instruction that relies on sociocultural understandings of identity, then draw on illustrations from classroom research to explore three key ways that an identity-focused approach challenges current approaches to pre-service teacher education related to literature instruction. Specifically, we explore challenges to the ways that we teach teachers to select and evaluate literary texts, plan literature instruction, and engage in inquiry and dialogue with students.