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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 study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

The purpose of this paper is to bring to light the double edges faced by individuals who have international and multicultural experiences. The implication is that these individuals encounter acculturation challenges, and also gain from their multiculturality. The authors adopt Berry’s (2011) integration and multiculturalism framework to analyze the experiences and challenges that multi-culturals face. This paper suggests ways to glean the silver lining within organizations to help manage and master multicultural experiences in the workplace to benefit both individuals and organizations.

The authors used empirical materials from expatriates who have worked across multiple cultural contexts. Based on these the authors present three examples to illustrate how expatriates and multicultural individuals place themselves in situations where they experience contact and challenges associated with adopting multiple cultures. The authors then analyze these examples to show how the experiences involve psychological-level integration challenges for Multi- and n-culturals.

The three multicultural expatriate examples suggest that individuals with international and multicultural experiences who are successful at managing their experiences develop cognitive and behavioral complexity. However, these individuals also face continuous acculturation including cognitive and ethno-cultural identity conflicts such as, rejection from multiple cultural perspectives because they continually cross-multiple cultural microcosms. Suggestions are presented to help maintain one’s sense of self-worth and minimizing ethno-cultural conflicts.

Notwithstanding the value of analyzing the examples of expatriate acculturation experiences, the limitation to the examples is that it is limited to the experience of three individuals. However, the examples were effective in raising points to discuss relevant challenges and/or the double-edged reality faced by boundary spanners, multi-, and n-culturals.

The paper presents possible ways multi- and n-culturals navigate through their multiculturalism, including suggestions to help individuals who struggle with their multiculturalism through mentoring.

The paper highlights the challenges of acculturation and suggests ways that individuals can overcome these challenges. It further suggests how organizations can take advantage of such individuals by utilizing existing personnel within the organization.

The paper is one of the few that acknowledge multiculturalism is highly challenging even for successful multi-culturals and n-culturals. Currently the literature is scant concerning how individuals can manage and master multicultural experiences in the workplace. The paper suggests a number of useful strategies for individuals and organizations to manage the challenges.

The police often respond to persons who are not in direct violation of the law, but are rather undergoing behavioral crises due to mental illness or substance abuse disorders. The purpose of this study is to examine how police behavior influences civilian bystanders' emotional responses and perceptions of procedural justice (PPJ) when officers interact with these populations, which traditionally have been stigmatized in American culture.

Using a factorial vignette approach, the authors investigate whether perceived public stigma moderates the relationship between police behaviors (i.e. CIT tactics, use of force) and PPJ. The authors also investigate whether emotional reactions mediate the relationship between police behaviors and PPJ.

Regardless of suspect population (mental illness, substance use), use of force decreased participants' PPJ, and use of CIT tactics increased PPJ. These effects were consistently mediated by anger, but not by fear. Interactive effects of police behavior and perceived public stigma on PPJ were mixed.

Fear and anger may operate differently as antecedents to PPJ. Officers should note using force on persons in behavioral crisis, even if legally justifiable, seems to decrease PPJ. They should weigh this cost pragmatically, alongside other circumstances, when making discretionary decisions about physically engaging with a person in crisis.

This chapter advances our understanding of vulnerable consumers by exploring new relationships between resource scarcity and consumer decision-making. Although resource scarcity often prompts individuals to pull back on spending, recent research has shown that it can also increase consumers' motivation to engage in behaviors that fulfill their need for personal control. We extend this stream of research by offering the novel proposition that because resource scarcity motivates the desire for control, activating thoughts about scarcity will increase consumers' interest in products offering self-improvement benefits. We offer initial empirical evidence for when resource scarcity causes consumers to forgo their desire to save by increasing their willingness to pay for products that offer self-improvement benefits. In doing so, this chapter (i) highlights resource scarcity, a state of vulnerability, as an antecedent to the desire for self-improvement, (ii) provides a more nuanced perspective on the motivational underpinnings of resource scarcity and its effects on consumption, and (iii) sheds light on when resource scarcity can increase rather than decrease consumer spending.

Two new User Specifications have recently been published by the Council for Educational Technology for the United Kingdom (formerly NCET). Prepared by the Working Party on Standards and Specifications for Educational and Training Equipment, the new USPECs bring to four the number published so far.

Both authors have been involved as lay members in research and other activities for a number of years, ensuring they represent the views of members of the public. This chapter identifies what is, and what is not, patient and public involvement as well as highlighting the importance of involving members of the public in all aspects of the research process. Best practice is explored as identified in the UK Standards for Public Involvement 2019 and the UK Policy Framework for Health and Social Care Research 2020. The implications of the Mental Capacity Act and its wording on research matters are also considered. Case studies have been incorporated to highlight the impact of involving patients and members of the public in all aspects of the research process. These include the lessons learnt by researchers and lay members of the team. The aspiration is to move towards more collaboration between members of the public and researchers; therefore, we discuss co-production of research or community-based participatory research (CBPR). We highlight the need for a better partnership between researchers and members of the public. The benefits of this are explored along with the consequences for all involved.

This chapter presents a compassionate response model of workplace anger. The model incorporates an interpersonal feedback loop to show how compassionate responses to workplace anger have the potential for generating gratitude within the angry individual. Both reactions should ultimately result in more favorable organizational outcomes from anger episodes. In addition, the model identifies message, individual, relational, and organizational factors moderating the likelihood that an anger expression, compassion, and gratitude progression take place. The model proposes that anger expression is not inherently negative for individuals and organizations, but may initiate a series of potentially positive exchanges of emotion and caring.

Immigration enforcement along the Southwest border between United States and Mexico has long channeled migrants into perilous desert corridors, where many thousands have died, out of general public view. In response to this humanitarian crisis, activists from organizations such as No More Deaths (NMD) trek deep into the treacherous desert, hoping to save lives, honor the remains of those who did not survive, and influence public opinion about border enforcement policies. NMD’s activism is not merely utilitarian but also deeply expressive; ultimately, they hope to convey the message that all lives – including those of unauthorized migrants – are worth saving. The Trump Administration has escalated repressive tactics intended to silence these forms of border-policy dissent. Some federal land managers now blacklist NMD, preemptively denying requests for access permits. Meanwhile, the US Attorney’s office has aggressively prosecuted members for humanitarian activities. This chapter explains the expressive components of humanitarian activism in this context and of the government’s attempt to suppress it, suggesting the need for constitutional scrutiny and legal change.