Search results

Elder abuse results in high rates of morbidity and mortality. It has longstanding physical and psychological effects and is difficult to detect. Due to fear or embarrassment, victims may make attempts to hide it rather than to disclose and professionals are often reluctant to report it as they may worry about worsening a situation. If detected early enough, serious harm can be prevented and lives saved. Screening and screening tools can assist health and social care practitioners to detect abuse. This review of screening tools was undertaken as part of an MSc in clinical research, funded by the National Institute for Health Research; the purpose of this paper is to report on the review and its findings.

This was a systematic review with eligibility inclusion and exclusion criteria decided in advance. Keywords and their synonyms were combined and then used to search health and social care databases. Data items were collected from the included studies. The preferred reporting item for systematic reviews and meta-analysis was followed for the reporting of the results. A narrative synthesis approach was applied to the analysis.

A total of 34 full text studies were downloaded, read and analysed. In all, 11 met the inclusion criteria and were included in the final analysis. Of these, three studies reported sensitivity and specificity, with the remainder reporting validity and reliability testing. In total, 12 tools of varying length and quality were found. The length and characteristics of tools affects the efficacy of their use. The clinical environment will determine choice of screening tool to be used. Screening tools should be used within an overall system of detection and management of abuse.

The synthesis of results was challenging due to the lack of homogeneity between the included studies. The variations in tool characteristics and qualities added to this challenge. A further limitation was the lack of a gold standard tool in elder abuse.

This systematic review highlights a lack of robust evidence in the development and validation of screening tools to detect elder abuse. Though there is an increasing awareness and knowledge about elder abuse, its detection remains problematic and the lack of research in this area is worth emphasising. Specific tools, centred on the clinical setting in which they are used, are recommended.

The authors reviewed studies of validated tools to screen for cognitive impairment among prisoners. The purpose of this paper is to assist organisations in identifying cognitive impairment in correctional facilities.

A targeted literature review identified peer-reviewed articles on screening of adults in jails, prisons, police watch-houses, custody suites, rehabilitation facilities and forensic settings or community settings for offenders. Validation of screening tools in secure settings, psychometric properties and cultural discrimination is included in this review.

Eight screening tools are considered suitable for use in correctional settings. Two screening tools are recommended for cognitive impairment, one is recommended for adaptive functioning assessment and one is recommended for screening of brain injury. Two screening tools are noted to be subject to piloting and further development for use with First Nations people, and two screening tools for cognitive impairment are noted for positive consideration.

Recommendations for screening tools are based on review only and evaluation was infeasible.

Short, reliable measures of cognitive ability for use in correctional facilities are needed. Such tools must be appropriate with respect to their purpose, feasible within the clinical capability of staff and sufficiently cheap to administer to allow widespread use.

Screening of prisoners for cognitive impairment allows early detection to facilitate rehabilitation and therapy. This research is at the systems level. Therefore, the authors do not purport to provide guidance for individual clinicians.

The purpose of this paper is to outline and report on the initial development of a screening tool for offenders with suspected intellectual disability (ID) known as the rapid assessment of potential intellectual disability (RAPID).

This paper summarises the wider literature in relation to screening tools and methodology, indicating that quick and easy screening measures for this population are sparse. It outlines the processes involved in the early stages of developing an evidence-based screening tool for ID offenders, and an overall pathway approach to the identification, assessment and diagnosis of ID.

It is possible to develop a tool that can be used to identify potential ID with relative ease. The RAPID screening tool provided practitioners with a simple and easy measure to identify such individuals so that they may be referred for further specialist assessment. It has also demonstrated that it is an effective measure in identifying offenders with a possible ID.

Formal statistical validation of this tool will serve to establish and measure its overall effectiveness and utility, further encouraging the timely identification of ID offenders.

This paper responds to current extensive literature about the variability of screening measures, and provides an effective solution to the identification of vulnerable offenders. Those who may benefit from an assessment of ID, and thereafter reasonable adjustments and alternatives to custodial sentencing are considered.

The offender personality disorder (OPD) pathway faces the difficult task of identifying individuals who are eligible for their service from the entire probation caseload. The offender assessment system personality disorder (OASys PD) screen is a national screening tool used by the pathway to help with this task. This paper aims to describe an evaluation of the effectiveness of this plus an additional screening tool currently used to identify eligible individuals for the OPD service in the South of England. Recommendations for improvements were made as necessary.

A mixed methods design used a quantitative analysis of data on the effectiveness of the OASys PD for correctly identifying individuals and a thematic analysis of a focus-group conducted with clinicians within the service.

The analysis revealed a positive predictive value of the OASys PD screen of 72% and a negative predictive value of 91%. Key themes from the focus-group revealed what worked well about the screening process, what was difficult and what needed to be improved.

The OASys PD performed better than the clinicians had expected. It was recommended that the service continued to use the combination of the screening tool and the interviews with minor adjustments.

This is the first research study of its kind on the effectiveness of the OASys Personality Disorder Screening tool. Using such a tool with some caution (the addition of consultation) creates a useful and effective process for tackling the very difficult task of identifying people for the community component of the Offender Personality Disorder Service. This research provides some evidence for the validity of such a process that is currently used throughout the National Probation Service in England and Wales.

The purpose of this paper is to estimate the accuracy and effectiveness of screening tools and subsequent interventions in the detection and treatment of intimate partner violence (IPV) in non-high-risk settings (defined here as those in which routine IPV screening does not take place in the UK, such as in general practice).

Rapid review as defined by Grant and Booth – it is used under time or financial constraint to assess what is known using systematic review methods. Medline, PsycINFO, Embase and Cochrane Library databases to May 2019 were searched for “intimate partner violence” and synonyms plus terms related to screening and interventions. A Medline update was performed in August 2020. Data were extracted with the help of a predesigned tool and were synthesised to answer the two study aims. Data were mixed quantitative and qualitative.

The search yielded 10 relevant papers on screening (6 on accuracy and 4 on effectiveness) and 13 on intervention. These showed evidence of the effectiveness of simple screening tools and of subsequent interventions. However, the evidence was insufficient to support a change in UK guidelines which currently do not recommend their use outside of current high-risk environments.

Clinicians outside of high-risk areas should consider the use of some IPV screening tools and interventions but only within research protocols to gather further evidence.

The existing literature expresses a strong need to develop tools that support the manufacturing reshoring decision-making process. This paper aims to examine the suitability of analytical hierarchy process (AHP)-based tools for initial screening of manufacturing reshoring decisions.

Two AHP-based tools for the initial screening of manufacturing reshoring decisions are developed. The first tool is based on traditional AHP, while the second is based on fuzzy-AHP. Six high-level and holistic reshoring criteria based on competitive priorities were identified through a literature review. Next, a panel of experts from a Swedish manufacturing company was involved in the overall comparison of the criteria. Based on this comparison, priority weights of the criteria were obtained through a pairwise analysis. Subsequently, the priority weights were used in a weighted-sum manner to evaluate 20 reshoring scenarios. Afterwards, the outputs from the traditional AHP and fuzzy-AHP tools were compared to the opinions of the experts. Finally, a sensitivity analysis was performed to evaluate the stability of the developed decision support tools.

The research demonstrates that AHP-based support tools are suitable for the initial screening of manufacturing reshoring decisions. With regard to the presented set of criteria and reshoring scenarios, both traditional AHP and fuzzy-AHP are shown to be consistent with the experts' decisions. Moreover, fuzzy-AHP is shown to be marginally more reliable than traditional AHP. According to the sensitivity analysis, the order of importance of the six criteria is stable for high values of weights of cost and quality criteria.

The limitation of the developed AHP-based tools is that they currently only include a limited number of high-level decision criteria. Therefore, future research should focus on adding low-level criteria to the tools using a multi-level architecture. The current research contributes to the body of literature on the manufacturing reshoring decision-making process by addressing decision-making issues in general and by demonstrating the suitability of two decision support tools applied to the manufacturing reshoring field in particular.

This research provides practitioners with two decision support tools for the initial screening of manufacturing reshoring decisions, which will help managers optimize their time and resources on the most promising reshoring alternatives. Given the complex nature of reshoring decisions, the results from the fuzzy-AHP are shown to be slightly closer to those of the experts than traditional AHP for initial screening of manufacturing relocation decisions.

This paper describes two decision support tools that can be applied for the initial screening of manufacturing reshoring decisions while considering six high-level and holistic criteria. Both support tools are applied to evaluate 20 identical manufacturing reshoring scenarios, allowing a comparison of their output. The sensitivity analysis demonstrates the relative importance of the reshoring criteria.

The purpose of this study was to examine the literature surrounding dementia in the aging correctional population and assess the role of cognitive screening related to dementia detection within corrections. The literature regarding the role of dementia within the justice continuum is scant. Furthermore, correctional health researchers have not reached a consensus on the best age to administer cognitive screening in older persons or prioritizes a screening tool for the early detection of dementia.

A key search term list including dementia screening and was developed to review the literature surrounding dementia and the aging correctional population. PubMed, Criminal Justice Abstracts (Ebsco) and the National Criminal Justice Reference Service were used within the academic search. A gray literature search using these same search terms was conducted reviewing criminal justice federal agencies and organizations for additional information on the dementia experience within correctional settings. Snowballing was used to capture relevant theoretical and empirical knowledge.

Shortages in aging specialized health-care staffing presents a barrier for the clinical interpretation of Montreal Cognitive Assessment (MoCA) results. Correctional officers are also identified as useful candidates within the administration of cognitive screening with proper training. The MoCA may be the optimal cognitive screening tool for dementia, until an original cognitive screening tool is created specific to the correctional population. An age of 55 years or older may serve as the best cutoff score for classifying incarcerated individuals as older persons, and screening should be prioritized for these individuals. Finally, new specialized programs related to dementia within correctional settings are identified.

A limitation of this research is the conflicting opinions among researchers regarding the use of general cognitive screening tools within the correctional setting.

This research can inform correctional organizational policy and practices regarding the screening of older persons suspected of dementia. Most notably, this research proposes that correctional settings should incorporate the MoCA within initial screening of all individuals 55 years of age or older, enriching the job design of correctional officer's job positions to include cognitive testing, and for correctional settings to provide dementia and age-associated training for correctional officers. Finally, this paper informs future research in the development of a cognitive assessment tool specific to the correctional population.

Reports on the authors' experience with a patient safety quality improvement program, intended to reduce the incidence and severity of adverse outcomes for emergency department (ED) patients aged ≥75. The Identification of Seniors at Risk scale was used for screening, and those at high risk were referred for appropriate intervention. The plan‐do‐study‐act improvement cycle was followed, conducting process evaluation to diagnose and correct implementation difficulties. Reports that: implementing an ED screening and referral program is deceptively difficult; process evaluation multidisciplinary working group meetings are an essential improvement tool; screening inclusion criteria had to be adapted to the subject population in order to make efficient use of staff time; the screening questions and process required ongoing assessment, revision, and local adaptation in order to be useful; and high‐risk screening in the ED is critical to a hospital system's ability to anticipate clinical problems; the plan‐do‐study‐act improvement cycle is a practical and useful tool for improving quality and systems in a real care setting.

The purpose of the study is to identify and ascertain if there were any validated tools for diagnosing or screening autism spectrum disorder in adults with ID. The estimated prevalence of intellectual disability (ID) in the general population is about 10.37/1,000 population (Maulik et al., 2011). In total, 1 out of 4 individuals with ID suffers from an autism spectrum disorder (ASD) (Sappok et al., 2010). Early diagnosis and support for ASD is key to having a good quality of life. The diagnosis of ASD in people with an ID presents its own challenges and it is likely under-identification of ASD amongst adults with ID by about 20% to 30% (Emerson and Baines, 2010).

Studies were selected based on the following criteria: studies that reported either screening or diagnostic tools for ASD, participants had an ID i.e. a mean IQ of <70, adults i.e. participants were >18 years of age at the time of entry to the study and articles reported either sensitivity, specificity or area under the curve. Relevant studies that were published up to January 2020 were identified from EMBASE, PsychINFO, CINAHL and PubMed. In total, 75 papers were identified of which 15 papers met the criteria.

The screening or diagnostic tools currently in use is dependant on the degree of ID. A number of the tools had good psychometric properties and utility when used in people with specific degrees of ID or when used in combination with another screening or diagnostic tool. The authors could not identify a diagnostic tool that could be used across all levels of severity of ID unless used in combination. Hence, concluded that there is a need for a diagnostic tool with good psychometric properties for the assessment of ASD in adults with all degree of ID within a reasonable time period without the need for an additional tool to be used in conjunction.

Currently, the “gold standard” for diagnosing ASD is a lengthy and time-consuming process carried out by trained multi-disciplinary team members who assess historical, behavioural and parent/carer report to arrive at a diagnosis. There are a number of tools that have been developed to aid diagnosis. However, it is important to identify the tools that can optimise the procedures and are also time-efficient.

The purpose of this paper is to examine staff views’ of the usefulness of the Her Majesty’s Prison and Probation Service (HMPPS) screening tools for learning disability and/or learning challenges (LDC) on offending behaviour programme selection and programme participant’s learning experiences.

In total, 11 treatment managers (TMs) and 10 programme graduates across 4 prison sites, from a range of HMPPS accredited programmes were interviewed. The interviews were transcribed, analysed and interpreted using Braun and Clarke’s (2006) method of thematic analysis.

Overall, TMs found the screening tools useful in aiding programme allocation decisions, particularly, in terms of the triangulated approach and were, in general, using them in line with the guidance. A number of key factors influenced programme allocation decisions, including participant factors, information gathered from a number of sources and from a range of staff and in collaboration with the individual. The importance of being responsive to the needs of the individual was highlighted. Group participants generally felt they were on the right programme according to their needs and found the programmes responsive. Suggestions for further research and improving programme selection are made.

Data were collected from four prisons, each providing a number of different accredited programmes. Caution is, therefore, needed when generalising the findings.

This research contributes to ensuring that those with LDC have equality of opportunity in reducing their risk of reoffending through accessing HMPPS accredited offending behaviour programmes most responsive to their learning needs. It also contributes to the growing evidence base about the effective use of LDC screening tools in forensic settings.