Search results

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.

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.

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.

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.

Autism spectrum disorder (ASD) has been studied as a neurodevelopmental disorder since Leo Kanner's early observations of abnormal head circumference in autistic children. In the past few years, there has been much progress made in elucidating the anatomical and functional abnormalities in ASD. This paper aims to summarise the extant research.

This paper provides a summary of relevant research findings in the neuroimaging of autism for the past 12 month period. Papers were identified using the Medline search terms: autism; ASD (functional); magnetic resonance imaging (MRI); neuroimaging; diffusion tensor imaging (DTI); and endophenotype.

Relatively recent techniques such as functional MRI and DTI have furthered the initial work derived from early histological and structural imaging studies. Even newer techniques, such as DTI tractography and support vector machine analysis, and other computer‐based learning methods have allowed us to move beyond regional variations in grey and white matter volume and study ASD as a disorder of connectivity, and of regional cerebral function and neural circuitry. Brain regions and neural circuits that are implicated in the core symptoms of ASD (deficits in social reciprocity, language and communication, and restricted and stereotyped interests) have been repeatedly shown to be abnormal in those individuals.

This paper aims to provide a background for clinicians to the current research and focuses on developments in the field of neuroimaging of ASD from the past year, which have generated further insights into the neurobiology of ASD.

The purpose of this paper is to determine the extent of autism spectrum disorder (ASD) traits among prisoners. The authors tested the hypotheses that ASD traits would: be continuously distributed among prisoners; be unrecognised by prison staff; and predict whether a prisoner met diagnostic criteria for ASD.

ASD traits were measured among 240 prisoners in a male prison in London, UK using the 20-item Autism Quotient (AQ-20). Further diagnostic assessment was carried out using the Autism Diagnostic Observation Schedule. Results were compared with ASD data from the 2007 Psychiatric Morbidity Survey.

There were 39 participants with an AQ-20 score=10; indicating significant autistic traits. The distribution of ASD traits among participants appeared to be normal and was not significantly higher than the rate found in a population-based sample from England.

Few studies have explored ASD traits among prisoners. The authors identified high levels of unrecognised ASD traits among a group of male prisoners, many of whom went on to meet diagnostic criteria for ASD. The study highlights the need for specialist assessment within the criminal justice system for individuals with neurodevelopmental disorders including ASD. The authors discuss the process of carrying out an ASD assessment project in a prison.

The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID).

The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test.

Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study.

The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.

At this time of the year, if you can't think what else to give your relatives, or your nearest and dearest, then for the sake of W H Smith and Christina Foyle, give them all books. With that maxim in mind we invited regular reviewers for the Yorkshire Boast (“Yorks band leader lost with Titanic”, remember?) to pick the best books of 1985 or thereabouts.

This systematic review paper aims to investigate seasonal ambient change’s impact on the incidence of falls among older adults.

The population, exposure, outcome (PEO) structured framework was used to frame the research question prior to using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Three databases were searched, and a total of 12 studies were found for inclusion, and quality appraisal was carried out. Data extraction was performed, and narrative analysis was carried out.

Of the 12 studies, 2 found no link between seasonality and fall incidence. One study found fall rates increased during warmer months, and 9 of the 12 studies found that winter months and their associated seasonal changes led to an increase in the incidence in falls. The overall result was that cooler temperatures typically seen during winter months carried an increased risk of falling for older adults.

Additional research is needed, most likely examining the climate one lives in. However, the findings are relevant and can be used to inform health-care providers and older adults of the increased risk of falling during the winter.

This article examines the links between average city size, fiscal decentralisation, and national economic growth in 33 Organisation for Economic Co-operation and Development (OECD) countries.

The data in this paper comprise an unbalanced panel dataset which contains economic growth indicators, average city size, fiscal decentralisation indicators and control variables in 33 OECD member countries from 1975 to 2015 in five-year intervals. Fixed-effects (FE) estimators are used for the analysis.

This research finds i) countries with larger weighted average city sizes have higher economic growth, ii) countries with greater fiscal decentralisation have higher economic growth, but iii) countries with larger weighted average city sizes with greater decentralisation have lower rates of economic growth.

The research highlights the importance of agglomerations and decentralised governance and management for economic growth. While the findings are consistent with previous evidence that larger city sizes and fiscal decentralisation are separately associated with higher rates of economic growth, the authors find countries which have larger cities and greater fiscal decentralisation experience lower rates of economic growth highlighting a need for caution on decentralisation agendas in such cases. The implications of this suggest policymakers should proceed with caution on decentralisation agendas in countries with large cities.

AT the present time leisure is a subject which does not attract much serious attention. Sporadic discussions break out now and again among small groups; or it provides a topic for the popular press during the ‘silly season’. There is, however, a distinct possibility that in the measurable future an Institute of Leisure Study will be needed.

The purpose of this paper is to describe the findings from a pilot and a follow-on study in which care assistants in care homes were trained to use sporting memories work to better help and engage with residents with dementia and low mood. Care homes have to support increasingly more fragile people and often the range of activities in the homes do not offer the best engagement between residents and staff to benefit the residents. This is for reasons of time to run activities in a busy home, and because of the need to find financially viable means of running a range of activities. Care assistants in care homes are a group of non-professionally educated workers and are often overlooked for training beyond basic health and safety training to help them improve their work and the care they provide. This work sought to explore whether sporting memories work was viable as an activity to offer in care homes via the training of care assistants.

The paper discusses the evidence from a pilot and then follow-on project in care homes in one city area. In the pilot observation was made of a training session and follow up interviews were undertaken with care home managers to see how the implementation of sporting memories was going. In the follow-on project the support to those undertaking the training was modified to include three learning network sessions. Data were collected on the experience of participants and their use of sporting memories work.

The findings were that care assistants could be trained in using sporting memories work and they often found it easy to use and fulfilling for them and people they cared for. This was despite the care assistants who participated often not having much interest in sports and little experience in this kind of work. However, practical barriers to maintaining the use of sporting memories work did remain.

The evidence to date is of case studies of training staff in care homes in the use of sporting memories work, which provides good grounding for proof of the concept and key issues, but further research is needed on the costs and impacts of sporting memories work in care homes. The lack of direct feedback about experiences of care home residents of sporting memories work and its impact on them is a further limitation.

Sporting memories work is a flexible and readily adoptable intervention to engage older people in care homes and the evidence to date is that care assistants in care homes can be trained to use this approach to engaging older people. Practical challenges still remain to using sporting memories work in care homes, notably the issue of time for staff to do the work, but it is an approach for care homes to have available to them to match up to the interests of residents.

Sporting memories work can be an important part of meeting some of the challenges society faces with an ageing population profile and to enhancing the care home environment and care assistants can be trained to use the approach.

This is the first paper to discuss training care home staff in the use of sporting memories work.