The sensitivity and specificity of the Modified Conflict Tactics Scale for detecting clinically significant elder abuse

2009 ◽  
Vol 21 (4) ◽  
pp. 774-778 ◽  
Author(s):  
Claudia Cooper ◽  
Kate Maxmin ◽  
Amber Selwood ◽  
Martin Blanchard ◽  
Gill Livingston
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Judgment ◽  
Scoring System ◽  
Elder Abuse ◽  
High Sensitivity ◽  
Family Carers ◽  
Conflict Tactics Scale ◽  
People With Dementia ◽  
Clinically Significant ◽  
Conflict Tactics

ABSTRACTBackground: A third of family carers of people with dementia describe acting abusively in research studies, but far fewer cases of abuse are currently detected in clinical situations. This discrepancy may be explained by inadequate detection by health professionals, or disagreement regarding what constitutes elder abuse. This study was undertaken to determine the sensitivity and specificity of the revised Modified Conflict Tactics Scale (MCTS) for detecting clinically significant abuse.Methods: We interviewed 220 family carers of people consecutively referred to psychiatric services with dementia in Essex and London (U.K.), using the MCTS to measure abuse. We defined abuse cases using (1) the MCTS conventional scoring system; (2) the Pillemer criteria; and (3) clinical judgment of an expert panel.Results: Our panel judged that 15 (6.8%) of carers reported potentially clinical concerning abusive behavior; but 47 (21%) were cases according to the Pillemer criteria and 74 (34%) using the MCTS conventional scoring system. We developed a weighted MCTS scoring system, with high sensitivity and specificity for detecting clinically concerning abuse.Conclusions: The MCTS could be used routinely in clinical practice with carers of people with dementia to detect clinically concerning cases of abuse, many of which are currently being missed.

scholarly journals Family carers' distress and abusive behaviour: longitudinal study

2010 ◽  
Vol 196 (6) ◽  
pp. 480-485 ◽  
Author(s):  
Claudia Cooper ◽  
Martin Blanchard ◽  
Amber Selwood ◽  
Zuzana Walker ◽  
Gill Livingston
Keyword(s):  
Longitudinal Study ◽  
Elder Abuse ◽  
Anxiety And Depression ◽  
Psychological Interventions ◽  
Family Carers ◽  
People With Dementia ◽  
Specialist Services ◽  
The Family ◽  
Abusive Behaviour ◽  
Conflict Tactics

BackgroundA third of family carers of people with dementia report abusive behaviour towards the person for whom they are caring. This is the first longitudinal study to investigate such behaviour.AimsTo test our hypotheses that carers' reports of abusive behaviour would increase over time, and that change in abuse scores would be predicted by change in anxiety and depression scores.MethodIn total, 131 (71.6%) of the family/friend dementia carers consecutively recruited from new referrals to Essex and London community mental health teams who were interviewed at baseline, completed the revised Modified Conflict Tactics Scale to measure abuse 1 year later.ResultsSixty-three (48.1%) of the carers reported any abusive behaviour at baseline compared with 81 (61.8%) a year later (χ2 = 6.9, P = 0.009). An increase in abuse scores was predicted by an increase in anxiety and depressive symptoms (respectively ß = 0.32, t = 3.9, P<0.001 and ß = 0.24, t = 2.9, P = 0.005), and by less domiciliary care at baseline (ß = –0.18, t =–2.2, P = 0.031).ConclusionsMost abusive behaviour reported by carers at baseline persisted or worsened in the following year, despite contact with specialist services. We suggest that trials of psychological interventions shown to reduce anxiety and depression in the carers of people with dementia are needed to determine whether they also reduce elder abuse, and can be delivered cost-effectively within the National Health Service (NHS).

scholarly journals DOP80 Automatic detection of ulcers and erosions in PillCam™ Crohn’s capsule using a convolutional neural network

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S111-S112
Author(s):  
M Saraiva ◽  
T Ribeiro ◽  
J Afonso ◽  
H Cardoso ◽  
J Ferreira ◽  
...  
Keyword(s):  
Small Intestine ◽  
Sensitivity And Specificity ◽  
Automatic Detection ◽  
High Sensitivity ◽  
Response To Treatment ◽  
Automatic Identification ◽  
Tertiary Centre ◽  
Clinically Significant ◽  
Prognostic Prediction ◽  
First Time

Abstract Background Capsule endoscopy (CE) plays a central role in the management of patients with suspected or known Crohn’s disease (CD). It is indicated for the diagnosis, classification, monitoring of the response to treatment, and prognostic prediction. In 2017, PillCam™ Crohn’s Capsule (PCC) was introduced. It has demonstrated greater accuracy in detecting and evaluating the extent of lesions in these patients. However, this new tool produces thousands of images, whose revision is time-consuming and prone to errors, since lesions can be restricted to a small number of images. In the last decade, several Artificial Intelligence (AI) algorithms were developed, and demonstrated potential to mitigate some of the drawbacks of CE. Among AI tools, Convolutional Neural Networks (CNN) display the best performance for imagery analysis. This study aims to develop an AI algorithm based on an CNN for the automatic detection of ulcers and erosions of the small intestine and colon in PCC images. Methods A total of 8 085 PCC images were extracted from a single tertiary centre between 2017–2020. This pool of images was constituted by 2 855 images depicting ulcers, 1 975 erosions; the remaining with normal enteric and colonic mucosa. For the automatic identification of these findings, this pool of images was split into training and validation datasets. A CNN model with transfer learning using tensorflow and keras tools was constructed. The performance of the network was subsequently assessed in an independent test set. Results After optimizing the different layers of the CNN, our model was able to detect and distinguish small intestinal or colonic erosions or ulcers with a sensitivity and specificity of 90.0% and 96.0%, respectively. The precision and accuracy of this model were 97.1% and 92.4%, respectively (Figure 1). Particularly, the CNN detected ulcers with a sensitivity of 83% and specificity of 98%, and erosions with sensitivity and specificity of 91% and 93%, respectively. Conclusion Our group developed, for the first time, a CNN capable of automatically detecting ulcers and erosions of the small intestine and colon in PCC images with high sensitivity and specificity. These findings are extremely important since they pave the way for the development of systems for the automatic detection of clinically significant lesions, optimizing diagnostic performance and efficiency of monitoring CD activity.

scholarly journals High sensitivity and specificity screening for clinically significant intimate partner violence.

2020 ◽  
Author(s):  
Richard E. Heyman ◽  
Katherine J. W. Baucom ◽  
Shu Xu ◽  
Amy M. Smith Slep ◽  
Jeffery D. Snarr ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Sensitivity And Specificity ◽  
Partner Violence ◽  
High Sensitivity ◽  
Intimate Partner ◽  
Clinically Significant

scholarly journals Effectiveness of START psychological intervention in reducing abuse by dementia family carers: randomized controlled trial

2015 ◽  
Vol 28 (6) ◽  
pp. 881-887 ◽  
Author(s):  
Claudia Cooper ◽  
Julie Barber ◽  
Mark Griffin ◽  
Penny Rapaport ◽  
Gill Livingston
Keyword(s):  
Elder Abuse ◽  
Psychological Intervention ◽  
Controlled Trial ◽  
Depression And Anxiety ◽  
Family Carers ◽  
Intervention Effect ◽  
Treatment As Usual ◽  
Abusive Behavior ◽  
People With Dementia ◽  
Dementia Research

ABSTRACTBackground:Family carers of people with dementia frequently report acting abusively toward them and carer psychological morbidity predicts this. We investigated whether START (STrAtegies for RelaTives), a psychological intervention which reduces depression and anxiety in family carers also reduces abusive behavior in carers of people living in their own homes. We also explored the longitudinal course of carer abusive behavior over two year.Methods:We included self-identified family carers who gave support at least weekly to people with dementia referred in the previous year to three UK mental health services and a neurological dementia service. We randomly assigned these carers to START, an eight-session, manual-based coping intervention, or treatment as usual (TAU). Carer abusive behavior (Modified Conflict Tactic Scale (MCTS) score ≥2 representing significant abuse) was assessed at baseline, 4, 8, 12, and 24 months.Results:We recruited 260 carers, 173 to START and 87 to TAU. There was no evidence that abusive behavior levels differed between randomization groups or changed over time. A quarter of carers still reported significant abuse after two years, but those not acting abusively at baseline did not become abusive.Conclusion:There was no evidence that START, which reduced carer anxiety and depression, reduced carer abusive behavior. For ethical reasons, we frequently intervened to manage concerning abuse reported in both groups, which may have disguised an intervention effect. Future dementia research should include elder abuse as an outcome, and consider carefully how to manage detected abuse.

Detector-C: A Blood-based IVD with High Sensitivity and Specificity for Early Detection and Screening of Colorectal Cancer

2010 ◽  
Vol 48 (08) ◽  
Author(s):  
A Rosenthal ◽  
H Köppen ◽  
R Musikowski ◽  
R Schwanitz ◽  
J Behrendt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Detection ◽  
Sensitivity And Specificity ◽  
High Sensitivity

Cancer treatment decisions for people living with dementia: experiences of family carers

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711545
Author(s):  
Catherine Hynes ◽  
Caroline Mitchell ◽  
Lynda Wyld
Keyword(s):  
Cancer Treatment ◽  
Healthcare Professionals ◽  
Cancer Recurrence ◽  
Treatment Decisions ◽  
Support Needs ◽  
Family Carers ◽  
Structured Interviews ◽  
Power Of Attorney ◽  
Cancer Data ◽  
People With Dementia

BackgroundDementia and cancer are both diseases associated with older age. The National Cancer Data Audit in England found that 4.4% of people diagnosed with cancer also had cognitive impairment. Decisions about cancer treatment can be very complex when someone already has dementia. Often someone’s closest relative may be asked to make decisions on their behalf. Little is known about the psychosocial impact that this has on carers, or what their support needs are during this time.AimTo explore the experiences of family carers who have been involved in making cancer treatment decisions on behalf of a relative with dementia, in particular identifying challenges and support needs.MethodThe authors are conducting semi-structured interviews with carers of people with dementia who have been involved in making decisions about cancer treatment on their behalf. Data is being thematically analysed using an inductive approach. Two researchers will independently verify themes.ResultsThe authors expect to have completed 14–18 interviews and will report their preliminary findings. Family carers experience many difficulties in the context of cancer and dementia, including lack of support when coping with the aftereffects of cancer treatment, lack of awareness among healthcare professionals regarding the authority granted by a lasting power of attorney and the anxiety created by feeling responsible for identifying cancer recurrence.ConclusionThis study will highlight that supporting someone with dementia through cancer treatment, and having to make decisions about it on their behalf, creates unique challenges for carers. Currently there is a significant lack of support for those facing this distressing experience.

Trends in Diagnosis for Active Tuberculosis Using Nanomaterials

2019 ◽  
Vol 26 (11) ◽  
pp. 1946-1959 ◽  
Author(s):  
Le Minh Tu Phan ◽  
Lemma Teshome Tufa ◽  
Hwa-Jung Kim ◽  
Jaebeom Lee ◽  
Tae Jung Park
Keyword(s):  
Sensitivity And Specificity ◽  
High Efficiency ◽  
Point Of Care ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Diagnostic Methods ◽  
Advantages And Disadvantages ◽  
Treatment And Prevention ◽  
Clinical Tools ◽  
Diagnostic Applications

Background:Tuberculosis (TB), one of the leading causes of death worldwide, is difficult to diagnose based only on signs and symptoms. Methods for TB detection are continuously being researched to design novel effective clinical tools for the diagnosis of TB.Objective:This article reviews the methods to diagnose TB at the latent and active stages and to recognize prospective TB diagnostic methods based on nanomaterials.Methods:The current methods for TB diagnosis were reviewed by evaluating their advantages and disadvantages. Furthermore, the trends in TB detection using nanomaterials were discussed regarding their performance capacity for clinical diagnostic applications.Results:Current methods such as microscopy, culture, and tuberculin skin test are still being employed to diagnose TB, however, a highly sensitive point of care tool without false results is still needed. The utilization of nanomaterials to detect the specific TB biomarkers with high sensitivity and specificity can provide a possible strategy to rapidly diagnose TB. Although it is challenging for nanodiagnostic platforms to be assessed in clinical trials, active TB diagnosis using nanomaterials is highly expected to achieve clinical significance for regular application. In addition, aspects and future directions in developing the high-efficiency tools to diagnose active TB using advanced nanomaterials are expounded.Conclusion:This review suggests that nanomaterials have high potential as rapid, costeffective tools to enhance the diagnostic sensitivity and specificity for the accurate diagnosis, treatment, and prevention of TB. Hence, portable nanobiosensors can be alternative effective tests to be exploited globally after clinical trial execution.

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