An assessment of the English and maths skills levels of prisoners in England

Although the direct links between education and reducing recidivism in prisoners are problematic, there is little argument that education is a factor in promoting reintegration and rehabilitation. There is a current focus in prison education on education for employment, and yet there are no recent or unambiguous data about the skills levels of the prison population. The most often quoted figures are both 15 years out of date and deeply flawed in terms of their comparisons with the general population. This article sets out a new study that takes the mandatory initial assessments carried out on every new prisoner between August 2014 and July 2015 and compares them with the national Skills for Life survey conducted in 2011. This provides us with some hard facts about the English and maths skills of the past year's intake of prisoners. The conclusions argue that while the numeracy skills of prisoners are better than previously understood, the cohort has extremely poor literacy skills, and addressing these needs should be a priority for government

Numeracy skills and the numerate environment: affordances and demands

In the 2012 PIAAC Survey of Adult Skills of 23 industrialised countries, the UK (England & NI) scored below average on adult numeracy. Several recommendations focus on the need for (some) individuals in the population to undergo training. Yet, even in “high-performing countries” like the Netherlands, many adults (1.5M) score at or below PIAAC Level 1 (sometimes designated as “functionally innumerate”). The question arises as to how all of these people manage in important domains of their lives. In this article we aim to consider the context of the exercise of numeracy by adults, drawing on earlier research in mathematics education. We examine a recent conception of an adult’s ‘literate environment’ (EU HLG on Literacy, 2012), and extend this to reflect on the idea of an adult’s ‘numerate environment’. We consider the range of practices that particular adults may engage in, and the demands that these may make on the adult, the affordances the practices may offer; the latter include the opportunities, and the supports and / or barriers produced within these practices, and in cultures more generally, that may foster or impede an adult’s ongoing numerate development. We give examples of each of these aspects of adults’ numerate practices, and consider implications for the teaching, learning and development of numeracy

The modern role of antipsychotics for the treatment of agitation and psychosis in Alzheimer's disease

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordINTRODUCTION: Antipsychotics have long been the mainstay of treatment for agitation and psychosis in Alzheimer's disease. Despite their current use successive studies have shown that they only confer a modest benefit which must be balanced against their well-established serious side effects (extrapyramidal symptoms, stroke, accelerated cognitive decline and mortality). Areas covered: This review outlines the current guidance on antipsychotic usage and the evidence of their continued usage against a backdrop of emerging pharmacological treatments and an increasing emphasis on the importance of non-pharmacological interventions. Expert Commentary: The current justification for antipsychotic us in the context the changing landscape of prescribing and provide a view on the most promising alternative candidates to this class of drug are appraised

SuperIdentity: fusion of identity across real and cyber domains

Under both benign and malign circumstances, people now manage a spectrum of identities across both real-world and cyber domains. Our belief, however, is that all these instances ultimately track back for an individual to reflect a single ‘SuperIdentity’. This paper outlines the assumptions underpinning the SuperIdentity Project, describing the innovative use of data fusion to incorporate novel real-world and cyber cues into a rich framework appropriate for modern identity. The proposed combinatorial model will support a robust identification or authentication decision, with confidence indexed both by the level of trust in data provenance, and the diagnosticity of the identity factors being used. Additionally, the exploration of correlations between factors may underpin the more intelligent use of identity information so that known information may be used to predict previously hidden information. With modern living supporting the ‘distribution of identity’ across real and cyber domains, and with criminal elements operating in increasingly sophisticated ways in the hinterland between the two, this approach is suggested as a way forwards, and is discussed in terms of its impact on privacy, security, and the detection of threa

A biopsychosocial interpretation of the Neuropsychiatric Inventory – Nursing Home assessment: reconceptualising psychiatric symptom attributions

Background: The Neuropsychiatric Inventory is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric is important since the treatment and management of psychiatric symptoms relies on this understanding. Aims: This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in NPI-NH interviews. Method: The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n=651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n=3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with Orientation & Memory, Expressions of Need, Poor Care and Communication or Understandable Reactions) Results: Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (e.g. poor care and communication). Conclusions: The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively

Proteomic Analysis of a Noninvasive Human Model of Acute Inflammation and Its Resolution: The Twenty-one Day Gingivitis Model

The 21-day experimental gingivitis model, an established noninvasive model of inflammation in response to increasing bacterial accumulation in humans, is designed to enable the study of both the induction and resolution of inflammation. Here, we have analyzed gingival crevicular fluid, an oral fluid comprising a serum transudate and tissue exudates, by LC−MS/MS using Fourier transform ion cyclotron resonance mass spectrometry and iTRAQ isobaric mass tags, to establish meta-proteomic profiles of inflammation-induced changes in proteins in healthy young volunteers. Across the course of experimentally induced gingivitis, we identified 16 bacterial and 186 human proteins. Although abundances of the bacterial proteins identified did not vary temporally, Fusobacterium outer membrane proteins were detected. Fusobacterium species have previously been associated with periodontal health or disease. The human proteins identified spanned a wide range of compartments (both extracellular and intracellular) and functions, including serum proteins, proteins displaying antibacterial properties, and proteins with functions associated with cellular transcription, DNA binding, the cytoskeleton, cell adhesion, and cilia. PolySNAP3 clustering software was used in a multilayered analytical approach. Clusters of proteins that associated with changes to the clinical parameters included neuronal and synapse associated proteins

Polygenic Risk Scoring is an Effective Approach to Predict Those Individuals Most Likely to Decline Cognitively Due to Alzheimer’s Disease

BACKGROUND: There is a clear need for simple and effective tests to identify individuals who are most likely to develop Alzheimer’s Disease (AD) both for the purposes of clinical trial recruitment but also for improved management of patients who may be experiencing early pre-clinical symptoms or who have clinical concerns. OBJECTIVES: To predict individuals at greatest risk of progression of cognitive impairment due to Alzheimer’s Disease in individuals from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) using a polygenic risk scoring algorithm. To compare the performance of a PRS algorithm in predicting cognitive decline against that of using the pTau/Aß1-42 ratio CSF biomarker profile. DESIGN: A longitudinal analysis of data from the Alzheimer’s Disease Neuroimaging Initiative study conducted across over 50 sites in the US and Canada. SETTING: Multi-center genetics study. PARTICPANTS: 515 subjects who upon entry to the study were diagnosed as cognitively normal or with mild cognitive impairment. MEASUREMENTS: Use of genotyping and/or whole genome sequencing data to calculate polygenic risk scores and assess ability to predict subsequent cognitive decline as measured by CDR-SB and ADAS-Cog13 over 4 years RESULTS: The overall performance for predicting those individuals who would decline by at least 15 ADAS-Cog13 points from a baseline mild cognitive impairment in 4 years was 72.8% (CI:67.9-77.7) AUC increasing to 79.1% (CI: 75.6-82.6) when also including cognitively normal participants. Assessing mild cognitive impaired subjects only and using a threshold of greater than 0.6, the high genetic risk participant group declined, on average, by 1.4 points (CDR-SB) more than the low risk group over 4 years. The performance of the PRS algorithm tested was similar to that of the pTau/Aß1-42 ratio CSF biomarker profile in predicting cognitive decline. CONCLUSION: Calculating polygenic risk scores offers a simple and effective way, using DNA extracted from a simple mouth swab, to select mild cognitively impaired patients who are most likely to decline cognitively over the next four years

Cost-effectiveness of Dementia Care Mapping in care home settings – Evaluation of a randomised controlled trial

Background: Behaviours such as agitation impact on the quality of life of care home residents with dementia and increase health care use. Interventions to prevent these behaviours have little evidence supporting their effectiveness or cost-effectiveness. We conducted an economic evaluation alongside a trial assessing Dementia Care Mapping™ (DCM) versus usual care for reducing agitation and highlight methodological challenges of conducting evaluations in this population and setting. Methods: RCT data over 16 months from English care home residents with dementia (intervention n = 418; control n = 308) were analysed. We conducted a cost-utility analysis from the healthcare provider perspective. We gathered resource use and utility (EQ-5D-5L and DEMQoL-Proxy-U) from people living with dementia and proxy informants (staff and relatives). Data were analysed using seemingly unrelated regression, accounting for care home clustering and bootstrapping used to capture sampling uncertainty. Results: Costs were higher in the intervention arm than control arm (incremental = £1,479) due in part to high cost outliers. There were small QALY gains (incremental = 0.024) in favour of DCM. The base case ICER (£64,380 per QALY) suggests DCM is not cost-effective versus usual care. With the exception of analyses excluding high cost outliers, which suggested a potential for DCM to be cost-effective, sensitivity analyses corroborated the base case findings. Bootstrapped estimates suggested DCM had a low probability (p<0.20 where λ=£20,000) of being cost-effective versus control. Conclusion: DCM does not appear to be a cost-effective intervention versus usual care in this group and setting. The evaluation highlighted several methodological challenges relating to validity of utility assessments, loss to follow-up and compliance. Further research is needed on handling high cost individuals and capturing utility in this group