Individual, interpersonal, incident and community level variables associated with adult homicide and availability in the Victorian Homicide Register.

Individual, interpersonal, incident and community level variables associated with adult homicide and availability in the Victorian Homicide Register.</p

Definitions of terms in this protocol.

BackgroundThere is a need for both descriptive and analytical evidence on the factors associated with older adult homicide. The current landscape is insufficient because most published research is confined to the United States, and contains insufficient data about the homicide context. This study protocol describes the proposed method for examining the characteristics and factors associated with older adult homicide in the Australian state of Victoria, using data generated for the criminal and coronial investigation into these deaths stored in the Victorian Homicide Register (VHR). Outcomes will support practitioners, policy makers and other key stakeholders to strengthen prevention strategies to reduce the risk of future homicides among older Victorians.MethodsThis study will comprise a single-jurisdiction population-based cross-sectional design to analyse consecutive cases of homicide among community-dwelling older adults in Victoria, Australia for the period 2001 to 2015. All homicides of adults aged 18 years and older, and where the Coroner’s investigation is completed at data extraction will be included. Variables will be selected in accordance with elements of the social-ecological model (i.e., individual, interpersonal, incident, and community). This will include: socio-demographic characteristics; presence of mental or physical illness; deceased-offender relationship; nature of any abuse between the deceased and offender; incident location and weapon used; the presence of alcohol or drugs; and criminal justice outcomes. Homicide rates per 100,000 population will be calculated for older adults (aged 65 years and older) and younger adults (aged 18–64 years), and compared as rate ratios using Poisson regression. Descriptive statistics and cross-tabulation will be generated for factors associated with homicide for older compared to younger adults. Homicide typologies based on deceased-offender relationship and motive will be explored within group and family homicides will be compared between older and younger adults.</div

Modified social-ecological model–older adult homicide.

Modified social-ecological model–older adult homicide.</p

Case Identification diagram: Adult homicides in Victoria, Australia 2001–2015.

Case Identification diagram: Adult homicides in Victoria, Australia 2001–2015.</p

Additional file 1: of The utility of medico-legal databases for public health research: a systematic review of peer-reviewed publications using the National Coronial Information System

Descriptive table of original research studies with NCIS as primary data source published in peer-reviewed journal. (PDF 274 kb

A systematic review of medication non-adherence in persons with dementia or cognitive impairment

<div><p>Background</p><p>Adherence to medication is vital for disease management while simultaneously reducing healthcare expenditure. Older persons with cognitive impairment (CI) are at risk for non-adherence as cognitive processes are needed to manage medications. This systematic review focuses on the relationship between medication non-adherence and specific cognitive domains in persons with CI, and explores determinants of medication non-adherence. When available, relationships and factors are compared with cognitively intact populations.</p><p>Methods</p><p>A seven database systematic search of studies published between 1 January 1949–31 December 2015 examining medication non-adherence in community dwelling persons with CI or dementia was conducted. Articles reporting medication non-adherence in people with CI or dementia in the community, with or without caregiver supports were eligible for inclusion. Papers reporting adherence to treatments in cognitively intact populations, populations from hospital or institutional settings, for non-prescribed medication or those describing dementia as a factor predicting medication non-adherence were excluded. Data on study and population characteristics, research design, data sources and analysis, specific cognitive domains, non-adherence prevalence, measurement of adherence, salient findings, factors associated with adherence and strategies to improve medication adherence were extracted. Study limitations included inconsistencies between data sources and definitions, resulting in a loss of fidelity in the value and comprehensiveness of data, as well as exclusion of non-pharmacological treatments and regimens.</p><p>Findings</p><p>Fifteen studies met inclusion criteria. Adherence among CI subjects ranged from 10.7%-38% with better rates of adherence in non-CI individuals. Medication non-adherence definitions varied considerably. New-learning, memory and executive functioning were associated with improved adherence and formed the focus of most studies. Multiple factors were identified as modulators of non-adherence.</p><p>Conclusion</p><p>This review highlights a gap in knowledge on how specific cognitive domains contribute to medication non-adherence amongst CI populations, and demonstrates the current focus is limited to two domains: memory and executive functioning.</p></div

Findings of Selected Studies.

<p>Findings of Selected Studies.</p

DSM V Criteria for Diagnosing Major & Minor Neurocognitive Disorder (NCD)^*.

<p>DSM V Criteria for Diagnosing Major & Minor Neurocognitive Disorder (NCD)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0170651#t001fn001" target="_blank">*</a>}.</p

Methods and Populations of Selected Studies.

<p>Methods and Populations of Selected Studies.</p

Significant Factors for Medication Adherence and Non-Adherence in Cognitively Intact and Cognitively Impaired Individuals.

<p>Significant Factors for Medication Adherence and Non-Adherence in Cognitively Intact and Cognitively Impaired Individuals.</p