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In 1968, the humanitarian and development charity Oxfam asked a simple question: does aid work? What this meant in practice was that it appointed Bernard Llewellyn as its first Aid Appraiser. His conclusions were that roughly 50 percent of most aid work was wasted and ill-spent, too often on what he disparaged as ‘monuments to human folly’. That the organisation continued to support such initiatives he blamed on the ‘Oxfam bias’. There was always somebody to claim that aid worked. Llewellyn’s criticisms, and those who followed him, were acknowledged but the sector has been able to absorb them and move on. Indeed, a development studies literature has pointed to the self-perpetuating nature of aid work more generally: the ‘anti-politics machine’. One consequence has been that, if it is not known what works, then it is not known either what contribution charity has to the mixed economy of overseas welfare. That this has never been determined is not only a reflection of the ongoing disputes about the meaning of charity itself but also the reason for its subsequent growth.
This chapter describes the Mental Health Gap Action Programme (mhGAP) and the mhGAP-Intervention Guide (mhGAP-IG) developed by the World Health Organization (WHO), aimed at scaling up suicide prevention and management services to bridge unmet need.The mhGAP-IG is an evidence-based tool for mental disorders with structured and operationalised guidelines for clinical decision-making targeting non-specialist community and primary care workers in low and middle-income countries (LMICs).
This study aimed to explore the correlates of zero, one, and multiple performance validity test (PVT) failures on cognitive test performance in patients with various degrees of severity of traumatic brain injury.
Method:
306 participants completed the Trail Making Test as part of a neuropsychological evaluation within 1–36 months post-injury. They were assigned to zero, one, or ≥ two fail groups on the basis of at least two independent PVTs. Group differences in Trail Making Test performance were analyzed with analysis of variance, with post hoc contrasts with the Bonferroni correction for multiple comparisons. Groups were also compared on various background characteristics.
Results:
Participants who passed all PVTs had statistically significantly better performance on both parts of the Trail Making Test as compared to those who failed either one or multiple PVTs, with the latter two groups not differing statistically significantly from each other. PVT failure was relatively more common in participants who were female, had an uncomplicated mild TBI, were involved in financial compensation-seeking, and were seen at a longer time point since injury.
Conclusion:
Failure of even only one PVT is associated with lower neuropsychological test performance in patients with traumatic brain injury, especially when empirically validated criteria are used that are stratified by injury severity. Such failure does not always reflect malingering but must be interpreted and addressed in the context of patient background characteristics.
Provide a systematic overview of assessment approaches for treatment decisions after internal contamination with plutonium, americium, or curium and the efficacy of decorporation treatment with diethylenetriamine pentaacetate (DTPA) among humans and animals.
Methods
MEDLINE, EMBASE, and Cochrane Library were searched until December 06, 2023. Controlled experimental animal studies and human studies were eligible. Hand search of relevant reports continued until December 24, 2024. Risk of bias was assessed with the OHAT and JBI critical appraisal tools. Narrative synthesis was performed.
Results
A total of 37 studies and 1 report were included. Two studies reported averted dose in humans following DTPA ranging from 150 μSv to 1.1 Sv, but the contribution of rapid contamination assessments to treatment decisions was unclear. Numerous outcomes across different treatment schedules and observation periods were studied in animal populations. Studies provided very low certainty evidence of positive treatment effects.
Conclusions
Whether rapid dose assessment contributes to timely treatment decisions could not be assessed with the limited amount of informative studies. In animal studies, DTPA treatment seems to be effective in reducing radiation burden and other proximal outcomes, but risk of bias is high. Evidence for humans is based on a small number of case studies where reductions in body burden have been reported.
At the beginning of this book, we examined your own play memories and those of other people. We concluded that play really matters to children. But what do we really learn about children’s learning and development when we observe and analyse play? We begin this chapter by looking at a play memory of a 16-year-old boy whose parents used play to support their son in dealing with the arrival of his new baby sister.
Delivering safe, high-quality care needs a competent and capable workforce, particularly as clinical practices change with scientific and technical advances. Structured learning opportunities are a central approach to building and maintaining competencies, but ineffective training wastes the scarce resources and staff time. This Element provides a review of education and training design, implementation, and evaluation methods used in healthcare improvement. Drawing from the general learning sciences and healthcare education and training literatures, the authors describe five pillars of effective training. For each pillar, they provide actionable guidance based on the best available evidence. Three examples of quality and safety programmes are given to illustrate the positive impact of well-designed training, and the challenges of good training design in healthcare improvement. This title is also available as open access on Cambridge Core.
The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) is an observational study of more than 1100 participants across the dementia spectrum. This research note describes the development and features of the neuropsychological research battery, which is available in English and French. The training of staff and procedures for quality assurance are described. The battery assesses learning and memory, processing speed, attention, executive function, visuoperceptual processing, and language, and the available test scores are described. We outline our goals for future work including: (1) increasing the sociodemographic diversity of the participant cohorts, (2) determining the psychometric properties of the battery, (3) establishing robust normative data from control participants followed longitudinally, and (4) examining longitudinal data on individuals at risk of dementia and across the dementia spectrum. The COMPASS-ND neuropsychology data will provide a unique open-access database of deeply phenotyped participants with or at risk of dementia for Canadian and international researchers.
Employment testing is routinely performed in South Africa today, but this was not always the case. Turning its back on its apartheid history of racial segregation and discrimination, South Africa has developed a progressive legal system to thwart bias and promote fairness in employment testing. This chapter explores employment-related testing in the public and private sectors, beginning with an overview of South Africa’s apartheid history, followed by a discussion of how the current legal system addresses fairness. A distinctive aspect of South African law is that preferential treatment, including lower cutoffs and within-group norming for protected groups, is not only mandated but also widely practised as the norm rather than the exception. Our review concludes that South Africa has enacted an extensive legal framework to promote equality and prevent unfair discrimination.
Catch-neuter-vaccinate-release (CNVR) programmes for free-roaming dogs (FRD) are humane and effective in controlling dog populations in developing countries. However, each component, from capture to release, can impact an individual animal’s welfare. This study aimed to develop a standardised welfare assessment scoring system for evaluating the welfare of dogs undergoing routine CNVR procedures at a veterinary training facility in Goa, India and to assess the impact of a targeted staff training intervention by comparing welfare assessment scores before and after its implementation. A score-based protocol was designed, incorporating 22 animal-, resource-, and management-based parameters covering six key steps of the CNVR procedure: catching/transport; cage/holding area; pre-operative period; surgery; post-operative period; and release. Eighty-two dogs were assessed initially. Areas for improvement were identified and informed the design of a targeted staff training intervention involving theory-based lectures and interactive sessions. Knowledge was assessed before and after receiving the intervention, with total scores on the assessment improving. The welfare assessment was repeated on another 81 dogs. Total welfare scores for individual dogs improved significantly after the staff intervention compared with before. This study demonstrates that a welfare assessment tool can be used to assess the welfare of individual dogs in a busy CNVR programme; furthermore, it can inform the compilation and delivery of a targeted staff training intervention and demonstrate improvements in dog welfare after such an intervention.
An epilogue assesses the impact of the antiwar movement. Both activists and scholars disagree over its significance. Despite common misperceptions of the movement by the public, antiwar activists generally represented mainstream American political values. While the movement did not stop the war by itself, it imposed real limits upon presidential decisions to escalate American military expansion. Movement activists overwhelmingly waged peace using the tools of democracy to align the nation’s practice with its most righteous vision.
Assessment of mental health problems in children and young people (CYP) is an essential skill that requires a curious mind, a good knowledge of the subject and an ability to be empathic. Assessment should be structured with attention given to the developmental nature of the presenting difficulties and their impact on functioning. Similarly, understanding the impact of the child’s immediate environment on their mental health and integrating information from various sources is an important skill to be mastered. A thorough mental state examination of a CYP complimented by relevant physical examination is an integral component of a good assessment and creatively engaging a CYP in this process is crucial. A knowledge of psychometric profiles of various assessment and outcome measurement tools and the ability to skillfully use them in the assessment process is also important. The strength of child psychiatric assessments lies in multidisciplinary working. Specialist assessments by other professionals are valuable in arriving at a diagnosis or a formulation. The skill to sensitively feed this back to the CYP and their family, and engaging them in the next steps will help in a successful outcome. Ultimately, a good assessment ensures that the CYP and their families get the right help, at the right time from the right people.
This chapter provides an overview of neurodevelopmental disorders (NDDs) in children and young people. The definition and classification of NDDs is discussed, including key differences between ICD-10 and ICD-11 and the problematic use of language in diagnostic classifications, which is at odds with the social model of disability. Important stages of a multidisciplinary assessment of NDDs include a detailed developmental history, a psychosocial history, observation of the child, an assessment of the child’s communication and learning and supplementary rating scales. The role of professionals such as Community Paediatricians, Speech and Language Therapists, Occupational Therapists, teachers and Educational Psychologists is highlighted. Features of the main NDDs are outlined, including Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Specific Disorders of Development and Language and Tic disorders. Finally, an overview of treatment approaches and their evidence base is explored.
Attention deficit hyperactivity disorder (ADHD) is often associated with psychosocial functioning difficulties and valid measures of disability are needed for this population. The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is widely used to measure disability but has not been validated in the adult ADHD population.
Aims
This study aims to assess the psychometric properties of the WHODAS 2.0 in adults with ADHD, and to examine differences in disability levels between ADHD subtypes and gender.
Method
A cross-sectional study was conducted with 577 adults with ADHD (mean age: 38.24, s.d = 12.23; 52.3% male). ADHD severity was assessed using the ADHD Rating Scale (ADHD-RS) and Clinical Global Impression-Severity (CGI-S) Scale, while functionality was measured with the WHODAS 2.0 and the Functioning Assessment Short Test (FAST). Analyses included: (a) Cronbach’s α for internal consistency, (b) Pearson’s correlation for convergent validity, (c) Confirmatory Factor Analysis (CFA) for factor structure and (d) t-tests to compare disability levels across ADHD subtypes and gender.
Results
The WHODAS 2.0 demonstrated good internal consistency (Cronbach’s α = 0.89). Scores were significantly correlated with psychosocial functioning (FAST, r = 0.476, p < 0.001) and clinical measures. CFA supported the original six-factor structure (root mean square error of approximation 0.039, Comparative Fit Index 0.998, Tucker–Lewis Index 0.996). When comparing ADHD subtypes, participants with the combined subtype had higher WHODAS 2.0 total scores than those with the inattentive subtype (p = 0.006). Additionally, gender differences were identified, with females displaying higher disability levels (p = 0.005).
Conclusions
The WHODAS 2.0 demonstrates psychometric properties that suggest it is a valid and reliable tool for assessing disability in adults with ADHD.
We assessed whether higher caregiver depression is associated with increased likelihood of caregivers rating their children as screening positive for developmental disorders—autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder, emotional behavioral disorder, and functional impairment (FI)—among Ugandan children perinatally exposed and unexposed to HIV. Children and their primary caregivers were followed for 12 months. Caregiver depression was measured using the Hopkins Symptom Checklist-25 and categorized as low, moderate, or high based on terciles. Child developmental indices were derived from the Behavioral Assessment System for Children (third edition) at 0, 6, and 12 months. Multivariable linear regression estimated mean differences (MDs) in disorder indices with 95% confidence intervals (CIs) by caregiver depression level. Compared with highly depressed caregivers, those with low depression reported consistently lower ASD risk scores (MD: −0.35 to −0.32; 95% CI: −0.60 to −0.08). Similar trends were observed for FI (MD: −0.56 to −0.31; 95% CI: −0.81 to −0.06). Moderate depression was associated with modestly lower FI risk at baseline and 6 months but not at 12 months. Overall, higher caregiver depressive symptoms were linked to greater perceived child disorder risk. Evaluating caregiver depression alongside child screening may improve interpretation of developmental risk assessments.
The terms ‘curriculum’, ‘pedagogy’, ‘assessment’ and ‘reporting’ are often heard. Each of these terms has been interpreted in different ways and, throughout the history of formal education, one or another has been often at the forefront of educational thinking and practice. We consider that these four areas are inextricably interwoven and changes in policy or practice in one area influence each of the others. This chapter introduces some of the literature, research and practice to help develop an understanding of curriculum, pedagogy, assessment and reporting. We will discuss the interrelationship and alignment of these four areas, enabling reflection on how changes in each of these areas at a national, system or school level impact the day-to-day work of teachers.
The Ming dynasty’s survival depended on locating and employing men with the ability to direct military forces, and contemporary observers were deeply concerned with the nexus of command, troop morale, and dynastic fighting capacity. This essay focuses on the years following the Tumu Crisis of 1449, a time when dynastic authorities were particularly alive to issues of military ability, and it draws on the perspectives of two men, the Minister of War, Yu Qian 于謙 (1398–1457), and another more junior official, Ye Sheng 葉盛 (1420–72). The essay offers a snapshot of how military ability was defined, cultivated, assessed, and rewarded. Further, it suggests that, read carefully, the writings of Ye Sheng and Yu Qian not only offer insight into the views of elite civil officials but also shed light, however faint and wavering, on military labor and working conditions for those who fought and commanded for a living.
The chapter will help you to be able to explain the structure of CBT as a whole, including the purpose of each stage of therapy, effectively structure a treatment session of CBT, so as to ensure the best possible experience for patients, and develop a strong therapeutic alliance with this process, based on active collaboration and genuine empathy, warmth and unconditional positive regard
Commercially run grade examinations and competitive music festivals, which tested learners’ attainment, were central to the consolidation of violin culture across Britain. Chapter 3 analyzes the string exams operated by three institutions, each of which targeted different socioeconomic groups. Bringing the College of Violinists – the first exam board to offer elementary string exams and the only one to guarantee string players would be assessed by specialists– into dialog with the more often discussed ABRSM and Society of Arts, the discussion evaluates exam requirements, candidate numbers, and success rates. At root, exams were tools for motivating students and supporting and shaping learning. Regional competition festivals offered additional opportunities for more advanced pupils’ performance to be assessed (in a public hall, as opposed to a private exam room) and, along with the exam boards, they contributed to the informal standardization of core repertoire. The chapter also surveys instructional materials, some of which were responses to the exam culture, and weighs students’ experiences of learning.
The chapter will help you to be able to explain the six key questions that are answered by a good formulation, consider the purpose of formulation in shaping assessments and intervention, and create effective and idiosyncratic formulations and treatment plans for your own patients