A Global Response to Elder Abuse and Neglect: Building Primary Health Care Capacity to Deal with the Problem Worldwide: Main Report
Bibliographic record
Abstract
The World Health Organization (WHO) and the Center for Interdisciplinary Gerontology/University of Geneva (CIG/UNIGE), in association with institutions in eight countries (Australia, Brazil, Chile, Costa Rica, Kenya, Singapore, Spain and Switzerland), formed a joint research programme aimed at tackling a substantial and yet hidden social problem: elder abuse and neglect. The foundations of the study were provided by the ground-breaking work conducted by a multidisciplinary and inter-institutional team from Montreal. The project objectives are: To develop and validate a reliable instrument applicable in different geographical and cultural contexts in order to increase awareness among PHC professionals to the problem of elder abuse and neglect. To build the capacity of PHC workers to deal with elder abuse and neglect through evidence-based education for the development of prevention strategies. The original project outline comprised the development and validation of a universal routine screening tool to facilitate the detection of elder abuse and neglect among PHC professionals. Consultations with experts and advisers during the initiation phase of the project, however, have indicated that it is critical to apply the concept of an elder abuse screening tool in the field of PHC; elder abuse involves psychosocial moments of stress not only for the patients but also for the PHC professionals, who are currently not equipped well enough with follow-up strategies. It was considered more appropriate to ultimately develop a tool that helps raise awareness about the issue of elder mistreatment among the PHC professionals and sensitizes them in dealing with potential abuse cases. Therefore, the goal of the WHO-CIG study is to provide an instrument to detect suspicions of elder abuse modelled on the Elder Abuse Suspicion Index (EASI), a questionnaire previously developed and tested in Montreal. Elder abuse and its detection are challenging and highly sensitive issues that need a linguistically and culturally specified approach and vocabulary. Consequently, the creation of a “universal” tool implies global testing. The first step was the qualitative testing of a set of questions, which led to the Montreal EASI, in the eight participating countries mentioned above. Further action such as the piloting of the tool in clinical settings and the expansion of the range of participating countries will be the basis for future studies. The results of the study confirm that in the opinion of the older people involved and, in particular, of the PHC professionals, the provision of a short instrument covering key dimensions of elder abuse might be a critical step in preventing and detecting such abuse. According to such results, however, a universal instrument applicable to all cultural and geographical contexts has not yet been developed; the appropriateness of its content and wording vary, depending on the setting. Nevertheless, the study participants believe that it is essential to equip PHC professionals with a set of questions to serve as a starting point in raising awareness about elder abuse.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".