From real to virtual prism adaptation therapy: a systematic review on benefits and challenges of a new potential rehabilitation approach.

Prism adaptation (PA) is a sensorimotor technique that has been shown to alleviate neglect symptoms. Due to its demonstrated functional effectiveness, PA has recently been implemented in virtual reality environments. However, research on virtual prism adaptation (VPA) is limited and it lacks a standardized methodological approach. It is crucial to investigate whether VPA can be effective in inducing traditional effect of PA and to have potential utility in a rehabilitation context. Clarifying this aspect would allow the use of VPA in a wider range of contexts and neurological disorders, with the additional opportunity to overcome PA traditional limits. The aim of the present study is to revise current literature on VPA in both healthy individuals and patients highlighting also its advantages and limitations. Studies performed between 2013 and 2023 and fulfilling the inclusion criteria were searched on three electronic databases, by combining the terms "Virtual prism adaptation" and "Virtual prism adaptation therapy. Out of 123 articles, only 16 met the inclusion criteria. The current literature review suggests that VPA may serve as a potentially useful tool for inducing visuomotor adaptation, with most studies conducted in healthy individuals. The high variability in the methodologies observed among studies suggests that more standardized approaches are needed to gain a deeper understanding of the mechanisms underlying adaptation and aftereffects when PA is administered in a virtual environment. Future studies should also address practical applications and clinical efficacy of VPA, particularly in patients with spatial neglect.

Trauma-informed care.

In recent years, trauma informed care has become a heavily researched topic; however, it has yet to achieve a universal standard in the field of pediatric medicine. One of the primary tenants of trauma informed care is a clear understanding of the pervasiveness and complexities of childhood trauma, and its intersection with a child and caregiver's physical wellness. A major component of trauma informed care is addressing the way medical providers may be exposed to vicarious trauma, secondary traumatic stress, and compassion fatigue. By taking proactive steps to educate medical providers on the effects of trauma, they are better equipped to assess a family's needs and provide enhanced quality of care for their patients and themselves.

Effects of early institutionalization involving psychosocial deprivation on cognitive functioning 60 years later: Findings of the LifeStories project.

BACKGROUND: Institutionalization involving psychosocial deprivation affects child development negatively. However, there are few longitudinal studies, and no prospective study has yet examined the consequences of institutionalization in late adulthood. OBJECTIVE: Investigating effects of psychosocial deprivation on cognitive functioning 60 years later. PARTICIPANTS AND SETTING: A population-based survey of institutionalized infants and toddlers was conducted in Switzerland from 1958 to 1961 (n = 387; Mage = 0.93 years, SD = 0.53, 48 % female, 48 % Swiss nationality). In parallel, a comparison group of 399 family-raised children were assessed (Mage = 0.85 years, SD = 0.50, 46 % female, 100 % Swiss nationality). Six decades later, data on cognitive functioning were collected for 88 of the institutionalized group (Mage = 62.63 years, SD = 1.32), and 148 of the comparison group (Mage = 65.06, SD = 1.32). METHODS: Standardized tests were used: the Brunet-Lézine Developmental Test in early childhood and a short form of the Wechsler Adult Intelligence Scale in late adulthood. RESULTS: Formerly institutionalized individuals scored lower on cognitive functioning (d = - 0.67, p < .001), with the greatest difference in working memory (d = -0.78, p < .001). Longer duration of institutionalization increased the risk of lower cognitive functioning, indicating a dose-response effect. Institutionalization's impact on adult cognitive functioning was mediated by early childhood developmental status but not by later educational attainment. CONCLUSIONS: This study confirms the early experience hypothesis, indicating that early life conditions have lasting effects on human development, even into late adulthood.

A Qualitative Study of Adult Protective Services Practitioners Responding to Allegations of Elder Abuse and Self-Neglect.

Adult Protective Services (APS) practitioners play an essential role in supporting older adults experiencing elder abuse and self-neglect (EASN), however, very little research has examined their experiences, from their perspectives. The purpose of this study was to examine the experiences of APS practitioners responding to allegations of EASN. Qualitative interviews were conducted with APS practitioners (n = 14) from the state of Maine. A descriptive phenomenological approach involving two independent assessors was used to code transcripts into themes. Two domains, each with various subthemes, were identified: (1) rewarding elements of role and (2) challenging aspects of role. The findings of this study emphasize how APS practitioners are motivated by their capacity to help elicit positive change in the lives of their clients and support the well-being of older adults experiencing EASN. However, APS practitioners must navigate numerous challenges and barriers in their role, including time constraints, high and complex caseloads, limited resources, and broader misconceptions on APS. These findings highlight the importance of addressing these stressors to support the well-being of APS practitioners, which, in turn, can help support the vulnerable older adults they serve.

Maternal victimization and neglected offspring: Child marriage, IPV and depression symptoms among Salar Muslim women.

BACKGROUND: Child neglect is prevalent in western rural China, yet there is limited research among ethnic minority communities. The Salar, a Turkic-Muslim ethnic minority residing primarily in western China, also face this specific problem. The group is deeply influenced by ethnicity, Islam and Chinese Confucianism, which in turn makes women vulnerable to child marriage and IPV. These victimizations, coupled with various life stressors, further complicate the challenges of providing adequate care for their children. OBJECTIVE: This study hypothesizes a relationship between child neglect and maternal child marriage, IPV victimization, and depression symptoms. PARTICIPANTS AND SETTING: 201 married Salar women from five villages in Xunhua Salar Autonomous County, China, were randomly selected to participate in the study. METHOD: A probability proportional to size (PPS) sampling approach was used to collect a random representative multi-stage cluster sample in 2022. Random effects Poisson regression models were used to test the hypotheses. RESULTS: The participants reported a 65.6 % rate of child neglect and a 30.8 % rate of IPV in the past year. 37.6 % experienced child marriage. Results revealed significant associations between child neglect and child marriage, IPV, and depression symptoms. A two-way interaction between IPV and depression symptoms was strongly positively associated with child neglect. CONCLUSIONS: This research indicates that Salar Muslim mothers who have experienced child marriage, adulthood victimization, and depression are at a higher risk of neglecting their children. The findings represent a valuable initial step toward researching and addressing the protection needs of women and children from Muslim ethnic minorities in China.

"I got to say two or three lines"-A systematic review of children's participation in child protective services.

BACKGROUND: Although children's right to participate in decisions that influence their lives is widely recognized, it is rarely present in the assessment and decision-making processes in child protective services (CPS). OBJECTIVE: The aim of this systematic review was to examine children's views and experiences of participating in CPS cases of child abuse and neglect and to identify the gap in scientific knowledge. METHODS: The systematic review follows the PRISMA statement and includes 13 peer-reviewed articles published in several academic journals from 2016 to 2023 reporting primary research with abused and neglected children registered in CPS. RESULTS: Thematic analysis identified five main themes: participation: assessment and decision-making, information and understanding, interaction and relationships, children vs parents, and experience of younger children. The findings show that although a few children reported instances of meaningful participation, overall, children's participation was often reduced to a tokenistic engagement, with limited influence on the decision-making processes. Children, especially younger children, receive insufficient information and struggle to understand the proceedings. Examples of prioritizing parents' views, needs, and rights rather than centering the children's perspectives are reported. CONCLUSIONS: The findings highlight a need for significant changes in how child participation is conceptualized and operationalized within CPS. Implications for practice, policy, and research are discussed to foster children's participation in CPS to contribute to the effective care and protection of children experiencing child abuse and neglect.

Adverse childhood experiences and risky behaviors in Oman: A cross-sectional study.

Objective: Adverse childhood experiences (ACEs), which refer to potentially traumatic events occurring during childhood, have been consistently linked to detrimental effects on high-risk behaviors through various studies. Nonetheless, such an association has rarely been examined in the context of Arab culture. This study aimed to investigate the association between ACE levels and high-risk behaviors (e.g., smoking, alcohol consumption, drug use, high-risk sexual behavior, and physical inactivity) among Omani adults. Methods: This was a cross-sectional study with convenience sampling. The participants were recruited from a university-affiliated medical facility in Oman. Data were collected in 2022. They were asked to complete the Adverse Childhood Experience International Questionnaire (ACE-IQ). Results: The study included 1648 Omani adults. Analyses revealed that the adjusted odds ratios (ORs) for engaging in some of the identified high-risk behaviors increased as the level of ACEs increased. Specifically, individuals with an ACE level of 4 exhibited higher odds of smoking (OR: 2.6), alcohol consumption (OR: 2.9), and risky sexual behavior (OR: 32) than those without ACEs. Conclusion: The findings of this study underscore a notable association between ACEs and high-risk behaviors among Omani adults. Consequently, there is a pressing need for intensified efforts to prevent ACEs when possible and to alleviate their adverse effects, emphasizing the importance of public health initiatives and interventions in Oman.

Early Life Adversity, Microbiome, and Inflammatory Responses.

Early life adversity has a profound impact on physical and mental health. Because the central nervous and immune systems are not fully mature at birth and continue to mature during the postnatal period, a bidirectional interaction between the central nervous system and the immune system has been hypothesized, with traumatic stressors during childhood being pivotal in priming individuals for later adult psychopathology. Similarly, the microbiome, which regulates both neurodevelopment and immune function, also matures during childhood, rendering this interaction between the brain and the immune system even more complex. In this review, we provide evidence for the role of the immune response and the microbiome in the deleterious effects of early life adversity, both in humans and rodent models.

Factors associated with self-neglect from a salutogenic perspective among community-dwelling older adults: A cross-sectional correlational study.

OBJECTIVES: To identify the associated factors of self-neglect in older adults from a salutogenic perspective. METHODS: A cross-sectional correlational study was conducted in two communities in Beijing with 486 older adults recruited from April to December 2022. Data were collected by a set of questionnaires. RESULTS: Sense of coherence (ß=-0.138), socio-demographic generalized resistance resources (GRRs) (smoking: ß=0.156), social GRRs (living alone: ß=0.093), psychological GRRs (self-esteem: ß=-0.126), and motivational GRRs (powerful others locus of control: ß=-0.199, chance locus of control: ß=0.119) were all associated with self-neglect among older adults (p<0.05). CONCLUSIONS: Sense of coherence and GRRs are vital to improve self-neglect in older adults. It is suggested to increase the level of self-esteem and the tendency of the health locus of control to largely facilitate self-neglect management in older adults.

The ripple effect of trauma: Evaluating vulnerability, post-traumatic stress symptoms, and aggression within a child and adolescent population.

BACKGROUND: The deleterious effects of experiencing adverse childhood experiences (ACEs), especially those associated with child abuse and neglect (CM-ACEs), is well documented. Two common behavioral and emotional concerns observed in children following CM-ACEs is post-traumatic stress and aggression. While support for cognitive models explaining both of these outcomes exists, little is known about any shared cognitive vulnerabilities that may explain the presence of both. OBJECTIVE: The purpose of the current study was to evaluate a cognitive model of vulnerability/safety as a shared underlying mechanism for the development of post-traumatic stress symptoms (PTSS) and aggression following the occurrence of CM-ACEs in children. METHODS: Male youth between the ages of 6 and 14 attending school within a residential setting participated in a school-based performance improvement program. As a part of the program, data were collected on the child's history of abuse, PTSS, aggression, and feelings of safety and vulnerability. RESULTS: The results of the SEM suggested that there was a significant serial indirect effect of vulnerability and PTSS on the relation between CM-ACEs and reactive aggression. This was not true for proactive aggression. DISCUSSION: The current results suggest that that there may be a shared schema-based model in which feelings of vulnerability and cognitive models promoting the world as an unsafe place may contribute to the maintenance and development of both PTSS and reactive aggression among children who have experienced abuse/neglect.

Caseload factors predictive of family abuse and neglect treatment outcomes.

BACKGROUND: In child welfare, caseloads are frequently far higher than optimal. Not all cases are created equal; however, little is known about which combination and interaction of factors make caseloads more challenging and impact child and family outcomes. OBJECTIVE: This study aims to identify which case, provider, and organizational factors most strongly differentiate between families with favorable and less-than-positive treatment outcomes. PARTICIPANTS AND SETTING: Participants were 25 family advocacy program providers and 17 supervisors at 11 Department of the Air Force installations. METHODS: Following informed consent, participants completed demographic and caseload questionnaires, and we collected information about organizational factors. Providers were sent a weekly case update and burnout questionnaire for seven months. We used linear mixed-effects model tree (LMM tree) algorithms to determine the provider, client, and organizational characteristics that best distinguish between favorable vs. unfavorable outcomes. RESULTS: The LMM tree predicting provider-rated treatment success yielded three significant partitioning variables: (a) commander involvement, (b) case complexity, and (c) % of clients in a high-risk field. The LMM predicting client-rated treatment progress yielded seven significant partitioning variables: (a) command involvement; (b) ease of reaching tenant unit command; (c) # of high-risk cases; (d) % of clients receiving Alcohol and Drug Abuse Prevention and Treatment services; (e) ease of reaching command; (f) % of clients with legal involvement; (g) provider age. CONCLUSIONS: This study is a first step toward developing a dynamic caseload management tool. An intelligent, algorithm-informed approach to case assignment could help child welfare agencies operate in their typically resource-scarce contexts in a manner that improves outcomes.

Receipt of parenting, disability, unemployment, and other income support payments in persons aged 16 to 33 years - the associations with child maltreatment.

BACKGROUND: Child maltreatment (CM) is a major public health concern with life-long effects. Its impact on income support has rarely been studied. OBJECTIVE: To examine the association between CM and receipt of income support payments and the budgetary impact for persons 16 to 33 years. PARTICIPANTS AND SETTING: A South Australian birth cohort, born 1986 to 2004 (n = 339,411). METHODS: We linked child protection (CP) administrative records with national welfare payment records, ending March 2020. Receipt of income support payments and mean payment amounts were described by CP contact (adjusted for child and family attributes). Budget impact was modelled at the national level. RESULTS: Adjusted odds ratio (AOR) for receipt of any income support payment was 3.01 (2.95-3.07) for individuals with any CP contact versus no CP contact. Among those receiving any payment, adjusted annualised mean benefit payment was $3754 (US$1446) among individuals with no CP contact, $6262 (US$4,307) in persons with any CP contact, and $9,747 in persons who'd been in OOHC. Cumulative payments modelled from age 16 to 33 years totalled $38,570 (US$26,652) for individuals with no CP contact, and $181,743 (US$125,003) for individuals who'd been in OOHC. Modelled for the Australian population to age 33, the extra cost associated with CP contact added 39 % to the government income support budget. CONCLUSION: CM is strongly associated with receipt of income support payments. Investment in effective preventive and protective strategies for CP involved children could address this core social determinant of health, while providing budget savings.

Obesity in childhood: associations with parental neglect, nutritional habits, and obesity awareness.

Background: The relationships underlying the dynamic between obesity and parental neglect in terms of nutritional habits and obesity awareness are unclear. Parental neglect remains a significant subject of concern that needs to be examined in the context of obesity. Methods: The aim was to examine the relationships between childhood obesity, parental neglect, children's eating habits and obesity. The study group consisted of 404 children and their parents from Ankara, Turkiye. As data collection tools, an Individual Information Form, Obesity Awareness Scale, the Parents Form of the Multidimensional Neglectful Behaviors Scale were administered. In addition, information on the children's body mass indexes was obtained by anthropometric measurements and the findings were recorded on the questionnaires of each child. Results: It was found that 98 (24.3%) of the children included in the study were overweight and 63 (15.6%) were obese. The results of the multinomial logistic regression analysis indicated that in the underweight and overweight group, the parents' perception of their child's weight predicted body mass index in children, and in the obese group, along with the parents' perception of their child's weight, the age and gender of the child, eating fast, obesity in the family and parental neglect were also predictors. Conclusion: Practitioners such as nurses, dietitians and child developmentalists working in schools should consider weight problems in children as one of the indicators of parental neglect and should implement interventive efforts to enhance parental supervision of children at risk.

Aftereffects of visuomanual prism adaptation in auditory modality: Review and perspectives.

Visuomanual prism adaptation (PA), which consists of pointing to visual targets while wearing prisms that shift the visual field, is one of the oldest experimental paradigms used to investigate sensorimotor plasticity. Since the 2000's, a growing scientific interest emerged for the expansion of PA to cognitive functions in several sensory modalities. The present work focused on the aftereffects of PA within the auditory modality. Recent studies showed changes in mental representation of auditory frequencies and a shift of divided auditory attention following PA. Moreover, one study demonstrated benefits of PA in a patient suffering from tinnitus. According to these results, we tried to shed light on the following question: How could this be possible to modulate audition by inducing sensorimotor plasticity with glasses? Based on the literature, we suggest a bottom-up attentional mechanism involving cerebellar, parietal, and temporal structures to explain crossmodal aftereffects of PA. This review opens promising new avenues of research about aftereffects of PA in audition and its implication in the therapeutic field of auditory troubles.

BEST FOR CAN - bringing empirically supported treatments to children and adolescents after child abuse and neglect: update to the study protocol.

Background: The implementation trial BESTFORCAN aims to evaluate the dissemination of Trauma-Focused Behavioural Therapy (TF-CBT) for children and adolescents in Germany with posttraumatic stress symptoms (PTSS) after child abuse and neglect (CAN) with a focus on supervision.Objective: This update to the study protocol outlines changes made due to practical reasons in the course of the ongoing trial while maintaining methodological quality.Method: The amendments to the original study protocol comprise (1) a more refined operationalisation of the primary outcome sufficiently adherent TF-CBT therapy (SATT), (2) changes in the study sites and (3) additional inclusion of one post-gradual psychotherapy training institute.Discussion: The adaptions to the original study protocol ensured high methodological quality through the transparent presentation of protocol modification: ensuring the recruitment of participating psychotherapists in training by including a further post-gradual training institute as well as an adaption of the measurement of SATT with high external validity. The objectives, diagnostic set, and secondary outcomes remained unimpaired by the amendment. Therefore, we expect the trial to provide evidence for the effect of model-specific trauma-focused supervision on the implementation outcomes of TF-CBT as compared to supervision as usual.Trial registration: German Clinical Trials Register identifier: DRKS00020516..

Update to the study protocol of the trial BESTFORCAN that investigates the implementation of trauma-focused behavioural therapy for children and adolescents with posttraumatic stress symptoms following abuse with a focus on the role of supervision.Adaptions have been made regarding the specification of the definition of sufficiently adherent intervention, relocation of the data-handling centre and the recruitment of one additional psychotherapy institute.The adaptions have no impact on the objectives, diagnostic set, secondary outcomes, or processes of data handling.

A comparison of virtual versus in-person delivery of SafeCare on parent and implementation outcomes.

BACKGROUND: Evidence-based prevention services for child abuse and neglect (CAN), typically delivered via home visiting (HV), pivoted to virtual delivery in 2020 to continue family services while adhering to the COVID-19 public health guidelines. OBJECTIVE: The study aims are to compare parent and implementation outcomes for the HV program, SafeCare©, delivered virtually versus in-person, across a 2-year period. METHODS: Three data sources were used to examine parent program engagement and skill mastery, as well as provider fidelity. Sources included: 1) quantitative service data collected as part of routine SafeCare implementation (in-person families, n = 923; virtual families, n = 1978), 2) qualitative survey data collected from SafeCare providers (n = 212) and 3) focus group data with SafeCare Providers (n = 9). RESULTS: Service data were examined using mixed models due to the nesting of the data, with all analyses controlling for time. Qualitative data from the survey and focus groups were analyzed using thematic coding. Data were triangulated from the three sources to answer the primary research question. Findings suggest that virtual delivery of SafeCare holds promise, with parents who participated virtually completing more modules at a faster pace than in-person clients. SafeCare parents demonstrated positive programmatic outcomes regardless of whether they participated in the program virtually or in-person. Provider fidelity remained high in the transition to virtual delivery. However, technology-related logistical issues and provider self-efficacy related to virtual delivery presented challenges to program success. CONCLUSIONS: The study has multiple implications for the HV field about the viability of virtual service delivery. Further research is warranted with data collected directly from parents, and a more critical analysis of what works best for whom and when to further advance the field.

Quantifying the Use of Space in the Clock Drawing Test: Validity in Hemispatial Neglect.

OBJECTIVE: The Clock Drawing Test (CDT) is a widely used test for cognitive screening as its execution taps into a large number of cognitive functions. Because of the involvement of visuospatial abilities, the CDT is also commonly used to assess hemispatial neglect. In the present study, we introduce a new quantitative scoring method for the CDT that aims to measure the use of space for each half of the clock face and asymmetries of space use. METHOD: Two measures are introduced: the explored space (ES) and used space (US) for each half of the clock, as well as two derived asymmetry indices. Such new measures were applied to CDTs of four groups of participants: right brain-damaged patients without visuospatial neglect, two groups of right brain-damaged patients with varying degrees of visuospatial neglect, and a group of neurologically healthy participants. RESULTS: Analyses showed that only neglect patients explored and used the left clock half significantly less than the right one. This result was also confirmed by the asymmetry indices, where neglect patients showed a stronger rightward bias. For neglect patients, the US asymmetry index correlated with the patients' scores on the neuropsychological tests. The analyses of receiver operating characteristic curves showed that left US and left ES scores had good accuracy in categorizing neglect patients. CONCLUSIONS: The present work provides new quantitative indices of CDT space usage in hemispatial neglect. Cutoffs are provided for clinical practice.

"All you need is compassion?" a latent profile analysis of neglect and self-compassion on child mental health.

BACKGROUND: Neglect is a common form of child maltreatment and profoundly affects children's mental health globally. Self-compassion may help children cope with neglect but the role of self-compassion in neglect context has been understudied. This study identifies distinct patterns of self-compassion and child neglect and explores how neglect and self-compassion profiles correlate with child mental health. METHODS: The sample includes 3342 children aged 8-16 (49.6 % female) from a national survey of 29 provinces in China using a multistage sampling method. We used latent profile analysis to identify distinct profiles of self-compassion and neglect and examine their combined effects on child mental health, including both positive indicators (hope, resilience) and negative indicators (anxiety, depression, academic burnout, and peer problems). RESULTS: We identified four neglect/self-compassion profiles: Adaptable Self-Carers (average neglect/high self-compassion), Vulnerable Languishers (high neglect/low self-compassion), Stable Self-Soothers (low neglect/average self-compassion), and Opportune Thrivers (low neglect/high self-compassion). The Vulnerable Languishers group exhibited the poorest mental health outcomes, whereas the Opportune Thrivers showed the best outcomes. Adaptable Self-Carers, although experiencing more neglect than Stable Self-Soothers, had better mental health than the latter, possibly due to their greater self-compassion. LIMITATIONS: The cross-sectional design limits our ability to determine causality, and the use of self-reported measures increases response bias risk. CONCLUSIONS: More self-compassion and less neglect are associated with more positive mental health outcomes. Moreover, self-compassion is a potential protective factor against the adverse effects of neglect on child mental health. Fostering self-compassion may boost positive adjustment in children who have experienced neglect.

A bibliometric review of unilateral neglect: Trends, frontiers, and frameworks.

BACKGROUND: Owing to the adverse effects of unilateral neglect (UN) on rehabilitation outcomes, fall risk, and activities of daily living, this field has gradually got considerable interest. Notwithstanding, there is presently an absence of efficient portrayals of the entire research field; hence, the motivation behind this study was to dissect and evaluate the literature published in the field of UN following stroke and other nonprogressive brain injuries to identify hotspots and trends for future research. MATERIALS AND METHODS: Original articles and reviews related to UN from 1970 to 2022 were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. CiteSpace, VOSviewer, and Bibliometrix software were used to observe publication fields, countries, and authors. RESULTS: A total of 1,202 publications were incorporated, consisting of 92% of original articles, with an overall fluctuating upward trend in the number of publications. Italy, the United Kingdom, and the United States made critical contributions, with Neuropsychologia being the most persuasive academic journal, and Bartolomeo P. ranked first in both the quantity of publications and co-citations. Keywords were divided into four clusters, and burst keyword detection demonstrated that networks and virtual reality might additionally emerge as frontiers of future development and warrant additional attention. CONCLUSIONS: UN is an emerging field, and this study presents the first bibliometric analysis to provide a comprehensive overview of research in the field. The insights and guidance garnered from our research on frontiers, trends, and popular topics could prove highly valuable in facilitating the rapid development of this field while informing future research directions.

Self-neglect as a significant public health issue: exploring the responsibility of the SPCDN.

Self-neglect is a recognised form of abuse affecting individuals across the lifespan. Gaps are evident within current data to support its prevalence; thus, it is considered to be an under-researched and under-reported phenomenon. Evidence suggests that there are multiple risk factors which contribute to self-neglect and sources recognise it leads to poorer health outcomes. Specialist Community Practitioner District Nurses (SCPDNs) deliver care across a diverse demographic and continuously assess risk for individuals in complex environments leading and managing the care of individuals who self-neglect. It is therefore essential that SCPDNs are equipped with the knowledge and skills required to therapeutically assess the health needs of this patient group and lead on the coordination of care. This article aims to explore the subject of self-neglect as a public health concern and appraise the role and responsibilities of the SCPDN within community nursing practice.