This study examined the nature and impacts of the professional override on the Level of Service Inventory–Ontario Revision (LSI-OR), using a large archival database of 40,539 individuals’ information. Research questions focused on the predictive validity of various LSI-OR risk metrics, including total risk/need scores, initial risk categories, and adjusted risk categories, for various types of recidivism; how professional overrides were used; whether they were used more with some groups than others; and whether their impacts varied depending on recidivism type. Overrides were applied in 15.4% of cases, most often (94.1%) to increase risk levels. Override use varied based on gender, race, and the nature of index offenses. Based on receiver operating characteristic analyses, the results generally indicated that adjusted risk levels (incorporating professional overrides) demonstrated inferior predictive validity relative to unadjusted metrics. The results suggest a need for increased caution and consistency in the application of professional overrides.

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Many people are keen to be actively involved in social life and activities, but even at an early stage, dementia can have a negative impact on social participation and access to leisure activities. As part of the IDoService project, this study has investigated people’s needs and wishes, barriers and facilitators to identify opportunities for improving access to meaningful activities. Individual and focus group interviews were conducted with 5 people living with mild to moderate dementia, 2 familial and 2 professional care partners, as well as 12 people working in the field of dementia and/or community activities. Thematic analysis has highlighted the benefits of participating in meaningful activities, such as empowerment and pride, social contacts, and feeling useful to others. A number of barriers to participation relating to individual and environmental factors were reported. Even where participants praised dementia-friendly activities and facilities, they advocated activities inclusive for all and mentioned that some people might be reluctant to participate in dementia-labelled activities because they may not be suitable for their needs. These results indicate the need for developing tailored opportunities for people with mild to moderate dementia and provide valuable insights for researchers, service providers, policymakers and charities wanting to improve access.

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