Educating novice practitioners to detect elder financial abuse: A randomised controlled trial

© 2014 Harries et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.This article has been made available through the Brunel Open Access Publishing Fund.Background - Health and social care professionals are well positioned to identify and intervene in cases of elder financial abuse. An evidence-based educational intervention was developed to advance practitioners’ decision-making in this domain. The objective was to test the effectiveness of a decision-training educational intervention on novices’ ability to detect elder financial abuse. The research was funded by an E.S.R.C. grant reference RES-189-25-0334. Methods - A parallel-group, randomised controlled trial was conducted using a judgement analysis approach. Each participant used the World Wide Web to judge case sets at pre-test and post-test. The intervention group was provided with training after pre-test testing, whereas the control group were purely given instructions to continue with the task. 154 pre-registration health and social care practitioners were randomly allocated to intervention (n78) or control (n76). The intervention comprised of written and graphical descriptions of an expert consensus standard explaining how case information should be used to identify elder financial abuse. Participants’ ratings of certainty of abuse occurring (detection) were correlated with the experts’ ratings of the same cases at both stages of testing. Results - At pre-test, no differences were found between control and intervention on rating capacity. Comparison of mean scores for the control and intervention group at pre-test compared to immediate post-test, showed a statistically significant result. The intervention was shown to have had a positive moderate effect; at immediate post-test, the intervention group’s ratings had become more similar to those of the experts, whereas the control’s capacity did not improve. The results of this study indicate that the decision-training intervention had a positive effect on detection ability. Conclusions - This freely available, web-based decision-training aid is an effective evidence-based educational resource. Health and social care professionals can use the resource to enhance their ability to detect elder financial abuse. It has been embedded in a web resource at http://www.elderfinancialabuse.co.uk.ESR

Using court reports to enhance knowledge of sexual abuse in sport: A Norwegian case study

Copyright @ 2013 The authorsSport scientists face difficulties in gaining access to data on sexual abuse in sport through conventional research sources and also in verifying media reports of such cases. One potential alternative source of data is court reports. The study reported here used a small number of court reports to examine issues confronting those researching sexual abuse in sport. Two questions were investigated: What do the court reports tell us about the perpetrators and their abuse strategies? How useful is content analysis of court reports for acquiring more knowledge about sexual abuse cases in sport? Data were drawn from electronic searches of the Norwegian Lovdata (Lawdata) website. 15 sport-based cases were revealed by the searches and then subjected to content analysis, both within- and cross-case. The findings confirm previous studies in relation to the perpetrator strategies and the absence of any perpetrator stereotype. The article concludes that court reports provide one valuable, yet still incomplete, source of information against which to test our understanding of sexual abuse in sport and develop abuse prevention measure

Will Parent Training Reduce Abuse, Enhance Development, and Save Money? Let's Find Out

Outlines a strategy for testing the feasibility of community-developed parent training initiatives to prevent child abuse and neglect. Calls for a federal grant program to test community-wide implementation of parent training programs in stages

Using court reports to enhance knowledge of sexual abuse in sport

Sexual abuse in sport is a relatively recent addition to the research agenda but has risen to prominence as a result of a number of highly-publicised cases. For scientists it is difficult to gain access to data on sexual abuse in sport through conventional survey or interview methods, or to verify media reports of such cases. One potential alternative source of data is court reports. The study reported here used a small number of court reports to examine a range of issues confronting those researching sexual abuse in sport. The following two questions were investigated: What characterised the perpetrators who were sentenced for sexual abuse in sport? How useful is content analysis of court reports for acquiring more knowledge about sexual abuse cases in sport? Altogether 15 sport-based cases were revealed from the Norwegian Lovdata (Lawdata) website. Some perpetrator-related patterns of risk and harm arising within and across the cases were examined: the findings confirm many of those of previous studies in relation to the characteristics of perpetrators and the absence of any perpetrator stereotype. The article concludes that court reports provide one valuable, yet still incomplete, source of information against which to test our understanding of sexual abuse in sport

Anal signs of child sexual abuse: a case–control study

Background: There is uncertainty about the nature and specificity of physical signs following anal child sexual abuse. The study investigates the extent to which physical findings discriminate between children with and without a history of anal abuse.<p></p> Methods: Retrospective case note review in a paediatric forensic unit.<p></p> Cases: all eligible cases from 1990 to 2007 alleging anal abuse.<p></p> Controls: all children examined anally from 1998 to 2007 with possible physical abuse or neglect with no identified concern regarding sexual abuse. Fisher’s exact test (two-tailed) was performed to ascertain the significance of differences for individual signs between cases and controls. To explore the potential role of confounding, logistic regression was used to produce odds ratios adjusted for age and gender.<p></p> Results: A total of 184 cases (105 boys, 79 girls), average age 98.5 months (range 26 to 179) were compared with 179 controls (94 boys, 85 girls) average age 83.7 months (range 35–193). Of the cases 136 (74%) had one or more signs described in anal abuse, compared to 29 (16%) controls. 79 (43%) cases and 2 (1.1%) controls had >1 sign. Reflex anal dilatation (RAD) and venous congestion were seen in 22% and 36% of cases but <1% of controls (likelihood ratios (LR) 40, 60 respectively), anal fissure in 14% cases and 1.1% controls (LR 13), anal laxity in 27% cases and 3% controls (LR 10).<p></p> Novel signs seen significantly more commonly in cases were anal fold changes, swelling and twitching. Erythema, swelling and fold changes were seen most commonly within 7 days of last reported contact; RAD, laxity, venous congestion, fissure and twitching were observed up to 6 months after the alleged assault.<p></p> Conclusions: Anal findings are more common in children alleging anal abuse than in those presenting with physical abuse or neglect with no concern about sexual abuse. Multiple signs are rare in controls and support disclosed anal abuse

Article 82 EC – The Problems and The Solution

The Commission's Guidance paper on exclusionary abuse under Article 82 EC is open to three fundamental criticisms. First, it leads to less legal certainty, because the rules suggested are vague and imprecise, because dominant companies will not have the information needed to apply them, and because the Commission is trying to change the law, which it has no power to do. Second, it would lead to some anticompetitive effects, because in practice it discourages price competition, by discouraging individualised price negotiations and retroactive rebates, and by suggesting that the Commission will protect not-yet-as-efficient competitors from price competition. Third, it leads to too many "false positives", i.e., findings of exclusionary abuse that are not justified in economics or law. The solution is to return to the test in the Treaty as interpreted by the Court of Justice: an exclusionary abuse must involve limiting the production, marketing or technical development of competitors of the dominant company, if harm is caused to consumers.Article 82EC, Competition, Abuse

The microassay on a card: A rugged, portable immunoassay

The Microassay on a Card (MAC) is a portable, hand-held, non-instrumental immunoassay that can test for the presence of a wide variety of substances in the environment. The MAC is a simple device to use. A drop of test solution is placed on one side of the card and within five minutes a color is developed on the other side in proportion to the amount of substance in the test solution, with sensitivity approaching 10 ng/ml. The MAC is self-contained and self-timed; no reagents or timing is necessary. The MAC may be configured with multiple wells to provide simultaneous testing for multiple species. As envisioned, the MAC will be employed first as an on-site screen for drugs of abuse in urine or saliva. If the MAC can be used as a screen of saliva for drugs of abuse, it could be applied to driving while intoxicated, use of drugs on the job, or testing of the identity of seized materials. With appropriate modifications, the MAC also could be used to test for environmental toxins or pollutants

Alcohol use, alcohol-related aggression and intimate partner abuse: a cross-sectional survey of convicted versus general population men in Scotland

Introduction and Aims. Scotland has a particular problem with alcohol, and the links between intimate partner abuse (IPA) and alcohol appear stronger here than elsewhere across Europe. This study explored differences in alcohol use, related aggression and relationship conflict across a number of groups: men convicted for intimate partner abuse, men convicted of general offences and men recruited from community sports teams. Design and Methods. Participants (n = 64) completed three questionnaires exploring their experiences of alcohol use (Alcohol Use Disorders Identification Test, AUDIT); alcohol and aggression (Alcohol Related Aggression Questionnaire, ARAQ-28), and relationship conflict (Revised Conflict Tactics Scale, CTS-2). Results. There were significant differences across the groups in terms of AUDIT and ARAQ-28 scores, IPA and general offenders scored higher than the community sample. CTS-2 scores showed significant differences: both offender groups reported more use of negotiation and psychological abuse, than the community men, and IPA offenders reported causing more physical harm than either general offenders or the community sample. ARAQ-28 scores correlated with psychological abuse for general offenders. Alcohol use was very high across all groups, but the community group did not endorse an aggression-precipitating view of alcohol and did not report high IPA. Discussion and Conclusions. Discussed is the need for cross-cultural research to explore putative mediators and moderators in the relationship between alcohol, aggressiveness and IPA. [Gilchrist EA, Ireland L, Forsyth A, Godwin J, Laxton T. Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland. Drug Alcohol Rev 2017;36:20-23

Predictive validity of the START for unauthorised leave and substance abuse in a secure mental health setting:a pseudo-prospective cohort study

Background Risk assessment and management is central to the nursing role in forensic mental health settings. The Short Term Assessment of Risk and Treatability (START) aims to support assessment through identification of risk and protective factors. It has demonstrated predictive validity for aggression; it also aims to aid risk assessment for unauthorised leave and substance abuse where its performance is relatively untested. Objectives To test the predictive validity of the START for unauthorised leave and substance abuse. Design A naturalistic, pseudo-prospective cohort study. Settings Four centres of a large UK provider of secure inpatient mental health services. Participants Inpatients resident between May 2011 and October 2013 who remained in the service for 3-months following assessment with the START by their clinical team. Exclusion criteria were missing assessment data in excess of prorating guidelines. Of 900 eligible patients 73 were excluded leaving a final sample size of n = 827 (response rate 91.9%). Mean age was 38.5 years (SD = 16.7); most participants (72.2%) were male; common diagnoses were schizophrenia-type disorders, personality disorders, organic disorders, developmental disorders and intellectual disability. Methods Routinely conducted START assessments were gathered. Subsequent incidents of substance abuse and unauthorised leave were coded independently. Positive and negative predictive values of low and elevated risk were calculated. Receiver Operating Characteristic analysis was conducted to ascertain the predictive accuracy of the assessments based on their sensitivity and specificity. Results Patient-based rates of unauthorised leave (2.4%) and substance abuse (1.6%) were low. The positive and negative predictive values for unauthorised leave were 5.9% and 98.4%; and for substance abuse 8.1% and 99.0%. The START specific risk estimate for unauthorised leave predicted its associated outcome (Area under the curve = .659, p < .05, 95% CI .531, .786); the substance abuse risk estimate predicted its outcome with a large effect size (Area under the curve = .723, p < .01, 95% CI .568, .879). Conclusions The study provides limited support for the START by demonstrating the predictive validity of its specific risk estimates for substance abuse and unauthorised leave. High negative predictive values suggest the tool may be of most utility in screening out low risk individuals from unnecessary restrictive interventions; very low positive predictive values suggest caution before implementing restrictive interventions in those rated at elevated risk. Researchers should investigate how multidisciplinary teams formulate risk assessments for these outcomes since they outperform the quantitative element of this tool