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

Expertise and the interpretation of computerized physiological data: implications for the design of computerized monitoring in neonatal intensive care

This paper presents the outcomes from a cognitive engineering project addressing the design problems of computerized monitoring in neonatal intensive care. Cognitive engineering is viewed, in this project, as a symbiosis between cognitive science and design practice. A range of methodologies has been used: interviews with neonatal staff, ward observations and experimental techniques. The results of these investigations are reported, focusing specifically on the differences between junior and senior physicians in their interpretation of monitored physiological data. It was found that the senior doctors made better use of the different knowledge sources available than the junior doctors. The senior doctors were able to identify more relevant physiological patterns and generated more and better inferences than did their junior colleagues. Expertise differences are discussed in the context of previous psychological research in medical expertise. Finally, the paper discusses the potential utility of these outcomes to inform the design of computerized decision support in neonatal intensive care

Elder financial abuse : research and training

Enhancing the detection and prevention of elder financial abuse. Resources for professionals developed by Brunel Institute for Ageing Studies

Motivation, goals, thinking, and problem solving

Introduction, Problem solving and motivation are closely intertwined, as is indicated by the classic definition of a problem situation from Duncker (1945, p. 1), “A problem arises when a living organism has a goal but does not know how this goal is to be reached.” Before proceeding further, we will briefly discuss some definitional issues and consider the relationships between goals and motives. Austin and Vancouver (1996, p. 338) proposed that goals be defined as “internal representations of desired states.” In a broad sense, a goal reflects a preference for some proposition to be true versus not true (e.g., the goal to have more money tomorrow than today reflects a preference for “having more money tomorrow” to be true rather than false). According to one dictionary definition (Chambers, 1962), “a motive is a consideration that excites to action (from the Latin, movere, to move).” Motives and goals are clearly very closely related concepts in that both involve representations of desired states. Austin and Vancouver made the useful suggestion that goals can vary in degree of specificity or abstractness and that more abstract goals, such as Need for Cognition (Cacioppo et al., 1996) or Achievement Need (Atkinson, 1964), are usefully labelled as motives and more specific representations of desired states should be labelled as goals. If a motive is to lead to action, it would seem that it must ultimately lead to the activation of a specific goal representation, which can then play a role in initiating and controlling behaviour. Research on problem solving tends to theorise at the level of goals rather than at the level of very broad motives (which are dealt with largely in personality and motivational psychology).</p

Generic and specialist occupational therapy casework in community mental health teams

The aim of this research was to conduct a cluster analysis on data from 40 community mental health occupational therapists to determine if subgroups of therapists had differing referral prioritisation policies. A Ward's cluster analysis showed four clusters to be present. These four subgroups of occupational therapists were found to differ according to several factors: the percentage of role dedicated to specialist occupational therapy or generic work, satisfaction with the balance in these roles, the number of hours worked, the number of professionally trained team members and the presence of referral prioritisation policies. The subgroups were named the aspiring specialists, the satisfied specialists, the satisfied genericists and the chameleons (those not set in applying a consistent or specific policy). The policies that led to mainly generic working gave greatest importance to clients who were potentially violent or at risk of suicide. The policies that led to more of an occupational therapy role gave particular importance to the reason for referral and the client's diagnosis. The College of Occupational Therapists has recommended that the majority of casework should be focused on specialist occupational therapy interventions (Craik et al 1998): most of the participants in this study were not meeting this recommendation. Although some aspired to being more specialist, the pressures to work generically may have been affecting referral policies. </jats:p

Use as abuse: a feasibility study of alcohol-related elder abuse

Feasibility study aimed to begin to explore the alcohol-related elder abuse problem in England and begin to characterise its role in cases of elder abuse, how practitioners were responding in these situations, and identify areas for further investigation.The purpose of this feasibility study was to collect substantive pilot data to scope the extent of alcohol-related elder abuse and neglect, and evaluate data sources and research methods to consider the development of a larger study on the role of alcohol misuse in cases of elder abuse and neglect