Framing the detection of elder financial abuse as bystander intervention: Decision cues, pathways to detection and barriers to action

This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here (http://bura.brunel.ac.uk/handle/2438/8569). Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.This article has been made available through the Brunel Open Access Publishing Fund.Purpose – The purpose of this paper is to explore the detection and prevention of elder financial abuse through the lens of a “professional bystander intervention model”. The authors were interested in the decision cues that raise suspicions of financial abuse, how such abuse comes to the attention of professionals who do not have a statutory responsibility for safeguarding older adults, and the barriers to intervention. Design/methodology/approach – In-depth interviews were conducted using the critical incident technique. Thematic analysis was carried out on transcribed interviews. In total, 20 banking and 20 health professionals were recruited. Participants were asked to discuss real cases which they had dealt with personally. Findings – The cases described indicated that a variety of cues were used in coming to a decision that financial abuse was very likely taking place. Common to these cases was a discrepancy between what is normal and expected and what is abnormal or unexpected. There was a marked difference in the type of abuse noticed by banking and health professionals, drawing attention to the ways in which context influences the likelihood that financial abuse will be detected. The study revealed that even if professionals suspect abuse, there are barriers which prevent them acting. Originality/value – The originality of this study lies in its use of the bystander intervention model to study the decision-making processes of professionals who are not explicitly charged with adult safeguarding. The study was also unique because real cases were under consideration. Hence, what the professionals actually do, rather than what they might do, was under investigation.Economic and Social Research Counci

Exploring financial abuse as a feature of family life: an analysis of Court of Protection cases

Presents an analysis of Court of Protection cases dealing largely with applications to revoke lasting powers of attorney (LPA) often where financial misbehaviour is implicated. In particular it focuses on the role of intra-family dynamics showing how family disputation can play a significant part in relation to the financial abuse that takes place. While financial abuse is frequently committed by strangers, in certain circumstances the perpetrators may be members of an older person’s own family. The research described here was part of a wider project exploring the financial abuse of adults of all ages who lack capacity, examining the role of various agencies in preventing or dealing with it. It used a mix of methods including the analysis of national and local statistics, interviews with professional experts in the law, banking and health and social work, together with a local area case study

Factors used in the detection of elder financial abuse: A judgement and decision-making study of social workers and their managers

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2011 Sage Publications Ltd.Factors social workers use in practice to detect elder financial abuse are currently unknown. A critical incident technique was applied within a judgement analysis approach to elicit cue use. Only three factors were key to decision-making: who raises concern, the elder’s mental capacity and the nature of the financial anomaly occurring.Economic and Social Research Counci

Influence of a walking aid on temporal and spatial parameters of gait in healthy adults

This is the post-print version of the final paper published in PM&R. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2014 Elsevier B.V.Objective - To determine the effect of using a walking aid on temporal and spatial parameters of gait when used for balance versus support on the dominant and nondominant hand side. Design - Repeated measures observational study design. Setting - University gymnasium. Participants - Twenty-seven healthy male and female adults of mean ± standard deviation age 44.74 ± 10.00 years. Methods - Five walking conditions (C) were completed by all participants on the GAITRite pressure mat. Normal walking (C1), walking with a cane in the dominant hand (C2) and nondominant hand (C3) as if using for balance, walking with a cane in the dominant hand (C4) and nondominant hand (C5) while allowing approximately 10% of the body weight through the cane. Main Outcome Measurements - Temporal measurements (swing time, stance time, single limb support time, double limb support time) as percentage of a gait cycle and the base of support for the left and the right foot for all 5 walking conditions. Results - A significant difference (P < .001) was observed between C1, C2, and C3 in percentage swing time and percentage stance time of the ipsilateral side, and in percentage single limb support time of the contralateral side. The double limb support time was significantly different (P ≤ .04) for both ipsilateral and contralateral sides. Comparisons among C1, C4, and C5 demonstrated significance (P < .001) for all variables. Post hoc analysis showed significance between C1 and C4, and C1 and C5 for all variables except percentage stance time of the ipsilateral side and percentage single limb support of the contralateral side. Conclusions - In healthy adults, use of a cane for balance modifies swing and stance parameters of the ipsilateral side and does not affect the base of support formed by the feet. When used for support, the cane alters the swing and stance parameters, and also the base of support formed by the feet

Hepatitis E virus (HEV) in Scotland:evidence of recent increase in viral circulation in humans

Background: Previous studies showed low levels of circulating hepatitis E virus (HEV) in Scotland. We aimed to reassess current Scottish HEV epidemiology. Methods: Blood donor samples from five Scottish blood centres, the minipools for routine HEV screening and liver transplant recipients were tested for HEV antibodies and RNA to determine seroprevalence and viraemia. Blood donor data were compared with results from previous studies covering 2004-08. Notified laboratory-confirmed hepatitis E cases (2009-16) were extracted from national surveillance data. Viraemic samples from blood donors (2016) and chronic hepatitis E transplant patients (2014-16) were sequenced. Results: Anti-HEV IgG seroprevalence varied geographically and was highest in Edinburgh where it increased from 4.5% in 2004-08) to 9.3% in 2014-15 (p = 0.001). It was most marked in donors &#60; 35 years. HEV RNA was found in 1:2,481 donors, compared with 1:14,520 in 2011. Notified laboratory-confirmed cases increased by a factor of 15 between 2011 and 2016, from 13 to 206. In 2011-13, 1 of 329 transplant recipients tested positive for acute HEV, compared with six cases of chronic infection during 2014-16. Of 10 sequenced viraemic donors eight and all six patients were infected with genotype 3 clade 1 virus, common in European pigs. Conclusions: The seroprevalence, number of viraemic donors and numbers of notified laboratory-confirmed cases of HEV in Scotland have all recently increased. The causes of this change are unknown, but need further investigation. Clinicians in Scotland, particularly those caring for immunocompromised patients, should have a low threshold for testing for HEV

Factors influencing decision-making by social care and health sector professionals in cases of elder financial abuse

This study aimed to identify the factors that have the greatest influence on UK social care and health sector professionals’ certainty that an older person is being financially abused, their likelihood of intervention, and the type of action most likely to be taken. A factorial survey approach, applying a fractional factorial design, was used. Health and social care professionals (n=152) viewed a single sample of 50 elder financial abuse case vignettes; the vignettes contained seven pieces of information (factors). Following multiple regression analysis, incremental F tests were used to compare the impact of each factor on judgements. Factors that had a significant influence on judgements of certainty that financial abuse was occurring included the older person’s mental capacity and the nature of the financial problem suspected. Mental capacity accounted for more than twice the variance in likelihood of action than the type of financial problem. Participants from social care were more likely to act and chose more actions compared to health sector participants. The results are discussed in relation to a bystander intervention model. The impact of the older person’s mental capacity on decision-making suggests the need for training to ensure action is also taken in cases where older people have full mental capacity and are being abused. Training also needs to highlight the more subtle types of financial abuse, the types that appear not to lead to certainty or action.This research was funded by the UK Cross Council, New Dynamics of Ageing programme (Economic and Social Research Council administered) [Grant No. RES-352-25-0026 to Mary Gilhooly (PI)]

Incubation and intuition in creative problem solving.

Creative problem solving, in which novel solutions are required, has often been seen as involving a special role for unconscious processes (Unconscious Work) which can lead to sudden intuitive solutions (insights) when a problem is set aside during incubation periods. This notion of Unconscious Work during incubation periods is supported by a review of experimental studies and particularly by studies using the Immediate Incubation paradigm. Other explanations for incubation effects, in terms of Intermittent Work or Beneficial Forgetting are considered. Some recent studies of divergent thinking, using the Alternative Uses task, carried out in my laboratory regarding Immediate v. Delayed Incubation and the effects of resource competition from interpolated activities are discussed. These studies supported a role for Unconscious Work as against Intermittent Conscious work or Beneficial Forgetting in incubation.What form might unconscious work take? On theoretical grounds, the notion that Unconscious Work involves the same processing steps as Conscious Work but minus conscious awareness is discounted, despite some recent arguments that the unconscious can duplicate any conscious function. A candidate account in terms of spreading activation, coupled with below-threshold but active goal representations, is put forward. This account could explain the emergence of subjectively sudden intuitive solutions (Aha-insight solutions) as a result of unconscious processes (Unconscious Work) during incubation periods

Individual differences and effective learning procedures: the case of statistical computing

This paper reports two experiments examining individual differences in procedures for learning to use MINITAB (1982 edition). In Experiment 1, ten novices provided think aloud protocols over five sessions of learning to use MINITAB. On the basis of overall performance, novices were divided into two groups of five faster and five slower learners. The protocols suggested that subjects used two major classes of learning strategy: learning by doing and learning by thinking. Each class of learning strategy comprised a set of learning procedures. Differences in procedure usage were confined primarily to the learning by doing procedures. Faster learners used the mapping and exploratory procedures more frequently than slower learners, paid more attention to prompts and error messages and acted appropriately on evaluation feedback. In contrast, slower learners used the trial and error and repetition procedures more frequently than faster learners. In Experiment 2,26 novices were allocated to one of three experimental groups. Group 1 received no instruction, Group 2 received instruction in the use of ineffective procedures (those procedures that did not serve to differentiate between fast and slow learners in Experiment 1) and Group 3 received instruction in the use of effective procedures (those procedures that did differentiate between fast and slow learners in Experiment 1). The overall performance of the effective procedures groups was significantly better than either the control or the ineffective procedures groups. Effective procedure usage ratings correlated significantly with overall performance. The negative correlations between effective procedure usage ratings and both requests for help and mean time to complete the MINITAB tasks were significant. Finally, on a free recall task, the effective procedures group remembered significantly more of the procedures they had been taught than the ineffective procedures group

Incubation mechanisms : Unconscious work v. forgetting v. attentional withdrawal

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