Cross-validation of the screening scale in an adult protective services sample

Adult Protective Services (APS) professionals are often called on to assess decision-making capacity when investigating financial exploitation. Previous research found that in consecutive APS cases, a decision-making screening scale (LFDSS) also detected financial exploitation. The purpose of this study was to apply the clinical cutoff scores derived from the previous study to a new sample of APS cases. Using a sample of 105 participants, from APS workers across 5 counties this study investigated the clinical utility of the LFDSS to detect financial exploitation based on ratings by APS professionals using the scale. Results demonstrate that the LFDSS has excellent internal consistency and clinical utility properties. This paper provides support for use of the LFDSS as a reliable and valid instrument. Instructions for use of the LFDSS are included in the article, along with information about online support tools.     

Identifying Systemically Important Banks: A temporal approach for macroprudential policies

Contrary to the general belief, systemic risk does not only regard the risk posed by balance sheet relationships and interdependencies among institutions. It also features a temporal dimension related to the inappropriate responses of financial market participants to changes in risk over time. This paper proposes a method to simultaneously address the cross-sectional and the time dimension in which systemic risk materializes. The method is based on the TOPHITS algorithm. It provides three scores, namely borrowing, lending and time scores: the first two represent the systemic importance of the borrowing and the lending activity associated with each financial institution,while the third represents an empirical Early Warning Signal of the financial crisis. Our findings reveal that the identification of the time score as an indicator for an incoming market distress could be relevant to design macro prudential policies.     

Inflation projections for monetary policy decision making

Many central banks set inflation targets over the medium term and inflation projections are a key input for monetary policy decision making. In this paper, we present the procedures used by the Spanish Central Bank staff to project consumer price inflation. We also provide some illustrations of their policy uses, such as fan charts, deflation probabilities and the monitoring of inflation targets.     

Resolving Rabin’s paradox

We present a theoretical model of Rabin’s famous calibration paradox that resolves confusions in the literature and that makes it possible to identify the causes of the paradox. Using suitable experimental stimuli, we show that the paradox truly violates expected utility and that it is caused by reference dependence. Rabin already showed that utility curvature alone cannot explain his paradox. We, more strongly, do not find any contribution of utility curvature to the explanation of the paradox. We find no contribution of probability weighting either. We conclude that Rabin’s paradox underscores the importance of reference dependence.

     

Every Minute Counts: Using Process Improvement and Performance Feedback to Improve Patient Flow in an Emergency Department

Prolonged emergency department (ED) visits are associated with a number of adverse outcomes for patients as well as lower patient satisfaction scores and increased costs. Several factors that influence the length of ED visits are out of the control of hospital employees, but some opportunities exist to improve performance. For this study, the ED department of a 150-bed hospital in the southeastern United States wanted to improve door-to-discharge time. To do so, a subprocess of door-to-discharge time was targeted, door-to-order. After analyzing the process, the team created standard orders for the 10 most common presenting conditions in the ER with preapproval, allowing nurses to submit the orders without the provider first visiting the patient. Following the process change, daily feedback was added to increase utilization of the preapproved orders. Reductions in door-to-order times and door-to-discharge were observed and patient satisfaction remained stable. Implications for future research in this area are discussed.     

Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review

Despite many studies indicating an association between problem gambling and delinquent behaviours among adolescents, there has been no effort to systematically analyze the state of the literature on this relationship. To fill this gap, we conducted a scoping review of the literature published between 2000 and 2016 on problem gambling and delinquent behaviours among adolescents. We searched twelve databases and reviewed reference lists to identify eligible studies. Search terms included a combination of medical subject headings and keywords for gambling, youth, and delinquency, which were combined with the Boolean operator “AND”. 1795 studies were identified through the literature search. Nine studies were eligible for inclusion. All of the studies were conducted in North America, with primarily male participants, and most of the data were cross-sectional. No qualitative studies met the inclusion criteria. Screening tools used to measure problem gambling were inconsistent, making comparisons across studies difficult. We found a consistent moderate to strong association between problem gambling and delinquent behaviour. Only one study presented associations by socio-economic status and none considered gender, sex or ethnic differences. Studies in the review showed that problem gambling is associated with both violent and non-violent behaviours among adolescents. These associations may suggest that problem gambling and delinquent behaviours have common risk factors and reflect a syndrome of risky behaviours best targeted through prevention and treatment that is holistic and considers the context in which the youth is situated. Further research is warranted to better understand the relationship between problem gambling and delinquent behaviours.     

Unclaimed Prize Information Biases Perceptions of Winning in Scratch Card Gambling

Unclaimed prize information (i.e., the number of prizes still available to be won) is information commonly provided to scratch card gamblers. However, unless the number of tickets remaining to be purchased is also provided, this information is uninformative. Despite its lack of utility in assisting gamblers in choosing the most favourable type of scratch card to play, we hypothesized that unclaimed prize information would bias participants’ judgments within a scratch card gambling context. In Experiment 1 (N?=?201), we showed that participants are influenced by this information such that they felt more likely to win, were more excited to play, and preferred to hypothetically purchase more of the scratch card with the greatest number of unclaimed prizes. In Experiment 2 (N?=?201), we attempted to ameliorate this bias by providing participants with the number of tickets remaining to be purchased and equating the payback percentages of all three games. The bias, although attenuated, still persisted in these conditions. Finally, in Experiment 3 (N?=?200), we manipulated the hypothetical scratch cards such that games with the highest number of unclaimed prizes were the least favourable, and vice versa. As in Experiment 2, participants still favoured cards with greater numbers of unclaimed prizes. Possible mechanisms underlying this bias are discussed. In conclusion, across three experiments, we demonstrate that salient unclaimed prize information is capable of exerting a strong effect over judgments related to scratch card games.     

Implicit Valuation of the Near-Miss is Dependent on Outcome Context

Gambling studies have described a “near-miss effect” wherein the experience of almost winning increases gambling persistence. The near-miss has been proposed to inflate the value of preceding actions through its perceptual similarity to wins. We demonstrate here, however, that it acts as a conditioned stimulus to positively or negatively influence valuation, dependent on reward expectation and cognitive engagement. When subjects are asked to choose between two simulated slot machines, near-misses increase valuation of machines with a low payout rate, whereas they decrease valuation of high payout machines. This contextual effect impairs decisions and persists regardless of manipulations to outcome feedback or financial incentive provided for good performance. It is consistent with proposals that near-misses cause frustration when wins are expected, and we propose that it increases choice stochasticity and overrides avoidance of low-valued options. Intriguingly, the near-miss effect disappears when subjects are required to explicitly value machines by placing bets, rather than choosing between them. We propose that this task increases cognitive engagement and recruits participation of brain regions involved in cognitive processing, causing inhibition of otherwise dominant systems of decision-making. Our results reveal that only implicit, rather than explicit strategies of decision-making are affected by near-misses, and that the brain can fluidly shift between these strategies according to task demands.