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Purpose The purpose of this paper is to discuss financial fraud and exploitation against seniors relating to wills, trusts and guardianship. The paper describes how this fraud affects its victims, points out red flags and makes recommendations that may help control this pervasive type of fraud. Design/methodology/approach Information from a range of different sources, such as journal publications, law textbooks, law enforcement websites and estate planning cases are used as a basis to provide information about how fraudsters are committing this type of fraud, which red flags to watch out for and how to prevent this fraud from occurring. Findings Fraud relating to wills, trusts and guardianship is oftentimes difficult to detect and continues to be a grave threat to its victims. While this fraud will likely never be eradicated, specific efforts have been put into place to track financial exploitation. Further steps presented in this paper can be deployed to help rein in these fraud schemes. Practical implications The paper provides useful information about frauds related to wills, trusts and guardianship for stakeholders. This includes, but is not limited to, anyone whose work is related to seniors, such as accountants, lawyers, regulators, bankers, financial planners, law enforcement personnel, academics, medical professionals, caregivers, family members and ethicists. These stakeholders can use this information to help combat this fraud and prevent not only financial losses of seniors but physical harm as well. Social implications Decreasing financial exploitation of seniors will not only improve their financial position and may reduce their reliance on Medicaid but will also improve their mental and physical well-being and save lives. Originality/value Research in the area of maltreatment and exploitation of older adults is still in its early stages, as knowledge of effective prevention, intervention and remediation practices are limited. This paper adds to the research in this arena by drawing on a unique set of resources that shed light on financial fraud commonly committed against seniors. This study also makes much needed recommendations that are aimed to prevent this threat related to wills, trusts and guardianship.

Purpose This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud. Design/methodology/approach This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws. Findings The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come. Research limitations/implications Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors. Practical implications Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers. Originality/value This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.

Purpose The purpose of this paper is to make readers aware of the extensiveness of healthcare fraud in the USA and how it involves and affects the government, healthcare providers, insurance companies, patients and the public. In addition, recommendations are made that may help control this pervasive type of fraud. Design/methodology/approach A range of different journal publications, information from government health institutions and law enforcement websites, healthcare fraud cases and healthcare laws are used as a basis to provide information about how fraudsters are committing healthcare fraud and how to prevent this fraud from occurring. Findings Despite increased funding and prosecution efforts by the government, healthcare fraud continues to be a major threat to the US economy and public. While healthcare fraud will never be eradicated, specific efforts can be deployed to help rein in these complex fraud schemes. Practical implications The paper provides a useful resource of information on healthcare fraud for healthcare providers, insurance companies, patients and the public that may help combat healthcare fraud and prevent financial losses. Social implications Every dollar saved from combating fraud could be used to improve access to more or better health services and can, thereby, save lives. Originality/value This paper provides recommendations regarding healthcare fraud that could help prevent this large drain on the US economy.

The purpose of this study is to extend the research on mutual fund performance persistence to net asset value and market price performance of domestic closed-end funds. While research has assessed the performance persistence of open-end mutual funds, it has not assessed the performance persistence of closed-end funds. Yet, the unique characteristics of closed-end funds allow stronger arguments for their persistence than the arguments previously submitted for open-end mutual funds. The results show evidence for risk-adjusted performance persistence.

Vertebrate limb outgrowth is driven by a positive feedback loop that involves Sonic hedgehog (Shh) and Gremlin1 (Grem1) in the posterior limb bud mesenchyme and Fibroblast growth factors (Fgfs) in the overlying epithelium. Proper spatio-temporal control of these signaling activities is required to avoid limb malformations such as polydactyly. Here we show that, in Tbx2-deficient hindlimbs, Shh/Fgf4 signaling is prolonged, resulting in increased limb bud size and duplication of digit 4. In turn, limb-specific Tbx2 overexpression leads to premature termination of this signaling loop with smaller limbs and reduced digit number as phenotypic manifestation. We show that Tbx2 directly represses Grem1 in distal regions of the posterior limb mesenchyme allowing Bone morphogenetic protein (Bmp) signaling to abrogate Fgf4/9/17 expression in the overlying epithelium. Since Tbx2 itself is a target of Bmp signaling, our data identify a growth-inhibiting positive feedback loop (Bmp/Tbx2/Grem1). We propose that proliferative expansion of Tbx2-expressing cells mediates self-termination of limb bud outgrowth due to their refractoriness to Grem1 induction., Author Summary Developmental defects of the limb skeleton, such as variations from the normal number of digits, can result from an abnormal size of the early limb bud. The mechanisms that restrict limb bud growth to avoid polydactyly, i.e. the formation of extra digits, are unclear. Gremlin 1 (Grem1) has been identified as a key regulator in this process via its role as secreted antagonist of Bone morphogenetic protein (Bmp) signaling. But it remains unknown how Grem1 expression is switched off appropriately to achieve normal limb bud size. Here we show in the mouse embryo that T-box transcription factor 2 (Tbx2) directly represses Grem1. We show that Tbx2-positive mesenchymal cells at the posterior margin of the limb bud create a Grem1-negative zone that expands concomitantly with limb bud growth. Progressive displacement of the source of Grem1 and its target region, the apical ectodermal ridge, eventually disrupts epithelial-mesenchymal signaling that is crucial for further proliferative expansion. Our data show how local control of signaling activities is translated into the architecture of the adult skeleton, i.e. the number or digits, which helps us to understand the molecular bases of human polydactyly.

Tbox18 (Tbx18) and Tbox15 (Tbx15) encode a closely related pair of vertebrate-specific T-box (Tbx) transcription factors. Functional analyses in the mouse have proven the requirement of Tbx15 in skin and skeletal development and of Tbx18 in the formation of the vertebral column, the ureter, and the posterior pole of the heart. Despite the accumulation of genetic data concerning the embryological roles of these genes, it is currently unclear how Tbx18 and Tbx15 exert their function on the molecular level. Here, we have initiated a molecular analysis of Tbx18 and Tbx15 proteins and have characterized functional domains for nuclear localization, DNA binding, and transcriptional modulation. We show that both proteins homo- and heterodimerize, bind to various combinations of T half-sites, and repress transcription in a Groucho-dependent manner. Competition with activating T-box proteins may constitute one mode of action as we show that Tbx18 interacts with Gata4 and Nkx2-5 and competes Tbx5-mediated activation of the cardiac Natriuretic peptide precursor type a-promoter and that ectopic expression of Tbx18 down-regulates Tbx6-activated Delta-like 1 expression in the somitic mesoderm in vivo.