Colorectal multidisciplinary meetings: how do they affect the timeliness of treatment?

BACKGROUND: The aim of this study is to determine whether multidisciplinary team (MDT) meetings alter the length of time to treatment (LOTT) for patients with colorectal cancer. METHODS: We conducted a retrospective audit of all patients with colorectal cancer from the Geelong Hospital (TGH) mandatory colorectal database from 1 January 2006 to 3 February 2011. To be included, patients had to have had elective surgical intervention for primary colorectal adenocarcinoma. A comparison of historical controls was conducted between patients discussed in MDT meetings and those managed prior to the introduction of MDT meetings (3 October 2006) to determine the LOTT in days from definitive diagnosis (colonoscopy) to definitive management (surgery, radiotherapy or chemotherapy). RESULTS: In total, the median LOTT for the historical control and MDT era patient populations were 19.5 and 20 days, respectively. Within the MDT era, we noticed significantly longer times to treatment for patients with rectal cancer who were seen in an MDT meeting prior to definitive management than patients who did not have an intervening MDT meeting (P < 0.001). With a difference of 7.5 days, the clinical significance of these findings remains contentious. However, it is worthwhile recognizing this trend in patients who are exhibiting symptoms due to near obstruction or significant bleeding. The LOTT for colon cancer patients remained unchanged. CONCLUSION: The introduction of MDT meetings to TGH has prolonged the LOTT for patients with rectal cancer. These findings pave the way for further revision of the efficiency of MDT meeting at TGH.

The decision-making processes adopted by rurally located mandated professionals when child abuse or neglect is suspected

The reporting of suspected child abuse and neglect is a mandated role of medical doctors, nurses, police and teachers in Victoria, Australia. This paper reports on a research study that sought to explicate how mandated professionals working in rural Victorian contexts identify a child/ren at risk and the decisions they make subsequently.

Stakeholders’ perspectives on the role of regulatory reform in integrated reporting

This paper reports on an exploratory study of the preferences of users of non-financial reporting for regulatory or voluntary approaches to integrated reporting (IR). While it is well known that companies prefer voluntary approaches to non-financial reporting, considerably less is known about the preferences of the users of non-financial information. IR is the latest development in attempts over 30 or more years to broaden organisational non-financial reporting and accountability to include the wider social and environmental impacts of business. It promises to provide a more cohesive and efficient approach to corporate reporting by bringing together financial information, operational data and sustainability information to focus only on material issues that impact an organisation’s ability to create value in the short, medium and long term. The study found more support for voluntary approaches to IR as the majority of participants thought that it was too early for regulatory reform. They suggested that IR will become the reporting norm over time if left to market forces as more and more companies adopt the IR practice. Over time IR will be perceived as a legitimate practice, where the actions of integrated reporters are seen as desirable, proper, or appropriate. While there is little appetite for regulatory reform, half of the investors support mandatory IR because, in their experience, voluntary sustainability reporting has not led to more substantive disclosures or increased the quality of reporting. There is also evidence that IR privileges financial value creation over stewardship, inhibiting IR from moving beyond a weak sustainability paradigm.

Effects of the SEC's XBRL mandate on financial reporting comparability

© 2015 Elsevier Inc. In 2009, the US Securities and Exchange Commission (SEC) made it mandatory for firms to file interactive data using XBRL along with their 10-K and 10-Q reports on EDGAR. There was an initial three-year phase-in period, with the first (last) phase covering the largest (smallest) firms in the US capital markets. We examine the implications of the SEC's XBRL mandate for financial statement comparability. Our results indicate that financial statement comparability declined in the initial years after the mandate. We also find that firms that use more company-specific extension taxonomies (companies are allowed to use their own taxonomies when the standard taxonomy provided by the Financial Accounting Standards Board (FASB) is inadequate) have lower financial statement comparability in the post-mandate years. Finally, we document that the level of discretion involved in measuring particular financial statement line items is related to the post-mandate change in comparability - we find that selling, general and administrative expense (SG&A) comparability declined after the mandate, while depreciation comparability did not change.

Selecting, training and assessing new general practice community teachers in UK medical schools

Background: Standards for undergraduate medical education in the UK, published in Tomorrow’s Doctors, include the criterion ‘everyone involved in educating medical students will be appropriately selected, trained, supported and appraised’. Aims: To establish how new general practice (GP) community teachers of medical students are selected, initially trained and assessed by UK medical schools and establish the extent to which Tomorrow’s Doctors standards are being met. Method: A mixed-methods study with questionnaire data collected from 24 lead GPs at UK medical schools, 23 new GP teachers from two medical schools plus a semi-structured telephone interview with two GP leads. Quantitative data were analysed descriptively and qualitative data were analysed informed by framework analysis. Results: GP teachers’ selection is non-standardised. One hundred per cent of GP leads provide initial training courses for new GP teachers; 50% are mandatory. The content and length of courses varies. All GP leads use student feedback to assess teaching, but other required methods (peer review and patient feedback) are not universally used. Conclusions: To meet General Medical Council standards, medical schools need to include equality and diversity in initial training and use more than one method to assess new GP teachers. Wider debate about the selection, training and assessment of new GP teachers is needed to agree minimum standards.

Australian real estate management and development companies and women directors

Purpose – There is a large literature advocating the importance of a greater proportion of women directors on boards of publicly listed firms. The purpose of this paper is to examine the numbers and proportions of women directors, including women executive directors, on listed Australian Real Estate Management and Development (REMD) companies to identify how prevalent women directors are on such boards.
Design/methodology/approach – The study examines the numbers and proportions of women directors for 35 REMDs in 2011 and compares this to the broad board composition data on 1,715 Australian Stock Exchange listed entities. Statistically significant findings are evident due to the identified low proportions.
Findings – The study finds that of all the Financials Sub Industry sector groups, REMDs have the lowest proportion of female directors on theirs boards – eight women on each of 35 company boards compared to 159 men on these 35 boards at 2011. Of the eight, there were only two women executive directors on boards compared to 50 men. Statistically, it appears that having women directors on REMD boards is not considered important. Even at December 2014, there are only ten women on seven company boards and only one remaining executive director of an REMD company.
Practical implications – Given that female board representation is positively related to accounting returns and that there is a growing voice for legislation to impose mandatory proportions of women directors on boards around the world, it may be in the interests of REMD boards to consider appointing more women more quickly.
Originality/value – The study is the first to examine the numbers and proportions of women directors amongst REMD companies to identify the paucity of such women directors.

Cardiovascular risk screening of volunteer firefighters

Background: The work demands involved in firefighting place significant stress on the cardiovascular system. This study investigated the application of the AHA/ACSM Health/Fitness Facility Preparticipation Screening Questionnaire in volunteer Country Fire Brigade (CFA) firefighters. Methods: Cardiovascular disease (CVD) risk factors were measured in 3777 CFA firefighters and entered into a modified version of the American Heart Association (AHA)/ACSM Health/Fitness Facility Preparticipation Screening Questionnaire to stratify individuals as low, moderate or high risk. Results: Just over half (50.8%) of female and more than two thirds (68.2%) of male CFA firefighters were classified as moderate risk. The questionnaire further stratified 2.6% of female and 5.2% of male CFA firefighters as high risk while the remaining 46.6% and 26.6% of female and male firefighters, respectively, were classified as low risk. Conclusion: The majority of firefighters screened were at moderate risk and therefore, would be advised by AHA/ACSM guidelines to undertake and pass a detailed medical examination and a medically supervised exercise test prior to initiating vigorous intensity physical activity. However, considering the financial and practical implications (e.g., reduced emergency response capacity) the introduction of mandatory screening may cause, fire agencies should focus screening for high risk personnel only, while promoting agency wide CVD health education.