Quality of internal control procedures : antecedents and moderating effect on organisational justice and employee fraud

Purpose – This study aims to bring together theoretical concepts from the organizational justice, internal control and fraud literature to develop two distinct models relating to employee fraud and the quality of internal control procedures (ICP), respectively.

Design/methodology/approach – Survey data from 64 Australian firms were used to develop the two models. The first model was tested using a logistic regression analysis, and the second model was tested using a multiple regression analysis.

Findings – The first model reveals that the quality of ICP has a moderating effect on the relationship between perceptions of organizational justice and employee fraud. The second model indicates that ICP quality is significantly and positively related to three key organizational factors: the corporate ethical environment, the extent of risk management training of staff, and the internal audit (IA) activity level.

Practical implications – Risk management strategies relating to employee fraud will need to pay greater attention to organizational factors that affect both perceptions of justice at the workplace and ICP quality, including fostering a more ethical and equitable work environment, increasing IA activities and staff training in risk management.

Originality/value – Using the fraud triangle framework, this study extends previous literature by providing empirical evidence on the role of organizational justice and ICP regarding employee fraud.

The 'caffeine-sweetness' effect; potential reduction of energy in caffeinated sugar-sweetened soft drinks

Background – Excessive consumption of sugar sweetened beverages (SSB) is a contributing factor in the occurrence of overweight and obesity. The high energy intake, low satiation, high glycemic index, and intense marketing are all thought to contribute to their over consumption. In addition, the role of the mildly-addictive chemical caffeine in SSB has been questioned (Griffiths and Vernotica, 2000, Keast and Riddell, 2007). We have previously shown that low concentrations of caffeine may decrease sweetness of sugars and thereby result in excess energy in SSB formulations (Ebbeling et al., 2006).
Objective – Without noticeably affecting flavour, to determine potential energy reduction when decreasing sucrose concentration from caffeinated and de-caffeinated SSB.
Design – Human psychophysical taste evaluations in water, sucrose and model SSB. Triangle forced-choice ascending method of limits was used to determine caffeine taste threshold in water and sucrose (n= 62). Directional paired comparison tests to determine 1/ the influence of caffeine on sweetness of sucrose (n= 23), and 2/ the nonperceivable difference when decreasing the sucrose and caffeine concentrations in a model SSB (n= 30).
Outcomes – Caffeine, at sub-threshold concentrations in common SSB (0.67mM) can be perceived in sucrose solutions because it significantly inhibits sweetness (p<0.001), the ‘caffeine sweetness effect’. Presumably coremoval of caffeine and sucrose could be achieved without affecting the sweetness of the SSB. Removing caffeine from the model SSB allowed an energy reduction of 137.4 KJ per 500 ml serving (12.6% sucrose reduction) without noticeably affecting flavour for 80% of the population. The energy reduction possible without co-removal of caffeine was a more modest 32 KJ per 500 ml serving (3.5% sucrose reduction).
Conclusion – Sub-threshold concentrations of caffeine suppress sweetness resulting in higher concentrations of sugars in SSB. Excessive consumption of SSB is linked to the obesity epidemic, and we suggest the removal of caffeine and subsequent removal of 137.4 KJ energy will have long term public health benefits.

Dyslipidaemia in rural Australia : the evidence treatment gaps

Aims & rationale/Objectives : Hypercholesterolaemia accounts for 11.6% of total deaths and 6.2% of the disability burden for the Australian population.1 This paper reports population lipid profiles for three rural Australian populations, and assesses evidence-treatment gaps against the most recent (2005-2007) Australian guidelines.

Methods : Three population surveys were undertaken in the Greater Green Triangle. 3,320 adults aged 25-74 yrs were randomly selected using age/gender stratified electoral roll samples and of these 1563 subjects participated in the survey. Anthropometric, clinical and self-administered questionnaire data relating to chronic disease risk were collected in accordance with the WHO MONICA protocol.2 A detailed investigation of dyslipidaemia was included.

Principal findings : All required data was available for 1255 participants. Age-standardised mean total cholesterol (TC), triglycerides, LDL cholesterol and HDL cholesterol concentrations were 5.36 mmol/l, 1.42 mmol/l, 3.23 mmol/l and 1.48 mmol/l, respectively. Amongst those taking lipid-lowering medication, just 11% categorised as secondary prevention/diabetes, and 39% as primary prevention, achieved all lipid targets. In the 20% of untreated participants at high risk of a primary cardiovascular event, 26% were aware of their hypercholesterolaemia and just 2% achieved all lipid targets (2.8% achieved TC?5.5 mmol, 8.5% achieved LDL<3.5 mmol/l). 11.2% of the overall population used lipid-lowering medication (95% was statin monotherapy).

Implications : Most adults do not achieve their target lipid profile. This paper identifies the subpopulations and lipid components which need to be targeted for future interventions. It also identifies substantial evidence-treatment gaps which should be addressed to help improve lipid profiles at a population level.

Thinking about thinking : innovative pedagogy designed to foster thinking skills in junior primary classrooms

This article reports on the collaborative initiative of two primary school teachers who created and implemented innovative pedagogy in order to foster a culture of thinking in their classrooms. The paper outlines teaching strategies that were used with the intent of making students mindful of themselves as learners and thinkers. A 'Toolbox', inspired by 'Habits of Mind' and the Visible Thinking approach to teaching and learning, is described in narrative form by one of the teachers. The Toolbox aims to equip students with the thinking tools to make their thinking visible to themselves, their peers and their teachers.

Appearing pedagogy : from embodied learning and teaching to embodied pedagogy

In this paper images are used to support the conceptualisation and recognition of embodied pedagogy. Analysis of data gathered during an arts-based teaching project in pre-service teacher education revealed the presence of an embodied pedagogy and supports the further deployment of embodied teaching and learning in teacher education. Embodied pedagogy includes embodied teaching and embodied learning but is conceptualised through ‘pedagogy as relational’ – between teaching and learning and between teacher and learner. Through image this paper presents traces of embodied pedagogy from the classroom. These tracings of embodied pedagogy in classrooms defy baseline certainty and instead assert Benjamin’s thesis that knowledge can only ‘stand up’ through multiplicity, through all acts of knowing.

Having a baby in the new land : a qualitative exploration of the experiences of Asian migrants in rural Tasmania, Australia

Introduction: Australia is a land of cultural diversity. Cultural differences in maternity care may result in conflict between migrants and healthcare providers, especially when migrants have minimal English language knowledge. The aim of the study was to investigate Asian migrant women’s child-birth experiences in a rural Australian context.

Method: The study consisted of semi-structured interviews conducted with 10 Asian migrant women living in rural Tasmania to explore their childbirth experiences and the barriers they faced in accessing maternal care in the new land. The data were analysed using grounded theory and three main categories were identified: ‘migrants with traditional practices in the new land’, ‘support and postnatal experiences’ and ‘barriers to accessing maternal care’.

Results: The findings revealed that Asian migrants in Tasmania faced language and cultural barriers when dealing with the new healthcare system. Because some Asian migrants retain traditional views and practices for maternity care, confusion and conflicting expectations may occur. Family and community play an important role in supporting migrant women through their maternity care.

Conclusions: Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers were recommended to improve available maternal care services.

Skill shortages in health : innovative solutions using vocational education and training

Introduction: This article reports findings of a project funded by the Australian National Council for Vocational Education Research. The project explores solutions to current and projected skills shortages within the health and community services sector, from a vocational education and training perspective. Its purpose is to locate, analyse and disseminate information about innovative models of health training and service delivery that have been developed in response to skill shortages.

Methods: The article begins with a brief overview of Australian statistics and literature on the structure of the national health workforce and perceived skill shortages. The impact of location (state and rurality), demographics of the workforce, and other relevant factors, on health skill shortages is examined. Drawing on a synthesis of the Australian and international literature on innovative and effective models for addressing health skill shortages and nominations by key stakeholders within the health sector, over 70 models were identified. The models represent a mixture of innovative service delivery models and training solutions from Australia, as well as international examples that could be transposed to the Australian context. They include the skill ecosystem approach facilitated by the Australian National Training Authority Skill Ecosystem Project. Models were selected to represent diversity in terms of the nature of skill shortage addressed, barriers overcome in development of the model, healthcare specialisations, and different customer groups.

Results: Key barriers to the development of innovative solutions to skills shortages identified were: policy that is not sufficiently flexible to accommodate changing workplace needs; unwillingness to risk take in order to develop new models; delays in gaining endorsement/accreditation; current vocational education and training (VET) monitoring and reporting systems; issues related to working in partnership, including different cultures, ways of operating, priorities and timelines; workplace culture that is resistant to change; and organisational boundaries. For training-only models, additional barriers were: technology; low educational levels of trainees; lack of health professionals to provide training and/or supervision; and cost of training. Key enhancers for the development of models were identified as: commitment by all partners and co-location of partners; or effective communication channels. Key enhancers for model effectiveness were: first considering work tasks, competencies and job (re)design; high profile of the model within the community; community-based models; cultural fit; and evidence of direct link between skills development and employment, for example VET trained aged care workers upskilling for other health jobs. For training only models, additional enhancers were flexibility of partners in accommodating needs of trainees; low training costs; experienced clinical supervisors; and the provision of professional development to trainers.

Conclusions: There needs to be a balance between short-term solutions to current skill shortages (training only), and medium to longer term solutions (job redesign, holistic approaches) that also address projected skills shortages. Models that focus on addressing skills shortages in aged care can provide a broad pathway to careers in health. Characteristics of models likely to be effective in addressing skill shortages are: responsibility for addressing skills shortage is shared between the health sector, education and training organisations and government, with employers taking a proactive role; the training component is complemented by a focus on retention of workers; models are either targeted at existing employees or identify a target group(s) who may not otherwise have considered a career in health.

Vietnamese-born health professionals : negotiating work and life in rural Australia

Introduction: Australia is a culturally diverse nation due to migrants from a wide variety of countries creating a multicultural society. The health professions are highly valued by the younger generation of overseas-born migrants who have acculturated into Australian society; many have chosen health care as their profession in Australia. However, most migrants settle in metropolitan areas and young health professionals may find working in rural or remote Australia culturally and professionally highly challenging. The present study of migrant health professionals examined the life experiences and acculturation strategies of Vietnamese-born health professionals working and living in rural Australia. Objectives: The two main study objectives were to: (1) examine aspects of the acculturation of overseas-born and Australian-trained health professionals in the Australian health discourse; and (2) identify key coping strategies used by them when in working in the rural context.

Methods: Six overseas-born, Australian-trained health professionals were invited to participate in this qualitative study using a snowball sampling technique. The participants were all born in Vietnam and had experienced working in rural Australia. They included three medical doctors, a dentist, a physiotherapist and a nurse. The interviews were recorded and four participants also provided additional written responses to some of the open-ended interview questions. The interview data were transcribed and later coded for thematic analysis. Topics and themes that emerged focused on the issues and strategies of acculturation to the rural health context.

Results: The study showed that the acculturation process was affected by the participants’ views about and attitudes towards working in an Australian rural context. The study identified these essential strategies used by the participants in adapting to a new workplace: collaborating, distancing, adjusting, repairing, and accommodating.

Conclusion: The study provides insights into the lives of these health professionals in a rural context, and particularly their experience of cultural shock and the coping strategies they may use. A need is identified for a larger study to inform recruitment and retention of these health professionals to rural Australia, and to assist universities to prepare such students and their clinical supervisors for rural placements.

Fractal analysis of bone texture : a screening tool for stress fracture risk?

Background The aim of this study was to identify specific bone characteristics of stress fracture (SF) cases in sportswomen. To date, no tool is able to distinguish individuals who are at risk, limiting preventive measures.

Material and methods We investigated the skeletal system of sportswomen who did sustain SF in the past (n = 19) and compared it with that of female controls (C) with a similar sporting history but without any fracture history (n = 20).

Bone mass and body composition were measured using dual-energy X-ray absorptiometry. Bone micro-architecture was investigated by calcaneal ultrasound and fractal analysis of calcaneus radiographic images. Oestradiol levels were measured by E.I.A, and IGF-1 by R.I.A. Menstrual characteristics, nutrient intake, and training were assessed using questionnaires.

Results The result of the fractal analysis, expressed by the Hmean parameter, was significantly lower in the SF group, reflecting a more complex structure of the trabecular micro-architectural organization (P < 0·005). Body mass index (BMI) at birth was also found to be lower in the SF cases as compared with their C (P < 0·03).

Multivariate analysis revealed that the fractal parameter Hmean, bone mineral content (BMC) at Ward's triangle and the BMI at birth correctly assigned 84·85% of the female athletes into their respective SF or C groups (P = 0·001).

Conclusion These results suggest that the fractal parameter and the BMI at birth may be able to identify female athletes most at risk for this overuse bone injury, as their low indexes might reflect a greater skeletal sensitivity.

Addressing evidence treatment gaps for cardiovascular disease through primary care collaboration

Aims & Rationale/Objectives
The aim is to establish the frequency of counselling by general practitioners (GPs) and community pharmacists (CPs) for patients with uncontrolled CVD risk factors. This will identify conditions for which CPs might collaborate with GPs in addressing evidence-treatment gaps.

Methods
A population survey undertaken in the Wimmera region of Victoria in 2006. 1425 adults aged 25-84 yrs were randomly selected using age/sex stratified electoral role samples. A representative 723 participants were recruited.

Principal Findings
Data on GP and CP visits were available for 694 participants. Overall, participants visited GPs 4.6 times and CPs 6.0 times/annum. However, one third of participants never consulted a pharmacist in 12 months compared to just 11.5% for GPs. Among obese patients (BMI ?? 30), the average number of visits/annum was 4.5 to GPs and 6.8 to CPs. The equivalent numbers were 5.6 and 8.6 respectively for those with systolic BP ?? 140 mmHg; 3.7 and 5.5 for total cholesterol > 5.0 mmol/L; and, 6.7 and 14.6 for patients with random blood glucose concentrations ?? 7.0 mmol/L.

Implications
People with suboptimal status for most common CVD risk factor are counselled frequently by CPs. A coordinated approach with GPs to the delivery of cardiovascular health promotion could provide valuable reinforcement of key messages and offers greater opportunity to identify at-risk individuals. Acknowledgements: KM is a pharmacist-academic at Greater Green Triangle UDRH, a position funded by the Department of Health and Ageing through the Rural and Remote Pharmacy Workforce Development Program

The influence of learning environment on student conceptions of learning

Responding to the increasing numbers of students who now study across more than one of the traditional sectors of education and training, this research explored quantitative differences in conceptions of learning between students who had entered university study on the basis of a VET qualification, and those who had entered on a basis of previous university studies. Using the Conceptions of Learning Inventory the research also used gender as an independent variable. While some differences were shown between the previously-VET and previously-university students and some differences between genders these differences were characterised by low to moderate effect sizes only. The authors conclude that the quantitative differences are not particularly important, but that qualitative research may indicate differences in kind between the conceptions of learning of the two groups.

Detection and treatment of hypertension in rural Australia

Background: The inequity of cardiac health outcomes between metropolitan and rural areas is well documented. As hypertension is a major cardiovascular risk factor, we need to have a better understanding of how well it is detected and managed rural areas. This study reports on the prevalence, detection and treatment of hypertension in rural Australia.

Method: Three population stratified surveys were undertaken in the Greater Green Triangle. Three thousand three hundred and twenty adults aged 25–74 years were randomly selected, stratified by gender and 10-year age groups. Anthropometric, clinical and self-administered questionnaire data relating to chronic disease risk were collected in accordance with the WHO MONICA protocol. Blood pressure (BP) was measured by trained nurses and the questionnaire collected information on the history of hypertension and medications used for treatment.

Results: Information on BP measurement, medication and awareness was available on 1506 (45%) participants. Study found that one-third of participants had hypertension. Only 54% (95% CI 47–60) of male and 71% (65–77) of female participants with hypertension were aware of their condition. While only half of the participants with hypertension were treated, only half of these treated participants had their hypertension under control. Treatment and control of hypertension was more common in women (60%, 54–67 and 55%, 47–64) compared with men (42%, 36–49 and 35%, 26–44).

Conclusion: Results of our study suggest that detection and treatment of hypertension in rural is suboptimal, particularly in men. If cardiovascular outcomes are to improve in rural Australia, people need to be encouraged to have their blood pressure measured regularly and better systems for the management of hypertension in primary care are needed.

Management of lipids in rural Australia : are the guidelines being followed?

Background: Hypercholesterolaemia is ranked seventh among the major factors contributing to the overall burden of disease in Australia. Guidelines for evidence-based lipid management were released in 2001 and updated in 2005, however little population level data has been published on the current gap between recommended management and actual practice in Australia.

Method: Three population stratified surveys were undertaken in the Greater Green Triangle. Three thousand three hundred and twenty adults aged 25–74 years were randomly selected, stratified by gender and 10-year age groups. Anthropometric, clinical and self-administered questionnaire data relating to cardiovascular disease risk were collected in accordance with the WHO MONICA protocol. Blood samples were collected for lipid profile analysis. Participants were divided into four groups—Group 1: treated, high CVD risk; Group 2: treated, primary prevention; Group 3: untreated, high CVD risk; Group 4: untreated, low CVD risk. For each of these groups we compared cholesterol, HDL cholesterol, triglyceride and LDL cholesterol with targets recommended by the National Heart Foundation's 2005 guidelines.

Results: All lipids were at target in 39.4% of the study population with marked differences between groups: Group 1, 11.2%; Group 2, 38.5%; Group 3, 1.8%; Group 4, 47.6%.

Only 50.8% of the untreated high CVD risk group reported having blood cholesterol measured within the last 12 months.

Conclusion: Current rates of detection and treatment practices in rural Australia are suboptimal. Although one-third of the study population age 25–74 years are at sufficiently high risk to warrant consideration of lipid lowering medication only just over half of these were on treatment at the time of the study. These results suggest that an intensive implementation plan is required for the management of hyperlipidaemia in rural Australia.

Should capillary blood glucose measurements be used in population surveys?

Objective
To determine the accuracy and appropriateness of capillary blood glucose testing in population surveys.
Materials and methods
Capillary blood glucose using the Rochec ACCU-CHEK instrument and Advantage 11 Test Strips was compared to a laboratory instrument. Three independent cross-sectional risk factor surveys (n=1432) and baseline individuals from the Greater Green Triangle Diabetes Prevention Project (n=341) provided both fasting plasma and capillary blood glucose measurements. Accuracy of capillary glucoses was assessed using the ISO 15197 standard. The median age of the participants was 71years, ranging from 25 to 84years. There were 799 males and 974 females.
Results
Capillary glucose method had poorer precision at lower concentrations (CV: 9.50%, mean=3.09mmol/L, CV: 4.90%, mean=16.78mmol/L, n=233 replicates). Individual discrepancies were seen across the measuring range (2.8–19.9mmol/L, n=1773). In total, 94.5% of results fell within the minimum acceptable accuracy standards. This was slightly short of the 95% of results required to meet the ISO 15197 standard. The prevalence of diabetes in the study population using glucose 7.0mmol/L was 2.4% (95%CI 1.8–3.3%) according to fasting plasma glucose and 2.8% (2.1–3.8%) according to fasting capillary glucose. The lower WHO-defined cut-off of 6.1mmol/L for capillary blood glucose testing gave a prevalence of 10.7% (9.0–12.5%).
Conclusions
This study of matched capillary and plasma glucose results concludes that while it is appropriate to use fasting capillary glucose levels to determine the prevalence of diabetes in populations, it should not be used to reliably diagnose diabetes in individuals.

Exploratory surgery of the female psyche

The thesis explores the visual narrative concerning a journey of empowerment for women. To enable the journey to advance the inquiry is directed into two areas. The first area is female gender, which is argued to be socially constructed and implicit in the marginalisation of women in western society. The second area is ‘feminine authority’, which is gained by developing an understanding and acceptance of the characteristics which have historically been considered as belonging to the feminine. Granting these characteristics agency would recognise their authority and assist in the elevation of the female to a position of equality in western society. Beginning from a feminist position, the research supported the belief that the female is marginalised in western society. It also confirmed the notion that empowerment and authority can be attained by women if they actively pursue the following; • Explore their own psychology beyond the existing socially constructed gender roles. • Develop an understanding of their feminine self by applying Jung's theories on individuation and archetypes. • Expose the underlying patriarchal influence in western epistemology and science by challenging existing deeply held cultural and scientific beliefs and by actively contributing as feminists to the areas of epistemology and science. Archetypal myths of the ‘feminine’ have developed from an androcentric position. They enforce and perpetuate gender imbalance which contributes to the disenfranchisement of women in western society, ‘Individuation’ is a process in which a person explores aspects of themselves to bring forth parts of their unconscious into their conscious mind in an attempt to gain a deeper understanding of themselves. As a consequence the consciousness develops closer links with archetypal memories which assists the exploration. The ‘true feminine’ is the feminine not restricted or defined by the dominant androcentric view. Knowledge of the feminine empowers women to address the marginalisation of the female in western society and assists in the process of gaining female authority. This enquiry also investigated the four stages of female psychological development with regard to patriarchal influences. Of particular importance is the second stage of psychological development where the female identifies with historically perceived inferior characteristics of the female. This is when she rejects her connections with the primacy of female power and her deep connections with nature which were inherited from archaic times. It is at this stage that she absorbs the myths associated with western patriarchal society which effectively disempower her. Western epistemology, with its emphasis on ‘objective’ investigation and empiricism contributes to the support for and promotion of ‘inferior’ female gender. This type of investigation is brought into question when areas of research into primates and human evolutionary theory is shown to develop from an androcentric view. Western knowledge has associations with power and justice and power is commonly associated with dominance. Regard for ‘truth’ and ‘absolute’ can be viewed as key elements in the support for knowledge and its associations with power. Knowledge has historically maintained suppression of individual experience which promotes a universalised account. This suppression of beliefs other than the dominant authority maintains the existing dominant social structure. Foucault's view of the genderised or inscribed body alerts us to areas where dominance, resistance and power play a part in maximising masculine power and control. Gender becomes an instrument of power within the existing patriarchal structure. Gender, knowledge and power are identified as areas obstructing female empowerment. Part 3 of this exegesis examines the imagery which embodies the visual narrative. Particularly, the harlequin image, its historical background and connections with ancient mythology including reference to Jungian psychology. The harlequin image is developed sequentially in the earlier black and white drawings on paper. These drawings contained a female figure which was often placed in juxtaposition with a Venus or goddess image, reference was also made to ‘eve’ and the ‘siren’. These elements provided the framework which enabled the harlequin image to emerge and evolve. The narrative developed with an understanding of the ‘feminine’ aspects of the psyche which resulted in the harlequin acquiring the elevated authority of a goddess. The Harlequin evolved from my need for symbolic representation of the female psyche. It represents contradiction and dualism. It is a composition of opposites, reflects masculine and feminine traits, the dark and light of the conscious and unconscious mind, it houses both comic and sinister elements, is a trickster and menace. The costume, colours and patterns are expressive elements conducive to fragmentation and layering within the composition of the paintings. Jung examined the harlequin in Picasso's paintings. He concluded that as Picasso drew on his inner experiences the harlequin became important as a symbol; it was a pictorial representation from the unconscious psyche. It travelled freely from the conscious to the unconscious and represented the masculine and feminine, chthonian and apollonian. The final painting in the series, a triptych, completes the narrative and stands alone as a salutatory work. It unites the series by combining existing compositional devices and technique while making reference to imagery from previous works, ‘The Three Graces Victorious’, expresses the authority of the feminine. It completes a victorious stage of a journey where the harlequin is empowered by archaic memories and knowledge of the psyche. The feminine is hailed, elevated and venerated. Other elements which assist in expressing the visual narrative are; colour, technique and influence. Colour is explored and its use as an emotive devise in expressionism. Paul Klee's writing on the use of colour and it's symbolic meaning and Julia Kristeva's investigation on colour from a psychoanalytic and semiotic view are also discussed. To indicate influences and connections within my oeuvre, reference is also made to the following: Jasper Johns' for his use of imagery in his ‘Four Seasons’ series with it's reference to a journey of maturation and Louise Bourgeois' work which deals with issues of gender, memories and past journeys. Although ‘The Three Graces Victorious’; the concluding painting for the investigation is celebratory and represents a finality to the thesis, it points to further areas that impede feminine development and need future examination. Reference is made to a continuation of the exploratory journey by plotting the Harlequin/Goddesses future directions. Although the Harlequin/Goddess is empowered with newly acquired authority, her future journey does not need to be bound by mathematics or limited by rationality. She does not require power to dominate or gender structures to subjugate, but requires limitless boundaries and contexts. The Harlequin/Goddess's future journey is not fixed.