Earnings management in the process of preparing corporate financial reports

Earnings management (EM) literature examines managers��� use of judgment in financial reporting and in structuring transactions to alter financial reports for a specific reason. Mainstream EM literature strongly concentrates on statistical research methodologies and it is driven by positive accounting theory. Although EM occurs in the process of preparing corporate financial reports, that process has so far largely remained a ���black box��� in prior literature. The purpose of this study is to analyze what EM is, how and why it unfolds and how it is intertwined in the process of preparing corporate financial reports. In order to meet the needs of the study, a qualitative case study method will be used. The contribution of this study is threefold. First, it indicates that the concept of EM is not as unam-biguous as the prior literature has assumed. I find that EM is socially constructed and more open to interpretation than absolutely dichotomous conception given by previous studies. Second, this study contributes to our knowledge of the role and the importance of actors involved in conducting EM, indicating that EM is much more actor-dependent than the prior literature has assumed. Third, this study broadens our knowledge base with regard to the processes and potential for EM in academic research.

Financial controlling and management in recovered paper joint ventures

The objective of this Master���s thesis is to examine financial functions, controlling and management in joint ventures of Manufacturing Corporation Oyj Recovered Paper business area. This case study investigated the current situation of financial functions and find out causes that have led the situation. Current situation of financial functions in joint ventures is variable. The most of the companies is outsourced at least some tasks. However, narrow reporting and problems in reliability are the biggest lack of financial controlling and management. The result of study consists of two parts: short-term and long-term improvement. Short-term improvement includes selected solution to outsource all routine financial tasks to new outsourcing partner and improve financial functions. Long-term improvements aim to create better controlling and management system to joint ventures. It is formed corporate governance and performance measurement. In this study it developed new Balanced Scorecard (BSC) for recovered paper joint ventures. Dimensions of BSC are quality, delivery (time), price and financial controlling and management. Earlier researched are showed problems in success of joint venture relationships. Similar results are obtained in this study. In future research, suitable of developed Balanced Scorecard for other industries could be studied

The effects of congestion in the daily management of a trauma hospital

Today���s healthcare organizations are under constant pressure for change, as hospitals should be able to offer their patients the best possible medical care with limited resources and, at the same time, to retain steady efficiency level in their operation. This is challenging, especially in trauma hospitals, in which the variation in the patient cases and volumes is relatively high. Furthermore, the trauma patient's care requires plenty of resources as most the patients have to be treated as single cases. Occasionally, the sudden increases in demand causes congestion in the operations of the hospital, which in T����l�� hospital appears as an increase in the surgery waiting times within the yellow urgency class patients. An increase in the surgery waiting times may cause the diminution of the patient's condition, which also raises the surgery risks. The congestion itself causes overloading of the hospital capacity and staff. The aim of this master���s thesis is to introduce the factors contributing to the trauma process, and to examine the correlation between the different variables and the lengthened surgery waiting times. The results of this study are based on a three-year patient data and different quantitative analysis. Based on the analysis, a daily usable indicator was created in order to support the decision making in the operations management. By using the selected indicator, the effects of congestion can be acknowledged and the corrective action can also be taken more proactively.

Pediatric pain: prevalence, assessment, and management in a teaching hospital

The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients’ pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child’s pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.

Financial Risk Management, Firm Structure & Valuation, an Empirical Analysis.

Rapport de recherche

Experience in the Surgical Management of Abdominal Compartment Syndrome in the Hospital Occidente de Kennedy

The abdominal compartment syndrome (ACS) is the result of various physiological alterations produced by an abnormal increase of the intra-abdominal pressure. Some of these patients will undergo a surgical procedure for its management. Methods: This is a retrospective case series of 28 patients with ACS who required surgical treatment at the Hospital Occidente de Kennedy between 1999 and 2003. We assessed retrospectively the behavior of McNelis���s equation for prediction of the development of the ACS. Results: The leading cause of ACS in our study was intraabadominal infection (n=6 21,4%). Time elapsed between diagnosis and surgical decompression was less than 4 hours in 75% (n=21) of the cases. The variables that improved significantly after the surgical decompression were CVP (T: 4,0 p: 0,0001), PIM (T: 2,7; p: 0,004), PIA (T1,8; p:0,034) and Urine Output (T:-2,4; p:0,02). The values of BUN, Creatinine and the cardiovascular instability did not show improvement. The ICU and hospital length of stay were 11 days (SD: 9) and 18 days (SD13) respectively. Global mortality was 67,9% (n=19) and mortality directly attributable to the syndrome was 30% (n=8). The behavior of the McNelis���s equation was erratic. Conclusions: The demographic characteristics as well as disease processes associated with ACS are consistent with the literature. The association between physiological variables and ACS is heterogeneous between patients. Mortality rates attributable to ACS in our institution are within the range described world-wide. The behavior of the McNelis���s equation seems to depend greatly upon fluid balance.

Percepci��n de los trabajadores acerca del sistema de seguridad y salud en el trabajo en un hospital de III nivel, Bogot��-Colombia. 2014.

Objetivo: Evaluar la percepci��n que tienen los trabajadores acerca del sistema de seguridad y salud en el trabajo en la poblaci��n asistencial y administrativa en un Hospital de III nivel de atenci��n., Bogot��-Colombia. Materiales y m��todos: Estudio de corte transversal en poblaci��n de trabajadores asistenciales y administrativos. Se aplic�� el ���Cuestionario N��rdico Sobre Seguridad en el Trabajo NOSACQ 50 Spanish��� validado. La muestra fue probabil��stica estratificada aleatoria, en 308 trabajadores (230 asistenciales y 78 administrativos). Resultados: El promedio de edad fue 39.5�� 12 a��os, con mayor frecuencia de g��nero femenino (74.68%), estado civil soltero (38.96%) y nivel educativo t��cnico (34.40%). La percepci��n que tienen los trabajadores acerca del sistema de seguridad y salud en el trabajo fue independiente de su tipo de actividad laboral administrativa y asistencial (p>0.05), la mayor percepci��n en ambos grupos fue la confianza de los trabajadores en la eficacia del sistema de seguridad (2.71 y 2.77), y las de menor percepci��n presentaron el empoderamiento de seguridad de gesti��n (2.35 y 2.46) y la seguridad como prioridad de los empleados y rechazo del riesgo (2.35 y 2.40). Conclusiones: Los trabajadores del Hospital tienen un nivel adecuado de buena percepci��n acerca de los aspectos de seguridad y salud en el trabajo donde se evidenci�� que la fortaleza es la confianza de los trabajadores en la eficacia del sistema y la debilidad del sistema se encuentra en la falta de empoderamiento y rechazo al riesgo.

Integrated clinical pathway management for medical quality improvement-based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

The role of Investment Management Systems in regulatory compliance: a Post-Financial Crisis study of displacement mechanisms

The financial crisis of 2007���2009 and the resultant pressures exerted on policymakers to prevent future crises have precipitated coordinated regulatory responses globally. A key focus of the new wave of regulation is to ensure the removal of practices now deemed problematic with new controls for conducting transactions and maintaining holdings. There is increasing pressure on organizations to retire manual processes and adopt core systems, such as Investment Management Systems (IMS). These systems facilitate trading and ensure transactions are compliant by transcribing regulatory requirements into automated rules and applying them to trades. The motivation of this study is to explore the extent to which such systems may enable the alteration of previously embedded practices. We researched implementations of an IMS at eight global financial organizations and found that overall the IMS encourages responsible trading through surveillance, monitoring and the automation of regulatory rules and that such systems are likely to become further embedded within financial organizations. We found evidence that some older practices persisted. Our study suggests that the institutionalization of technology-induced compliant behaviour is still uncertain.

Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

Objective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained. Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%]) and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%]) were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01). Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%]) (P < 0.01). Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation wards 14 [47%]) (P < 0.01). Loose stools were the most prevalent factor present at baseline in 13 of the 19 (68%) subjects whose fecal incontinence had resolved at 3 months. Conclusion: The distribution of the factors contributing to fecal incontinence in older people living at home differs from those cared for in nursing home and hospital wards settings. These differences need to be borne in mind when assessing people in different settings. Management appears to result in a cure for those who are not significantly disabled with loose stools as a cause for their fecal incontinence, but this would need to be confirmed by further research.

Change management in practice: an ethnographic study of changes to contract requirements on a hospital project

Changes to client requirements are inevitable during construction. Industry discourse is concerned with minimizing and controlling changes. However, accounts of practices involved in making changes are rare. In response to calls for more research into working practices, an ethnographic study of a live hospital project was undertaken to explore how changes are made. A vignette of a meeting exploring the investigation of changes illustrates the issues. This represents an example from the ethnographic fieldwork, which produced many observations. There was a strong emphasis on using change management procedures contained within the contract to investigate changes, even when it was known that the change was not required. For the practitioners, this was a way of demonstrating best practice, transparent and accountable decision-making regarding changes. Hence, concerns for following procedures sometimes overshadowed considerations about whether or not a change was required to improve the functionality of the building. However, the procedures acted as boundary objects between the communities of practice involved on the project by coordinating the work of managing changes. Insights suggest how contract procedures facilitate and impede the making of changes, which can inform policy guidance and contract drafting.