Internal audit involvement in enterprise risk management

Purpose – The purpose of this paper is to examine the impact of internal auditors’ involvement in enterprise risk management (ERM) on perceptions of their willingness to report a breakdown in risk procedures and whether a strong relationship with the audit committee affects such willingness to report. The study also investigates the use of ERM and the role of internal audit in ERM in Australian private and public sector entities.
Design/methodology/approach – The study uses an experimental design, manipulating the internal auditor’s involvement in ERM and the strength of the relationship between internal audit and the audit committee. Participants are 117 certified internal auditors. The study also gathers descriptive data on the use of ERM.
Findings – The study indicates that a high involvement in ERM impacts the perceptions of internal
auditors’ willingness to report a breakdown in risk procedures to the audit committee. However, a strong relationship with the audit committee does not appear to affect their perceived willingness to report. The study also finds that the majority of organisations have recently adopted ERM. Internal auditors are involved in ERM assurance activities but some also engage in activities that could compromise objectivity.
Research limitations/implications – There are internal and external validity threats associated with the experimental design.
Practical implications – The findings reinforce the need for organisations to adhere to the recommendations of the Institute of Internal Auditors and to ensure that internal auditors do not play an inappropriate role in ERM.
Originality/value – The paper contributes to our understanding of the impact of involvement in ERM on internal audit objectivity and of the current role of internal audit in ERM in Australia.

El dialogo Socratico como razonamiento colegiado

Thinking with clarity and avoiding contradictions are some of the contributions of philosophy to bioethics, politics or the public sector.  Through philosophical practice, some of the subjects generally treated in educational contexts are now applied within the world of industry or the private company.  Thus, Socratic Dialogue turns into a very powerful tool to reveal deeper levels of group decision making.  The author explains the steps of this particular appraoch and how this methodology works in reality using an example of his personal practice.

A deliberative approach to Northeast Asia's contested history

The failure to reconcile views of the past and to address historical injustice has damaged inter-state relations in Northeast Asia. Joint committees, dialogues and the participation of civil society have been used to address historical issues, but scholars in the disciplines of international relations and area studies have largely ignored these dialogues and deliberative forums. At the same time, there is an emergent theoretical literature on how deliberative democracy can address ethnic conflicts and historical injustice. There is a serious disconnect or distance between the theoretical literature on the resolution of conflicts via deliberation on the one hand, and empirical studies of deliberative approach in East Asia on the other. This article aims to address this shortcoming in the study of the politics of historical dispute in Northeast Asia by proposing a deliberative approach to history disputes and highlighting the achievements, limits and dynamics of deliberation. Through mapping and comparative testing, we confirm that deliberation offers some potential for a departure from nationalist mentalities and a shift towards a consciousness of regional history in Northeast Asia. Our empirical test of the utility of the deliberative approach suggests that a new model for addressing regional disputes may be emerging.

Developing a placebo-controlled trial in surgery : issues of design, acceptability and feasibility

Background: Surgical placebos are controversial. This in-depth study explored the design, acceptability, and feasibility issues relevant to designing a surgical placebo-controlled trial for the evaluation of the clinical and cost effectiveness of arthroscopic lavage for the management of people with osteoarthritis of the knee in the UK.
Methods: Two surgeon focus groups at a UK national meeting for orthopaedic surgeons and one regional surgeon focus group (41 surgeons); plenary discussion at a UK national meeting for orthopaedic anaesthetists (130 anaesthetists); three focus groups with anaesthetists (one national, two regional; 58 anaesthetists); two focus groups with members of the patient organisation Arthritis Care (7 participants); telephone interviews with people on consultant waiting lists from two UK regional centres (15 participants); interviews with Chairs of UK ethics committees (6 individuals); postal surveys of members of the British Association of Surgeons of the Knee (382 surgeons) and members of the British Society of Orthopaedic Anaesthetists (398 anaesthetists); two centre pilot (49 patients assessed).
Results: There was widespread acceptance that evaluation of arthroscopic lavage had to be conducted with a placebo control if scientific rigour was not to be compromised. The choice of placebo surgical procedure (three small incisions) proved easier than the method of anaesthesia (general anaesthesia). General anaesthesia, while an excellent mimic, was more intrusive and raised concerns among some stakeholders and caused extensive discussion with local decision-makers when seeking formal approval for the pilot. Patients were willing to participate in a pilot with a placebo arm; although some patients when allocated to surgery became apprehensive about the possibility of receiving placebo, and withdrew. Placebo surgery was undertaken successfully.
Conclusions: Our study illustrated the opposing and often strongly held opinions about surgical placebos, the ethical issues underpinning this controversy, and the challenges that exist even when ethics committee approval has been granted. It showed that a placebo-controlled trial could be conducted in principle, albeit with difficulty. It also highlighted that not only does a placebo-controlled trial in surgery have to be ethically and scientifically acceptable but that it also must be a feasible course of action. The place of placebo-controlled surgical trials more generally is likely to be limited and require specific circumstances to be met. Suggested criteria are presented.

Review : Ethics for health care (2nd edition) by Catherine Berglund

Ethics is a broad discipline and in health the debate between bioethics and behavioural ethics is one that goes to the centre of public health debates.

Physical activity promotion for male factory workers : a realistic option?

Issue addressed: Worksites are a promising setting for health promotion initiatives. While there is an accumulated body of evidence indicating favourable health and cost outcomes, there have been difficulties identified in recruiting and influencing blue- collar workers. This descriptive study aimed to identify specific opportunities and barriers which may impact upon physical activity options at work for male blue-collar factory workers.

Methods: Fifteen manager interviews and worksite observations, and eight employee group discussions were conducted in manufacturing industry worksites.

Results: Several key barriers emerged which limit opportunities for blue-collar employees to participate in physical activity at work: time constraints; limited facilities; and lack of interest from management to facilitate physical activity due to limited resources and concerns about safety issues. Potential opportunities included the presence of change rooms, showers, outdoor areas suitable for physical activity, nearby parks and local fitness facilities, and occupational health and safety committees.

Conclusions: Increasing opportunities for workers to be active at work did not emerge as a priority of managers who may need to be convinced that allocating time and resources to physical activity is a wise investment and that workers need an environment that both supports and encourages participation in physical activity. The role of physical activity in relation to injury prevention and potential reductions in Workcover premiums is worthy of further investigation.

So what? While worksite physical activity promotion is a national health objective, there are numerous actual and perceived barriers to initiatives directed at factory workers. Rather than offering specific programs, it may be more productive to address work practices and environmental and regulatory barriers through established occupational health and safety channels. Information and education strategies to change the attitudes and beliefs of management and workers about these issues, as well as about the health benefits of physical activity, may also be helpful.

Evaluation of a training program to assist care staff to better recognize and manage depression among palliative care patients and their families

This study was designed to evaluate the effectiveness of a training program to improve the knowledge, attitudes, and self-efficacy of palliative care staff and thus enable them to better detect and manage depression among palliative care patients and their families. Participants were 90 professional carers who completed a four-session training program. Knowledge, attitudes, self-efficacy, and barriers to working with depressed patients were assessed preintervention, post-intervention, and at a three-month follow-up. The results demonstrated that compared to the control group, the intervention group had improved in all of these areas. Improvements were maintained at the three-month follow-up in all areas except attitudes. The results of this study indicate the importance of training in managing depression among palliative care staff. Booster sessions will likely be needed to ensure that training program gains are maintained.