Saturday, August 31, 2019

Ethics and Internal Auditors

Professionalism, Ethical Codes and the Internal Auditor: A Moral Argument Mary Ann Reynolds ABSTRACT. This paper examines the case of the internal auditor from a sociological and ethical perspective. Is it appropriate to extend the designation of professional to internal auditors? The discussion includes criteria from the sociology literature on professionalism. Further, professional ethical codes are compared. Internal auditors’ code of ethics is found to have a strong moral approach, contrasting to the more instrumental approach of certified professional accountants.Internal auditors are noted as using their code of ethics to help resolve professional ethical dilemmas. Introduction Society grants professional standing to those groups which contribute to the well being of the broader society. Business experts in such groups as business ethics consultants and internal auditors lay claim to professional standing which if granted enhances both their credibility and marketability . But is this claim justified? Although business ethicists are beginning to debate this issue they presently lack a common body of knowledge or agreed upon expertise.As defined expert knowledge is one of the common criterion for professional definition their claim awaits the development of consensus (Cohen, 1992; Stark, 1993; and Dean, 1997) However a similar group, internal auditor’s have a fifty year history of moving to achieve this recognition. This paper will examine the justification of their claim to professionalism in light of current practice. Mary Ann Reynolds is assistant professor of accounting at Western Washington University. Her current research publications are primarily in the areas of ethics, and environmental accounting.This is of importance to society because internal auditor’s provide a peculiar service in that they contribute to the control of the integrity of financial information in a market economy. Public accountants, represented by the Americ an Institute of Certified Public Accountants (AICPA) have long held professional status based on their responsibility to audit publicly issued financial statements. Public accountants provide a range of service but are specifically licensed to perform the external audit of publicly issued financial statements.Internal auditors in contrast have no licensure requirement and practice within the corporation or organization that employs them. There may be great similarity in the work performed by these two branches of accounting. Internal auditors may perhaps be considered a subset of accounting and as such may be included under the professional rubric. However they may also be viewed as a particular class of business expert or consultant, not serving the public good and not necessarily adhering to standards or codes of conduct, in which case the claim to professionalism would not hold.However, as a result of the Foreign Corrupt Practices Act of 1977 corporations are required to maintain effective internal controls to prevent fraud and bribery of foreign officials. Internal auditors have been instrumental in providing this service as well as compliance audits to ensure meeting regulatory requirements. Society appears to expect a professional service even though licensure has not been required nor formally granted. The internal auditor serves an important link in the business and financial reporting process of corporations and not for profit providers but can they be considered professionals?Journal of Business Ethics 24: 115–124, 2000.  © 2000 Kluwer Academic Publishers. Printed in the Netherlands. 116 Mary Ann Reynolds Professionalism: A societal perspective Accountants perform agreed upon services within an orderly social and economic context. The claim to classify accounting, and auditing, as classical professions is based upon their relationship to society as a whole and the question of professionalism must therefore be studied not just in the context of a division of labor but, â€Å"as part of a network of social and economic relations (Dingwell, p. 2). Professions do, in fact, contract with society and a sociological level of analysis is thus useful in examining accounting practice (Fogarty, 1995). The functionalist perspective deriving from Parsons (1951, 1968) classic works in particular provides a useful explanatory model for understanding accounting in its social environment. Functionalists contend that society will organize to maintain itself and then various functions arise to preserve the stability of the social system.Anthropologists utilizing functionalism as a heuristic tool have identified four of the prerequisites to maintain society as: 1) shared cognitive orientations, 2) normative regulation of means, 3) effective control of disruptive forms of behavior and 4) communication (Aberle et al. , 1960). Accounting reports as an inherent part of the resource allocation process and can appropriately be viewed as commun ication as well as one of the control mechanisms (Reynolds, 1989). The functionalist perspective is chosen from among possible approaches such as taxonomic, neo-Weberian, or Marxist (Saks, 1988) as relevant to accountants.As Montagna (Freidson, 1973, p. 146) notes professional accountants are, â€Å"designers of order†. Accounting theory follows the basic assumptions of the functionalist perspective in that they contribute to accurate communication, control and the maintenance of order. Although work on professions following a functionalist foundation is continued by Moore (1970), some specific insight can be gained by returning to issues raised by Parsons and Hughes in earlier work. A range of criteria have been proposed as indicators of professional status in this society. Parsons focused on the function served, i. e. aintenance of order and control, while Hughes discussed licensure and certification as indicators Are internal auditors properly designated as professionals? This continuing discussion is emphasized by Wesberry’s (1989, p. 25) regretting that internal auditor’s cannot yet claim to â€Å"have arrived†, to unequivocally claim professional status. Further debate arises as questions about future directions for internal auditing indicate a wide range of possibilities. Opposite ends of the spectrum are expressed by an interview with Michael Hammer (1998) and a review of Israeli legislation (Friedberg and Mizrahi, 1998).In an interview published in the Internal Auditor, Michael Hammer encourages internal auditors to move to a consultancy position and to convince management that the consultant’s role is in fact the role in which the internal auditor adds value to the company. This contrasts to the prominence internal audits were recently accorded in Israel where the Knesset mandated that every public body or organization must have an internal audit. Thus we see the current debate as whether internal auditors are class ified as workers with a particular expertise, or as professionals?This discussion can be informed by reference to the sociology of professions and examination of the proposed profession’s ethical code. The author examines the unresolved claim of professional status for internal auditors and considers their development and use of a code of ethic as one type of supporting evidence. The specific case of the internal auditor is addressed by reviewing: 1) the internal auditor’s claim to professionalism based on their function in society, 2) criteria for professions, and 3) development of an ethical code.The paper is organized as follows: the examination is located in the societal perspective and then specific professional characteristics are reviewed. The third section discusses codes of ethics and compares elements contained in recognized professional accounting codes. Section IV discusses the internal auditors code in particular, the guidance for conflict resolution and f inally, the moral focus of the internal auditor’s professional ethics code is discussed. Section five is the conclusion. Professionalism, Ethical Codes and the Internal Auditor of societal mandate.Jackson (1970, p. 6) enumerates: craft, skills, intellectual training and the concept of duty with a service ideal and objective disinterestedness as criteria for distinguishing professions. Thus, for an occupation to become a profession it is considered one which is practiced by a few experts using special knowledge in a field which reflects issues of concern to society. Further, normative standards of practice are then set by the professional bodies. Evolving professional status within a society is additionally evidenced by development and adherence to a standard or code.Thus, the consideration of an occupation as professional or nonprofessional is based on an accumulation of critical discriminating characteristics ( Jackson, 1970, p. 23). To those noted above Schumpeter (1951) ad ds the consideration of monopoly power. Monopoly versus non monopoly is an indictor of the degree to which charter to practice has been granted to the profession by society. Characteristics of professions. Within the social model professions are seen as emerging to serve the public good and are granted status by society because of the functions performed.The basic issues presented above led to the development of proposed listings of common characteristics for professions. The listing used by Millerson (1964), and Kultgen, (1988), utilizes both traits and functions as characteristics and is therefore inclusive of the issues raised. The listing includes the thirteen primary characteristics found in Table I. The first five general characteristics are widely accepted as definitional in the professions literature, they are appropriately applied to public accountants and are not argued separately in this paper.Characteristics numbered six through ten deal more particularly with the relati onship of professional service, and the professional, to the society and these will be examined in detail below. Characteristics eleven through thirteen further define the relationship of the professional practitioner to the client that is served and will be briefly discussed here. Characteristic number eleven asserts a fiduciary relationship toward the client. This requirement that the highest standard of loyalty be met TABLE I Primary characteristics of professions 117 General 01.A profession involves skill based on theoretical knowledge. 02. The skill requires extensive and intensive training and education. 03. The professional must demonstrate competence by passing a test. 04. The profession is organized and it is represented by associations of distinctive character. 05. Integrity is maintained by adherence to a code of conduct. Relationship to society 06. Professional service is altruistic. 07. The professional assumes responsibility for the affairs of others. 08. Professional service is indispensable for the public good. 09.Professionals are licensed, so their work is sanctioned by the community. 10. Professionals are independent practitioners, serving individual clients. Relationship to clients 11. They have a fiduciary relationship toward their clients. 12. They do their best to serve their clients impartially without regard to any special relationship. 13. They are compensated by fee or fixed charge. As summarized in Kultgen, 1988, p. 60, headings added. in serving the principal is difficult to apply directly to either public accountants, whose first duty is to the public good, or to internal auditors hose duty of good faith is to their immediate employer. However both groups do acknowledge their duty to act in good faith which may fulfil the intent of this requirement even though the duty is not to a client per se. Characteristic twelve requires impartiality, construed by accountants as objectivity. Public accountants are bound by the requirement to maintain an objective and independent attitude. Internal auditors are also enjoined to maintain an independent attitude, thus meeting this characteristic. The last characteristic is met by public accountants 118 Mary Ann Reynolds be a profession.Courtemanche (1991) provides an historical argument in favor of such professional recognition. Internal auditors working within corporations have asserted their right to hold themselves out as professionals. This has been challenged by CPA professionals in public practice. The issue reached the status of legal debate and court cases in Florida and Texas supported the legal right of accountants working within corporations, rather than in public practice, to use the professional CPA designation if they have passed the CPA examination and met the qualifying criteria (Baker and Hanson, 1997).A logical argument can also be constructed with reference to the professional characteristics previously summarized. Examination of the characteristics will reveal whether the preponderance apply to internal auditors or not. The first five characteristics generally define professions and can be seen to apply to internal auditors as well as to the certified public accountants. However, primary characteristics six through ten are open to debate and will be examined separately for applicability to internal auditors and the question of their professional standing.A discussion of each of these characteristics follows. Is the service performed by internal auditors altruistic? This may be questioned for most professions in any but an idealized definition of the functions that are performed. However, the focus of this characteristic seems to be that services performed are services that cannot be done by the client him/herself and that service performance is not primarily for personal enrichment. Compensation is provided to professionals to enable them to continue to perform the service. If public auditors are eld to enhance the proper flow of accounting information in a capital market as a necessary service (Brown and Bradshaw, 1988), then by extension internal auditors may be held to enhance the accurate flow of information from inside the corporation to the external capital market. By extension this may be construed as serving the public interest. However, because they are directly employed by the corporation they may be said to provide the service as a by product with personal gain, through the receipt charging an audit fee.It is not applicable to internal auditors who receive salary. In addition to these thirteen primary characteristics Kultgen (1988) also notes these seven ancillary characteristics: 1) loyalty to colleagues, 2) regular professional development, 3) prestige based on guaranteed service, 4) use of individual judgment, 5) work is not manual, 6) profits are not capital dependent and 7) status is widely recognized. These seven ancillary characteristics reflect more on the professional practitioner as an i ndividual and less on function within society.Examining both sets of characteristics from a societal perspective, it is readily seen how the public accounting profession meets the criteria within this model and can therefore be held to maintain order and contribute to the stability of the society. Further, in granting the Certified Public Accountants, as professionals, exclusive license to practice society acknowledges their important role and grants a monopoly position. Professions contract with society and acknowledge their role and responsibility by establishing codes of conduct.The development of a formalized code has been seen as a necessary indicator of professionalism (Newton, 1982, and Loeb, 1984). Thus, society acknowledges the professions’ contribution to the public good and the professions acknowledge their responsibility to society. Professional accountants, as represented by the American Institute of Certified Public Accountants (AICPA), have held themselves to b e a profession and have accepted the obligations coincident with that designation.Certified public accountants (CPAs) conform to both the major thirteen characteristics and the seven ancillary characteristics and are commonly held to be professionals. However, Zeff (1987, p. 67) argues that their professionalism is, â€Å"diluted by rule dominated practices. † For the purposes of this paper the assumption will be made that public accounting, as practiced by CPA’s, is indeed a profession. Can this professional designation be extended to include internal auditors, as a branch of accounting, under the professional rubric?The research question specifically addressed in this paper is whether or not internal auditing, as a special case of accounting, can also be held to Professionalism, Ethical Codes and the Internal Auditor of salaries, as the primary goal. Thus, only partially supporting the claim to professional designation. Is responsibility assumed for the affairs of ot hers? This normally connotes an area of expertise held by the professional, essential to the recipient, about which advice is given.The recipient is not able to evaluate the information for him/herself. This is clearly the case with regard to the classic professions of law, medicine, and architecture (Kultgen, 1988). The public auditor is specifically employed to exercise professional judgement and offer an opinion as an expert. Therefore this can be considered applicable to the public auditor. However, the case cannot be extended to the internal auditor in this instance, as the client, i. e. the corporation, has its own accountants employed to generate the required accounting information and the internal auditor primarily serves an internal control function, even though accounting expertise may be needed and additional accounting advice may be sought. This control function serves the corporation directly and only indirectly serves society Is the professional service indispensable t o the public good? Public audits have been mandated by legally authorized bodies, thus recognizing that they are considered essential to the public good by allocating resources to them.With the public demand for the control of fraud evidenced by the Foreign Corrupt Practices Act of 1977 internal auditors became more active as a means of internal control, and fraud detection that was part of the proposed solution to protect the public interest (Lambert and Hubbard, 1989). Internal auditors, in their professional capacity, may be asked to design internal control systems and to assist in the construction of corporate codes of ethics (Peacock and Palfrey, 1991), thus, serving as an integral part of the overall control system and by extension may be considered indispensable to the public good.Is internal auditors’ licensing sanctioned by the community? Referring to the previous argument some level of public sanction is implied. However, licensure implies authority to license, 119 which must be granted by an authoritative body. In the case of Certified Public Accountants (CPA), state boards of accountancy are empowered by the respective legislatures to license public accountants practicing in the state. Internal auditors are not licensed by a legislative authority. Rather, they are certified by the Institute of Internal Auditors (IIA) upon successful completion of an experience requirement and a qualifying exam.No authoritative body claims jurisdiction over their activities. Within the corporation, however, internal auditors have responsibilities defined by the corporation and authority granted by means of a charter. This internal authority granting charter should be signed by the executive management and by the audit committee representing the shareholders (Ratliff et al. , 1988). In the context of an internal, company specific activity, this can be construed as granting professional right to practice by appropriate authority.This is not however, an authorit y granted by society nor does it extend beyond the charter granting corporation. This is, at best, a limited type of licensure as no monopoly is granted and certification is not required. Is the internal auditor an independent practitioner serving individual clients? The issue of the charter for internal audit departments is particularly relevant to this discussion. Internal auditors operate within the corporation by right of a charter establishing their rights and responsibilities and granting them authority to function ( Johnson, 1986).The charter establishes the internal audit department as an independent function which enables the internal auditor to operate as an individual professional serving a client. Although the client in this case is the corporation, the required independence of attitude and function can be seen to qualify the internal auditor as an independent practitioner. Examination of the applicability of the six ancillary characteristics to internal auditors contrib utes to the resolution of the question of professionalism. The six ancillary characteristics are specifically included in the code of ethics developed by the Institute of Internal Auditors.Thus, a preponderance of the characteristics, or 120 Mary Ann Reynolds punishments are structured to reward ethical behavior. Thus, the outcomes of professional behavior, whether moral or prudent, will enhance the public good. However, the Institute of Internal Auditors has chosen to emphasize high moral character. Article VIII of the IIA Code of Ethics specifically states that internal auditors should be ever mindful of their obligation to maintain a high standard of morality. It is useful to examine ethical codes and seek identification of common themes or components.A comparison by Kultgen (1988) of the American Association of University Professors; American Bar Association; American Institute of Certified Public Accountants; American Medical Association; American Psychological Association; Eng ineers Council for Professional Development; Institute of Electrical and Electronics Engineers; and Sigma Delta Chi (Society of Professional Journalists) found a number of common elements. The common elements noted include; loyalty to the client, employer, or institution; avoidance of conflict of interest or bribery. Competence, objectivity and honesty about qualifications were also universal.Additional themes such as respect for the territorial rights of colleagues and professional self-monitoring were also widely evidenced. The lack of regulatory oversight allowing self-monitoring, or a profession’s control over its membership and practice, is granted by society (Armstrong and Vincent, 1988). This ability to continue to be self regulated is one which the accounting profession in particular has vigorously defended. Another type of examination is provided by Harris and Reynolds (1992) with a specific comparison of the codes from various branches of the accounting profession.T his detailed comparison of the codes also focuses on dilemmas inherent within the various codes as well as, among various levels of society. An examination of the code of the internal auditors in comparison to the code of the AICPA reveals useful insights. Elements listed in the eight articles of the internal audit code include: honesty, objectivity, diligence, morality, dignity, organizational loyalty, independent mental attitude, competence, conformity to standards, confidentiality, full disclosure, continuing education, nonacceptance of criteria, cited are applicable to internal auditors in their own right.It is therefore, logical to extend the classification of accountants as professionals to internal auditors as professionals. To further legitimate this claim the Institute of Internal Auditors was formed in New York City in 1941, standards were established and a Code of Ethics adopted thus implicitly reflecting their acceptance of their responsibility to society. Examination of the code of ethics adopted may also shed light on their claim to professional status. The following section examines their code and compares it in part to the code adopted by public accounting professionals through the AICPA.Ethical codes: A comparison A profession’s mission and responsibility can be enunciated through the code of ethics to which it subscribes. Like other professions, internal auditors have developed and formally adopted a professional code. In the development of an ethical code there are two basic ethical viewpoints: 1) moral, 2) prudent, which may be adopted. Kultgen (1988) in his work on professions, distinguishes between these two approaches as follows: â€Å"Moral persons recognize the intrinsic value of each member of the moral community; merely prudent persons recognize only their own value and treat others as instrumentality’s. . . . Professional practices can be, â€Å"examined from the moral point of view, asking how they contribute to, or detract from the aggregate happiness and fair distribution of goods in the moral community (1988, p. 32). † Accountants are often viewed as utilitarian in approach and may thus be expected to choose the prudent approach. Examination of the AICPA code reveals that although the principles section in the introduction addresses moral components, the enforceable rules section of the code is predominantly a guide to practice. This is in contrast to the internal auditor’s code which is a guide to individual moral behavior.In a well organized society the rewards and Professionalism, Ethical Codes and the Internal Auditor gifts, and no commission of acts discreditable. This list encompasses both character attributes: honesty, dignity, morality, loyalty, nonacceptance of gifts and no commission of acts discreditable; and professional performance of duty attributes: objectivity, independent mental attitude, competence, conformity to standards, and full disclosure. Thus, the code gives clear indication of the personal qualifications perceived to be essential to perform the requisite public service in an ethical manner.With the emphasis placed on loyalty, dignity and morality the assumption can be made that this institute adopts a moral, rather than a prudent, view of ethical behavior. The emphasis in the internal auditor ethical code reflects an individual level of ethical behavior and decision making. The factor of voluntary compliance further indicates an individual level of ethics. Note that internal auditor’s membership is voluntary and members personally choose to subscribe to the higher duty. There is no societal enforcement if this duty is not met, the only enforcement is forfeiture of membership and certification (Loeb, 1984).The contrast with the AICPA code of conduct shows the AICPA code to have a more institutional focus. Rather than the specification of individual moral characteristics, forms of practice are discussed. The ethical code can be seen as directed to the firm of accountants rather than to the individual per se. The new AICPA code, as adopted in 1988, states positive principles about appropriate professional conduct and is goal driven (Meigs et al. , 1989). In contrast to the Institute of Internal Auditors code, the AICPA code may be viewed as adopting a prudent, or instrumental, ethical view.The AICPA code preamble and article II both express the professions’ responsibilities to the public interest. Here again, membership is voluntary and members commit themselves to honor the public trust and maintain professional excellence. Elements of the code in support of this include: objectivity, independence, scope and nature of services, compliance with standards, confidentiality, contingent fees, advertising and other solicitation, incompatible occupations and form of practice and name. Mention is also made of integrity. Integrity, however, is seen in the 121 context of professional judgment.The professi onal, by this standard of integrity, must be independent, not knowingly misrepresent the facts; and not subject his/her judgment to the judgment of others (AICPA, 1988). Again, the emphasis is on the professional performance of duties in the public arena and serving the public good. Further, Rule 501 enjoins members not to commit acts discreditable to the profession. Enforcement of the AICPA code takes several forms. Members can be censured by one of the designated review boards and membership in the AICPA revoked, the ability to practice before the SEC revoked, or the state license revoked.Licensure is granted by the state boards and revocation of the license goes through a state board procedure also. This constitutes a legal enforcement and the accountant would no longer be licensed to practice. Some of these contrasts between the AICPA and the IIA codes arise from structural differences. Namely, public auditors’ codes include structure of practice considerations such as ad vertising and contingent fees, and permissible firm names; that are not relevant to the internal auditor.Beyond structure, the basic difference evidenced is the AICPA emphasis on a practical, prudent, institutional approach, whereas the IIA emphasizes a moral and individual approach. This difference may in part reflect the varying degree of societal regulation within which the two groups operate. The societal regulation in turn may reflect the level of societal recognition and as internal auditing evolves and gains public recognition, regulation and possible licensing may follow. Examination of additional accounting professional codes provides further points of comparison.The Institute of Internal Auditors (IIA) code is the only code to call explicitly for the maintenance of personal dignity. Some commonalties emerge however, as both the Government Financial Officers Association (GFOA) and the IIA included: exercise of due care, or diligence, and loyalty to employer (Harris and Reyn olds, 1992). Both the governmental financial accountants and the internal auditors function in an environment where they are working as professionals, but within an entity 122 Mary Ann Reynolds on the externally issued financial statements (Lambert and Hubbard, 1989).That the internal audit profession is seen as a significant player in the societal move to deter fraud serves to legitimate their claim to professionalism. At the same time this may exacerbate conflicting loyalty problems. Clearly, the choice will fall on the internal auditor as an individual and it may be to this end that strong individual character has been emphasized in the IIA code. This conclusion follows from Kultgen’s statement that, â€Å"a valid professional ethic, therefore, is critical for the moral development of the individual practitioner (1988, p. 12). Resolution of ethical conflicts requires that the internal auditor recognize sources of harm or conflict and have some guidance on appropriate resp onse. Stanford (1991) recommends four sources of guidance. These are: 1. the IIA Code of Ethics; 2. the IIA’s Standards for the Professional Practice of Internal Auditing; 3. the IIA’s position paper on whistle blowing; 4. consultation with peers. Ratliff (Ratliff et al. , 1988) also suggests that guidance will be found in both the Standards and the Code of Ethics and Wallace (1986) emphasizes that the standards and code go hand in hand to provide guidance.A recent study by Seigel, O’Shaughnessy and Rigsby (1995) confirms that practicing internal auditors report using the code of ethics to guide their judgment on ethical issues in the performance of their professional responsibilities. Seigel et al. further conclude that the majority of internal auditors consider the primary purpose of the ethical code is to provide guidance. Internal auditors are indeed being given a special task. In the organizational structure of the corporation if the internal auditors repor t to the audit committee, as recommended, management may perceive them as adversarial.If fraud or inefficiencies are discovered both professional ethics and personal moral judgment will be needed to resolve conflict. Conflict also arises within the code itself. There is a basic conflict juxtaposing disclosure and confidentiality and rather than independently in society. Thus the adjuration to loyalty to the employer is appropriate. Professional conflict resolution: Guidelines The codes of ethics are adopted to provide guidance to the practicing professional. Kultgen (1988, p. 13) notes, â€Å". . . professionals, precisely as professionals, are confronted with serious conflicts of duty, and conflicts between duty and self-interest. One purpose for codes of ethics is to provide guidance for the resolution of conflict. The internal auditor faces possible conflict in the practice of his/her profession within an organization. Although independence, in theory, is established by the corp orate charter and is required by the code, it may be difficult to achieve in practice. Internal auditors faced with choices that may not appear beneficial to upper management or the organization may find it difficult to maintain an objective disinterestedness. Loyalty, an explicit component of the ethical code, may also present conflicts.The internal auditor may face a conflict between loyalty to the profession and professional standards as they are articulated in the standards and the code of ethics, and his/her employer. The interest of the firm in presenting information may not always be consonant with the interest of society to receive full disclosure of information as management seeks to protect strategic and proprietary information. Although internal auditors may be part of the management team they may also serve a control function on managerial activities, another source of potential conflict.Thus, even within the firm they may have conflicting loyalties (Lambert and Hubbard, 1989). Their obligation to the organization constrains them to safeguard the assets of corporation, minimize waste and inefficiency and watch for deliberate wrongdoing and conflicts of interest (Verschoor, 1987). As a result of the Report of the National Commission of Fraudulent Financial reporting (Treadway Commission, 1987) there is an increasing responsibility for the internal auditor to be active in identifying fraud leading to material misstatementProfessionalism, Ethical Codes and the Internal Auditor also loyalty and objectivity (see Harris and Reynolds, 1992, for a full discussion). Dilemmas arising from these juxtapositions are inherent in the statement of the code consequently the individual practitioner must ultimately turn to his/her own moral response for guidance and resolution. A further role suggested for the internal auditor is monitoring corporate codes of conduct. While this may well be an appropriate extension of internal auditors role it is in the nature of a c onsulting service not a professional accounting service.Indeed, as noted in the introduction, business ethics consultants are developing to advise organizations on ethical codes, problems and approaches to resolution (Dean, 1997). Internal auditors are well positioned to participate in this discussion, though it does not help to resolve the question of professionalism examined in this paper. 123 individual professional within a firm. The IIA code focuses on the morality and dignity of the individual and pushes code adherents toward the achievement of a professional ideal.Thus by noting the internal auditor’s development and use of a code of ethics, reviewing their relationship to the accounting profession and examining their function in society, their claim to professional designation can be supported. The preponderance of the evidence supports their status as professionals. References Aberle, D. F. , A. K. Cohen, A. K. Davis, M. J. Levy Jr. and F. X. Sutton: 1960, ‘The Functional Prerequisites of a Society’, Ethics 60 (University of Chicago Press). Armstrong, M. B. and J. I. Vincent: 1988, ‘Public Accounting: A Profession at a Crossroads’, Accounting Horizons (March), 94–98.Brown, G. R. and W. A. Bradshaw: 1988, ‘The External Auditor’s Pivotal Role’, CA Journal ( Jan/Feb), 46–52. Baker, J. D. and R. K. Hanson: 1997, ‘The â€Å"Holding Out†, Issue’, Internal Auditor (Feb), 62–67. 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Freidson, E. : 1971, The Professions and Their Prospects, Freidson (ed. ) (Sage Publications, Beverly Hills, CA).Jackson, J. A. : 1970, Professions and Professionalization (Cambridge University Press). Conclusion Accounting is acknowledged as a profession serving society’s needs. Examining both primary and ancillary professional characteristics shows the appropriateness of including internal auditors within this professional designation. Further, their code of ethics is similar to ot her professional codes and provides guidance to them in their professional practice. One purpose of profession’s codes of ethics is to legitimate the profession and publicize standards of conduct (Sawyer, 1991).Another is to provide guidance for ethical conflict resolution. The IIA Code of Ethics serves both of these purposes for its professional constituency. The code implicitly recognizes the responsibility extended to the profession by society. 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E. : 1984, ‘Codes of Ethics and Self Regulation for Non Public Accountants: A public Policy Perspective’, Journal of Accounting and Public Policy, 1–8. Meigs, W. B. , O. R. Whittington, K.Pany and R. F. Meigs: 1989, Principles of Auditing (Irwin, Homewood, IL). Millerson, G: 1964, ‘Dilemmas of Professionali sm’, New Society ( June 4), 15–16. Montagna, P. D. : 1971. ‘The Public Accounting Profession, Organization, Ideology and Social Power’, in Freidson (ed. ), Professions and Their Prospects (Sage Publications, Beverly Hills, CA). Moore, W. : 1970, The Professions: Roles and Rules (Russell Sage Foundation, New York). Newton, L. H: 1982, ‘The Origins of Professionalism: Sociological Construction and Ethical Implications’, Business and Professional Ethics Journal (Fall), 41–57.Parsons, T. : 1951, The Social System (The Free Press, Glencoe, IL). Parsons, T. : 1968, ‘Professions’, in D. Sill (ed. ), International Encyclopedia of the Social Sciences, XII (Macmillan and The Free Press, New York). Peacock, E. and S. H. Pelfrey: 1991, ‘Internal Auditors and the Code of Conduct’, Internal Auditor (Feb), 45–49. Ratliff, R. L. , W. A. Wallace, J. K. Loebbecke and W. G. McFarland: 1988, Internal Auditing Principles Wes tern Washington University, Department of Accounting, College of Business and Economics, WA 98225-9071, Bellingham, U. S. A. E-mail: MaryAnn. [email  protected] edu.

Friday, August 30, 2019

American Indian Stories: Native Americans Essay

In American Indian Stories, University of Nebraska Press Lincoln and London edition, the author, Zitkala-Sa, tries to tell stories that depicted life growing up on a reservation. Her stories showed how Native Americans reacted to the white man’s ways of running the land and changing the life of Indians. â€Å"Zitkala-Sa was one of the early Indian writers to record tribal legends and tales from oral tradition† (back cover) is a great way to show that the author’s stories were based upon actual events in her life as a Dakota Sioux Indian. This essay will describe and analyze Native American life as described by Zitkala-Sa’s American Indian Stories, it will relate to Native Americans and their interactions with American societies, it will discuss the major themes of the book and why the author wrote it, it will describe Native American society, its values and its beliefs and how they changed and it will show how Native Americans views other non-Natives. Before the introduction of the â€Å"pale face† Native Americans lived a calm and serene life. They lived in big communities and help one another in order to survive. They had a form of religion, poly-theistic, that would be their main form of salvation. They had chiefs and warriors. They had teepees that would allow them to quickly pack up and move. The Native Americans were a nomadic, primitive people that did not live up to the whiter man’s view of â€Å"civilization†. However, the white man, pale face, felt the need to change the Native Americans barbaric ways of life. The Americans were smart in their efforts in trying to convert the Indians. They would go after the kids because they were still young and gullible. â€Å"Yes, my child, several others besides Judewin are going away with the palefaces. Your brother said the missionaries had inquired about his little sister†¦ â€Å"Did he tell them to take me, mother† (40). The children were impressionable. In this first story, the daughter gets hooked on going with the missionaries because they said they had apple trees and being that she has never seen an apple tree, she begged her mother to go not knowing that her mother did not want to send her away. Some Indians enjoyed leaving with the Americans; others did not because of what the Americans had done to the Indians. The mother in this story had told her daughter stories of what the paleface had done and how they had killed most of her family. â€Å"There is what the paleface has done! Since then your father too has been buried in a hill nearer the rising sun. We where once very happy. But the paleface has stolen our lands and driven us hither. Having defrauded us of our land, the paleface forced us away† (10). Having knowing this, the little girl still persisted and wanted to go with the paleface. Many of the Indians that left with the missionaries were gone for many years and did not know how much had changed back at home. In the story The Soft-Hearted Sioux a young man comes back home after receiving an education from the missionaries. He had left before he was taught how to survive out in the wild. He came back to dying and starving parents. He was brainwashed by the missionaries because he went against his family’s customs and told the medicine man never to come back and that God will save his father. He started preaching God’s words to his people and they left the community. His father was growing sicker and sicker and he needed food. His son went out everyday trying to get something but had no skills in hunting. His father had told him to go two hills over and he could find meat. With no concept of ownership, the son went and killed a cow that belonged to an American. Upon leaving with the meat he was chased down and attacked by the â€Å"owner† of the cattle. The son accidentally killed the man and fled back to his father’s teepee only to realize that he was too late and that his father had died. He was so conditioned by the white man that he had forgotten his ancestors’ ways of survival. The book suggests that Native Americans were not savages and that they had a normal lifestyle before the Americans came in and changed everything. Their society was based upon helping one another out. It was also based upon mobility. They would have to make homes in such a way that they could just pack up and leave whenever they needed to. The Native Americans had a values based on nature, life and death. The believed that you must respect nature, respect the living and put a special emphasis on the dead. In The Dead Man’s Plum Bush the little girl walked by a plum bush that had just blossomed out beautiful plums. When the girl had reached to grab one of the plums her mother had told her not to and explained that â€Å"the roots are wrapped around an Indian’s skeleton. A brave is buried here. While he lived he was so fond of playing the game of striped plum seeds that, at his death, his set of plum seeds were buried in his hands. From them sprang up this little bush† (32). The fact that the bush was there because of a man’s fascination with plum seeds and that no one can enjoy its fruits shows how much respect for the dead is played through the Native Americans’ beliefs. Zitkala-Sa’s main motives for writing this book was to show â€Å"one of the first attempts by a native American woman to write her own story† (back cover). Another main motive was to inform people of the way that the Americans came and took over the Indians’ land and people; the land was taken by force and the people by bribing little kids. The main theme for the book was to show how the Indians felt about the Americans. Going by the book, there is no set way of showing how many people liked or disliked the Americans. However, it is noticeable that the parents clearly did not like the Americans because they knew what the Americans had done to them in the past and what they are doing to them presently. They knew that the Americans came in and killed their ancestors and forced others to leave their lands. They knew that they were taking their children away and brainwashing them into thinking that their families were savages and that the Americans had more to offer them. They knew that the Americans were making their kids forget about their ways of living and their beliefs. The children, however, saw the Americans invitation as a way to better themselves and their families. The children would happily go away with the American strangers thinking that everything would be better for them. Zitkala-Sa tried to show how her people were treated by Americans in her book American Indian Stories. She showed how the Indians life was before the Americans and how it had changed after the introduction of the Americans. She proved that not all of the Indians liked the white people. She proved that most of the children that left did not remember their family’s way of life. She proved that when the Americans came they not only took the Indians’ land, they also took their people. Works Cited Zitkala-Sa. American Indian Stories. University Of Nebraska Press. Lincoln and Lo.

Thursday, August 29, 2019

Recommendation and rationale the idea of building prisons Research Paper

Recommendation and rationale the idea of building prisons - Research Paper Example The ability of other methods to yield greater benefits to the entire state, as opposed to imprisonment justifies the position of not building more prisons. Adopting techniques, which reduce crime from an early age of an individual’s life, for example, benefits the society in a number of ways, which necessitates that legislators concentrate their efforts on establishing such mechanisms. Quality early childhood education for all, for example, allows children to access education at a tender age. Subsequent access to such education allows the children to concentrate on building their professions, thus shifting their minds from criminal activities. On the other hand, children who do not access education at an early age get the opportunity to interact with criminals in their neighborhoods, thus increasing their possibility of engaging in crime. As the â€Å"economic opportunity institute† reports, 70 percent of the children who do not access quality early childhood education pose a higher probability of being arrested for a criminal activity by the time they reach 18 years, compared to those who access quality early childhood education. More to this, leaving out at-risk children from early childhood education multiplies their risk of becoming chronic lawbreakers by five times. This means that building more prisons does not serve to reduce crime. Instead, handling the root of the problem can bear better fruits, and give benefit the community a better return on investments made.

Wednesday, August 28, 2019

EB Essay Example | Topics and Well Written Essays - 1500 words

EB - Essay Example on the Scarborough campus. This, we hope, will provide a major step forward in the development of student facilities. This research also serves to fulfil partial requirements of my degree programme. 1.2 Background to research The Scarborough campus does not currently have a school bus and so the implementation of such a system would help to alleviate some of the problems that students currently face students in their efforts to arrive on the campus in time for classes. A properly run bus system would reduce lateness and provide a convenient means of getting from home to the campus. The bus will also help in transporting students between Scarborough campus and the main campus. However, the system would only make sense if it is feasible 2.0 Research Description and Methodology 2.1 Plan of research The research is in the form of a survey. ... The questionnaire was designed to allow for five alternative choices in most cases. There was only one question requiring a yes or no answer. Only two questions were designed using the Likert scale with choices ranging from 1 to 5 with 1 being the weakest/lowest and 5 being the strongest/highest. Delanshire & Petrosky, 1998 indicates that: â€Å"Whenever you use checklists or rating scales, you simplify and more easily quantify people’s behaviors and attitudes. In the process you may lose valuable information.† (qtd. in Leedy and Ormrod, 2005, pg187). However, it is hoped that no valuable information is lost here. 2.2 Discussion of methods The research looks at key variables that will help determine the feasibility of the bus system such as where students live, the circumstances under which they would want to take a bus, how often they travel by bus, get an idea of the timetable which would suggest frequency of use and the price that students consider reasonable. These questions were derived from the consideration of factors that would make the system feasible. If there are no students who are in need of the service, it will not be workable. 3.0 Data Collection 3.1 Data Collection procedures Data was collected with the use of questionnaires which were emailed to the respondents. After they were returned the data was collated and analysed using graphs and charts. The questionnaire is included in the Appendix. 3.2 Sampling Method The sample was not randomly selected because of the time constraint. It was administered to classmates and a few other students. Therefore, we know that the sample chosen was biased. 4.0 Findings 4.1 Overall Findings Questionnaires were emailed to a total of 50

Tuesday, August 27, 2019

As far as the critical analysis, I want you to choose an article that Assignment

As far as the critical analysis, I want you to choose an article that addresses issues families or individuals in rural communities face in regards to healthcare - Assignment Example One thinks that the author used appropriate sources of information. The policies and programs of the government mentioned in the article are relevant in the topic being discussed. The government programs that are cited give value to the ideas communicated by the author. The arguments presented are adequately supported by studies and literatures in the field of interest. Table 1 which outlined the reasons for choosing rural nursing practice and Table 2 which showed the challenges associated with rural nursing practice were helpful in driving the message that the author wishes to convey. It gives a clear picture of the state of nurses in rural communities. I find the article very meaningful because it gives me a clearer understanding about the difficulties faced by rural nurses as opposed those working in the urban areas. It made me sympathize with them regarding the challenges that they face, yet still choosing to have a career in rural areas, when they in fact have a choice. I also feel that the government must do their part in supporting these rural practitioners. Although private institutions can help through educational support for nurses, I believe that a greater part of the funding should come from the government. Rural nurses contribute a lot to the healthcare services of rural areas, especially in the absence of physicians. If the government cannot support them, the rural areas will not have access to quality healthcare service. Government should think of incentives for rural nurses so that our country can expect an increase in their number. Government should coordinate with the regional medical directors and the rural nurses themselves and conduct a needs assessment in rural areas to determine the training and professional skills needed by the nurses serving in the remote areas. Medical educational institutions must also be supportive in this area. This article has enlightened me

Monday, August 26, 2019

Project Essay Example | Topics and Well Written Essays - 2000 words - 1

Project - Essay Example But in Balanced Scorecard the performance of an organization is looked into from a broader angle which spans over perspectives like: Financial, Customer, Internal business process, Learning and growth. This is done to integrate the various complexities in the operating environment of a modern-day firm and so that the along with the financial model other factors which have crucial effects on the firm are taken into account. This tool evaluates performance of an organization and provides a framework for guidance. This system is used by organizations, private, governmental and non-profit to examine their performance in relation to their strategic objectives. Using the balanced Scorecard system, it is possible to measure and evaluate the process which is responsible for present and future value creation. This also acts as a guiding framework for managerial decision making in context of areas to be focused upon and resources to be put into in order to create value. Analysis through this system brings forth the ‘value drivers’ in an organization (Balance Scorecard basics, 2009; Kaplan R.S. and Norton D.P., 1996). The main angles or points of discussion for the organization under the ‘customer perspective’ are identification of their target customers and also their won value proposition which would attract the customers. Identification of the value proposition is crucial because otherwise the organization would surely loose focus. Value propositions might emanate from: Operational excellence- These kinds of organizations get their value proposition from excellence and primary focus only on their operations and generally offer no-frill products or services. Example: EasyJet the European low-cost airline. Leadership through product- These firms depend on constant innovation and research to deliver better products to their customers. They become product leaders and lead the way in the market by always striving to and delivering

Sunday, August 25, 2019

Solving Ethical Problem Case Study Example | Topics and Well Written Essays - 1000 words

Solving Ethical Problem - Case Study Example Ben Garishon,a senior loan officer with first national Federal bank ,the second largest institute in Wyoming does not really understand what ethics are when dealing with bank loans customers. This is proved by the fact that he puts the burden of the cost of trip to assess the collateral of loan application on Dough Whitton, a loan applicant. Ben further states that loan customers were obliged to donate prizes for annual fundraisers picnic. Shelby Grant, a loan officer feels that asking the customer to pay the cost of trip to assess the collateral and asking loan customers to contribute prizes to annual fundraisers as being unethical. As a result, Ben and Shelby are at loggerhead and this clearly brings out the fact that ethical standards when dealing with customers need to be assessed and a solution found to avoid confusion and misunderstanding. The point of contention to loan department within the bank is whether it is ethical to transfer the cost and obligations of the bank to the customers which brings out the problem as lack of understanding of business ethics by members of staff.. Input Loan department has been placing financial burdens to its customers on matters which the bank can carry out. This has raised ethical issue and has raised concern and misunderstanding between staff of the loan department. Some members of the loan department such as Ben Garishon is resistant to change about the new ethical issues facing businesses. He fears that change in covering the cost of trips to assess customer's collateral will be costly to the bank and that the bank will not enough money for charity if it do not compel the loan customers to contribute prize to annual fundraiser picnic. Andrew law states," You don't get creative by staying in the same place" and that is why failure by the organization to change has been left behind in ethics related matter and this is the bone of contention between Ben and Shelby. In the cause/ effect aspect of a problem, the cause of the problem is failure to apply ethics when performing business operations and this has several effects to the business, employees and the customers. According to the case, the problems are as a result of failure to accept changes in business ethics. The assumption by Ben is that the business does not have to maintain ethical standards as doing so is likely to be costly to the business and since he is the senior loan officer, his decision are the best and does not consider the opinion of other members. Due to this fact, disagreement will arise between the members of the staff which is likely to cause disappointments to the customers as in the case where Shelby Grant refused to call customers to contribute prizes in fundraising picnic and his refusal to go and evaluate loan collateral. These problems can be solved through dialogue and constant education on changes in business ethical trends within organizations. Solution The best solution to tackle the ethical problem within the organization is through educating the staff about the importance of maintaining ethical standards within the business and allowing dialogue among different officials within the organization to iron out contentious issues and reach an amicable consensus on why and how to apply different ethics in business. Through education and dialogue, different view points will be considered and a solution obtained to ensure that all members comply with modern business ethical standards. This will also enhance consultation before any decision is made. Swot analysis of educating staff on ethics Strength: Through ethics education, members of staff will be taught new information about ever changing ethical trends in business cycle and so they will be able to cope with any change without much problems. Weakness: Since ethical issues within the organization are varied and ever-changing, education tend to be time consuming and most aspects of ethics are not likely to be covered. Opportunities: Education will arm the staff with business ethics that will

Saturday, August 24, 2019

Marine Organisation Essay Example | Topics and Well Written Essays - 2250 words - 1

Marine Organisation - Essay Example Management has to deal with many matters keeping external environment in mind. Its main concern is Bulk Carrier design and safety and this means that the importance attached to the safety of the ships is the main theme of the organisation. It has a technical committee called CASTEC, which meets twice a year to discuss technical matters, and deal with other connected issues. Bulk carrier design and safety had been of paramount importance and in late 1980s after some of them were lost and immediate programme had to be adapted with changes in the SOLAS Regulations and IACS rules. The main difference came with the introduction of new hull that would avoid considerable amount of damage and survive maximum amount of impact. IMO initiated a number of safety assessment studies, and the findings also had a number of recommendations and potential rules by December 2002, the SOLAS amendments were accepted by IMO, including the introduction of Double Skin Bulk carriers. Intercargo always works with close contact with IACS and the target had been designing and executing useful, safe, efficient and environmentally friendly sleek streamlined bulk carriers. It continues to monitor, research and understand the reasons of carrier losses and had been collecting all the statistics from 1990, and reports in its Bulk Carrier Casualty Report with analysis and pertinent answers to many hitherto unanswered questions. Number of cargo carriers and the lives of people employed in them, and the cargo are comparatively safer now. They have to make amenable rules so that the Port State Control’s rules and regulations are not flouted, as they are governed by the international conventions like SOLAS, STCW AND MARPOL that form the set of rules for the security, safety of the cargo ships. Pollution control in the high seas has become a matter of absolute concern for the shipping industry. We see many

The Relationship between Ornament and Light in New York City Assignment

The Relationship between Ornament and Light in New York City - Assignment Example This paper examines the association between light and ornament as two significant elements of architecture by critically examining the case of New York City. Moreover, the paper also assesses the perspective of whether light can be classified as an ornament by studying architectural examples across New York City. The significance of ornaments in architecture is reflected in their cultural value and the manner in which the placement of ornaments aids a viewer to establish a relation with the surrounding.2Moreover, the placement of an ornament also allows the beauty of a building to be communicated to the viewer.3In this case, the role of an ornament is to essentially convey a message regarding the architectural figure and represent the meaning of the building through its addition. In the realm of modern and innovative architectural progress, the utilization of three-dimensional ornaments has essentially established a vivid association between light and ornament. As noted by Strehlke and Loveridge, the integration of three-dimensional ornament permits the viewer to receive multiple messages regarding the figure through the presence of light and shadows on a range of varied angles.4 This notion establishes the significance of light within the context of ornaments and also suggests that light can serve a purpose which is similar to that of ornamentation in terms of fulfilling a decorative objective or conveying a specific message to the viewer. In this regard, light can be categorized as an ornament itself because it meets the objectives of ornamentation in an effective manner. In the case of New York City, the use of light as a form of ornament conveys the true meaning and essence behind the cultural heritage, diversity and spirit of the city. The primary example which highlights the vibrancy and effervescence of New York City is reflected in the

Friday, August 23, 2019

UNIT 4 INDIVIDUAL PROJECT Essay Example | Topics and Well Written Essays - 1750 words

UNIT 4 INDIVIDUAL PROJECT - Essay Example The company needs to target an unserved but profitable segment of the market to increase sales and boost image minus the fierce competition. Distribution channels. The company depends largely on department stores to sell its products. Reebok should explore other channels that would effectively promote the increased visibility of its products in the market. Intellectual property rights. The company produces its products through independent manufacturers in third world countries. Despite the enforcement of patent laws, knockoffs proliferate in many international markets which have an adverse affect on Reebok’s revenues. Our passion for winning creates our possibilities. We harness the boundless creative energy of every individual to make the differences that count - to captivate the consumer and create an exceptional global brand and organization. a. [Pros] Reduced production costs and lead time, increased gross margins in the long run and creates new sources of raw materials for footware product lines as well as develop more efficient distribution channels. a. [Pros] Reebok needs to stick to more conservative demand forecasts to effectively control marketing, advertising and other related expenses; minimize production problems, cut costs and generate adequate cash flow for debt servicing. 1. Recommending the implementation of the Market Development Strategy [Alternative 1] to increase brand value and gain a bigger market share, if not a controlling interest in the athletic shoes and sports apparel market. 5. Product lines intended for outdoor activities should also be developed apart from contact sports, with 40% of the subject segment looking for new outdoor activities, among them backpacking/hiking (47%), road biking (38%), camping (30%) and paddle sports (23%). (NPD Group, as cited in Rab, 2004) 1. Revamp of existing marketing platforms and repositioning to new segment must be

Thursday, August 22, 2019

Environmental Pollution Essay Example for Free

Environmental Pollution Essay 1. Effects on Climate Land pollution can affect the general environment of the Earth. Land pollutions leads to loss in the forest cover of Earth. This is in turn going to affect the amount of rain. Less rains mean lesser vegetation. The effect of all different kinds of pollution will eventually lead to problems like acid rains, greenhouse effect, global warming. All of these problems have already initiated and need to be curbed before the situation runs out of control. 2. Extinction of Species One of the major causes of concern is the extinction of species. Species are pushed towards endangerment and extinction primarily by two processes. Habitat fragmentation is the fragmentation of the natural habitat of an organism; cause primarily by urban sprawl. Habitat destruction, on the other hand, is when land clearing adversely affects animals special such that their natural habitat is lost. Both the actions can cause some species to go extinct and others to become invasive. 3. Biomagnification Biomagnification is the process in which certain non-biodegradable substances go on accumulating in the food-chain (in one or more species). The most common example is of methylmercury in fish and mercury in eagles. Not only does biomagnification put the particular species at risk, it puts all the species above and below it at risk, and ultimately affects the food pyramid. 4. Effects on Biodiversity Species extinction and biomagnification is going to overthrow the balance of nature very significantly. The main reason for this is disturbance created in the food chain. To give you a very simple example on account of biomagnification of mercury in eagles, they might go extinct in the subsequent years. However, we know eagles prey on snakes. Less (or no) eagles will then result in more number of snakes! As you may have realized, land pollution is indeed going to affect a lot more things than we though it will. Hence, I leave you with some corrective measure you can take on a personal level to reduce land pollution. Encourage organic farming buy organic food. Proper garbage disposal separate your garbage before you give it to the garbage collector; and strictly say NO to plastic. Encourage recycling buy recycled products, notebooks, paper, etc. Restrict use of herbicides and pesticides they are not only used in farm, but in your own backyard as well. If we reduce our contribution to garbage and litter, therein itself we will be able to significantly reduce land pollution and probably curb it entirely in the near future. Also do realize this isnt only about land pollution; it is about all kinds of pollution. We need to take steps to prevent damaging our Earth. We have no other place to go. Read more at Buzzle: http://www.buzzle.com/articles/causes-and-effects-of-land-pollution.html

Wednesday, August 21, 2019

Effect of THNPs on Heroin OD Mortality | Methodology

Effect of THNPs on Heroin OD Mortality | Methodology Chapter 2. Methods 2.1 Introduction This chapter contains a precise description of the process used to search and appraise the evidence for this systematic literature review. The search was carried out during August and September 2014. An in-depth description of how evidence and research available related to the PICO question were generated, will be discussed. As mentioned in the previous chapter, the aim of this dissertation is to determine the effect of THNPs to heroin users, on heroin OD mortality. The analysing process of the PICO question, whether THNPs reduces the incidence of fatal heroin OD deaths, will be amplified through a description of the actual search strategy, and the methods used to appraise the retrieved studies. Through specific criteria, a systematic approach was applied in obtaining and selecting the relevant literature. Identified keywords used for the search syntaxes will be presented, together with the databases used for the retrieval of evidence, and the number of hits produced from each database. Search syntax is the relationship of a sequence of words used in a search strategy. A discussion of the inclusion and exclusion criteria set for this systematic review (SR) will follow, together with the methods of appraisal chosen to evaluate the studies. 2.2 Keywords and databases used PICO Element Description Keywords Population Heroin injection users in the community heroin users, injection drug users, drug users, opioid users Intervention Take-home naloxone program take-home naloxone program, naloxone distribution program, Comparison No comparison Outcome Reduced incidence of fatal heroin OD deaths OD reversal, OD prevention, opioid OD prevention, heroin OD prevention, harm reduction According to Timmins and McCabe (2005) the cornerstone of an effective search strategy is the use of proper keywords. A number of keywords were formulated from the PICO question elements, and from the preliminary search of the literature. These were mainly identified from titles and keywords used in articles found from the preliminary search. Table 2.1 below, shows the keywords used in relation to each PICO element. Table 2.1 Keywords developed to describe the PICO framework The main electronic systematic search with the search syntaxes explained further on in this chapter was carried out using different databases accessed from the Hybrid Discovery (HyDi) available from the online library at the University of Malta. Relevant databases were found on HyDi by choosing the category ‘Health Sciences’ and sub-category ‘Nursing’ since the other sub-category is ‘Midwifery’ which is unrelated. Six databases were used to conduct a search for the literature. These were Academic Search Complete, Cumulative Index to Nursing and Allied Health CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, and Cochrane Database of SRs; via EBSCO host search engine together with Medline via ProQuest search engine, and Science Direct. In addition to these databases Google Scholar was also utilised, but the search syntaxes combinations could not be used since the search engine does not have an advanced search strategy, a nd the search resulted in large thousands of articles. Therefore simple keywords alone were used to search for any other relevant studies, or to obtain full text versions which are not available in other databases. Strengths and limitations of each database are described below in table 2.2. Database Strength Limitation Academic Search Complete Daily updates Provides full text journals Available only from EBSCO host CINAHL Plus with Full Text Weekly updates Over 950 journals Covers references and abstracts from 1982 onwards Available only from EBSCO host English and American language bias Cochrane Library Cochrane Central Register of Controlled Trials Cochrane Database of SRs Research analyzed using trustworthy methods Large source of literature Up-to-date Complete text reviews Limited by restrictions Medline Records indexed with Medical Subject Heading (MeSHÂ ®) Provides a large source of life sciences evidence needed by health professionals Limited by restrictions Science Direct Provides full text from Elsevier Science journals Provides full text articles Limited by restrictions Google Scholar Free access web based search engine Large amount of results due to lack of an advanced search strategy Table 2.2 Databases strengths Limitations 2.3 Inclusion and Exclusion Criteria For readers to assess reliability and validity of a SR they have to be provided with a set of inclusion and exclusion criteria (Cronin, Ryan, Coughlan, 2007). Furthermore, Torgerson (2003) suggests that a set of inclusion and exclusion criteria are important so that throughout the search, only the articles that will answer the PICO question are extracted while others are eliminated. During the preliminary search it was noted that literature about the subject lacks randomized controlled trials (RCTs’), meta-analysis, and SRs. As shown in figure 2.1, these study designs are found at the top of the hierarchy of evidence as described by Aslam et.al (2012). Hence, all types of study designs were part of the inclusion criteria. Sibbald Roland (1998) said that clinical trials are known to be a gold standard to perform good evidence based practice and although they were in the inclusion criteria, the results were negative since up-to date no RCTs have taken place. Although this is a major limitation for this literature review, one must keep in mind that currently, the first and largest RCT is being carried out as described in chapter 1. Source type selected in all databases was ‘Academic Journals’ since books, newspaper articles, and magazines are not of strong evidence for evidence based healthcare because sometimes they do not have any type of study design, and may be narrative. Each search was limited to English language literature only. Studies that administered intranasal (IN) naloxone were excluded since this method is an off-label method (Doe-Simkins, Walley, Epstein, Moyer, 2009), and in an RCT by Kelly et al. (2005) it was found that IM naloxone was clinically more effective than IN naloxone (6 minutes vs 8 minutes). Table 2.3 and table 2.4 below describe further in detail the inclusion and exclusion criteria respectively. Figure 2.1 The Hierarchy of Evidence Pyramid (adapted from Aslam et al. 2012, p.3) Table 2.3 Inclusion Criteria Inclusion Criteria Rationale Literature had to be in English language Not possible to translate to English Studies published from 1980’s till September 2014 Studies about THN commenced in the 90’s, and so all studies are obtained (Darke Hall, 1997) Involving heroin injection drug users above 18 years of age Since the population are adults injecting heroin, and in all studies found, drug users were of 18 years and above Involving THNP Since this review concerns the outcome of THNP Experimental studies including RCTs’, reviews, observational studies including cohort studies and longitudinal studies To include all study designs and to not eliminate valuable literature Study needed to have an outcome of survival rates or OD reversals associated to THNP If outcomes were different, studies would not answer the PICO question Exclusion Criteria Rationale Studies researching attitudes, views and opinions of health care practitioners providing THN and other stakeholders such as police Outcome of studies unrelated to PICO question Studies about experiences of fatal OD victims where naloxone was not provided to heroin users as a preventive measure of fatal OD Studies had to have THNP studied as a preventive measure rather than other measures Development of instrument tools for THNP evaluation These instruments do not answer the PICO question Users of prescription opiates including methadone Since population is specifically heroin injection drug users Studies including HIV, AIDS, buprenorphine, methadone, and supervising injecting facilities as a main topic For the fact that THNP is the main subject and intervention of this SR Studies were intra nasal naloxone was used Naloxone nasal spray is not yet approved or licensed anywhere in the world Studies where naloxone was not administered by any of the participants The outcome was not attributed directly to naloxone administration Studies not published in English Not possible to translate to English Table 2.4 Exclusion Criteria 2.4 Search Strategy The keywords mentioned in table 2.1 were developed so that each PICO element has its own search syntax as identified by Bettany-Saltikov, (2012). The use of search syntaxes has assisted in narrowing the search to the most relevant studies to the PICO question. Table 2.5 below, shows the search syntax used for each PICO item. PICO element Search syntax number Search syntax Population Search syntax 1 heroin users OR injection drug users OR drug users OR opioid users Intervention Search syntax 2 take-home naloxone program OR naloxone distribution program Outcome Search syntax 3 overdose reversal OR overdose prevention OR opioid overdose prevention OR heroin overdose prevention OR harm reduction OR overdose mortality Table 2.5 Search syntaxes Search syntaxes were combined as described here: Population (syntax 1) AND Intervention (syntax 2) Population (syntax 1) AND Outcome (syntax 3) Intervention (syntax 2) AND Outcome (syntax 3) Boolean logic operator ‘OR’ was used to combine each keyword of each PICO element syntax, while the operator ‘AND’ was used to combine the PICO elements together as described above. In all search fields of the databases used except Google Scholar, ‘In All Text’ was selected for all searches. In Google Scholar the keywords searched independently were ‘take-home naloxone’ and ‘naloxone distribution’. These keywords were searched in titles only, since when searched for anywhere in the article the results were over 50,000 with most of them irrelevant to the dissertation. As shown in table 2.6 below, the defined search resulted in 2,260 articles. After the titles were evaluated whether they fit with the inclusion and exclusion criteria mentioned previously, and removing duplicate articles the search results were reduced to 160 articles by reading through the titles. The abstracts of these 160 articles were read and consequently 25 articles were noted to be directly related to the PICO question addressed in this dissertation, as they all met the inclusion criteria. One of the 25 articles which is a study by Lenton Hargreaves (2000) was not available online for free. The author, Professor Lenton was contacted via e-mail. Fortunately there was an immediate response, and the article was provided for free. However, after reading these 25 articles, 15 were eliminated because they had one or more of the exclusion criteria fit. The remaining 10 articles were identified and had fit all of the inclusion and exclusion criteria and were chosen for the critical a ppraisal of this systematic literature review. Furthermore the search was enhanced by looking up at all the reference lists of the final articles chosen for critical appraisal, but no new studies were found. Identified studies for critical appraisal are the following: Strang et al. (2008), Piper et al. (2008), Tobin, Sherman, Beilenson, Welsh, Latkin (2009), Enteen et al. (2010), Wagner et al. (2010), Bennett, Bell, Tomedi, Hulsey, Kral (2011), Bennett Holloway (2012), Lankenau et al. (2013), Banjo (2014), and Clark, Wilder, Winstanley (2014). In addition to the electronic search, a hand search was done within the University of Malta library which did not produce any results. Table 2.6 below presents the number of hits obtained from each of the databases above and the different search syntaxes combination. Database Keywords Number of hits Academic Search Complete search syntax 1 AND search syntax 2 274 search syntax 1 AND search syntax 3 272 search syntax 2 AND search syntax 3 55 CINAHL Plus with Full Text search syntax 1 AND search syntax 2 7 search syntax 1 AND search syntax 3 114 search syntax 2 AND search syntax 3 10 Cochrane Central Register of Controlled Trials search syntax 1 AND search syntax 2 0 search syntax 1 AND search syntax 3 0 search syntax 2 AND search syntax 3 0 Cochrane Database of SRs search syntax 1 AND search syntax 2 0 search syntax 1 AND search syntax 3 1 search syntax 2 AND search syntax 3 0 Medline search syntax 1 AND search syntax 2 31 search syntax 1 AND search syntax 3 228 search syntax 2 AND search syntax 3 28 Science Direct search syntax 1 AND search syntax 2 532 search syntax 1 AND search syntax 3 485 search syntax 2 AND search syntax 3 145 Google Scholar take-home naloxone, naloxone distribution 78 Total number of literature found = 2,260 Table 2.6 Number of articles found from each search 2.5 Refining of the research question After finding the relevant literature to the original PICO question, and considering properly the population being studied, the research question was duly refined since this systematic literature review will be based on the impact of THNP effect on heroin OD deaths amongst heroin injection drug users. Initial PICO question was: ‘Do naloxone take-home programs provided to drug users in the community reduce the incidence of fatal opioid OD?’ The question was refined to: Do naloxone take-home programs reduce the incidence of fatal heroin OD amongst heroin injection users? The refining of the PICO question was essential since some of the literature concerned prescription opioid users or general drug users, but the reviewer’s main interest is heroin injection users. 2.6 Methods of Appraisal After identifying the relevant studies and refining the PICO question, the next step for this dissertation was to critically appraise the literature. This will be covered in chapter 3. Critical appraisal is the evaluation of strength and quality of research studies in order to deliver evidence-based clinical decisions and after determining the worthiness of different studies through the use of different critical appraisal tools, multiple research findings can be synthesized together to develop evidence-based-practice (LoBiondo-Woods Haber, 2013). Furthermore, Burls (2009) argues that studies being biased can result in false outcomes and conclusions, because they are not composed of an acceptable quality. A bias is an orderly deviation of the results occurring from the way that a study is led, investigated or reported. In light of this, critical appraisal tools were developed to help researchers in identifying valid and reliable studies. Specific critical appraisal tools in the form of checklists are used to analyse different study designs. Commonly used appraisal tools are: Critical Appraisal Skills Programme (CASP) Scottish Intercollegiate Guidelines Network (SIGN) Centre for Evidence Based Mental Health (CEBMH) Critically Appraise Topic (CAT) After studying and considering all of the above methods of appraisal, together with other appraisal tools, it was decided that the CASP appraisal tools are to be used for critically appraising the identified studies relevant to the PICO question. The reason for choosing the CASP appraisal tools is because it is clear, concise, and easy to understand. CASP offers different checklists appropriate for different research designs where one can critically evaluate research through a set of questions and helps in determining the quality of the literature being appraised. At this phase, the studies were also rated and arranged according to the hierarchy of evidence adopted from Aslam (2012) as shown in figure 2.1. 2.7 Conclusion In conclusion, the study’s main objective is to determine whether THNPs reduces the mortality rate of heroin OD. Several keywords were identified from the PICO question elements, and from preliminary search results. These keywords were systematically searched in different databases using different search syntaxes combinations. A set of inclusion and exclusion criteria were then set up in order to get to the studies relevant to the PICO question. PICO question was then refined and then it was decided to use the CASP appraisal tools for evaluating the relevant studies which will be discussed in the next chapter. Words 1763

Tuesday, August 20, 2019

Global issue in nursing shortage

Global issue in nursing shortage The increase in nursing shortage is a global issue. The rate of turnover and migration through health care system professionals is highly increasing which cause shortage in some countries or hospitals. This shortage is considered vital as it affects patients health status and quality of delivered care. In order to achieve health care effectiveness, health care systems have to overcome the shortage of qualified health personnel. Hiring graduated nurses and retaining employed staff nurses is very essential. The aim of this paper is to discuss generally the global nursing shortage and particularly the nursing shortage in UAE. Nurses play an important role in health care systems as they are considered the front line of any health care system. The crisis of nursing shortage is highly increasing worldwide. Buchan Aiken, (2008) defined nursing shortage as the unwilling to work in specific conditions rather than the shortage of people having nursing qualifications. Health care systems face difficulties in recruiting retaining nurses due to two reasons; nursing shortage and staff turnover. For example, the turnover rate in USA in year 2000 was between 10%- 30%, while in UK it was between 15%- 20% (Zurn et al. 2005). Turnover can be either voluntary like looking for a better income or better working conditions, and less work stress and overload, or involuntary like dismissal or medical disability. However, nursing shortage is considered a problem due to aging population, population growth and higher patient expectations (Simoen et al. 2005). In USA, the ratio of nurse: patient is 10:1000, while in Asia and Afr ica it is 0.5:1000 which is huge shortage (Buchan Aiken, 2008). The impact of nursing shortage Nursing shortage has a depressing impact on health care systems. The inability to overcome this shortage will affect the improvement of health care systems. Nursing shortage can be noted when there is an imbalance between nursing skills and the actual number of nurses (Buchan Aiken, 2008). On the other hand, not all available nurses are willing to work in their field due to payment and benefits issues which make them to choose non-nursing employment or no employment. Moreover, the shortage is widely noted in nurses who have specialty in some areas like critical care or emergency (Kingma, 2007). Causes of nursing shortage There are plenty of factors which lead to nursing shortage like decrease number of new recruited staff, inappropriate use of nursing skills, inadequate career support, gender-based discrimination in some cultures, and poor recruitment policies (National Center for Health Workforce Analysis, 2007; Buchan, 2006). Nurses keep searching for better opportunities to improve their skills, knowledge, and economic level. Therefore, nurses migrate from one country to the other. Barriers to nursing migration When nurses take the decision to migrate they keep in consideration some obstacles that they might face.   One important issue to think about is certificate accreditation and requalification process. Other issues include the cost of living, the need to learn new language, and adapting a new clinical environment (Chandra and Willis, 2005; Kingma, 2006). Socially, there are some other barriers to migration; leaving families to stabilize persons condition, facing new culture and environment, and racism which may lead to discrimination (Chandra and Willis, 2005). Ways to decrease turnover rate In order to overcome turnover problem, health care systems have to change their style of management. One way is by involving staff in decision making which make staff responsible. Promotions are also considered another way of decreasing turnover rate as staff will remain in hospitals to achieve and reach better positions. Moreover, staff self-scheduling is a good way of decreasing turnover rate as some staff dont like to work weekends, nights, or overtime (Stordeur Hoore, 2006). Nursing shortage in UAE Nowadays Emirati women have the right to join different educational and working fields. They are supported by low and government to improve their selves. However, Emirati women are not very involved in all fields like nursing. The dependency on expatriate nurses in UAE is very considerable as the percentage of Emirati national nurses is only 3% (FDON 2003). In 1960s, expatriate nurses started to turn up in UAE, while there were basic healthcare services in some areas like Dubai and Ras Al Khaima (al Rifai et al, 1996). As stated by Al Rifai Van Der Merwe (2002), the MOH is the largest health care source and it has more than 17000 employees, 10000 from different countries and backgrounds. Around 6000 work in MOH and the rest are divided in the privet sector (Al-Rifai van der Merwe2002). Disadvantages of hiring expatriate nurses Delivering the appropriate nursing care with respect to cultural and back ground differences is threatened by hiring expatiate nurses who are sometimes not fully aware of the surrounding culture. This issue may develop a conflict between nurses and patients, and increase the gap between them. However, this conflict may affect the quality of nursing care as nurses may try to enforce their own believes and values on patients. On the other hand, patients might be affected by not continuing treatment or following the treatment regimen properly because of stress, cultural conflict and ethical issues (El-Haddad, 2006). Factors that lead to nursing shortage in UAE There are some factors that lead to low percentage of national nurses in UAE. An important factor is gender-bias; the general idea in the country is that women have to take care and nurse their own families and that nurses are the handmaids for doctors. Another factor is the difference in nursing programs with the lack of updated educational resources. One more, is the low English level of students with the lack of Arabic educational resources (El-Haddad, 2006). Establishing Federal Department of Nursing Emirates Nursing Association Federal Department of Nursing was established in 1992 by MOH. A team of professional nurses and administrative staff were specially made to evaluate the nursing profession (Al-Rifai van der Merwe2002). On the other hand, the establishment of Emirates Nursing Association started much earlier; in 1970s. To start with the process of establishing an association there should be 50 national nurses according to UAE low. The effort remained over 30 years until finally in 2001 national nurses were able to start the Emirates Nursing Association which was considered an important event in the history of UAE. Since that time nationals started to join nursing field and be effective members within the health care system (El-Haddad, 2006). WHO recommendations to improve nursing programs According to (WHO, EMRO, 1998) recommendation in 1995, nursing programs have to be standardized within 15 years. The program would be designed as a four years university program with a certificate of bachelor of nursing science. On the other hand, nurses who have diploma degree will have the chance of continuing their education by joining bridging programs, which is encouraged and supported by the government until all nurses within the 15 years period time will have the BSN degree. This program will improve the nursing education and will improve the quality of care in the health care system. Nurses will be more updated and will have a solid base to build on their skills and experience, and will be able to work according to high level of standards. With regards to patients, patient will have better outcomes as they will be receiving a high quality of care. On the other hand, the number of practical nurses who depend on skills only will decrease by time (WHO, EMRO, 1998). Conclusion To conclude, there is a global nursing shortage worldwide. Population growth, searching for a better income and being involved in a better working environment are causing nurses to migrate from one country to the other; causing an increase demand of recruiting and retaining nurses. In UAE, nursing profession started to improve and develop recently. The need for a high number of national nurses made the government to encourage students by giving them a high standard level of education, higher income, and improving staff by giving them the chance of continuing education. The mission of government by this development is to prove the effective role of national nurses, overcome nursing shortage in UAE, and to improve the quality of care being delivered to patient as their expectations and level of knowledge are increasing. In my opinion, nurses are the forefront in the health care system and the better the level of nurses the system has, the better outcomes achieved. References Al- Rifai, F. et al, (1996). The Nursing Profession and Future Directions in Arab GCC States [Arabic Document]. Executive Board of the Council of Arab GCC States Health Ministers, Riyad. Al-Rifai, F. van der Merwe, A., S., (2002). Licensing and regulation of nurses in the United Arab Emirates. In policy and politics in Nursing and Health Care (Mason, D., Leavitt, J. Chaffee, M. eds). Sounders, St. Louis, MO, PP. 728-734. Buchan, J. Aiken, L., (2008), Solving nursing shortages: a common priority, Journal of Clinical Nursing, 17, 3262-3268. Buchan, J., (2006). Evidence of nursing shortage or a shortage of evidence?, Journal of Advanced Nursing, 56, 457- 458. Chandra, A., and Willis, W. K. (2005). Importing Nurses: Combating The Nursing Shortage. (In Context. Healthcare and Public Policy). Hospital Topics 83 (2): 33-7. El-Haddad, M., (2006). Nursing in The United Arab Emirates: an historical background, International Council of Nurses, 284-289. Federal Department of Nursing FDON), MOH, UAE(2003), Annual Report. FDON, Abu Dhabi. Kingma, M. (2007). Nurses on the Move: A Global Overview, Health Services Research 42:3, part2, 1281-1298. Kingma, M., (2006). Nurses on the Move: Migration and the Global Health Care Economy. Ithca, NY: Cornell University Press. National Center for Health Workforce Analysis (2007). Toward a Method for Identifying Facilities and Communities with Shortages of Nurses, Summary report. US. Department of Health and Human Services, Health resources and Services Administration, Bureau of Health Professions, Washington DC. Simeon, S., Villeneuve, M. Hurst, J. (2005). Tackling Nurse Shortages in OECD Countries. OECD Health working Papers 19, DELSA/ ELSA/ WD/HEA (2005). Stordeur, S., Hoore, W., (2006). Organizational configuration of hospitals succeeding in attracting and retaining nurses, Journal compilation, 45-57. World Health Organization-Eastern Mediterranean Regional Office (WHO-EMRO), (1998). Nursing Education in The Eastern Mediterranean Region- Guidelines   on Future Directions [EMRO Technical Publication Series 26]. World Health Organization-Eastern Mediterranean Regional Office, Alexandria. Zurn, P., Dolea, C., Stilwell, B., (2005). Nurse Retention and Recruitment: Developing a Motivated Workface, World Health Organization Department of Human Resources for Health, ICN 2005, Issue 4, Geneva, Switzerland.

Monday, August 19, 2019

The Cause of World War I Essay -- World War 1 One WWI First History Es

The Cause of World War I I Feel that there many reasons for the start of the First World War and not just one, I think it’s a bit more complicated than that. I have put them into six categories but could be split into more if necessary. All the categories concern the main powers of Europe. The war was mainly started by feuds between the powers. There are alliances between the powers, ‘ The Triple Alliance, ’ which contained: Germany, Austria and Italy. ‘ The Triple Entente, ’ which contained: Great Britain, Russia and France. The trigger to the war I feel was the Franz Ferdinand incident. Franz Ferdinand, the heir to the Austrian-Hungry throne, on the 28th of June 1914 was attempted to be assassinated. The incident happened when a grenade hit his car, injuring an officer. Later on that day on his way to visit the officer in hospital, his driver took a wrong tern straight past Principe of the ‘Black Hand’ movement, who killed the Archduke and his wife. The next event in the chain was that because the Serbs want there people freed they cause up roar, as they are a Nationalist group. Serbia was commanding that they handed over Bosnia. Austria-Hungry after the Archduke being killed feel that they have to go to war with Serbia, but don’t want to as they know that if they do Russia will get involved, as there so many Slavs in Russia. Austria-Hungry go to Germany to ask for there backing in the war. On the 23rd of July, knowing that they will have Germanys backing, send ...