Disclosure and Reporting of Governance Practices by Australian Residential Aged Care Providers: Accountability to Stakeholders

The Residential Aged Care (RAC) Sector in Australia is significant in terms of the ageing population (consistent with most developed countries), and the fact that it will affect the majority of the population in terms of the need for RAC at some stage in their lives. Having access to information for stakeholders to make informed and timely decisions regarding the comparison of RAC providers is often difficult due to there being higher demand than supply, small timeframe to make decisions with a high emotional content and the difficulty in changing providers. Information was gathered from the RAC provider\u27s website, reports and other publicly available information, to determine their level of governance disclosure, over a three year period. It was found that the RAC providers should not just be limited to their legal reporting requirements (mandatory), but instead should also endeavour to disclose additional voluntary information, in order for their stakeholders to make informed decisions. In addressing the Australian RAC Sector\u27s stakeholder governance information needs, a governance framework (RAC Sector Governance Framework) and the G-CARD (Governance Checklist Aged Residential Disclosure) Model were developed for this sector to improve governance disclosure. This research provides new insights and a basis for further research to determine whether the Australian RAC Sector have improved their consistency and adequacy of their governance disclosure through the use of the proposed G-CARD Model and associated framework

Financial Disclosure by Australian Residential Aged Care Providers: Are They Suffering Dementia?

Australia’s Residential Aged Care (RAC) Sector is significant in terms of its ageing population, which is consistent with most developed countries. It is therefore vital for stakeholders to have access to RAC providers’ financial information to make informed and timely decisions. It is often difficult for stakeholders to accurately compare the financial information of RAC providers due to there being a small timeframe to make decisions with a high emotional content. This research will enable RAC providers and their stakeholders to consider the current level of disclosure required and the level of voluntary disclosures providers in the sector choose to disclose, and whether this level of disclosure is adequate for stakeholders to make informed decisions. Information was gathered from the RAC provider\u27s annual and/or financial reports, to determine their level of financial disclosure, over a three year period. It was found that the RAC providers’ level of financial disclosure could be more consistent and adequate by complying with the Australian Financial Reporting Framework, including an independent Audit Report. Hence, this research provides new insights and a basis for further research to determine whether the Australian RAC Sector have improved their consistency and adequacy of their financial disclosures through the use of the proposed RAC GPFR Framework

The Labyrinth of International Governance Codes: The Quest for Harmonization

The background to this research is based on the considerable debate as to whether there will ever be one international currency, one “business” language spoken or one set of accounting standards applicable to all businesses listed in various countries stock exchanges. Governance principles are no different! Is it possible to create one set of rules or principles to guide all businesses across borders? This research compares the governance standards and regimes across the globe, from China, to the Nordic region (Sweden, Norway, Denmark, Iceland & Finland), Europe, Asia-Pacific (New Zealand, Australia) and the United States of America. Using archival data, governance codes from around the world are compared and contrasted. The findings show that across borders governance codes are very similar, with the opportunity to create a Global Governance Standard (GGS), applicable to any business in any country. The Global Governance Standard (GGS) is a one-size-fits-all regime applicable to businesses listing on stock exchanges. The GGS is not unlike the harmonisation of accounting standards. The “one-size-fits-all” GGS could potentially apply to any large business, listed on any stock exchange, creating efficiencies and ease of comparison for potential stakeholders interested in businesses. The “BOARDSS” model can be used by listed companies, in order to satisfy corporate governance codes from across the globe. Board: to ensure the board are selected carefully. Open: The make sure that the board is transparent and accountable. Auditor Independence: ensure accounts are audited by an independent auditor. Remuneration: the CEO and executive staff are reviewed, and supported by a smaller remuneration committee. Directors are selected for their ability to “add-value” to the strategic direction of the company, and the support of the CEO. Directors’ performance should be reviewed annually. Reducing the labyrinth of governance codes to just one GGS would create a uniform approach to governance, supported by government and stock exchanges around the world. A GGS would be the final evolution in the notion of governance since the codes of conduct of Hammurabi of 1800 BC. Let the borders be gone, and the Global Governance Standard (GGS) left standing as the final chapter in governance evolution

Planktonic foraminifera organic carbon isotopes as archives of upper ocean carbon cycling.

The carbon cycle is a key regulator of Earth's climate. On geological time-scales, our understanding of particulate organic matter (POM), an important upper ocean carbon pool that fuels ecosystems and an integrated part of the carbon cycle, is limited. Here we investigate the relationship of planktonic foraminifera-bound organic carbon isotopes (δ13Corg-pforam) with δ13Corg of POM (δ13Corg-POM). We compare δ13Corg-pforam of several planktonic foraminifera species from plankton nets and recent sediment cores with δ13Corg-POM on a N-S Atlantic Ocean transect. Our results indicate that δ13Corg-pforam of planktonic foraminifera are remarkably similar to δ13Corg-POM. Application of our method on a glacial sample furthermore provided a δ13Corg-pforam value similar to glacial δ13Corg-POM predictions. We thus show that δ13Corg-pforam is a promising proxy to reconstruct environmental conditions in the upper ocean, providing a route to isolate past variations in δ13Corg-POM and better understanding of the evolution of the carbon cycle over geological time-scales

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Forouzanfar MH, Afshin A, Alexander LT, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. LANCET. 2016;388(10053):1659-1724.Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57.8% (95% CI 56.6-58.8) of global deaths and 41.2% (39.8-42.8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211.8 million [192.7 million to 231.1 million] global DALYs), smoking (148.6 million [134.2 million to 163.1 million]), high fasting plasma glucose (143.1 million [125.1 million to 163.5 million]), high BMI (120.1 million [83.8 million to 158.4 million]), childhood undernutrition (113.3 million [103.9 million to 123.4 million]), ambient particulate matter (103.1 million [90.8 million to 115.1 million]), high total cholesterol (88.7 million [74.6 million to 105.7 million]), household air pollution (85.6 million [66.7 million to 106.1 million]), alcohol use (85.0 million [77.2 million to 93.0 million]), and diets high in sodium (83.0 million [49.3 million to 127.5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Copyright (C) The Author(s). Published by Elsevier Ltd

Do Governance Borders Really Matter?: The Labyrinth of Interwoven International Governance Codes, the Ongoing Evolution into One Regime

There is much debate as to whether there will ever be one international currency, or one ‘business’ language spoken, one set of accounting standards applicable to all businesses listed in various countries stock exchanges. Governance principles are no different. Is it possible to create one set of rules or principles to guide all businesses across borders? This research compares the governance standards across the globe, from China, to the Nordic region, Europe, Asia-Pacific and the United States of America. The question is asked, will there ever be one ‘governance regime’. The findings show that across borders governance codes are very similar, with the opportunity to create a Global Governance Standard (GGS), applicable to any business in any country. The ‘one-size-fits-all’ GGS could potentially apply to any large business, listed on any stock exchange, creating efficiencies and ease of comparison for potential stakeholders interested in the business. Reducing the labyrinth of governance codes to just one would create a uniform approach to governance, supported by government and stock exchanges around the world, the GGS would be the final evolution in the notion of governance since the codes of conduct of Hammurabi of 1800 BC. Let the borders be gone, and the GGS left standing as the final chapter in governance evolutio

Disclosure and Reporting of Governance Practices by Australian Residential Aged Care Providers: Accountability to Stakeholders

The Residential Aged Care (RAC) Sector in Australia is significant in terms of the ageing population (consistent with most developed countries), and the fact that it will affect the majority of the population in terms of the need for RAC at some stage in their lives. Having access to information for stakeholders to make informed and timely decisions regarding the comparison of RAC providers is often difficult due to there being higher demand than supply, small timeframe to make decisions with a high emotional content and the difficulty in changing providers. Information was gathered from the RAC provider’s website, reports and other publicly available information, to determine their level of governance disclosure, over a three year period. It was found that the RAC providers should not just be limited to their legal reporting requirements (mandatory), but instead should also endeavour to disclose additional voluntary information, in order for their stakeholders to make informed decisions. In addressing the Australian RAC Sector’s stakeholder governance information needs, a governance framework (RAC Sector Governance Framework) and the G-CARD (Governance Checklist Aged Residential Disclosure) Model were developed for this sector to improve governance disclosure. This research provides new insights and a basis for further research to determine whether the Australian RAC Sector have improved their consistency and adequacy of their governance disclosure through the use of the proposed G-CARD Model and associated framework

The Alzheimer\u27s Approach to Financial Disclosure: The Case of Australian Residential Aged Care Providers

There can little doubt that would be residents, their relatives and those acting on their behalf, would like to be able to choose which aged care facility best meets the financial and care positions of their relatives and loved ones. There is equally no doubt that those who run such aged care facilities are in the best position to provide such information. But, the analysis which has preceded above indicates that they generally have failed to do so. The Models and Frameworks presented in this paper were developed to address this lack of adequate and consistent disclosure in the Australian RAC Sector. The results show that the sector itself is suffering Alzheimer’s disease, with a lack of transparency, accountability and general disclosure