Accounting for hospices: Palliative care at risk

This paper is based on a presentation given at the British Accounting and Finance Association 46th Annual Conference in 30 March to 1 April 2010 at Cardiff City HallThis article is concerned with how the Government’s end of life care strategy seeks to draw upon the capacity and additional choice provided by voluntary charitable hospices in England. Constructing a hospice financial business model we consider the extent to which the policy intersection outlined in the Governments End of Life Care Strategy between Primary Care Trust (PCT) commissioning and the contribution of voluntary hospices is robust or fragile going forward

Teaching Accounting and Finance to non-specialists: revealing the students' perspective on the learning experience

This study is concerned with the non-specialist accounting and finance students’ perspective on the usefulness, scope, and practical application of relevant modules within their program of study. It also evaluates relevant teaching and learning approaches adopted by accounting academics teaching non-specialist - instead of introductory - accounting modules, through revealing the students' perceptions on the effectiveness of these approaches in creating a high quality learning experience. Lectures' teaching competencies are rated first in terms of importance for their learning experience by the vast majority of students. Issues relevant to the curricula's 'real world' application, as well as, the development of clear links between lecture material and assessment practise, engrossed considerable attention by the respondents. Education technology and reading material on the other hand appeared to be of prior importance for a smaller number of students

Business models in health care: Accounting for the sustainability of palliative and end of life care provision by voluntary hospices' in England

This study evaluates the sustainability of palliative and end of life care provision by voluntary hospices in England. Using a mixed methods, inductive approach, we construct a ‘descriptive business model’ for hospices which is grounded in analysis of relevant accounting information, and supported by narratives extracted from interviews with senior clinical and non clinical managers from four large and medium sized hospices. The study reveals the strengths and weaknesses of the hospice business model and evaluates its robustness against forthcoming challenges. Our findings highlight the gradual transition from a basic voluntary sector business model to a complex, highly sophisticated, and institutionalized care establishment, sharing many of the characteristics found in large private and public organizations. The sustainability however of the business model is threatened due to its exposure to a number of contradictory forces. Whilst demand for palliative and end of life care going forward is set to increase, due to both demographic and regulatory factors, hospices' voluntary income is highly volatile. Dependency on sustaining a complex network of stakeholder groups to underwrite income, challenges the hospice business model’s ability to cope with the anticipated challenges

Ascertaining the impact of endogenous and exogenous factors on the performance of students taking non-specialist accounting courses

This study aims to evaluate the potential determinants of academic performance of non-specialist accounting students. Considering both actual and initially expected performance, in conjunction with students’ learning styles and preferences, we use two econometric methods - Ordinal Probit and Ordinary Least Squared - in order to investigate and assess the impact of endogenous and the exogenous factors on the students’ academic achievement. Eventually, based on the results of our estimations, and by dividing the non-specialist students into segments, according to their demographic characteristics, we run a series of simulations to estimate empirically the likelihood of the students to report an academic performance weaker, in line, better, and considerably better than what they expected

Accounting for the Hospice Business Model in England

PhDThis thesis evaluates the viability of palliative and end of life care provision by voluntary hospices in England. Literature on voluntary hospices’ management and financial feasibility is fragmented and scattered within and across academic and practitioner discourses. It can still however be consolidated to lay the foundations for developing a study that reveals how charitable income streams, donated to underwrite hospices’ activity, are significant relative to Government funding. Using a mixed methods, inductive approach, I construct a ‘descriptive business model’ for hospices which is grounded in analysis of relevant accounting information, and supported by narratives extracted from interviews with senior clinical and non clinical managers from four large and medium sized hospices. The study reveals the strengths and weaknesses of the hospice business model and evaluates its robustness against forthcoming challenges. The thesis findings highlight the gradual transition from a basic voluntary sector business model, to a complex, highly sophisticated, and institutionalized care establishment, which is sharing many of the characteristics found in large private and public organizations. The sustainability however of the business model is threatened due to its exposure to a number of contradictory forces. Whilst demand for palliative and end of life care going forward is set to increase, due to both demographic and regulatory factors, hospices' voluntary income is highly volatile. Dependency on sustaining a complex network of stakeholder groups to underwrite income, challenges the hospice business model’s ability to cope with the anticipated challenges

A Grounded Theory to Map the Territory of Saudi Corporate Social Responsibility Reporting

This study investigates the practice of corporate social responsibility reporting (hereafter CSRR) in the context of Saudi Arabia. The investigation encompasses a detailed description of corporate social responsibility (hereafter CSR) perception, CSR implementation and CSRR; and an interpretation for reporting practice. The interpretation seeks to provide a grounded theory that is capable of offering a plausible explanation for what shapes this reporting. In addition, the study examines and links the drivers and desired outcomes of CSRR. A primarily interpretive philosophical assumption was employed in the study, utilising the grounded theory methodology and semi-structured interviews as a tool for data collection. The data were collected through three phases of interviews with participants from the Saudi petrochemical and energy industry. The personnel chosen to participate in the research were those with direct CSR involvement who were empowered to make decisions; most of them were leaders or managers. The first two phases were designed to elicit what is understood by CSR within Saudi companies, how it is implemented and how it is then reported. These two phases built the preliminary concepts and categories of the open and axial coding analysis. The third phase of interviews were then used to construct the selective codes and to identify the core concept in order to generate the theory. The use of the grounded theory methodology exactly as instructed is largely absent from the CSR literature. The first part of the findings provides a description of CSR practices. It reveals that despite the uncertainty regarding exactly what CSR means to Saudi companies and what it involves, CSR is perceived as an important concept. A gap between how it is perceived and how it is to be implemented as well as a lack of a systematic CSR strategy and performance measurements were evidenced. CSR is implemented as ‘external’ to business operations and there is a lack of creativity. There is also evidence of a gap between CSR implementation/activities and CSRR. CSRR is arbitrary and inconsistent, lacks a formal mechanism, has many transparency issues, and gains less attention than CSR activities. The second part of the findings- built utilising the first part- presents a grounded theory that is induced to interpret the reporting practices of Saudi companies. The generated theory is illustrated in a textual and diagrammatical model that maps the territory of Saudi CSRR. Based on the managerial perspectives, the map explains what forms and shapes the reporting practices, illustrating and identifying accountability (both tacit and/or explicit) as the core concept/engine of the CSRR mechanism. Accountability in this grounded theory not only reenergises the conventional importance of the concept but also extends its scope. Therefore, accountability is not only society-centred but also organisation-centred. The study concludes by suggesting a number of broad proposals and recommendations for future research and practice, which were developed by considering the challenges faced by companies that were captured during the analysis. It is hoped that the recommendations will improve CSRR

Reinvigorating research on sustainability reporting in the construction industry: A systematic review and future research agenda

Data availability: Data available on request from the authors.Copyright © 2023 The Author(s).. This study investigates sustainability reporting (SR) in the construction industry, which is vital to achieving sustainable development goals. Despite extensive research on sustainability practices, scant attention has been paid to SR, a crucial channel for communicating and managing sustainability performance. Aiming to advance SR research, this study systematically reviews 150 articles on the topic in 73 journals. The review reveals significant knowledge gaps and methodological limitations, highlighting the need for a more diversified theoretical lens for evaluating the complex nature of SR. The investigation identifies four study themes: assessment and indicators, determinants, strategic management, and outcomes of SR. The review offers a comprehensive analysis of the current literature and presents an integrated framework that encompasses sustainability attributes and reporting in the construction sector. The study’s contributions include directions for future research and practical implications for managers and policymakers that can support the transition toward sustainable development in the construction industry

Parathyroid autotransplantation in extensive head and neck resections: case series report

Permanent or temporary hypoparathyroidism may be a debilitating result of radical cervical surgery, as noted most commonly following thyroid or parathyroid surgery. However, it can also be the outcome of any surgical procedure involving bilateral extensive manipulation of the anterior neck triangle, especially in order to ensure oncologically adequate surgical margins

Aggressive treatment of metastatic squamous cell carcinoma of the rectum to the liver: a case report and a brief review of the literature

BACKGROUND: Rectal squamous cell carcinoma (SCC) is a rare tumor. The incidence of this malignancy has been reported to be 0.25 to 1 per 1000 colorectal carcinomas. From a review of the English literature 55 cases of SCC of the rectum have been published. In this study we report a rectal metastatic SCC to the liver, discussing the efficacy of aggressive adjuvant and neo-adjuvant therapies on survival and prognosis. CASE PRESENTATION: A 39-year-old female patient with a pure SCC of the rectum diagnosed endoscopically is presented. The patient underwent initially neoadjuvant chemo-radiotherapy and then abdominoperineal resection with concomitant bilateral oophorectomy and hysterectomy, followed by adjuvant chemo-radiotherapy. Five months after the initial operation liver metastasis was demonstrated and a liver resection was carried out, followed by adjuvant chemotherapy. Eighteen months after the initial operation the patient is alive. CONCLUSION: Although prognosis of rectal SCC is worse than that of adenocarcinoma, an aggressive therapeutic approach with surgery as the primary treatment, followed by combined neo- and adjuvant chemo-radiotherapy, may be necessary in order to improve survival and prognosis

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London