Audit Testing Research Articles

8192 A Two-Cycle Clinical Audit Testing Inpatient Management Of Hypophosphatemia In A UK District Hospital

Abstract Disclosure: J. Porto: None. E. Ssemmondo: None. N. Obike: None. A. Abobaker: None. R. March: None. N. Tun: None. T. Pawlak: None. Objective: A clinical audit was conducted to assess if there was any improvement in management of hypophosphatemia among patients admitted to the medical wards using the local Trust protocol, following structured edcational sessions to the junior doctors covering medical wards. Design and methodology: The 2 cycles of the audit were conducted between March 2020 and September 2021 in Scarborough district Hospital. The clinical notes of 52 patients (20 in the first cycle and 32 in the re-audit) with hypophosphatemia were reviewed. These were identified using the electronic laboratory results of patients within the study period. The aspects of the trust protocol for management of hypophosphatemia that were audited; documentation of symptoms associated with low phosphate levels, cardiac monitoring in severe hypophosphatemia, identification of the likely cause of hypophosphatemia, the presence or absence of associated acute kidney injury (AKI) and initiation of phosphate replacement. The results of the first audit were presented at the local hospital clinical governance meeting (August 2020). Following this, 2 teaching sessions and 2-case based discussion on hypophosphatemia were organised for all the doctors in the department of medicine. The re-audit was subsequently conducted after the fourth teaching session. The proportions of each audited item were compared between the first audit and the re-audit using Fisher exact probability test. Results:25% of patients in the first audit had severe hypophosphatemia compared to 28% in the re-audit. In patients with severe hypophosphataemia, only 33.3% had cardiac monitoring during the re-audit cycle compared to 60% in the first cycle, and the difference was not statistically significant (p=0.58). There was significant improvement in the documentation of symptoms of hypophosphataemia amongst inpatients during the re-audit cycle compared with the initial cycle; 62.5% vs only 10% (P 0.002). Most patients had an underlying cause of the hypophosphatemia identified (80% and 62.5%-first and second cycle respectively). AKI was associated with hypophosphataemia in 15% & 34.4% (P 0.2) in the first and second cycles respectively. Despite low phosphate levels, 25% and 28.1% at the initial audit and the second cycle respectively did not receive any form of phosphate replacement. Conclusion: The two-cycle clinical audit showed that the teaching sessions on management of hypophosphatemia increased the awareness of the importance to document whether the patients were symptomatic or asymptomatic following the drop in their phosphate levels, which can help to identify patients at risk of developing complications, such as cardiac arrythmias. However, these sessions were not sufficient to improve overall management of patients with low phosphate levels. Presentation: 6/1/2024

Analisis Implementasi Continuous Auditing pada Inspektorat Kabupaten Gorontalo

This digitalization progress affects the accounting process which also has an impact on the audit process. New technologies that help lighten the audit work are starting to emerge, one of which is continuous auditing which has the concept of real-time audit testing without disrupting the company's operational processes and reducing the time lag between the initial report and the audit result report. The achievement of the APIP capability of the Gorontalo Regency area has reached level 3, meaning that it is able to manage risks and is able to provide early warnings. However, in reality there is a phenomenon of corruption cases in Gorontalo Regency with a not insignificant number. Therefore, this study aims to determine how Continuous Auditing is implemented at the Gorontalo Regency Inspectorate. This research method uses a qualitative method with a descriptive approach. There are 2 informants in this study. In this study, data was collected using observation, interview, and documentation techniques. The results of this study indicate that the Gorontalo Regency Inspectorate has implemented Continuous Auditing in village financial management, namely in the form of Siswaskeudes (Village Financial Supervision System).

Combined Use of Phosphatidylethanol and the Audit Test for Detecting of Alcohol Abuse

Aim: To estimate the prevalence of alcohol abuse among men by using combined the direct biochemical marker phosphatidylethanol (PEth) and the AUDIT questionnaire (Alcohol Use Disorders Identification Test). Subjects and Methods: The concentration of PEth was determined in 136 blood samples of men aged 15 - 65 years. The blood was obtained from the laboratory of the medical advisory centre, where it was submitted for routine biochemical analysis. Immediately before blood sampling, clients were asked to complete the AUDIT questionnaire. Determination of the concentration of PEth was carried out using the method of high performance liquid chromatography - tandem mass spectrometry (HPLC - MS). Statistical data processing was carried out using the Statistica 10.0 program. Results: Discrimination by the level of alcohol consumption using the concentration of PEth showed that the proportion of abstinents (practically not drinking alcohol) among men was 20.6 %; the proportion of moderate drinkers was 63.1 %; the proportion of alcohol abusers was 16.3 %. The highest average concentration of PEth, as well as the proportion of those who abuse alcohol, was observed in the age groups of 50 - 59 and 60+ years. The distribution by level of alcohol consumption according to the total score of the AUDIT test was as follows: abstinents - 17.9 %; moderate drinkers - 69.6 %; alcohol abusers - 12.5 %. The highest average test score, as well as the highest share of alcohol abusers, was observed in the age group 50 - 59 years. Correlation analysis did not reveal any relationship between the concentration of PEth in the blood and the total score of the AUDIT test in any of the age groups of men. Conclusion: The results indicate a fairly high prevalence of alcohol abuse among men. Alcohol-related problems are especially high among middle-aged men. The outcomes suggest a low concordance between the concentration of PEth in the blood and the AUDIT score.

Evaluation of neurocognitive functions in young university students who frequently consume alcohol at the UJED Durango Law School

The objective of this research is to evaluate the state of the neurocognitive functions of young frequent alcohol users of the Faculty of Law and Political Science of the Juárez University of the State of Durango, for this two instruments were applied: the AUDIT test, to identify the level of alcohol consumption of the students and the BCSE brief test to evaluate the cognitive state of the participants. 100 students participated voluntarily. In the results, it can be observed that 60% of the students evaluated have medium to excessive alcohol consumption, and 40% obtained low level scores in the cognitive assessment. Decision-making, planning, self-monitoring, spatial orientation, attentional control, and cognitive flexibility are the areas most affected by alcohol consumption, in addition to making them less consistent in fulfilling their school obligations and affecting their cognitive capacity necessary to correctly acquire knowledge.

Impact of alcohol consumption and diet on quality of life in higher education. A structural equation model.

Alcohol consumption among Spanish undergraduates during their university time has increased exponentially in recent years. In addition, this lifestyle change is associated with abandoning the Mediterranean diet, increasing the risk of suffering some kind of injury and affecting their quality of life. The study was carried out with a sample of 1,057 Spanish university students, 12.1% (n = 127) of them women and 87.9% (n= 930) men. The SF-36 questionnaire was used to measure health-related quality of life, the MEDAS test to check adherence to the Mediterranean diet, and the AUDIT test to measure alcohol consumption. The results show an inverse relationship between injury and quality of life (β= -0.020) and adherence to the Mediterranean diet (β= -0.042) among students who have suffered some kind of injury. On the other hand, there was a positive relationship with alcohol consumption (β= -0.046). The main conclusion is that lower alcohol consumption and higher adherence to the Mediterranean diet was associated with a better quality of life and a reduced risk of injury in undergraduates in southern Spain.

Diagnostika alkoholovej choroby pečene u gastroenterológa

Summary: The alarming rise in morbidity and mortality from liver diseases is the reason for searching ways to reverse this trend. The COVID-19 period was a time of increased consumption of spirits in Slovakia and associated morbidity and mortality. An effective tool for early detection of risky alcohol consumption is screening in the form of the AUDIT questionnaire followed by intervention and screening of liver disease in the form of laboratory and imaging methods, including ultrasonography and elastography using non-invasive fibrosis indices. Screening for risky alcohol consumption and advanced liver fibrosis in gastroenterologist, hepatologist and general practitioner outpatient offices will help to detect at-risk individuals early and start intervention. This paper presents a screening proposal in the context of the latest EASL and AASLD guidelines and available current reviews of screening worldwide. The goal is to reduce the adverse effects of alcohol in Slovakia. Key words: risk alcohol consumption – AUDIT test – elastography – screening

Impact of the COVID-19 pandemic on the mental state of Polish students

Introduction: The COVID-19 pandemic has undoubtedly affected the mental health of the population. This issue has become the focus of interest of various research groups in recent years, resulting in a number of publications on the subject. Among other things, increases in anxiety, aggression, depression and other variables have been observed in different populations. Material and method: The authors of the present project conducted a web-based survey among university students in Poland. They used scales to assess the intensity of anxiety (GAD-7), aggressive behaviour (Buss-Perry Aggression Questionnaire -ABPQ), alcohol consumption (AUDIT test), and mental toughness (ER-89). The entire survey was conducted in two stages, with the second stage taking place by sending survey forms to email addresses previously provided by respondents. Results: In the first term of the study, higher levels of anxiety and anger and lower levels of alcohol consumption were observed among women compared to men. Medical students reported lower levels of verbal, physical and generalised aggression compared to non-medical students. A follow-up study conducted after three months showed a reduction in anxiety among students. Discussion: Adaptation to the COVID-19 pandemic among students did not differ from changes in other communities. Women are characterized by higher levels of anxiety and anger and less alcohol consumption compared to men. A significant decrease in anxiety intensity was observed in the follow-up study. Medical students were characterized by lower levels of verbal, physical and generalized aggression. Keywords: anxiety, students, alcohol consumption, COVID-19, ego-resilience

Sendemails: An automated email package with multiple applications

In this article, we illustrate the sendemails command, which allows users to automatically send emails with Stata through PowerShell. Researchers can use this package to perform several email tasks, such as contacting students or colleagues with standardized messages. Additionally, researchers can perform more complex tasks that entail sending randomized messages with multiple attachments from multiple accounts; these tasks are often necessary to conduct correspondence audit tests. This article introduces the sendemails command and illustrates multiple examples of its application. The online appendix discusses an application of this package to correspondence audits.

Cognitive dissonance and auditor professional skepticism

PurposeThis study aims to demonstrate how pressures (incentives) in the audit environment can lower audit quality because of a breakdown between professionally skeptical (PS) judgment (risk assessment) and PS action (testing).Design/methodology/approachThe authors used a Qualtrics-based experiment with attitude change as a proxy measure of cognitive dissonance (CD). The authors analyze the results using a one-way independent between-group ANOVA with post hoc tests and t-tests.FindingsThe authors find that auditors experience CD when they fail to take appropriate high PS action (audit tests) that are in line with high PS judgment (risk assessments). The motivational force to reduce CD drives auditors to revise their assessments upward (rank higher), lower diagnostic audit tests (PS actions) and lower risk assessments (PS judgments). This leads to lower overall professional skepticism, and hence lower audit quality.Originality/valueThis investigation provides an empirical investigation of Nelson’s (2009) model of professional skepticism and demonstrates a specific mechanism for how incentives in the audit environment lower audit quality. Based on the findings, treatments to enhance audit quality can benefit by strengthening the critical link between PS judgments (risk assessments) and PS actions (audit tests).

Предикторы развития двигательных нарушений при пробуждении после общей анестезии у пациентов травматологического профиля (проспективное когортное исследование)

Analysis of published studies shows that information on patients' hyperactivity on awakening is ambiguous, both regarding the definition of this condition itself and the causes of its occurrence. In the field of neurology and neurophysiology, there is a lack of data on the mechanisms of development of early cognitive impairment after surgery, as well as on the definition of vulnerable patients before surgery and anesthesia. Objective. To determine the prognostic value of predictors of different values on the RASS scale in trauma patients to assess the development of major clinical outcomes. Material and methods. A two-center prospective cohort study of patients aged 45–74 years after planned traumatologic surgeries under general anesthesia was conducted. Demographics, comorbidities, background therapy, preoperative laboratory examinations and testing (ASA, MoCA, AUDIT, CFS, HADS-A, RASS) were analyzed as part of the study. After extubation in the operating room, patients were evaluated using the RASS, CAM-ICU, CAM-ICU-7, NRS, and BPS scales. Statistical analysis was performed using SPSS Statistics 27.0.1.0 software. Results. Two hundred subjects were included in the study between March 2021 and June 2022. An independent predictor of positive Richmond Agitation-Sedation Scale (RASS) values after extubation in the operating room was adherence to alcohol (AUDIT test, optimal cut-off point ≥2 points, Se=59.2%, Sp=72.2%, estimate=0.440; 95% confidence interval (CI) 0.158-0.723, p=0.002). Risk factors of zero and negative RASS scores were found to be predictors of satisfactory quality by ROC analysis. When assessing the impact on clinical outcomes, differences were observed between the groups of patients with positive and zero values on the RASS scale. Conclusion. Patients with positive values on the RASS scale were statistically significantly more likely to have postoperative delirium - 12 (24.5%) patients, p=0.002.

Audit Operasional : Studi Literatur Perkembangan Saat Ini

Operational audit is an Internal Control System for following up on evaluation recommendations which will later provide suggestions for improvement for divisional divisions and will provide audit testing if an activity has been suspected by the auditor. The objective of an Operational Audit is to objectively obtain and evaluate evidence about economic activities and events. This study aims to provide a broad overview of the current Operational Audit through a literature study for the 2013-2022 period. Structured Literature Review (SLR) is used to investigate how Operational Audit develops and focuses. This study uses the keywords “Operational” and “Operational Audit” to identify studies that are relevant to a particular topic. A total of 20 published studies were found. This study identifies the main directions of Operational Audit research in the 2013-2022 period and discusses several important aspects of the research, namely methodology, research methods, and research variables used. To enrich the results, this study defines the scope, type of industry, topics and variables used in this research. This study provides insight into future Operational Audit research which is used by researchers to develop Operational Audit research. Some of the items proposed could be used as a guide for future Operational Audit research, such as sustainability in the public sector. Ensuring sustainability is one of the research topics that can serve as a direction for future researchers. Qualitative descriptive can be an alternative to explain the reality of sustainability reporting.

Regional features of the alcohol situation and health and demographic consequences

Purpose: based on the results of the analysis of official statistics of medical and demographic indicators and data from a questionnaire survey on alcohol consumption, to highlight the features of alcoholization in cities and villages of the Republic of Mari El with the rationale for priority areas for reducing negative consequences. Methods. Processing of data on alcohol consumption, medical and demographic indicators, as well as the results of a survey of 403 people according to the AUDIT test was carried out using descriptive statistics, Pearson’s chi-square test, ANOVA multivariate analysis of variance, and Spearman’s correlation analysis. Results. About 80% of the respondents used alcoholic beverages, one in five of them in excessive quantities. With an increase in the age group of the population, the consumption of low-alcohol drinks was replaced by strong ones, accompanied by a decrease in the proportion of teetotalers and a reduction in consumption in alcohol equivalent. An increase in the level of education had a positive effect on the proportion of non-drinkers and the strength of drinks consumed. Alcohol consumption among rural residents, compared with urban residents, was characterized by a high proportion of strong alcoholic beverages, with a greater prevalence of vodka and moonshine. Mortality and socially significant morbidity rates correlated with a delayed effect with the level of alcohol sales and consumption. Conclusion. One of the leading ways to reduce the risk to public health from alcohol is to reduce the consumption of strong drinks, which have a long period of negative effects.

Nutritional habits in Spanish female students of childbearing age

AimTo analyse the dietary habits, alcohol consumption, healthy eating index and student performance of a sample of students at a Spanish university to determine if their intake of nutrients reach optimal levels for fertility. MethodsDescriptive cross-sectional study of female university students in Madrid, data were collected in Nutrition classes. Participants were 470 women nursing studying at a private university in Madrid, non-random sample was used. An AUDIT test was conducted to determine alcohol consumption. Habits and dietary assessment with a three-day record using DIAL® program to know main nutrients intake. Quantitative variables appeared as mean ± standard deviation, adjusted for all pairwise comparisons using the Bonferroni correction Statistical analysis was performed using SPSS 25®. ResultsThe majority of the Spanish university women of reproductive age participating in the study did not have the recommended intake of some macro and micronutrients carbohydrates, vitamins D and B9, Mg, Fe, and I. ConclusionsThis study opens further lines of research. It is necessary to carry out qualitative research into students’ self-perception and their dietary and sleeping habits. Addressing ways to improve food access, dietary quality, and healthy lifestyle, should be focused on future intervention programs and policies for college students.

Integrating data analytics into the auditing curriculum: Insights and perceptions from early-career auditors

This study aims to help audit educators determine how, where, and to what extent audit data analytics (ADA) should be integrated into existing auditing curriculum to better prepare students for the auditing profession. We interview early-career auditors to understand their experience with ADA and add their perspective to the literature on audit curriculum changes. This group performs many of the tasks where ADA techniques would be applied and can provide valuable insight to audit educators based on their work experience and recent completion of auditing and/or data analytics courses. Responses indicate that early-career auditors rely more routinely on traditional ADA tools (e.g., Excel) and that the use of advanced ADA tools (e.g., Power BI and Alteryx) is relatively limited. Furthermore, firm-provided training on advanced ADA tools focuses on navigating tools rather than interpretation of ADA output. We also find that, regardless of the ADA tool used, the skillset used most frequently is interpretation of ADA output to identify anomalies and determine the impact on audit testing, which could be emphasized in existing audit courses. Most participants expressed that rather than removing content from the audit course to make room for data analytics, faculty should integrate ADA within existing content, encouraging audit educators to change how they teach, rather than what they teach. Specifically, faculty can provide hands-on examples of ADA to supplement lectures on existing topics or assign case studies that use ADA tools. These findings have implications for immediate changes to integrate ADA into auditing courses that are more manageable than a complete overhaul of the audit curriculum.

Prevalence of alcohol consumption in the population of the municipality of mit㸠2022: cross-sectional study applying the audit test

Prevalence of alcohol consumption in the population of the municipality of mit㸠2022: cross-sectional study applying the audit test

Alcohol use: prevalence and associated factors in a sample of Tunisian students

IntroductionThe use of alcohol, in particular its harmful use and alcohol dependence, represent a public health problem of interest to all age groups. Indeed, alcohol is responsible for a heavy burden of disease and a considerable socio-economic burden.ObjectivesTo determine the prevalence of alcohol use and the main factors associated with it in a sample of Tunisian students.MethodsThis is an analytical cross-sectional study carried out during the 2020/2021 academic year with a sample of Tunisian students. We used an anonymous self-administered questionnaire distributed online via social networks. Our questionnaire included a section focusing on socio-demographic characteristics and the AUDIT test (Alcohol Use Disorders Identification Test) to detect alcohol addiction.ResultsOur study enrolled 772 students .The average age of the study population was 23.29 ±3.25.Two hundred ninety-nine students (38.7%) consumed alcohol. The mean age at first use was 18.44 (3.09). Fifty-two alcohol users (17.4%) presented a risk of alcohol dependence. The first consumption contexts were mostly “between friends” (57.4%) and “party time “(23.5%).The main effects sought were the effect of disinhibition (64.5%) and social integration (41.1%) were predominant responses. The determining factors of alcohol consumption were age (p<10-3), male gender (p<10-3), and the presence of grade repetition (p<10-3), wealthy socioeconomic level (p<10-3), and participation in community life (p<10-3).ConclusionsAlcohol use and especially alcohol dependence may have harmful effects on student’s life. It is relevant to screen this addiction to better its prevention.Disclosure of InterestNone Declared

Remembering Fraud in the Future: Investigating and Improving Auditors' Attention to Fraud during Audit Testing*

ABSTRACTDuring the testing stages of the audit, auditors must divide their attention simultaneously between (i) performing the planned audit procedures and (ii) remaining broadly skeptical and alert for fraud. Regulators note instances in which auditors do not take actions that effectively respond to fraud risks during these later stages, suggesting auditors may devote insufficient attention to fraud while they are busy executing the planned audit procedures. Leveraging prospective memory theory, I identify and test an intervention that can improve auditors' attention to fraud by encouraging auditors to have implementation intentions—that is, more detailed plans about when and how they will consider fraud. I find that encouraging implementation intentions interacts with auditors' perceived fraud task importance to increase auditors' attention to fraud when this attention would otherwise be lower, making auditors more likely to take effective fraud actions. Importantly, these results also indicate that, even in a high fraud risk setting, auditors may devote insufficient attention to fraud while performing the planned audit procedures, confirming concerns voiced by regulators. However, my study also highlights concerns about regulators' inspection processes prompting auditors to focus too heavily on inspection risk, as the results suggest auditors are less likely to detect fraud in high‐risk audit areas thought to have low inspection risk.

The Adequacy of the Rehabilitation External Auditor’s Using Analytical Procedures in Identifying and Evaluating Banking Risks: a Field Study on a Sample of Auditing Companies and Offices in Iraq

Purpose: The purpose of the research is to provide information about the Adequacy of the scientific and practical qualifications as well as the significance of the fact that the external auditor (auditor of accounts) should have such qualifications to enable him to carry out the audit process effectively and efficiently. This enables him to use the analytical techniques and their varied ways to recognize and assess the significant banking risks that must be focused on, as well as to pinpoint the areas that require more research and audit tests. Theoretical framework: The research is based on a main hypothesis that meeting the qualification requirements (scientifically and practically) for the external auditor would enable him to employ analytical procedures during the various stages of the audit process to identify and evaluate the banking risks). Methodology: The research is based on the descriptive method to cover the theoretical and analytical part in the practical side by creating a questionnaire that was given to a sample of auditors and those working with them in businesses and audit offices in Iraq of the first class using (70) questionnaires. The statistical program (SPSS v.18) (AMOS V.24) was relied upon to analyze the data and test the hypotheses. Results: The research arrived at the conclusion that the availability of the external auditor's scientific and practical qualifications contributes to employing analytical procedures and using them in the audit process, enabling him to assess banking risks, increase the chance of finding and reporting violations, and prevent deficiencies in the performance of audit duties. The impact of the study on community: Emphasizing that bodies and organizations should prepare programs and training courses to increase the auditor’s scientific and practical qualification, especially in areas that contribute to acquiring the knowledge and skill necessary to apply analytical procedures and areas that work to improve and enhance their capabilities in the field of auditing. Scientific value: One of the motives of the study is to draw the attention of the external auditor to the importance of being sufficiently qualified from a scientific and practical point of view in the field of applying analytical procedures and their various methods and their impact on increasing the results obtained and access to key facts in the banking sector.

Longitudinal change of inhibitory control functional connectivity associated with the development of heavy alcohol drinking.

Heavy drinking (HD) prevalent pattern of alcohol consumption among adolescents, particularly concerning because of their critical vulnerability to the neurotoxic effects of ethanol. Adolescent neurodevelopment is characterized by critical neurobiological changes of the prefrontal, temporal and parietal regions, important for the development of executive control processes, such as inhibitory control (IC). In the present Magnetoencephalography (MEG) study, we aimed to describe the relationship between electrophysiological Functional Connectivity (FC) during an IC task and HD development, as well as its impact on functional neuromaturation. We performed a two-year longitudinal protocol with two stages. In the first stage, before the onset of HD, we recorded brain electrophysiological activity from a sample of 67 adolescents (mean age = 14.6 ± 0.7) during an IC task. Alcohol consumption was measured using the AUDIT test and a semi-structured interview. Two years later, in the second stage, 32 of the 67 participants (mean age 16.7 ± 0.7) completed a similar protocol. As for the analysis in the first stage, the source-space FC matrix was calculated, and then, using a cluster-based permutation test (CBPT) based on Spearman's correlation, we calculated the correlation between the FC of each cortical source and the number of standard alcohol units consumed two years later. For the analysis of longitudinal change, we followed a similar approach. We calculated the symmetrized percentage change (SPC) between FC at both stages and performed a CBPT analysis, analyzing the correlation between FC change and the level of alcohol consumed in a regular session. The results revealed an association between higher beta-band FC in the prefrontal and temporal regions and higher consumption years later. Longitudinal results showed that greater future alcohol consumption was associated with an exacerbated reduction in the FC of the same areas. These results underline the existence of several brain functional differences prior to alcohol misuse and their impact on functional neuromaturation.

Sendemails: An automated email package with multiple applications

Correspondence audits are a popular method to examine discrimination in a causal framework. However, they often require sending hundreds or thousands of emails to subjects. The sendemails package allows users to automatically send emails with Stata through PowerShell, which is open-source and cross-platform. Researchers can use this package to perform several email tasks, such as contacting students or colleagues with standardized messages. Additionally, researchers can perform more complex tasks that entail sending randomized messages with multiple attachments from multiple accounts, tasks that are often necessary to conduct correspondence audit tests. This paper introduces the command and illustrates multiple examples of its application.