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This paper examines the demand- and supply-side factors associated with audit partner selection and assignment in the United States. First, we examine whether audit partner gender and experience are associated with board and management gender and experience. Second, we investigate whether engagement audit quality varies with audit partner gender and experience, controlling for selection effects. The results indicate that companies with more gender-diverse boards of directors and top management teams are more likely to have a female lead audit partner. In addition, the experience of the client's board is positively associated with the experience of the lead audit partner. In terms of audit quality, we find that higher audit fees are positively associated with female and more experienced audit partners. Our results shed light on the important role that partner characteristics play in the demand and supply sides of audit quality.

Aims: The audit aimed to evaluate assessment, intervention, and signposting for alcohol use problems in people with gambling disorder presenting to the Southern Gambling Service (SGS). Methods: The study included ninety-eight patients referred to SGS between the 28 December 2023 to 2 April 2024, who completed initial assessments. Baseline data were analysed to stratify patients’ alcohol use risk based on their extended Alcohol Use Disorder Identification Test (AUDIT-C) and Estimated Weekly Alcohol Consumption (EWAC) scores, which were collected via a digital pre-assessment tool. Clinical assessment letters were also reviewed to assess documented compliance with National Institute for Health and Care Excellence (CG115) guidelines, the Department of Health and Social Care guidance and the Royal College of Physicians regarding appropriate management according to their risk brackets. Outcomes included: (1) determining if those scoring at least 5 on the extended AUDIT-C received a full AUDIT assessment; (2) if higher risk groups (scores of 5–10) received brief interventions and (3) if those with 11 or more received advice on safe alcohol reduction and signposting to alcohol services. Results: Forty-four full records were examined: 26 [59%] patients scored <5 (AUDIT-C, lower risk), 14 [32%] patients scored 5–10 (higher risk) and 4 [9%] scored at least 11. In the latter category, 100% of patients received a formulation discussing their alcohol use and 75% of them an alcohol-related International Classification of Diseases 11 diagnosis as part of this formulation. While 100% completed the AUDIT-C and EWAC, none completed the full AUDIT. 7% of those in the higher risk category received documented brief interventions. Of the possibly dependent patients, 1 (25%) was signposted, based on documentation, to alcohol services and no patients received documented advice on avoiding an abrupt alcohol cessation. Conclusion: The audit highlighted strengths (such as 100% of patients being screened for alcohol use problems using AUDIT-C and EWAC) but also areas for improvement (e.g. in conducting appropriate advice interventions and signposting to alcohol services, and ensuring these steps are clinically documented). Recommendations for improvement included: (1) adding a full AUDIT screening for those scoring at least 5 in the extended AUDIT-C; (2) upskilling staff in brief intervention advice; (3) developing a regional alcohol services directory for signposting; and (4) providing psychoeducation materials on safe alcohol use. After implementation of recommendations, the audit will be repeated.

Aims: The aim of the audit was to ensure that the referral practices and assessment methods of patients who received ECT were carried out and documented as per the NICE guidelines. Methods: Study was carried out at Allied Hospital 2, Faisalabad Medical University, Faisalabad. Data was collected from May 2023 to October 2023. Study includes all the inpatients referred for ECT during a 6-month period from May 2023 to October 2023. The data was collected by examination of the patient’s notes to establish the adherence to all 9 standards required by NICE guidance. Results: Total number of patients was 47 (24 females and 23 males) the results show that ECT guidelines were followed and 100% compliance was achieved in all standards except one. Assessment of cognitive functions, 44 patients (86.3%) were assessed for their cognitive functions before the course of treatment but only 29 patients (56.9%) were assessed after the course. Conclusion: The adherence to referral and consent standards was excellent; however, greater attention is needed in the implementation and documentation of cognitive assessments before, during, and after treatment. This is particularly important due to the high incidence of cognitive dysfunction observed following ECT administration.

Aims: Risperidone is a commonly used antipsychotic drug in the LD population. One of its common side effects is hyperprolactinemia, which can cause a range of symptoms. Women may experience oligomenorrhoea, amenorrhoea, galactorrhoea (breast milk production), and decreased libido. Men may experience decreased libido, erectile dysfunction, gynaecomastia, infertility, decreased bone mass, and galactorrhoea. These symptoms may go unnoticed in the LD population and lead to behavioural changes. BNF advises monitoring of prolactin at baseline, after 6 months and then annually. Methods: Identify patients on either oral or intramuscular risperidone and those receiving intramuscular paliperidone within the psychiatry case load. Determine whether these patients have their prolactin levels checked annually. All patients assessed in the East CLDT psychiatry clinic who are on risperidone or paliperidone should have their prolactin levels monitored at least once a year. Results: Out of 106 patients, we identified 27 patients on risperidone (25.4%). 8 out of the 27 patients did not have their prolactin levels checked within the last year (29.6%). 8 out of 19 patients (42.4%) who did have their prolactin levels checked within the last year did not have them checked annually previously. This indicates that approximately 60% of patients are not receiving regular monitoring of their prolactin levels. Conclusion: Approximately 60% of our patients are not having their prolactin levels checked annually. To address this, we can enhance our communication by including a recommendation in our clinic letters to GPs, urging them to include prolactin testing in the annual health check blood work. Additionally, it is essential to regularly monitor symptoms of hyperprolactinaemia during our clinic visits and to educate caregivers about these issues. Symptoms such as gynaecomastia can cause discomfort and may lead to behavioural changes in individuals with intellectual disabilities. By prioritizing these measures, we can improve patient care and outcomes significantly.

Opponents of mandatory rotation argue that a change of partner is bad for audit quality, as it results in a loss of client-specific knowledge. On the other hand, proponents argue that a change of partner is beneficial, as it results in a positive peer review effect and a fresh perspective on the audit. We test the impact of mandatory partner rotation on audit quality using a unique dataset of audit adjustments in China. Our results suggest that mandatory rotation of engagement partners results in higher quality audits in the years immediately surrounding rotation. Specifically, we find a significantly higher frequency of audit adjustments during the departing partner's final year of tenure prior to mandatory rotation and during the incoming partner's first year of tenure following mandatory rotation.

We examine whether and how individual auditors affect audit outcomes using a large set of archival Chinese data. We analyze approximately 800 individual auditors and find that they exhibit significant variation in audit quality. The effects that individual auditors have on audit quality are both economically and statistically significant, and are pronounced in both large and small audit firms. We also find that the individual auditor effects on audit quality can be partially explained by auditor characteristics, such as educational background, Big N audit firm experience, rank in the audit firm, and political affiliation. Our findings highlight the importance of scrutinizing and understanding audit quality at the individual auditor level.

Although regulation makes audit committees responsible for determining and negotiating audit fees, researchers and practitioners express concerns that CFOs continue to control these negotiations. Thus, regulation may give investors a false sense of security regarding auditor independence. We utilize the recent financial crisis and economic recession as an exogenous shock that allows us to shed light on the relative influence of the audit committee and the CFO on fee negotiations. During the recession, we find larger fee reductions in the presence of more powerful CFOs, and smaller fee reductions in the presence of more powerful audit committees. We also find the CFO or the audit committee primarily influences fees when their counterpart is less powerful. Our findings suggest a more complex relationship between the CFO and the audit committee than current regulations recognize and cast doubt on the ability of regulation to force one structure on the negotiation process.

Conventional wisdom holds that joint audits would improve audit quality by enhancing audit evidence precision because \"Two heads are better than one.\" Our paper challenges this wisdom. We show that joint audits by one big firm and one small firm may impair audit quality, because, in that situation, joint audits induce a free-riding problem between audit firms and reduce audit evidence precision. We further derive a set of empirically testable predictions comparing audit evidence precision and audit fees under joint and single audits. This paper, the first theoretical study of joint audits, contributes to a better understanding of the economic consequences of joint audits on audit quality.