Search results for: corporate ethics policy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5190

Search results for: corporate ethics policy

2190 Systematic Review of Quantitative Risk Assessment Tools and Their Effect on Racial Disproportionality in Child Welfare Systems

Authors: Bronwen Wade

Abstract:

Over the last half-century, child welfare systems have increasingly relied on quantitative risk assessment tools, such as actuarial or predictive risk tools. These tools are developed by performing statistical analysis of how attributes captured in administrative data are related to future child maltreatment. Some scholars argue that attributes in administrative data can serve as proxies for race and that quantitative risk assessment tools reify racial bias in decision-making. Others argue that these tools provide more “objective” and “scientific” guides for decision-making instead of subjective social worker judgment. This study performs a systematic review of the literature on the impact of quantitative risk assessment tools on racial disproportionality; it examines methodological biases in work on this topic, summarizes key findings, and provides suggestions for further work. A search of CINAHL, PsychInfo, Proquest Social Science Premium Collection, and the ProQuest Dissertations and Theses Collection was performed. Academic and grey literature were included. The review includes studies that use quasi-experimental methods and development, validation, or re-validation studies of quantitative risk assessment tools. PROBAST (Prediction model Risk of Bias Assessment Tool) and CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) were used to assess the risk of bias and guide data extraction for risk development, validation, or re-validation studies. ROBINS-I (Risk of Bias in Non-Randomized Studies of Interventions) was used to assess for bias and guide data extraction for the quasi-experimental studies identified. Due to heterogeneity among papers, a meta-analysis was not feasible, and a narrative synthesis was conducted. 11 papers met the eligibility criteria, and each has an overall high risk of bias based on the PROBAST and ROBINS-I assessments. This is deeply concerning, as major policy decisions have been made based on a limited number of studies with a high risk of bias. The findings on racial disproportionality have been mixed and depend on the tool and approach used. Authors use various definitions for racial equity, fairness, or disproportionality. These concepts of statistical fairness are connected to theories about the reason for racial disproportionality in child welfare or social definitions of fairness that are usually not stated explicitly. Most findings from these studies are unreliable, given the high degree of bias. However, some of the less biased measures within studies suggest that quantitative risk assessment tools may worsen racial disproportionality, depending on how disproportionality is mathematically defined. Authors vary widely in their approach to defining and addressing racial disproportionality within studies, making it difficult to generalize findings or approaches across studies. This review demonstrates the power of authors to shape policy or discourse around racial justice based on their choice of statistical methods; it also demonstrates the need for improved rigor and transparency in studies of quantitative risk assessment tools. Finally, this review raises concerns about the impact that these tools have on child welfare systems and racial disproportionality.

Keywords: actuarial risk, child welfare, predictive risk, racial disproportionality

Procedia PDF Downloads 56
2189 Recruitment Strategies and Migration Regulations for International Students in the United States and Canada: A Comparative Study

Authors: Aynur Charkasova

Abstract:

The scientific and economic contributions of international students cannot be underestimated. International education continues to be a competitive global industry, and many countries are seeking to recruit the best and the brightest to reinforce scientific innovations, boost intercultural learning, and bring more funding to universities and colleges. Substantial changes in international educational policies and migration regulations have been made in the hopes of recruiting global talent. This paper explores and compares recruitment strategies, employment opportunities, and a legal path to permanent residency policies related to international students in the United States of America and Canada. This study will utilize the legal information available from the government websites of both countries and peer-reviewed scholarly articles and will highlight which approach promises a better path in recruiting and retention of international students. The findings from the study will be discussed and recommendations will be provided.

Keywords: International students, current immigration policies, STEM, employability, visa reforms for international students, Canadian recruitment policy

Procedia PDF Downloads 78
2188 Urbanization Level and Tempo (Speed) in Tigray Regional State, Ethiopia

Authors: Fikre Belay Tekulu

Abstract:

Background and objective: The study attempts to determine the level and tempo or speed of urbanization in the Tigray regional state based on census data from 1994 to 2013 in Ethiopia. Methods: The study examined the level and tempo of urbanization based on the 1994 and 2007 censuses as well as the 2013 CSA projection data. Findings: The level of urbanization at the regional level was found in 1994, 2007, and 2020 at 14.9%, 21.7%, and 27.7 % respectively. Whereas the level of urbanization varies among the zones of the region, the higher level of urbanization was recorded in the Eastern zone, followed by the Western, Southern Zone and Central zone of Tigray. The tempo or speed of urbanization was determined to be 0.49 percent per year at the regional level, with the Eastern area of Tigray showing the greatest tempo or speed of urbanization. Conclusions: Unbalanced urbanization among the zones results in socio-economic challenges. The study recommended several policy interventions aimed at judicious urbanization suitable for sustainable development.

Keywords: urbanization, census, tempo or speed, urbanization level, Tigray

Procedia PDF Downloads 51
2187 Race, Class, Gender, and the American Welfare State (1930s-1990s)

Authors: Tahar Djebbar Aziza

Abstract:

The American society, like all societies, is fractured by social divisions between different groups of people. It is divided by race, class, gender, and other social and cultural characteristics. Social divisions affect the way and the manner welfare is delivered for citizens within the American society. The welfare state exists to guarantee the promotion of well –being for all the different components within a society without taking into account their age, gender, their ethnicity/race, or their social belonging (class). Race, class, and even gender issues are the main factors that affected the formal structure, the nature, as well as the evolution of the American welfare state and led to its uniqueness. They have affected the structure and the evolution of the American welfare state since its creation in the 1930s, and led to its uniqueness in an international level. This study aims therefore at enhancing the readers’ awareness of social divisions: race, class, gender and their implications for the distribution of welfare resources and life chances in the USA from the early 1930s to the late 1990s.

Keywords: African Americans, class, gender, minority groups, race, social divisions, social policy, U.S. welfare state

Procedia PDF Downloads 561
2186 Incidence of and Risk Factors for Post-Operative Cognitive Dysfunction (POCD) in Neurosurgical Patients: A Prospective Cohort Study

Authors: Suparna Bharadwaj, Sriganesh Kamath, Gopalakrishna K. N., Subhas Konar

Abstract:

Introduction: Post-operative cognitive dysfunction (POCD) is a spectrum of clinical syndrome presenting as emergence delirium (ED) and/or post-operative delirium (POD). ED is a transient state (minutes to hours) of marked agitation after the discontinuation of general anesthesia, which does not respond to consoling measures. On the other hand, POD without identifiable etiology is not temporally related to emergence from anesthesia. These patients often emerge smoothly and may be lucid in the post-anesthesia care unit (PACU), but may develop fluctuating mental status, most commonly between postoperative days one and three. General anesthesia (GA) has been identified as a risk factor for POCD. Cranial surgeries involve brain handling in addition to exposure to GA. We hypothesize that the incidence of postoperative delirium after cranial surgery is twice that of spinal surgery. The primary objective of this study was to evaluate the incidence of emergence delirium and postoperative delirium in patients undergoing cranial and spinal neurosurgeries. The secondary objective was to identify the perioperative risk factors of ED and POD. Methods: This was a prospective cohort observation study conducted from March 2020 to September 2023 conducted at a tertiary neurocentre. After obtaining institutional ethics committee approval, adult patients undergoing cranial or spinal surgery with a Glasgow coma scale of 15 were included in the study. Patients undergoing cranial surgery are considered exposed to risk factors, while patients undergoing spinal surgery are considered unexposed. All study subjects received standard general anesthesia. About twenty perioperative parameters were identified as risk factors for POCD. ED was assessed using the Riker sedation agitation scale, and POD was assessed using the confusion assessment method. A sample size of 2000 patients was planned with 1000 each cranial and spinal cases. However, around 700 spinal patients could be recruited for this study. Results: In this study, about two thousand patients were screened for inclusion. However, 1185 cranial cases and 742 spinal cases were considered for final analysis. Both the groups were similar in terms of demographics. Incidence of ED was 25.8% after cranial surgery vs 10.24% after spinal surgery (relative risk 2.5). The incidence of POD after cranial surgery is 20.25% vs 2.15% after cranial surgery (relative risk 9.3). All the proposed risk factors were assessed using binomial logistic regression. Conclusion: Cranial cases expose patients to a nine times higher risk for the development of postoperative delirium. The presence of ED predisposes to POD representing a spectrum.

Keywords: post operative cognitive dysfunction, Neurosurgical patients cohort study, cohort study, emergence delirium

Procedia PDF Downloads 13
2185 Induction of Innovation (Districts) in (Spatial) Planning and Policy

Authors: Meera Prajapati

Abstract:

Technological innovation is important for economic and spatial rejuvenation. Innovation districts from the last decades around university towns offer interesting examples. Planning directs the interplay between economic and urban development in these innovation districts that appear in particular regions with economic benefits as a result of incentives to attract multinational industries in innovation centres, research parks, universities, bio incubator assets, etc. The inclination of the OECED towards developing entrepreneurship and innovation to harness a boost in growth requires sustainable living conditions. This research aims to understand ‘how innovation or knowledge centres affected development policies and helped cities to become a high-tech region?’ Therefore, the economic policies of cities are investigated as well as the location logic of centres and their intertwining with supporting services (health, education, living environment, etc.). Case studies (Eindhoven (The Netherlands) and Ho Chi Minh City (Viet Nam)) position Pune (India) in terms of the planning components of innovation.

Keywords: innovation districts, high-tech regions, smart cities, urban planning and policies

Procedia PDF Downloads 148
2184 SVID: Structured Vulnerability Intelligence for Building Deliberated Vulnerable Environment

Authors: Wenqing Fan, Yixuan Cheng, Wei Huang

Abstract:

The diversity and complexity of modern IT systems make it almost impossible for internal teams to find vulnerabilities in all software before the software is officially released. The emergence of threat intelligence and vulnerability reporting policy has greatly reduced the burden on software vendors and organizations to find vulnerabilities. However, to prove the existence of the reported vulnerability, it is necessary but difficult for security incident response team to build a deliberated vulnerable environment from the vulnerability report with limited and incomplete information. This paper presents a structured, standardized, machine-oriented vulnerability intelligence format, that can be used to automate the orchestration of Deliberated Vulnerable Environment (DVE). This paper highlights the important role of software configuration and proof of vulnerable specifications in vulnerability intelligence, and proposes a triad model, which is called DIR (Dependency Configuration, Installation Configuration, Runtime Configuration), to define software configuration. Finally, this paper has also implemented a prototype system to demonstrate that the orchestration of DVE can be automated with the intelligence.

Keywords: DIR triad model, DVE, vulnerability intelligence, vulnerability recurrence

Procedia PDF Downloads 123
2183 Community Product Development of Basket Handicraft-Bag, Ang Thong Province, Thailand

Authors: Patsara Sirikamonsin

Abstract:

The purposes of this study were I) to study development guidelines of community product which was basket handicraft-bag of Ang Thong province; II) to study consumer demand for the community of basket handicraft-bag products of Ang Thong province. Data were collected via group interview of the community of basket handicraft-bag and consumer in order to obtain information related to product development guidelines in line with consumer demand. The study revealed that development guidelines of community product which was basket handicraft-bag of Ang Thong province caused by the demand of consumers changed by the era which made community of basket handicraft-bag products of Ang Thong province might develop community products to be novel, stylish and accessible. The consumer demand for the product came from the need to consume goods that are like local symbols. Most of them were foreigners and tourists. The advantage of this research was that it would lead to policy implementation and lead to the development of basket handicraft-bag community products of Ang Thong to meet the needs of consumers.

Keywords: community product, product development, basket handicraft-bag, business research

Procedia PDF Downloads 184
2182 Comparison of the Effects of Alprazolam and Zaleplon on Anxiety Levels in Patients Undergoing Abdominal Gynecological Surgery

Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

Abstract:

Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

Procedia PDF Downloads 83
2181 The Challenge of Assessing Social AI Threats

Authors: Kitty Kioskli, Theofanis Fotis, Nineta Polemi

Abstract:

The European Union (EU) directive Artificial Intelligence (AI) Act in Article 9 requires that risk management of AI systems includes both technical and human oversight, while according to NIST_AI_RFM (Appendix C) and ENISA AI Framework recommendations, claim that further research is needed to understand the current limitations of social threats and human-AI interaction. AI threats within social contexts significantly affect the security and trustworthiness of the AI systems; they are interrelated and trigger technical threats as well. For example, lack of explainability (e.g. the complexity of models can be challenging for stakeholders to grasp) leads to misunderstandings, biases, and erroneous decisions. Which in turn impact the privacy, security, accountability of the AI systems. Based on the NIST four fundamental criteria for explainability it can also classify the explainability threats into four (4) sub-categories: a) Lack of supporting evidence: AI systems must provide supporting evidence or reasons for all their outputs. b) Lack of Understandability: Explanations offered by systems should be comprehensible to individual users. c) Lack of Accuracy: The provided explanation should accurately represent the system's process of generating outputs. d) Out of scope: The system should only function within its designated conditions or when it possesses sufficient confidence in its outputs. Biases may also stem from historical data reflecting undesired behaviors. When present in the data, biases can permeate the models trained on them, thereby influencing the security and trustworthiness of the of AI systems. Social related AI threats are recognized by various initiatives (e.g., EU Ethics Guidelines for Trustworthy AI), standards (e.g. ISO/IEC TR 24368:2022 on AI ethical concerns, ISO/IEC AWI 42105 on guidance for human oversight of AI systems) and EU legislation (e.g. the General Data Protection Regulation 2016/679, the NIS 2 Directive 2022/2555, the Directive on the Resilience of Critical Entities 2022/2557, the EU AI Act, the Cyber Resilience Act). Measuring social threats, estimating the risks to AI systems associated to these threats and mitigating them is a research challenge. In this paper it will present the efforts of two European Commission Projects (FAITH and THEMIS) from the HorizonEurope programme that analyse the social threats by building cyber-social exercises in order to study human behaviour, traits, cognitive ability, personality, attitudes, interests, and other socio-technical profile characteristics. The research in these projects also include the development of measurements and scales (psychometrics) for human-related vulnerabilities that can be used in estimating more realistically the vulnerability severity, enhancing the CVSS4.0 measurement.

Keywords: social threats, artificial Intelligence, mitigation, social experiment

Procedia PDF Downloads 68
2180 Public Perceptions of Solar Energy in South-West Nigeria

Authors: Kugbeme Isumonah

Abstract:

The Nigerian State has continued to battle huge power supply challenges. Erratic supply, low voltage, and billing issues characterize its power sector. Solar power is increasingly being advocated for as a potential to Nigeria’s energy crisis. This study investigates how the Nigerian public perceives solar power. It employs the use of an open-ended online survey eliciting responses from participants resident in two of South-West Nigeria’s largest cities (Lagos and Ibadan). The study found that general attitudes towards solar power are positive, and the energy source is viewed with great optimism within the context of solutions to Nigeria’s energy issues. It also found no significant variation in public perceptions of solar power along demographic lines. Further, it found that finance represents the biggest barrier to broader solar power adoption. The results of this study provide evidence for policy formulation geared towards addressing finance difficulties that currently impede expansion of solar power use in Nigeria.

Keywords: public perceptions, solar energy, Nigeria, attitudes

Procedia PDF Downloads 111
2179 The Organizational Commitment of the Public Enterprises in Thailand

Authors: Routsukol Sunalai

Abstract:

The purpose of this study is to examine the impact of public enterprise reform policy on the attributes of organizational commitments in the public energy enterprises in Thailand. It compares three structural types of public energy enterprises: Totally state-owned public enterprises (type I), partially transformed public enterprises (type II), and totally transformed public enterprises (type III), based on the degree of state partially transformed public enterprises (type II), and totally transformed public enterprises (type III),based on the degree of reformed organizations, by analyzing the presence of the desirable attributes of organizational commitment as perceived by employees. Findings indicate that there are statistically significant differences in the level of some dimensions of organizational commitment (affective commitment and normative commitment) between the three types of public energy enterprises. The lack of a structural type difference holds for only continuance commitment. The results also indicate empirical evidence concerning the causal relationship between the antecedents and including organizational commitment also.

Keywords: management control, organizational commitment, public enterprises in Thailand, public enterprise reform

Procedia PDF Downloads 293
2178 Combined Civilian and Military Disaster Response: A Critical Analysis of the 2010 Haiti Earthquake Relief Effort

Authors: Matthew Arnaouti, Michael Baird, Gabrielle Cahill, Tamara Worlton, Michelle Joseph

Abstract:

Introduction: Over ten years after the 7.0 magnitude Earthquake struck the capital of Haiti, impacting over three million people and leading to the deaths of over two hundred thousand, the multinational humanitarian response remains the largest disaster relief effort to date. This study critically evaluates the multi-sector and multinational disaster response to the Earthquake, looking at how the lessons learned from this analysis can be applied to future disaster response efforts. We put particular emphasis on assessing the interaction between civilian and military sectors during this humanitarian relief effort, with the hopes of highlighting how concrete guidelines are essential to improve future responses. Methods: An extensive scoping review of the relevant literature was conducted - where library scientists conducted reproducible, verified systematic searches of multiple databases. Grey literature and hand searches were utilised to identify additional unclassified military documents, for inclusion in the study. More than 100 documents were included for data extraction and analysis. Key domains were identified, these included: Humanitarian and Military Response, Communication, Coordination, Resources, Needs Assessment and Pre-Existing Policy. Corresponding information and lessons-learned pertaining to these domains was then extracted - detailing the barriers and facilitators to an effective response. Results: Multiple themes were noted which stratified all identified domains - including the lack of adequate pre-existing policy, as well as extensive ambiguity of actors’ roles. This ambiguity was continually influenced by the complex role the United States military played in the disaster response. At a deeper level, the effects of neo-colonialism and concern about infringements on Haitian sovereignty played a substantial role at all levels: setting the pre-existing conditions and determining the redevelopment efforts that followed. Furthermore, external factors significantly impacted the response, particularly the loss of life within the political and security sectors. This was compounded by the destruction of important infrastructure systems - particularly electricity supplies and telecommunication networks, as well as air and seaport capabilities. Conclusions: This study stands as one of the first and most comprehensive evaluations, systematically analysing the civilian and military response - including their collaborative efforts. This study offers vital information for improving future combined responses and provides a significant opportunity for advancing knowledge in disaster relief efforts - which remains a more pressing issue than ever. The categories and domains formulated serve to highlight interdependent factors that should be applied in future disaster responses, with significant potential to aid the effective performance of humanitarian actors. Further studies will be grounded in these findings, particularly the need for greater inclusion of the Haitian perspective in the literature, through additional qualitative research studies.

Keywords: civilian and military collaboration, combined response, disaster, disaster response, earthquake, Haiti, humanitarian response

Procedia PDF Downloads 130
2177 Links between Inflammation and Insulin Resistance in Children with Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: children, inflammation, insulin resistance, metabolic syndrome, obesity

Procedia PDF Downloads 138
2176 Covid Medical Imaging Trial: Utilising Artificial Intelligence to Identify Changes on Chest X-Ray of COVID

Authors: Leonard Tiong, Sonit Singh, Kevin Ho Shon, Sarah Lewis

Abstract:

Investigation into the use of artificial intelligence in radiology continues to develop at a rapid rate. During the coronavirus pandemic, the combination of an exponential increase in chest x-rays and unpredictable staff shortages resulted in a huge strain on the department's workload. There is a World Health Organisation estimate that two-thirds of the global population does not have access to diagnostic radiology. Therefore, there could be demand for a program that could detect acute changes in imaging compatible with infection to assist with screening. We generated a conventional neural network and tested its efficacy in recognizing changes compatible with coronavirus infection. Following ethics approval, a deidentified set of 77 normal and 77 abnormal chest x-rays in patients with confirmed coronavirus infection were used to generate an algorithm that could train, validate and then test itself. DICOM and PNG image formats were selected due to their lossless file format. The model was trained with 100 images (50 positive, 50 negative), validated against 28 samples (14 positive, 14 negative), and tested against 26 samples (13 positive, 13 negative). The initial training of the model involved training a conventional neural network in what constituted a normal study and changes on the x-rays compatible with coronavirus infection. The weightings were then modified, and the model was executed again. The training samples were in batch sizes of 8 and underwent 25 epochs of training. The results trended towards an 85.71% true positive/true negative detection rate and an area under the curve trending towards 0.95, indicating approximately 95% accuracy in detecting changes on chest X-rays compatible with coronavirus infection. Study limitations include access to only a small dataset and no specificity in the diagnosis. Following a discussion with our programmer, there are areas where modifications in the weighting of the algorithm can be made in order to improve the detection rates. Given the high detection rate of the program, and the potential ease of implementation, this would be effective in assisting staff that is not trained in radiology in detecting otherwise subtle changes that might not be appreciated on imaging. Limitations include the lack of a differential diagnosis and application of the appropriate clinical history, although this may be less of a problem in day-to-day clinical practice. It is nonetheless our belief that implementing this program and widening its scope to detecting multiple pathologies such as lung masses will greatly assist both the radiology department and our colleagues in increasing workflow and detection rate.

Keywords: artificial intelligence, COVID, neural network, machine learning

Procedia PDF Downloads 97
2175 A Proposal for an Excessivist Social Welfare Ordering

Authors: V. De Sandi

Abstract:

In this paper, we characterize a class of rank-weighted social welfare orderings that we call ”Excessivist.” The Excessivist Social Welfare Ordering (eSWO) judges incomes above a fixed threshold θ as detrimental to society. To accomplish this, the identification of a richness or affluence line is necessary. We employ a fixed, exogenous line of excess. We define an eSWF in the form of a weighted sum of individual’s income. This requires introducing n+1 vectors of weights, one for all possible numbers of individuals below the threshold. To do this, the paper introduces a slight modification of the class of rank weighted class of social welfare function. Indeed, in our excessivist social welfare ordering, we allow the weights to be both positive (for individuals below the line) and negative (for individuals above). Then, we introduce ethical concerns through an axiomatic approach. The following axioms are required: continuity above and below the threshold (Ca, Cb), anonymity (A), absolute aversion to excessive richness (AER), pigou dalton positive weights preserving transfer (PDwpT), sign rank preserving full comparability (SwpFC) and strong pareto below the threshold (SPb). Ca, Cb requires that small changes in two income distributions above and below θ do not lead to changes in their ordering. AER suggests that if two distributions are identical in any respect but for one individual above the threshold, who is richer in the first, then the second should be preferred by society. This means that we do not care about the waste of resources above the threshold; the priority is the reduction of excessive income. According to PDwpT, a transfer from a better-off individual to a worse-off individual despite their relative position to the threshold, without reversing their ranks, leads to an improved distribution if the number of individuals below the threshold is the same after the transfer or the number of individuals below the threshold has increased. SPb holds only for individuals below the threshold. The weakening of strong pareto and our ethics need to be justified; we support them through the notion of comparative egalitarianism and income as a source of power. SwpFC is necessary to ensure that, following a positive affine transformation, an individual does not become excessively rich in only one distribution, thereby reversing the ordering of the distributions. Given the axioms above, we can characterize the class of the eSWO, getting the following result through a proof by contradiction and exhaustion: Theorem 1. A social welfare ordering satisfies the axioms of continuity above and below the threshold, anonymity, sign rank preserving full comparability, aversion to excessive richness, Pigou Dalton positive weight preserving transfer, and strong pareto below the threshold, if and only if it is an Excessivist-social welfare ordering. A discussion about the implementation of different threshold lines reviewing the primary contributions in this field follows. What the commonly implemented social welfare functions have been overlooking is the concern for extreme richness at the top. The characterization of Excessivist Social Welfare Ordering, given the axioms above, aims to fill this gap.

Keywords: comparative egalitarianism, excess income, inequality aversion, social welfare ordering

Procedia PDF Downloads 66
2174 A Resilience-Based Approach for Assessing Social Vulnerability in New Zealand's Coastal Areas

Authors: Javad Jozaei, Rob G. Bell, Paula Blackett, Scott A. Stephens

Abstract:

In the last few decades, Social Vulnerability Assessment (SVA) has been a favoured means in evaluating the susceptibility of social systems to drivers of change, including climate change and natural disasters. However, the application of SVA to inform responsive and practical strategies to deal with uncertain climate change impacts has always been challenging, and typically agencies resort back to conventional risk/vulnerability assessment. These challenges include complex nature of social vulnerability concepts which influence its applicability, complications in identifying and measuring social vulnerability determinants, the transitory social dynamics in a changing environment, and unpredictability of the scenarios of change that impacts the regime of vulnerability (including contention of when these impacts might emerge). Research suggests that the conventional quantitative approaches in SVA could not appropriately address these problems; hence, the outcomes could potentially be misleading and not fit for addressing the ongoing uncertain rise in risk. The second phase of New Zealand’s Resilience to Nature’s Challenges (RNC2) is developing a forward-looking vulnerability assessment framework and methodology that informs the decision-making and policy development in dealing with the changing coastal systems and accounts for complex dynamics of New Zealand’s coastal systems (including socio-economic, environmental and cultural). Also, RNC2 requires the new methodology to consider plausible drivers of incremental and unknowable changes, create mechanisms to enhance social and community resilience; and fits the New Zealand’s multi-layer governance system. This paper aims to analyse the conventional approaches and methodologies in SVA and offer recommendations for more responsive approaches that inform adaptive decision-making and policy development in practice. The research adopts a qualitative research design to examine different aspects of the conventional SVA processes, and the methods to achieve the research objectives include a systematic review of the literature and case study methods. We found that the conventional quantitative, reductionist and deterministic mindset in the SVA processes -with a focus the impacts of rapid stressors (i.e. tsunamis, floods)- show some deficiencies to account for complex dynamics of social-ecological systems (SES), and the uncertain, long-term impacts of incremental drivers. The paper will focus on addressing the links between resilience and vulnerability; and suggests how resilience theory and its underpinning notions such as the adaptive cycle, panarchy, and system transformability could address these issues, therefore, influence the perception of vulnerability regime and its assessment processes. In this regard, it will be argued that how a shift of paradigm from ‘specific resilience’, which focuses on adaptive capacity associated with the notion of ‘bouncing back’, to ‘general resilience’, which accounts for system transformability, regime shift, ‘bouncing forward’, can deliver more effective strategies in an era characterised by ongoing change and deep uncertainty.

Keywords: complexity, social vulnerability, resilience, transformation, uncertain risks

Procedia PDF Downloads 104
2173 Does Stock Markets Asymmetric Information Affect Foreign Capital Flows?

Authors: Farid Habibi Tanha, Mojtaba Jahanbazi, Morteza Foroutan, Rasidah Mohd Rashid

Abstract:

This paper depicts the effects of asymmetric information in determining capital inflows to be captured through stock market microstructure. The model can explain several stylized facts regarding the capital immobility. The first phase of the research involves in collecting and refining 150,000,000 daily data of 11 stock markets over a period of one decade in an effort to minimize the impact of survivorship bias. Three micro techniques were used to measure information asymmetries. The final phase analyzes the model through panel data approach. As a unique contribution, this research will provide valuable information regarding negative effects of information asymmetries in stock markets on attracting foreign investments. The results of this study can be directly considered by policy makers to monitor and control changes of capital flow in order to keep market conditions in a healthy manner, by preventing and managing possible shocks to avoid sudden reversals and market failures.

Keywords: asymmetric information, capital inflow, market microstructure, investment

Procedia PDF Downloads 323
2172 Adaptation to Climate Change: An Anthropological Study on Changing Livelihood Strategies in South-West Coastal Bangladesh

Authors: Ashik Sarder

Abstract:

Bangladesh is a disaster-prone and one of the most vulnerable countries to climate change. The country has a long coastal area which is frequently being affected by several types of natural disasters due to climate change. The disasters have impacts on the life and livelihood of different natural resources depending on communities living in the coastal areas. The Malo is a Hindu religious traditional fishing community living at Sarafpur Union of Dumuria Upazila of Khulna district of south-west coastal Bangladesh. Fishing is the only means of their livelihood and the community has been engaged in fishing practices inherently in rivers, estuaries, and sea for more than 300 years. and they are totally dependent on this traditional occupation. But, in recent year’s climate change has negative impacts on their only livelihood option. The study aims to examine the impacts of climate change on the livelihood of Malo fishing community in south-west coastal Bangladesh, identify the adaptation strategies undertaken and practiced by Malo fishing community to cope with climate change and sustain their livelihood and explore the changing adaptation strategies undertaken by Malo fishing community and others. The study has been conducted from both qualitative and quantitative perspectives. Data has been collected from both primary and secondary sources. The primary data has been collected in the participatory observation approach following both qualitative and quantitative method. The primary source of data includes village census, face-to-face interview and in-depth case studies using structured questionnaire. The secondary source of the literature includes different national and international documents, policy papers, books and articles; related websites and peer-viewed documents on climate change, vulnerability, adaptation, livelihood, and fisheries. The study has identified different practices of adaption to climate change by Malo fishing community and others in the selected area. Three types of adaption practices have been identified. Firstly, the indigenous adaptation practices by Malo fishing community to cope with climate change have been identified. These identified adaptation practices by Malo fishing community include; ensuring drinking water and sanitation facilities, planting trees to tackle impacts of cyclone, excavating dumps to preserve the valuable assets, growing vegetables and rearing domestic livestock to earn surplus money, taking loans for ensuring continuation of present livelihood and migrating to near city or towns for better livelihood options. Secondly, adaptation initiatives undertaken by the government have provided limited facility to this vulnerable fishing community and made them benefited. And thirdly, some adaptation initiatives commenced by few non-government and community-based organizations have also made the Malo fishing community as beneficiaries. The study has suggested recommendations for Malo fishing community to overcome the challenges and impacts of climate change for retaining their traditional fishing livelihood. The accumulated recommendations would be very useful for the researchers, academicians, policy-makers of Government and non-government organizations to conduct more researches and take initiatives for Malo fishing community to make them more capable to sustain their fishing livelihood.

Keywords: climate change, livelihood, adaptation, anthropology, vulnerability

Procedia PDF Downloads 121
2171 Development and Characterization of Novel Topical Formulation Containing Niacinamide

Authors: Sevdenur Onger, Ali Asram Sagiroglu

Abstract:

Hyperpigmentation is a cosmetically unappealing skin problem caused by an overabundance of melanin in the skin. Its pathophysiology is caused by melanocytes being exposed to paracrine melanogenic stimuli, which can upregulate melanogenesis-related enzymes (such as tyrosinase) and cause melanosome formation. Tyrosinase is linked to the development of melanosomes biochemically, and it is the main target of hyperpigmentation treatment. therefore, decreasing tyrosinase activity to reduce melanosomes has become the main target of hyperpigmentation treatment. Niacinamide (NA) is a natural chemical found in a variety of plants that is used as a skin-whitening ingredient in cosmetic formulations. NA decreases melanogenesis in the skin by inhibiting melanosome transfer from melanocytes to covering keratinocytes. Furthermore, NA protects the skin from reactive oxygen species and acts as a main barrier with the skin, reducing moisture loss by increasing ceramide and fatty acid synthesis. However, it is very difficult for hydrophilic compounds such as NA to penetrate deep into the skin. Furthermore, because of the nicotinic acid in NA, it is an irritant. As a result, we've concentrated on strategies to increase NA skin permeability while avoiding its irritating impacts. Since nanotechnology can affect drug penetration behavior by controlling the release and increasing the period of permanence on the skin, it can be a useful technique in the development of whitening formulations. Liposomes have become increasingly popular in the cosmetics industry in recent years due to benefits such as their lack of toxicity, high penetration ability in living skin layers, ability to increase skin moisture by forming a thin layer on the skin surface, and suitability for large-scale production. Therefore, liposomes containing NA were developed for this study. Different formulations were prepared by varying the amount of phospholipid and cholesterol and examined in terms of particle sizes, polydispersity index (PDI) and pH values. The pH values of the produced formulations were determined to be suitable with the pH value of the skin. Particle sizes were determined to be smaller than 250 nm and the particles were found to be of homogeneous size in the formulation (pdi<0.30). Despite the important advantages of liposomal systems, they have low viscosity and stability for topical use. For these reasons, in this study, liposomal cream formulations have been prepared for easy topical application of liposomal systems. As a result, liposomal cream formulations containing NA have been successfully prepared and characterized. Following the in-vitro release and ex-vivo diffusion studies to be conducted in the continuation of the study, it is planned to test the formulation that gives the most appropriate result on the volunteers after obtaining the approval of the ethics committee.

Keywords: delivery systems, hyperpigmentation, liposome, niacinamide

Procedia PDF Downloads 114
2170 Environmental Quality in Urban Areas: Legal Aspect and Institutional Dimension: A Case Study of Algeria

Authors: Youcef Lakhdar Hamina

Abstract:

In order to tame the ecological damage specificity, it is imperative to assert the procedural and objective liability aspect, which leads us to analyse current trends based on the development of preventive civil liability based on the precautionary principle. Our research focuses on the instruments of the environment protection in urban areas based on two complementary aspects appearing contradictory and refer directly to the institutional dimensions: - The preventive aspect: considered as a main objective of the environmental policy which highlights the different legal mechanisms for the environment protection by highlighting the role of administration in its implementation (environmental planning, tax incentives, modes of participation of all actors, etc.). - The healing-repressive aspect: considered as an approach for the identification of ecological damage and the forms of reparation (spatial and temporal-responsibility) to the impossibility of predicting with rigor and precision, the appearance of ecological damage, which cannot be avoided.

Keywords: environmental law, environmental taxes, environmental damage, eco responsibility, precautionary principle, environmental management

Procedia PDF Downloads 418
2169 Marketing Management and Cultural Learning Center: The Case Study of Arts and Cultural Office, Suansunandha Rajabhat University

Authors: Pirada Techaratpong

Abstract:

This qualitative research has 2 objectives: to study marketing management of the cultural learning center in Suansunandha Rajabhat University and to suggest guidelines to improve its marketing management. This research is based on a case study of the Arts and Culture Office in Suansunandha Rajabhat University, Bangkok. This research found the Art and Culture Office has no formal marketing management. However, the marketing management is partly covered in the overall business plan, strategic plan, and action plan. The process can be divided into 5 stages. The marketing concept has long been introduced to its policy but not apparently put into action due to inflexible system. Some gaps are found in the process. The research suggests the Art and Culture Office implement the concept of marketing orientation, meeting the needs and wants of its target customers and adapt to the changing situation. Minor guidelines for improvement are provided.

Keywords: cultural learning center, marketing, management, museum

Procedia PDF Downloads 387
2168 Prioritization of the Failure Factors of Rural Cooperatives in Iran: The Case of Isfahan Province

Authors: Maryam Najafi, Mahdi Rajabi

Abstract:

Although the rural cooperatives are an effective way for rural development in Iran, their potential is not applied effectively. The investigation of the failures of rural cooperatives helps the authorities to improve the routine procedures and eliminate the current barriers to the success of these cooperatives, and to remove the defects in order to have a more efficient policy. Therefore, this research aims to prioritize the failure factors of rural cooperatives in Isfahan province via the survey research method. For this purpose, the effective factors of these failures were investigated by the available research documents and then by the new information which was obtained from 20 questionnaires from the experts of Central Organization Rural Cooperatives in Isfahan province. The questionnaire results were analyzed by Analytical Hierarchy Process (AHP), Excel, and Expert Choice software. The results of this research showed that the most important failure factor of these cooperatives is the lack of the participation culture of cooperative members and then the performance of Central Organization Rural Cooperatives, and also loss of confidence of the members in the cooperation.

Keywords: cooperative, rural cooperatives, failure factors, analytical hierarchy process

Procedia PDF Downloads 134
2167 The Impact of the EU Competition Law on the Asian Systems

Authors: Maria Casoria

Abstract:

Throughout the last decade developing countries have been undergoing substantial reforms to promote the establishment of competition regimes, as consequence of the trade liberalization and the spread of a ‘competition awareness movement’ across the globe. The legislative trend affected the whole Asia. Notwithstanding the existence of extensive joint ventures, cartels and other collusive business relationships in this geographical area, almost all the countries have already passed or are committed to enforce specific laws in the field. The study dwells into legal solutions adopted in the five sub-regions in which the continent is commonly divided –i.e. Central, East, South, Southeast, and Western Asia- and, using a comparative methodology, shed lights on the main differences and similarities in place. The final outcome of the analysis is that, despite the undeniable divergences of approach, what links together the legislation in force in the region is the unveiled influence exercised by the European Union competition regulation. Consequently, in order to properly evaluate the deterrence of the rule of law in the sector concerned, it is fundamental to scrutinize the major role played by the EU and its policy for the evolution of pro-competitive practices in the continent.

Keywords: Asia, competition law, differences and similarities, European union, influences

Procedia PDF Downloads 277
2166 Youths Economic Empowerment through Vocational Agricultural Enterprises (Entrepreneurship) for Sustainable Agriculture in Nigeria: Constraints and Initiatives for Improvement

Authors: Thomas Ogilegwu Orohu

Abstract:

This paper presents agricultural education as a vocational study, an impetus for youths, economic empowerment. The survival of Nigeria’s agriculture rests squarely on the youth who are the farmers and leaders of tomorrow. Hitherto, the teaching and learning of agriculture has proceeded in such a manner that graduates of such programs have failed to make the successful launch into the world of agricultural enterprises (entrepreneurship). Major constraints that predisposed this anomalous situation were identified to include poor policy framework, socio-economic pressures, undue parental and peer influences, improper value orientation and of course, the nature of curricula. In response to the situation, some programs and/or initiatives aimed at inculcating entrepreneurial skills were proposed by this paper with identified target beneficiaries. The initiatives bordered on curricular reorientation that integrate entrepreneurship/enterprise education, retraining of graduates, financial support system among others.

Keywords: Program initiatives. vocational agriculture, youths’ empowerment, introduction

Procedia PDF Downloads 314
2165 PM₁₀ and PM2.5 Concentrations in Bangkok over Last 10 Years: Implications for Air Quality and Health

Authors: Tin Thongthammachart, Wanida Jinsart

Abstract:

Atmospheric particulate matter particles with a diameter less than 10 microns (PM₁₀) and less than 2.5 microns (PM₂.₅) have adverse health effect. The impact from PM was studied from both health and regulatory perspective. Ambient PM data was collected over ten years in Bangkok and vicinity areas of Thailand from 2007 to 2017. Statistical models were used to forecast PM concentrations from 2018 to 2020. Monitoring monthly data averaged concentration of PM₁₀ and PM₂.₅ were used as input to forecast the monthly average concentration of PM. The forecasting results were validated by root means square error (RMSE). The predicted results were used to determine hazard risk for the carcinogenic disease. The health risk values were interpolated with GIS with ordinary kriging technique to create hazard maps in Bangkok and vicinity area. GIS-based maps illustrated the variability of PM distribution and high-risk locations. These evaluated results could support national policy for the sake of human health.

Keywords: PM₁₀, PM₂.₅, statistical models, atmospheric particulate matter

Procedia PDF Downloads 161
2164 Key Factors Influencing Individual Knowledge Capability in KIFs

Authors: Salman Iqbal

Abstract:

Knowledge management (KM) literature has mainly focused on the antecedents of KM. The purpose of this study is to investigate the effect of specific human resource management (HRM) practices on employee knowledge sharing and its outcome as individual knowledge capability. Based on previous literature, a model is proposed for the study and hypotheses are formulated. The cross-sectional dataset comes from a sample of 19 knowledge intensive firms (KIFs). This study has run an item parceling technique followed by Confirmatory Factor Analysis (CFA) on the latent constructs of the research model. Employees’ collaboration and their interpersonal trust can help to improve their knowledge sharing behaviour and knowledge capability within organisations. This study suggests that in future, by using a larger sample, better statistical insight is possible. The findings of this study are beneficial for scholars, policy makers and practitioners. The empirical results of this study are entirely based on employees’ perceptions and make a significant research contribution, given there is a dearth of empirical research focusing on the subcontinent.

Keywords: employees’ collaboration, individual knowledge capability, knowledge sharing, monetary rewards, structural equation modelling

Procedia PDF Downloads 278
2163 Health Inequalities in the Global South: Identification of Poor People with Disabilities in Cambodia to Generate Access to Healthcare

Authors: Jamie Lee Harder

Abstract:

In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

Procedia PDF Downloads 152
2162 Farmers’ Perception, Willingness and Capacity in Utilization of Household Sewage Sludge as Organic Resources for Peri-Urban Agriculture around Jos Nigeria

Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

Abstract:

Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: ash, farmers, household, peri-urban, refuse, sewage, sludge, urban

Procedia PDF Downloads 141
2161 Maternal and Newborn Health Care Program Implementation and Integration by Maternal Community Health Workers, Africa: An Integrative Review

Authors: Nishimwe Clemence, Mchunu Gugu, Mukamusoni Dariya

Abstract:

Background: Community health workers and extension workers can play an important role in supporting families to adopt health practices, encourage delivery in a health care facility, and ensure time referral of mothers and newborns if needed. Saving the lives of neonates should, therefore, be a significant health outcome in any maternal and newborn health program that is being implemented. Furthermore, about half of a million mothers die from pregnancy-related causes. Maternal and newborn deaths related to the period of postnatal care are neglected. Some authors emphasized that in developing countries, newborn mortality rates have been reduced much more slowly because of the lack of many necessary facility-based and outreach service. The aim of this review was to critically analyze the implementation and integration process of the maternal and newborn health care program by maternal community health workers, into the health care system, in Africa. Furthermore, it aims to reduce maternal and newborn mortality. We addressed the following review question: (1) what process is involved in the implementation and integration of the maternal and newborn health care program by maternal community health workers during antenatal, delivery and postnatal care into health system care in Africa? Methods: The database searched was from Health Source: Nursing/Academic Edition through academic search complete via EBSCO Host. An iterative approach was used to go through Google scholarly papers. The reviewers considered adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance, and the Mixed Methods Appraisal Tool (MMAT) was used. Synthesis method in integrative review following elements of noting patterns and themes, seeing plausibility, clustering, counting, making contrasts and comparisons, discerning commons and unusual patterns, subsuming particulars into general, noting relations between variability, finding intervening factors and building a logical chain of evidence, using data–based convergent synthesis design. Results: From the seventeen of studies included, results focused on three dimensions inspired by the literature on antenatal, delivery, and postnatal interventions. From this, further conceptual framework was elaborated. The conceptual framework process of implementation and integration of maternal and newborn health care program by maternal community health workers was elaborated in order to ensure the sustainability of community based intervention. Conclusions: the review revealed that the implementation and integration of maternal and newborn health care program require planning. We call upon governments, non-government organizations, the global health community, all stakeholders including policy makers, program managers, evaluators, educators, and providers to be involved in implementation and integration of maternal and newborn health program in updated policy and community-based intervention. Furthermore, emphasis should be placed on competence, responsibility, and accountability of maternal community health workers, their training and payment, collaboration with health professionals in health facilities, and reinforcement of outreach service. However, the review was limited in focus to the African context, where the process of maternal and newborn health care program has been poorly implemented.

Keywords: Africa, implementation of integration, maternal, newborn

Procedia PDF Downloads 165