Search results for: legal judgment and decision making
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8225

Search results for: legal judgment and decision making

5555 Approaches to Reduce the Complexity of Mathematical Models for the Operational Optimization of Large-Scale Virtual Power Plants in Public Energy Supply

Authors: Thomas Weber, Nina Strobel, Thomas Kohne, Eberhard Abele

Abstract:

In context of the energy transition in Germany, the importance of so-called virtual power plants in the energy supply continues to increase. The progressive dismantling of the large power plants and the ongoing construction of many new decentralized plants result in great potential for optimization through synergies between the individual plants. These potentials can be exploited by mathematical optimization algorithms to calculate the optimal application planning of decentralized power and heat generators and storage systems. This also includes linear or linear mixed integer optimization. In this paper, procedures for reducing the number of decision variables to be calculated are explained and validated. On the one hand, this includes combining n similar installation types into one aggregated unit. This aggregated unit is described by the same constraints and target function terms as a single plant. This reduces the number of decision variables per time step and the complexity of the problem to be solved by a factor of n. The exact operating mode of the individual plants can then be calculated in a second optimization in such a way that the output of the individual plants corresponds to the calculated output of the aggregated unit. Another way to reduce the number of decision variables in an optimization problem is to reduce the number of time steps to be calculated. This is useful if a high temporal resolution is not necessary for all time steps. For example, the volatility or the forecast quality of environmental parameters may justify a high or low temporal resolution of the optimization. Both approaches are examined for the resulting calculation time as well as for optimality. Several optimization models for virtual power plants (combined heat and power plants, heat storage, power storage, gas turbine) with different numbers of plants are used as a reference for the investigation of both processes with regard to calculation duration and optimality.

Keywords: CHP, Energy 4.0, energy storage, MILP, optimization, virtual power plant

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5554 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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5553 The Effect of Law on Society

Authors: Rezki Omar

Abstract:

Openness cosmic shares dramatically in the order of something quite a bit of neglected priorities within the community at the level of thought and consciousness, and these priorities provider of legal and human rights awareness after a long delay in the process of awareness of human rights, there is no doubt that the long and arduous road. As is obvious to any observer public affairs as well as the specialist and the observer that there is growth and development in the scene and the legal movement is unprecedented, many when dealing with many of the details sought and tries as much as possible to know what is the natural rights, and duties that must comply with legally in no charge with the issue of what is going on, any attempt of weakness and lack of self-reliance and obstacles level during the search show him by virtue of the difficulty of the availability of legal information in some cases on a particular issue, whether or not the image is complete, legally insufficient. Law relationship to society basically a close relationship, there is no law society, a society is impossible without both at the level of domestic relations or international law: «There is a close link between law and society. The law remains influenced by the society in which it grew, as well as the law affects the society, which is governed by, the relationship between the community and law affected and the impact of relationship ». The law of the most important objectives of protecting members of society, and its role is based on the distribution of rights and duties in a fair way, and protect the public interest of the citizen’s basis. The word community when some sociologists are limited to the group that gathered, including cultural unity Cultural Group distinguish between society and the last. In the recent period issued a set of regulations in the various branches of law, which is different from the class and important one hand, and here is important study of the interaction between law and society, and how to make the laws effective in the community? The opposite is true as well. The law as a social phenomenon is impossible to understand and analyzed without taking into account the extent of their impact and vulnerability within the community and accepted. Must evoke the basis that it was developed to address the problems faced by citizens. The over-age and amplify the sanctions are a contradiction of that fundamental reform of the basic objectives of the offender more than anything else Calantqam and revenge, and if the process is not human mistakes. Michel Foucault believes that «tighten laws and regulations against criminals will not reduce the crime rate in the community, so you must activate the system of moral values of society after more deterrent, and the threat of scandal on a social level.» Besson and refers to the legislators, saying the law: «The only way to reduce the crime rate to strengthen the ethical system of the society, especially in the social Amnhoha sanctity of conscience, then you will not be forced to issue harsh sentences against criminals».In summary, it is necessary to combine the enactment of laws and activate the system of moral values and educational values on the ground, and to understand the causes of social problems at the root of all for the equation is complete, and that the law was drafted to serve the citizens and not to harm him.

Keywords: legislators, distinguish, awareness, insufficient

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5552 Evidence Theory Enabled Quickest Change Detection Using Big Time-Series Data from Internet of Things

Authors: Hossein Jafari, Xiangfang Li, Lijun Qian, Alexander Aved, Timothy Kroecker

Abstract:

Traditionally in sensor networks and recently in the Internet of Things, numerous heterogeneous sensors are deployed in distributed manner to monitor a phenomenon that often can be model by an underlying stochastic process. The big time-series data collected by the sensors must be analyzed to detect change in the stochastic process as quickly as possible with tolerable false alarm rate. However, sensors may have different accuracy and sensitivity range, and they decay along time. As a result, the big time-series data collected by the sensors will contain uncertainties and sometimes they are conflicting. In this study, we present a framework to take advantage of Evidence Theory (a.k.a. Dempster-Shafer and Dezert-Smarandache Theories) capabilities of representing and managing uncertainty and conflict to fast change detection and effectively deal with complementary hypotheses. Specifically, Kullback-Leibler divergence is used as the similarity metric to calculate the distances between the estimated current distribution with the pre- and post-change distributions. Then mass functions are calculated and related combination rules are applied to combine the mass values among all sensors. Furthermore, we applied the method to estimate the minimum number of sensors needed to combine, so computational efficiency could be improved. Cumulative sum test is then applied on the ratio of pignistic probability to detect and declare the change for decision making purpose. Simulation results using both synthetic data and real data from experimental setup demonstrate the effectiveness of the presented schemes.

Keywords: CUSUM, evidence theory, kl divergence, quickest change detection, time series data

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5551 Accessibility Assessment of School Facilities Using Geospatial Technologies: A Case Study of District Sheikhupura

Authors: Hira Jabbar

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Education is vital for inclusive growth of an economy and a critical contributor for investment in human capital. Like other developing countries, Pakistan is facing enormous challenges regarding the provision of public facilities, improper infrastructure planning, accelerating rate of population and poor accessibility. The influence of the rapid advancement and innovations in GIS and RS techniques have proved to be a useful tool for better planning and decision making to encounter these challenges. Therefore present study incorporates GIS and RS techniques to investigate the spatial distribution of school facilities, identifies settlements with served and unserved population, finds potential areas for new schools based on population and develops an accessibility index to evaluate the higher accessibility for schools. For this purpose high-resolution worldview imagery was used to develop road network, settlements and school facilities and to generate school accessibility for each level. Landsat 8 imagery was utilized to extract built-up area by applying pre and post-processing models and Landscan 2015 was used to analyze population statistics. Service area analysis was performed using network analyst extension in ArcGIS 10.3v and results were evaluated for served and underserved areas and population. An accessibility tool was used to evaluate a set of potential destinations to determine which is the most accessible with the given population distribution. Findings of the study may contribute to facilitating the town planners and education authorities for understanding the existing patterns of school facilities. It is concluded that GIS and remote sensing can be effectively used in urban transport and facility planning.

Keywords: accessibility, geographic information system, landscan, worldview

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5550 Application and Limitation of Heavy Metal Pollution Indicators in Coastal Environment of Pakistan

Authors: Noor Us Saher

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Oceans and Marine areas have a great importance, mainly regarding food resources, fishery products and reliance of livelihood. Aquatic pollution is common due to the incorporation of various chemicals mainly entering from urbanization, industrial and commercial facilities, such as oil and chemical spills. Many hazardous wastes and industrial effluents contaminate the nearby areas and initiate to affect the marine environment. These contaminated conditions may become worse in those aquatic environments situated besides the world’s largest cities, which are hubs of various commercial activities. Heavy metal contamination is one of the most important predicaments for marine environments and during past decades this problem has intensified due to an increase in urbanization and industrialization. Coastal regions of Pakistan are facing severe threats from various organic and inorganic pollutants, especially the estuarine and coastal areas of Karachi city, the most populated and industrialized city situated along the coastline. Metal contamination causes severe toxicity in biota resulting the degradation of Marine environments and depletion of fishery resources and sustainability. There are several abiotic (air, water and sediment) and biotic (fauna and flora) indicators that indicate metal contamination. However, all these indicators have certain limitations and complexities, which delay their implementation for rehabilitation and conservation in the marine environment. The inadequate evidences have presented on this significant topic till the time and this study discussed metal pollution and its consequences along the marine environment of Pakistan. This study further helps in identification of possible hazards for the ecological system and allied resources for management strategies and decision making for sustainable approaches.

Keywords: coastal and estuarine environment, heavy metals pollution, pollution indicators, Pakistan

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5549 COVID_ICU_BERT: A Fine-Tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

Procedia PDF Downloads 184
5548 Evaluation System of Spatial Potential Under Bridges in High Density Urban Areas of Chongqing Municipality and Applied Research on Suitability

Authors: Xvelian Qin

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Urban "organic renewal" based on the development of existing resources in high-density urban areas has become the mainstream of urban development in the new era. As an important stock resource of public space in high-density urban areas, promoting its value remodeling is an effective way to alleviate the shortage of public space resources. However, due to the lack of evaluation links in the process of underpass space renewal, a large number of underpass space resources have been left idle, facing the problems of low space conversion efficiency, lack of accuracy in development decision-making, and low adaptability of functional positioning to citizens' needs. Therefore, it is of great practical significance to construct the evaluation system of under-bridge space renewal potential and explore the renewal mode. In this paper, some of the under-bridge spaces in the main urban area of Chongqing are selected as the research object. Through the questionnaire interviews with the users of the built excellent space under the bridge, three types of six levels and twenty-two potential evaluation indexes of "objective demand factor, construction feasibility factor and construction suitability factor" are selected, including six levels of land resources, infrastructure, accessibility, safety, space quality and ecological environment. The analytical hierarchy process and expert scoring method are used to determine the index weight, construct the potential evaluation system of the space under the bridge in high-density urban areas of Chongqing, and explore the direction of renewal and utilization of its suitability.

Keywords: space under bridge, potential evaluation, high density urban area, updated using

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5547 Military Role of Russia beyond Its National Boundary

Authors: Nipuli Gajanayake

Abstract:

The Russian military role beyond its national frontier has become a debatable hot topic in the international political arena. It’s advanced, and strategic responses in combating regional and international security problems have always been a factor to debate and criticize. Under such critical circumstances, Russia is attentive to play its military role according to the provisions of the Military Doctrine of the Russian Federation. Most importantly, the legal basis of the doctrine has also consisted with the generally recognized principles and norms of international law. Therefore, Russian international military assistances are pledged to accomplish international peace and security. The expansion of Russian military participation in the United Nations Peacekeeping operations, and military- political, and technical cooperation have largely evident the great effort of Russia in maintaining and restoring international peace and security. Moreover, the conflict management diplomacy and the development of dialogue with nation states to confront military risks and threats can also identify as a part of preserving international peace and security. In addition, Russia strives to strengthen the system of collective security with regional and international organizations through the legal framework of the Collective Security Treaty Organization (CSTO). Maintaining cooperative ties with the Commonwealth of Independent States (CIS), the Organization for Security and Cooperation in Europe (OSCE) and the Shanghai Cooperation Organization (SCO) have highlighted the Russian deliberation on maintaining regional peace and security. Nevertheless, the extension of cordial relations with nation states and providing of military assistances during tensions and conflicts on their territories can also underscore as Russians commitments on maintaining international peace and security. Observing and recognizing the disparity between the West portrayed terms like ‘illegal Russian interventions’ and the comprehensive reality behind the ‘Russian military assistances’ are important to understand. However, a lopsided vision or a perspective towards the Russian international military role would not present a clear understanding about its valued and also dedicated hard work on maintaining international peace and security.

Keywords: collective security, diplomacy, international military role of Russia, international peace and security

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5546 The Messy and Irregular Experience of Entrepreneurial Life

Authors: Hannah Dean

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The growth ideology, and its association with progress, is an important construct in the narrative of modernity. This ideology is embedded in neoclassical economic growth theory which conceptualises growth as linear and predictable, and the entrepreneur as a rational economic manager. This conceptualisation has been critiqued for reinforcing the managerial discourse in entrepreneurship studies. Despite these critiques, both the neoclassical growth theory and its adjacent managerial discourse dominate entrepreneurship studies notably the literature on female entrepreneurs. The latter is the focus of this paper. Given this emphasis on growth, female entrepreneurs are portrayed as problematic because their growth lags behind their male counterparts. This image which ignores the complexity and diversity of female entrepreneurs’ experience persists in the literature due to the lack of studies that analyse the process and contextual factors surrounding female entrepreneurs’ experience. This study aims to address the subordination of female entrepreneurs by questioning the hegemonic logic of economic growth and the managerial discourse as a true representation for the entrepreneurial experience. This objective is achieved by drawing on Schumpeter’s theorising and narrative inquiry. This exploratory study undertakes in depth interviews to gain insights into female entrepreneurs’ experience and the impact of the economic growth model and the managerial discourse on their performance. The narratives challenge a number of assumptions about female entrepreneurs. The participants occupied senior positions in the corporate world before setting up their businesses. This is at odds with much writing which assumes that women underperform because they leave their career without gaining managerial experience to achieve work-life balance. In line with Schumpeter, who distinguishes the entrepreneur from the manager, the participants’ main function was innovation. They did not believe that the managerial paradigm governing their corporate careers was applicable to their entrepreneurial experience. Formal planning and managerial rationality can hinder their decision making process. The narratives point to the gap between the two worlds which makes stepping into entrepreneurship a scary move. Schumpeter argues that the entrepreneurial process is evolutionary and that failure is an integral part of it. The participants’ entrepreneurial process was in fact irregular. The performance of new combinations was not always predictable. They therefore relied on their initiative. The inhibition to deploy these traits had an adverse effect on business growth. The narratives also indicate that over-reliance on growth threaten the business survival as it faces competing pressures. The study offers theoretical and empirical contributions to (female) entrepreneurship studies by presenting Schumpeter’s theorising as an alternative theoretical framework to the neoclassical economic growth theory. The study also reduces entrepreneurs’ vulnerability by making them aware of the negative influence that the linear growth model and the managerial discourse hold upon their performance. The study has implications for policy makers as it generates new knowledge that incorporates the current social and economic changes in the context of entrepreneurs that can no longer be sustained by the linear growth models especially in the current economic climate.

Keywords: economic growth, female entrepreneurs, managerial discourse, Schumpeter

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5545 I Look Powerful So You Will Yield to Me: The Effects of Embodied Power and the Perception of Power on Conflict Management

Authors: Fai-Ho E. Choi, Wing-Tung Au

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This study investigated the effects of embodiment on conflict management. As shown in the research literature, the physiological (i.e. bodily postures) can affect the emotional and cognitive proceedings of human beings, but little has been shown on whether such effects would have ramifications in decision-making related to other individuals. In this study, conflict is defined as when two parties have seemingly incompatible goals, and the two have to deal with each other in order to maximize one’s own gain. In a matched-gender experiment, university undergraduate students were randomly assigned to either the high power condition or the low power condition, with participants in each condition instructed to perform a fix set of bodily postures that would either embody them with a high sense of power or a low sense of power. One high-power participant would pair up with a low-power participant to engage in an integrative bargaining task and a dictator game. Participants also filled out a pre-trial questionnaire and a post-trial questionnaire measuring general sense of power, self-esteem and self-efficacy. Personality was controlled for. Results are expected to support our hypotheses that people who are embodied with power will be more unyielding in a conflict management situation, and that people who are dealing with another person embodied with power will be more yielding in a conflict management situation. As conflicts arise frequently both within and between organizations, a better understanding of how human beings function in conflicts is important. This study should provide evidence that bodily postures can influence the perceived sense of power of the parties involved and hence influence the conflict outcomes. Future research needs to be conducted to investigate further how people perceive themselves and how they perceive their opponents in conflicts, such that we can come up with a behavioral theory of conflict management.

Keywords: conflict management, embodiment, negotiation, perception

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5544 Effect of Addition Cinnamon Extract (Cinnamomum burmannii) to Water Content, pH Value, Total Lactid Acid Bacteria Colonies, Antioxidant Activity and Cholesterol Levels of Goat Milk Yoghurt Isolates Dadih (Pediococcus pentosaceus)

Authors: Endang Purwati, Ely Vebriyanti, R. Puji Hartini, Hendri Purwanto

Abstract:

This study aimed to determine the effect of addition cinnamon extract (Cinnamomum burmannii) in making goat milk yogurt product isolates dadih (Pediococcus pentosaceus) to antioxidant activity and cholesterol levels. The method of research was the experimental method by using a Randomized Block Design (RBD), which consists of 5 treatments with 4 groups as replication. Treatment in this study was used of cinnamon extract as A (0%), B (1%), C (2%), D (3%), E (4%) in a goat’s milk yoghurt. This study was used 4200 ml of Peranakan Etawa goat’s milk and 80 ml of cinnamon extract. The variable analyzed were water content, pH value, total lactic acid bacterial colonies, antioxidant activity and cholesterol levels. The average water content ranged from 81.2-85.56%. Mean pH values rang between 4.74–4.30. Mean total lactic acid bacteria colonies ranged from 3.87 x 10⁸ - 7.95 x 10⁸ CFU/ml. The average of the antioxidant activity ranged between 10.98%-27.88%. Average of cholesterol levels ranged from 14.0 mg/ml–17.5 mg/ml. The results showed that the addition of cinnamon extract in making goat milk yoghurt product isolates dadih (Pediococcus pentosaceus) significantly different (P < 0.05) to water content, pH value, total lactic acid bacterial colonies, antioxidant activity and cholesterol levels. In conclusion, the study shows that using of cinnamon extract 4% is the best in making goat milk yoghurt.

Keywords: antioxidant, cholesterol, cinnamon, Pediococcus pentosaceus, yoghurt

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5543 Motivating Factors and Prospects for Rural Community Involvement in Entrepreneurship: Evidence from Mantanani Island, Sabah, Malaysia

Authors: F. Fabeil Noor, Roslinah Mahmud, Janice L. H. Nga, Rasid Mail

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In Malaysia, particularly in Sabah, the government has been promoting entrepreneurship among rural people to encourage them to earn their living by making good use of the diverse natural resources and local cultures of Sabah. Nevertheless, despite the government’s aim to encourage more local community in rural area to involve in entrepreneurship, the involvement of community in entrepreneurial activity is still low. It is crucial to identify the factors stimulate (or prevent) the involvement of rural community in Sabah in entrepreneurial activity. Therefore, this study tries to investigate the personal and contextual factors that may have impact on decision to start a business among the local community in Mantanani Island. In addition, this study also aims to identify the perceived benefits they receive from entrepreneurial activity. A structured face-to-face interview was conducted with 61 local communities in Mantanani Island. Data analysis revealed that passion, personal skills and self-confidence are the significant internal factors to entrepreneurial activity, whereas access to finance, labour and infrastructure are the significant external factors that are found to influence entrepreneurship. In terms of perceived rewards they received from taking up small business, it was found that respondents are predominantly agreed that entrepreneurship offers financial benefit than non-financial. In addition, this study also offers several suggestions for entrepreneurship development in Mantanani Island and it is hoped that this study may help the related agency to develop effective support policies in order to encourage more people in rural area to involve in entrepreneurship.

Keywords: entrepreneurship, motivation, perceived rewards, rural community

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5542 Investigating the Feasibility of Promoting Safety in Civil Projects by BIM System Using Fuzzy Logic

Authors: Mohammad Reza Zamanian

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The construction industry has always been recognized as one of the most dangerous available industries, and the statistics of accidents and injuries resulting from it say that the safety category needs more attention and the arrival of up-to-date technologies in this field. Building information modeling (BIM) is one of the relatively new and applicable technologies in Iran, that the necessity of using it is increasingly evident. The main purposes of this research are to evaluate the feasibility of using this technology in the safety sector of construction projects and to evaluate the effectiveness and operationality of its various applications in this sector. These applications were collected and categorized after reviewing past studies and researches then a questionnaire based on Delphi method criteria was presented to 30 experts who were thoroughly familiar with modeling software and safety guidelines. After receiving and exporting the answers to SPSS software, the validity and reliability of the questionnaire were assessed to evaluate the measuring tools. Fuzzy logic is a good way to analyze data because of its flexibility in dealing with ambiguity and uncertainty issues, and the implementation of the Delphi method in the fuzzy environment overcomes the uncertainties in decision making. Therefore, this method was used for data analysis, and the results indicate the usefulness and effectiveness of BIM in projects and improvement of safety status at different stages of construction. Finally, the applications and the sections discussed were ranked in order of priority for efficiency and effectiveness. Safety planning is considered as the most influential part of the safety of BIM among the four sectors discussed, and planning for the installation of protective fences and barriers to prevent falls and site layout planning with a safety approach based on a 3D model are the most important applications of BIM among the 18 applications to improve the safety of construction projects.

Keywords: building information modeling, safety of construction projects, Delphi method, fuzzy logic

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5541 PhilSHORE: Development of a WebGIS-Based Marine Spatial Planning Tool for Tidal Current Energy Resource Assessment and Site Suitability Analysis

Authors: Ma. Rosario Concepcion O. Ang, Luis Caezar Ian K. Panganiban, Charmyne B. Mamador, Oliver Dan G. De Luna, Michael D. Bausas, Joselito P. Cruz

Abstract:

PhilSHORE is a multi-site, multi-device and multi-criteria decision support tool designed to support the development of tidal current energy in the Philippines. Its platform is based on Geographic Information Systems (GIS) which allows for the collection, storage, processing, analyses and display of geospatial data. Combining GIS tools with open source web development applications, PhilSHORE becomes a webGIS-based marine spatial planning tool. To date, PhilSHORE displays output maps and graphs of power and energy density, site suitability and site-device analysis. It enables stakeholders and the public easy access to the results of tidal current energy resource assessments and site suitability analyses. Results of the initial development shows PhilSHORE is a promising decision support tool for ORE project developments.

Keywords: gis, site suitability analysis, tidal current energy resource assessment, webgis

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5540 Local Availability Influences Choice of Radical Treatment for Prostate Cancer

Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

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Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

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5539 Enforcement against Illegal Logging: Issues and Challenges

Authors: Muhammad Nur Haniff Mohd Noor, Rokiah Kadir, Suriyani Muhamad

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Sustainable forest management and forest protection can be hampered by illegal logging. Illegal logging is not uncommon in many wood-producing countries. Hence, law enforcement, especially in timber-producing countries, is crucial in ensuring compliance with forestry related regulations, as well as confirming that all parties obey the rules and regulations prescribed by the authorities. However, enforcement officers are encountering various challenges and difficulties which have undermined the enforcement capacity and efficiency. The appropriate policy responses for these issues are important to resolve the problems in the long term and empowering enforcement capacity to meet future challenges of forest law enforcement. This paper is written according to extensive review of the articles and publications by The International Criminal Police Organization (INTERPOL), The International Tropical Timber Organization (ITTO), Chatham House and The Food and Agriculture Organization of the United Nations (FAO). Subsequently, various books and journal articles are reviewed to gain further insight towards enforcement issues and challenges. This paper identifies several issues which consist of (1) insufficient enforcement capacity and resources (2) lack of coordination between various enforcement agencies, (3) corruption in the government and private sectors and (4) unclear legal frameworks related to the forestry sector. Next, this paper discusses appropriate policy responses to address each enforcement challenges according to various publications. This includes specific reports concerning forest law enforcement published by international forestry-related organizations. Therefore, lack of resources, inadequate synchronization between agencies, corruption, and legal issues present challenges to enforcement officers in their daily routines. Recommendations regarding proper policy responses to overcome the issues are of great importance in assisting forest authorities in prioritizing their resources appropriately.

Keywords: corruption, enforcement challenges, enforcement capacity, forest law enforcement, insufficient agency coordination, legislative ambiguity

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5538 The Determinants of Country Corruption: Unobserved Heterogeneity and Individual Choice- An empirical Application with Finite Mixture Models

Authors: Alessandra Marcelletti, Giovanni Trovato

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Corruption in public offices is found to be the reflection of country-specific features, however, the exact magnitude and the statistical significance of its determinants effect has not yet been identified. The paper aims to propose an estimation method to measure the impact of country fundamentals on corruption, showing that covariates could differently affect the extent of corruption across countries. Thus, we exploit a model able to take into account different factors affecting the incentive to ask or to be asked for a bribe, coherently with the use of the Corruption Perception Index. We assume that discordant results achieved in literature may be explained by omitted hidden factors affecting the agents' decision process. Moreover, assuming homogeneous covariates effect may lead to unreliable conclusions since the country-specific environment is not accounted for. We apply a Finite Mixture Model with concomitant variables to 129 countries from 1995 to 2006, accounting for the impact of the initial conditions in the socio-economic structure on the corruption patterns. Our findings confirm the hypothesis of the decision process of accepting or asking for a bribe varies with specific country fundamental features.

Keywords: Corruption, Finite Mixture Models, Concomitant Variables, Countries Classification

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5537 Evaluation of the Mechanical Behavior of a Retaining Wall Structure on a Weathered Soil through Probabilistic Methods

Authors: P. V. S. Mascarenhas, B. C. P. Albuquerque, D. J. F. Campos, L. L. Almeida, V. R. Domingues, L. C. S. M. Ozelim

Abstract:

Retaining slope structures are increasingly considered in geotechnical engineering projects due to extensive urban cities growth. These kinds of engineering constructions may present instabilities over the time and may require reinforcement or even rebuilding of the structure. In this context, statistical analysis is an important tool for decision making regarding retaining structures. This study approaches the failure probability of the construction of a retaining wall over the debris of an old and collapsed one. The new solution’s extension length will be of approximately 350 m and will be located over the margins of the Lake Paranoá, Brasilia, in the capital of Brazil. The building process must also account for the utilization of the ruins as a caisson. A series of in situ and laboratory experiments defined local soil strength parameters. A Standard Penetration Test (SPT) defined the in situ soil stratigraphy. Also, the parameters obtained were verified using soil data from a collection of masters and doctoral works from the University of Brasília, which is similar to the local soil. Initial studies show that the concrete wall is the proper solution for this case, taking into account the technical, economic and deterministic analysis. On the other hand, in order to better analyze the statistical significance of the factor-of-safety factors obtained, a Monte Carlo analysis was performed for the concrete wall and two more initial solutions. A comparison between the statistical and risk results generated for the different solutions indicated that a Gabion solution would better fit the financial and technical feasibility of the project.

Keywords: economical analysis, probability of failure, retaining walls, statistical analysis

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5536 Patient Engagement in Healthcare and Health Literacy in China: A Survey in China

Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

Abstract:

Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29),the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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5535 Building Information Modelling for Construction Delay Management

Authors: Essa Alenazi, Zulfikar Adamu

Abstract:

The Kingdom of Saudi Arabia (KSA) is not an exception in relying on the growth of its construction industry to support rapid population growth. However, its need for infrastructure development is constrained by low productivity levels and cost overruns caused by factors such as delays to project completion. Delays in delivering a construction project are a global issue and while theories such as Optimism Bias have been used to explain such delays, in KSA, client-related causes of delays are also significant. The objective of this paper is to develop a framework-based approach to explore how the country’s construction industry can manage and reduce delays in construction projects through building information modelling (BIM) in order to mitigate the cost consequences of such delays.  It comprehensively and systematically reviewed the global literature on the subject and identified gaps, critical delay factors and the specific benefits that BIM can deliver for the delay management.  A case study comprising of nine hospital projects that have experienced delay and cost overruns was also carried out. Five critical delay factors related to the clients were identified as candidates that can be mitigated through BIM’s benefits. These factors are: Ineffective planning and scheduling of the project; changes during construction by the client; delay in progress payment; slowness in decision making by the client; and poor communication between clients and other stakeholders. In addition, data from the case study projects strongly suggest that optimism bias is present in many of the hospital projects. Further validation via key stakeholder interviews and documentations are planned.

Keywords: building information modelling (BIM), clients perspective, delay management, optimism bias, public sector projects

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5534 Current Methods for Drug Property Prediction in the Real World

Authors: Jacob Green, Cecilia Cabrera, Maximilian Jakobs, Andrea Dimitracopoulos, Mark van der Wilk, Ryan Greenhalgh

Abstract:

Predicting drug properties is key in drug discovery to enable de-risking of assets before expensive clinical trials and to find highly active compounds faster. Interest from the machine learning community has led to the release of a variety of benchmark datasets and proposed methods. However, it remains unclear for practitioners which method or approach is most suitable, as different papers benchmark on different datasets and methods, leading to varying conclusions that are not easily compared. Our large-scale empirical study links together numerous earlier works on different datasets and methods, thus offering a comprehensive overview of the existing property classes, datasets, and their interactions with different methods. We emphasise the importance of uncertainty quantification and the time and, therefore, cost of applying these methods in the drug development decision-making cycle. To the best of the author's knowledge, it has been observed that the optimal approach varies depending on the dataset and that engineered features with classical machine learning methods often outperform deep learning. Specifically, QSAR datasets are typically best analysed with classical methods such as Gaussian Processes, while ADMET datasets are sometimes better described by Trees or deep learning methods such as Graph Neural Networks or language models. Our work highlights that practitioners do not yet have a straightforward, black-box procedure to rely on and sets a precedent for creating practitioner-relevant benchmarks. Deep learning approaches must be proven on these benchmarks to become the practical method of choice in drug property prediction.

Keywords: activity (QSAR), ADMET, classical methods, drug property prediction, empirical study, machine learning

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5533 Towards Resilient and Sustainable Integrated Agro-ecosystems Through Appropriate Climate-smart Farming Practices in Morocco Rainfed Agriculture

Authors: Abdelali Laamari, Morad Faiz, Ali Amamou And Mohamed Elkoudrim

Abstract:

This research seeks to develop multi-disciplinary, multi-criteria, and multi-institutional approaches that consider the three main pillars of sustainability (environmental, economic, and social aspects) at the level of decision making regarding the adoption of improved technologies in the targeted case study region in Morocco. The study is aimed at combining sound R&I with extensive skills in applied research and policy evaluation. The intention is to provide new simple, and transferable tools and agricultural practices that will enable the uptake of sustainability and the resiliency of agro-ecosystems. The study will understand the state-of-the-art of the impact of climate change and identify the core bottlenecks and climate change’s impact on crop and livestock productivity of the targeted value chains in Morocco. Studies conducted during 2021-2022 showed that most of the farmers are using since 2010 the direct seeding and the system can be improved by adopting new fertilizer and varieties of wheat. The alley-cropping technology is based on Atriplex plant or olive trees. The introduction of new varieties of oat and quinoa has improved biomass and grain production in a dry season. The research is targeting other issues, such as social enterprises, to diversify women’s income resources and create new job opportunities through diversification of end uses of durum wheat and barley grains. Women’s local knowledge is rich on the different end uses of durum and barley grains that can improve their added value if they are transformed as couscous, pasta, or any other products.

Keywords: agriculture, climate, production system, integration

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5532 Passive Attenuation of Nitrogen Species at Northern Mine Sites

Authors: Patrick Mueller, Alan Martin, Justin Stockwell, Robert Goldblatt

Abstract:

Elevated concentrations of inorganic nitrogen (N) compounds (nitrate, nitrite, and ammonia) are a ubiquitous feature to mine-influenced drainages due to the leaching of blasting residues and use of cyanide in the milling of gold ores. For many mines, the management of N is a focus for environmental protection, therefore understanding the factors controlling the speciation and behavior of N is central to effective decision making. In this paper, the passive attenuation of ammonia and nitrite is described for three northern water bodies (two lakes and a tailings pond) influenced by mining activities. In two of the water bodies, inorganic N compounds originate from explosives residues in mine water and waste rock. The third water body is a decommissioned tailings impoundment, with N compounds largely originating from the breakdown of cyanide compounds used in the processing of gold ores. Empirical observations from water quality monitoring indicate nitrification (the oxidation of ammonia to nitrate) occurs in all three waterbodies, where enrichment of nitrate occurs commensurately with ammonia depletion. The N species conversions in these systems occurred more rapidly than chemical oxidation kinetics permit, indicating that microbial mediated conversion was occurring, despite the cool water temperatures. While nitrification of ammonia and nitrite to nitrate was the primary process, in all three waterbodies nitrite was consistently present at approximately 0.5 to 2.0 % of total N, even following ammonia depletion. The persistence of trace amounts of nitrite under these conditions suggests the co-occurrence denitrification processes in the water column and/or underlying substrates. The implications for N management in mine waters are discussed.

Keywords: explosives, mining, nitrification, water

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5531 Annual Audit for the Year 2021 for Patients with Hyperparathyroidism: Not as Rare an Entity as We Believe

Authors: Antarip Bhattacharya, Dhritiman Maitra

Abstract:

Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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5530 Bakla Po Ako (I Am Gay): A Case Study on the Communication Styles of Selected Filipino Gays in Disclosing Their Sexual Orientation to Their Parents

Authors: Bryan Christian Baybay, M. Francesca Ronario

Abstract:

This study is intended to answer the question “What are the communication styles of selected Filipino gays in breaking their silence on their sexual orientation to their parents?” In this regard, six cases of Filipino gay disclosures were examined through in-depth interviews. The participants were selected through purposive sampling and snowball technique. The theories, Rhetorical Sensitivity of Roderick Hart and Communicator Style of Robert Norton were used to analyze the gathered data and to give support to the communication attitudes, message processing, message rendering and communication styles exhibited in each disclosure. As secondary data and validation, parents and experts in the field of communication, sociology, and psychology were also interviewed and consulted. The study found that Filipino gays vary in the communication styles they use during the disclosure with their parents. All communication styles: impression-leaving, contentious, open, dramatic, dominant, precise, relaxed, friendly, animated, and communicator image were observed by the gays depending on their motivation, relationship and thoughts contemplated. These results lend ideas for future researchers to look into the communication patterns and/or styles of lesbians, bisexuals, transgenders and queers or expand researches on the same subject and the utilization of Social Judgment and Relational Dialectics theories in determining and analyzing LGBTQ communication.

Keywords: communication attitudes, communication styles, Filipino gays, self-disclosure, sexual orientation

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5529 The Ethics of Physical Restraints in Geriatric Care

Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu

Abstract:

This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.

Keywords: ethics healthcare, geriatric care, healthcare, physical restraint

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5528 Professionals’ Learning from Casework in Child Protection: The View from Within

Authors: Jude Harrison

Abstract:

Child protection is a complex and sensitive practice. The core responsibility is the care and protection of children and young people who have been subject to or who are at risk from abuse and neglect. The work involves investigating allegations of harm, preparing for and making representations to the legal system, and case planning and management across a continuum of complicated care interventions. Professionals’ learning for child protection practice is evident in a range of literature investigating multiple learning processes such as university preparation, student placements, professional supervision, training, and other post-qualifying professional development experiences at work. There is, however, very limited research into how caseworkers learn in and through their daily practice. Little is known, therefore, about how learning at work unfolds for caseworkers, the dimensions in which it can be understood or the ways in which it can be best facilitated and supported. Compounding this, much of the current child protection learning literature reflects an orthodox conception of learning as mentalistic and individualised, in which knowledge is typically understood as abstract theory or as technical skill or competency. This presentation outlines key findings from a PhD research study that explored learning at work for statutory child protection caseworkers from an alternative interpretation of learning using a practice theory approach. Practice theory offers an interpretation of learning as performative and grounded in situated experience. The findings of the study show that casework practice is both a mode and site of learning. The study was ethnographic in design based and followed 17 child protection caseworkers via in-depth interviews, observations and participant reflective journaling. Inductive and abductive analysis was used to organise and interpret the data and expand analysis, leading to themes. Key findings show learning to be a sociomaterial property of doing; the social ontological character of learning; and teleoaffectivity as a feature of learning. The findings contribute to theoretical and practical understandings of learning and practice in child protection, child welfare and the professional learning literature more broadly. The findings have potential to contribute to policy directions at state, territory and national levels to enhance child protection practice and systems.

Keywords: adiult learning, workplace learning, child welfare, sociomaterial, practice theory

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5527 Modeling the International Economic Relations Development: The Prospects for Regional and Global Economic Integration

Authors: M. G. Shilina

Abstract:

The interstate economic interaction phenomenon is complex. ‘Economic integration’, as one of its types, can be explored through the prism of international law, the theories of the world economy, politics and international relations. The most objective study of the phenomenon requires a comprehensive multifactoral approach. In new geopolitical realities, the problems of coexistence and possible interconnection of various mechanisms of interstate economic interaction are actively discussed. Currently, the Eurasian continent states support the direction to economic integration. At the same time, the existing international economic law fragmentation in Eurasia is seen as the important problem. The Eurasian space is characterized by a various types of interstate relations: international agreements (multilateral and bilateral), and a large number of cooperation formats (from discussion platforms to organizations aimed at deep integration). For their harmonization, it is necessary to have a clear vision to the phased international economic relations regulation options. In the conditions of rapid development of international economic relations, the modeling (including prognostic) can be optimally used as the main scientific method for presenting the phenomenon. On the basis of this method, it is possible to form the current situation vision and the best options for further action. In order to determine the most objective version of the integration development, the combination of several approaches were used. The normative legal approach- the descriptive method of legal modeling- was taken as the basis for the analysis. A set of legal methods was supplemented by the international relations science prognostic methods. The key elements of the model are the international economic organizations and states' associations existing in the Eurasian space (the Eurasian Economic Union (EAEU), the European Union (EU), the Shanghai Cooperation Organization (SCO), Chinese project ‘One belt-one road’ (OBOR), the Commonwealth of Independent States (CIS), BRICS, etc.). A general term for the elements of the model is proposed - the interstate interaction mechanisms (IIM). The aim of building a model of current and future Eurasian economic integration is to show optimal options for joint economic development of the states and IIMs. The long-term goal of this development is the new economic and political space, so-called the ‘Great Eurasian Community’. The process of achievement this long-term goal consists of successive steps. Modeling the integration architecture and dividing the interaction into stages led us to the following conclusion: the SCO is able to transform Eurasia into a single economic space. Gradual implementation of the complex phased model, in which the SCO+ plays a key role, will allow building an effective economic integration for all its participants, to create an economically strong community. The model can have practical value for politicians, lawyers, economists and other participants involved in the economic integration process. A clear, systematic structure can serve as a basis for further governmental action.

Keywords: economic integration, The Eurasian Economic Union, The European Union, The Shanghai Cooperation Organization, The Silk Road Economic Belt

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5526 The Birth Connection: An Examination of the Relationship between Her Birth Event and Infant Feeding among African American Mothers

Authors: Nicole Banton

Abstract:

The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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