Fight against administrative corruption within governmental organizations from motto to practice (case study: Ministry of Economic Affairs and Finance)

Administrative corruption in a simple definition is violation of a law for personal benefits by utilization of job position. It is a phenomenon within today’s world as one of the most important obstacles on the way of societies’ progress. The impact of different factors in forming corruption has given it a complicated nature. Administrative corruption is a correlative issue and it is different according to value system of each society. This article is trying to present a solution in order to fight against administrative corruption through classification of staff with the help of explaining the relation of their perception, sensation and commitment towards corruption and corrupted situations. Present study in terms of purpose is developmental-practical, and in terms of execution and based upon research purposes is a survey. The study population is the staff of Ministry of Economic Affairs and Finance in 2015. In order to explain perception, sensation and the behavior of staff, the questionnaire of administrative corruption is designed in three dimensions: perceptive aspect (cognitive) which includes items for assessing the status of awareness and recognition of staff from instances and consequences of administrative corruption; sensation aspect which includes items for assessing the vision and tendencies of staff towards corruption, and behavioral aspect which is formed from items for assessing the behavior of staff in facing with corruptive situations. In order to identify the reasons of corruption two questionnaires of “National identity” and “Organizational culture” have been designed. The result of the research was that the perpetrators of corruption can be divided into three categories. First category is the staff that their perception is positive, it means that they have adequate cognition from manifestations and corruption consequences and their feeling about corruption is negative, it means that they consider it as an ominous phenomenon, but they are guilty of corruption. Second category is the staff that their perception is positive, they don’t see corruption as an ominous phenomenon. Consequently, their feeling toward corruption is positive, and they perpetrate it. The third category is the staff whose perception is negative, their feeling is uncertain, and they perpetrate it. The behavior of these categories will be interpreted in form of related theories. The significant note is that despite the tendency average to practice administrative corruption among governmental staff is lower than assumed average and it indicates that there is a protection of corruption perpetration, but the rank of our country is not favorable the International Organization report. This warning made the researchers to provide new solutions to help resolving this social issue by reviewing current solutions for prevention, and fighting against administrative corruption, regarding the richness of evaluating system in Iran. Keywords: corruption, administrative corruption, corruption perception, sense of corruption, corruption behavior, organizational culture, national identity. JEL Classification: D73, M12, Z1

Effect of water immersion on labor outcomes: A randomized clinical trial

Background: Water immersion during labor is increasingly being used in different medical facilities worldwide. Objective: This study aimed to determine the effects of water immersion during the first stage of labor on labor outcomes. Methods: This randomized controlled clinical trial was carried out from January to October 2015, in the labor and delivery ward of Khaleej-e Fars Hospital, Bandar Abbas, Iran. In total, 180 women were randomly allocated to a control group to receive routine care services and to an experimental group to receive water immersion during labor along with routine care services. The midwifery staff of the study setting regularly assessed uterine contractions, performed vaginal examinations, and monitored fetal heart rate. The length of the active phase of labor was measured in minutes as primary outcome. The independent-sample t and Chi-square tests were performed for data analysis. Results: The length of the active phase of labor in the experimental group was significantly greater than the control group (232.95 ± 20.76 vs. 165.81 ± 22.76 min; P P > 0.05). Conclusions: Water immersion during labor significantly prolongs the first stage of labor and significantly improves parturient women's satisfaction with the birth experience

Exploring first-time pregnant women's motivations for planning vaginal delivery: A qualitative study

Background: In spite of medical indications, preferences for the mode of delivery are influenced by several factors. However, as the literature suggests, the underlying motivation of women choosing vaginal delivery is rarely attended to. The current study aimed to explore first-time pregnant women's motivation for planning vaginal delivery. Materials and Methods: An exploratory design with in-depth interviews was employed from September 2015 to March 2016. Participants were asked key questions about their beliefs about vaginal delivery, perceived outcomes of vaginal delivery, the impact of others perspectives on their decision, and factors that might inhibit or facilitate vaginal delivery. A community advertisement was placed in obstetricians' offices, public health departments, as well as beauty salons throughout the city of Bandar Abbas, Iran, to enroll target participants. All interviews were tape-recorded, transcribed, and subsequently analyzed. Results: Twelve pregnant women within the age range of 19–33 years volunteered to participate. Ninety four initial codes were obtained. These codes were then summed up into three themes as well as six subthemes. The three themes specified were personal beliefs, deliberation and risk assessment, and personal autonomy. Conclusions: A number of key motivating factors such as fast recovery after vaginal delivery, immediate breastfeeding, and powerful bonding were identified, which were influential in choosing vaginal delivery. Awareness of the fact that the provided information shapes women's beliefs and can lead to attitude changes, midwives played a key role in shaping positive and healthy attitudes toward natural birth giving as well as empower them to make autonomous decision

Urban-rural differences in the pregnancy-related adverse outcome

Background: Little is known about potential urban-rural differences in adverse pregnancy outcomes. The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outcomes. Methods: We retrospectively assessed the pregnancy outcome of singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups based on living residency: 1) urban groupand 2) rural group.Demographic factors, obstetrical factors, maternal comorbidities, and adverse maternal and neonatal outcomeswere extracted from the electronic data of each mother. The Chi-square testwas used to compare differences between the groups for categorical variables. Logistic regression models were used to assess the association of adverse pregnancy, childbirth, and neonatal outcome with living residency. Results: Of 8888 mothers that gave birth during the study period, 2989 (33.6%) lived in rural areas. Adolescent pregnancy was more common in the rural area. Urban mothers had a higher education than rural mothers. Rural mothers were at higher risk for preterm birth aOR 1.81 (CI:1.24-2.99), post-term pregnancy aOR 1.5 (CI: 1.07-2.78), anemia aOR 2.02 (CI:1.07-2.34), low birth weight (LBW) aOR 1.89 (CI: 1.56-2.11), need for neonatal resuscitation aOR 2.66 (CI: 1.78-3.14), and neonatal intensive care unit (NICU) admission aOR 1.98 (CI:1.34-2.79). On the other hand, the risk of cesarean section was significantly lower compared to urban mothers aOR 0.58 (CI: 0.34-0.99). Conclusions: Our study discovered that mothers living in rural areas had a higher risk of developing anemia, preterm birth, post-term pregnancies, LBW, need for neonatal resuscitation, and NICU admission, but a lower risk of cesarean section

Machine learning models for predicting pre-eclampsia: a systematic review protocol

Introduction Pre-eclampsia is one of the most serious clinical problems of pregnancy that contribute significantly to maternal mortality worldwide. This systematic review aims to identify and summarise the predictive factors of pre-eclampsia using machine learning models and evaluate the diagnostic accuracy of machine learning models in predicting pre-eclampsia.Methods and analysis This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This search strategy includes the search for published studies from inception to January 2023. Databases include the Cochrane Central Register, PubMed, EMBASE, ProQuest, Scopus and Google Scholar. Search terms include ‘preeclampsia’ AND ‘artificial intelligence’ OR ‘machine learning’ OR ‘deep learning’. All studies that used machine learning-based analysis for predicting pre-eclampsia in pregnant women will be considered. Non-English articles and those that are unrelated to the topic will be excluded. PROBAST (Prediction model Risk Of Bias ASsessment Tool) will be used to assess the risk of bias and the applicability of each included study.Ethics and dissemination Ethical approval is not required, as our review will include published and publicly accessible data. Findings from this review will be disseminated via publication in a peer-review journal.PROSPERO registration number This review is registered with PROSPERO (ID: CRD42023432415)

Does cesarean section prevent adverse neonatal outcomes associated with meconium amniotic fluid?

Background: Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid (MAF) presents a challenge for healthcare providers. We aimed to compare the neonatal outcome of MAF cases delivered via cesarean section (CS) versus those delivered vaginally to determine if CS is a protective factor against the adverse neonatal outcomes. Methods: In this retrospective study, we assessed singleton pregnant mothers diagnosed with MAF who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 2020-2022. Mothers with certain adverse pregnancy conditions were excluded from the study. These conditions included: abnormal fetal heart rate and pattern, bloody amniotic fluid, malpresentation, abnormal placentation, chorioamnionitis, intrauterine growth restriction, intrauterine fetal death, obstructed labor, and maternal comorbidities. The MAF mothers were divided into two groups based on the method of delivery: those who had CS and those who had a normal vaginal delivery (NVD). Demographic factors, obstetrical factors, and neonatal outcomes were compared between the two groups. Results: Out of 746 MAF mothers, 213 (28.5%) underwent CS, while 533 (71.4%) had NVD. There were no significant differences between the groups in terms of demographic characteristics. Among MAF mothers who had CS, 66.2% were primiparous, and 33.8% were multiparous. For those who had NVD, 35.1% were primiparous, and 64.9% were multiparous. The first and 5-min Apgar values, rates of asphyxia, neonatal intensive care unit (NICU) admission, and neonatal death were not statistically different between the two delivery modes. The rate of newborns who breastfed within the first hour did not differ depending on the mode of delivery. Although initial resuscitation steps were required more frequently in MAF mothers with NVD than in those with CS (11.1% vs. 2.3%), no correlation was found between the mode of delivery and the need for resuscitation using logistic regression. Conclusions: Our research findings suggest that there were no superior neonatal outcomes in terms of CS compared to NVD in MAF mothers. Further studies are needed to provide more substantial evidence to support this conclusion

Machine learning-based approach for predicting low birth weight

Abstract Background Low birth weight (LBW) has been linked to infant mortality. Predicting LBW is a valuable preventative tool and predictor of newborn health risks. The current study employed a machine learning model to predict LBW. Methods This study implemented predictive LBW models based on the data obtained from the “Iranian Maternal and Neonatal Network (IMaN Net)” from January 2020 to January 2022. Women with singleton pregnancies above the gestational age of 24 weeks were included. Exclusion criteria included multiple pregnancies and fetal anomalies. A predictive model was built using eight statistical learning models (logistic regression, decision tree classification, random forest classification, deep learning feedforward, extreme gradient boost model, light gradient boost model, support vector machine, and permutation feature classification with k-nearest neighbors). Expert opinion and prior observational cohorts were used to select candidate LBW predictors for all models. The area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall, and F1 score were measured to evaluate their diagnostic performance. Results We found 1280 women with a recorded LBW out of 8853 deliveries, for a frequency of 14.5%. Deep learning (AUROC: 0.86), random forest classification (AUROC: 0.79), and extreme gradient boost classification (AUROC: 0.79) all have higher AUROC and perform better than others. When the other performance parameters of the models mentioned above with higher AUROC were compared, the extreme gradient boost model was the best model to predict LBW with an accuracy of 0.79, precision of 0.87, recall of 0.69, and F1 score of 0.77. According to the feature importance rank, gestational age and prior history of LBW were the top critical predictors. Conclusions Although this study found that the extreme gradient boost model performed well in predicting LBW, more research is needed to make a better conclusion on the performance of ML models in predicting LBW

Pregnancy, childbirth and neonatal outcomes associated with adolescent pregnancy

Objective: To assess the obstetric and neonatal outcomes associated with adolescent pregnancy in Iran. Methods: We retrospectively assessed women who gave birth between January 1st, 2020, and January 1st, 2022. These pregnant women were separated into two groups: (1) women aged 19 and younger; (2) women aged 20–34 years. Main outcome measures include preterm birth, maternal comorbidities, preeclampsia, eclampsia, low birth weight (LBW), intrauterine growth restriction (IUGR), placenta abnormalities, placenta abruption, chorioamnionitis, meconium fluid, fetal distress, methods of delivery, rate of cesarean section (CS), perineal lacerations, postpartum hemorrhage, childbirth trauma, shoulder dystocia, congenital malformation, and unfavorable maternal and neonatal outcome. Logistic regression models were used to determine the influence of teenage pregnancy on adverse pregnancy and childbirth outcomes. Results: Of 7033 deliveries, 92.4% of women were adults, and 7.6% were adolescents. Adolescents residing in rural districts were more common than adults (42.3% vs. 33.7%). However, access to prenatal facility care was the same as the majority of women had 6-10 prenatal care visits during their pregnancy. There was no difference in the risk of preeclampsia, placenta abruption, placenta previa, fetal distress, preterm labor, shoulder dystocia, perineal lacerations, childbirth trauma, congenital malformation, postpartum hemorrhage, intensive care unit admission, maternal death, and unfavorable neonatal outcome including stillbirth, neonatal intensive care unit admission, neonatal death in adolescent pregnancies compared to adults. Adolescents had a significantly higher risk of LBW (OR: 1.47, 95%CI: 1.01–2.73), IUGR (OR: 1.96, 95%CI: 1.31–2.45), and meconium fluid (OR: 1.74, 95%CI: 1.41–2.32), however, there was no statistically significant difference after adjusting the confounding factors. Compared with adults, adolescents had a significantly lower risk of CS (aRR: 0.67, 95%CI: 0.51–0.77) and a lower risk of gestational diabetes (aRR: 0.78, 95%CI: 0.51–0.95). Conclusions: Although we found no serious consequences of adolescent pregnancy, more research is needed to reach a more accurate conclusion about teenage pregnancy