35 research outputs found
Ethical Decision-Making in Islamic Financial Institutions in Light of Maqasid Al-Sharia: A Conceptual Framework
This article develops a conceptual framework for ethical decision‐making in Islamic financial institution based on the Islamic methodological approaches on ethics. While making use of the similarities between the scientific method and the Islamic jurisprudence method, a framework is developed by means of argumentation and reasoning to integrate Sharia doctrines with the “plan, do, check and act” (PDCA) cycle as a managerial tool. Using Al‐Raysuni's analysis of Al‐Shatibi's work on maqasid al‐sharia, this article develops a framework to assess the ethical aspects of Islamic financial operations, which is then applied to hypothetical cases. This approach can help overcome the methodological deficiencies in measuring ethical performance in Islamic finance by focusing on the process of ethical decision‐making that leads to the outcomes of organizational behavior beyond legality of contracts. The framework outlines the conditions under which an activity that is considered legal and permissible contractually could lead to outcomes that can make it ethical or unethical
Long-term thermal sensitivity of Earth’s tropical forests
The sensitivity of tropical forest carbon to climate is a key uncertainty in predicting global climate change. Although short-term drying and warming are known to affect forests, it is unknown if such effects translate into long-term responses. Here, we analyze 590 permanent plots measured across the tropics to derive the equilibrium climate controls on forest carbon. Maximum temperature is the most important predictor of aboveground biomass (−9.1 megagrams of carbon per hectare per degree Celsius), primarily by reducing woody productivity, and has a greater impact per °C in the hottest forests (>32.2°C). Our results nevertheless reveal greater thermal resilience than observations of short-term variation imply. To realize the long-term climate adaptation potential of tropical forests requires both protecting them and stabilizing Earth’s climate
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Risk-based management control resistance in a context of institutional complexity: evidence from an emerging economy
Analysis of success-dependent factors of green bonds financing of infrastructure projects in Ghana
Globally, Green Bonds have experienced a fair share of handicaps within the countries of issuance. In lieu of Ghana announcing the possibility of its first green bonds, it is crucial that lessons are taken from past developments to reinforce the prospects of a salutary roll out. This paper explores factors recommended as success-dependent in the Ghanaian markets. A quantitative approach is employed. Twelve factors are extracted from a review of available literature and converted into a questionnaire targeted at professionals in financial institutions. This included, managers, financial analysts, as well as top management personnel. In total 54 questionnaires were distributed. A total of 32 responses are received, proportional to a response rate of 60.37% and was analyzed with relative importance index and one-sample t-test. The results indicate that “Ensuring Good Credit Ratings, Provision of Local Guideline, and Proper Green Qualifications Criteria and Prioritizing Viable Projects” are highest ranked factors. It is important these are incorporated in the framework to be designed for the roll out of green bonds in the Ghana. Considerations should also be made with respect to the culture and state of the financial markets in the country while bringing out the appropriate structure to facilitate the issuances
The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey
Background: Antimicrobial Stewardship Programs (ASPs) have been promoted
to optimize antimicrobial usage and patient outcomes, and to reduce the
emergence of antimicrobial-resistant organisms. However, the best
strategies for an ASP are not definitively established and are likely to
vary based on local culture, policy, and routine clinical practice, and
probably limited resources in middle-income countries. The aim of this
study is to evaluate structures and resources of antimicrobial
stewardship teams (ASTs) in surgical departments from different regions
of the world.
Methods: A cross-sectional web-based survey was conducted in 2016 on 173
physicians who participated in the AGORA (Antimicrobials: A Global
Alliance for Optimizing their Rational Use in Intra-Abdominal
Infections) project and on 658 international experts in the fields of
ASPs, infection control, and infections in surgery.
Results: The response rate was 19.4%. One hundred fifty-six (98.7%)
participants stated their hospital had a multidisciplinary AST. The
median number of physicians working inside the team was five
[interquartile range 4-6]. An infectious disease specialist, a
microbiologist and an infection control specialist were, respectively,
present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component
in 59.0% of cases and was significantly more likely to be present in
university hospitals (89.5%, p < 0.05) compared to community teaching
(83.3%) and community hospitals (66.7%). Protocols for pre-operative
prophylaxis and for antimicrobial treatment of surgical infections were
respectively implemented in 96.2 and 82.3% of the hospitals. The
majority of the surgical departments implemented both persuasive and
restrictive interventions (72.8%). The most common types of
interventions in surgical departments were dissemination of educational
materials (62.5%), expert approval (61.0%), audit and feedback
(55.1%), educational outreach (53.7%), and compulsory order forms
(51.5%).
Conclusion: The survey showed a heterogeneous organization of ASPs
worldwide, demonstrating the necessity of a multidisciplinary and
collaborative approach in the battle against antimicrobial resistance in
surgical infections, and the importance of educational efforts towards
this goal