Greater Accountability Research Articles

Expert Consensus Statements on Smoking Cessation Best Practice in Saudi Arabia

Background: Each year in Saudi Arabia, approximately 70,000 individuals die from smoking-related diseases and there is an urgent need for practical, evidence-based, best-practice guidance on smoking cessation for healthcare professionals in this country. Methods: A working group of six prominent local practitioners from six medical centers and hospitals across the Kingdom of Saudi Arabia developed a series of consensus statements on current best practice in smoking cessation using available literature and the Delphi technique. Results: Four key topics were identified: Increasing awareness of smoking cessation programs; creating a patient journey that results in high patient satisfaction; Addressing healthcare professional engagement and greater accountability in the delivery of smoking cessation programs; Exploring the role of government/policymakers in shaping smoking cessation programs and providing incentives. Within each of these topics, members were well aligned on the consensus statements after the first round of the Delphi process, with >80% agreement on all statements. The strength of supporting evidence from the literature, including clinical guidelines and best-practice articles in smoking cessation published between 2016 and 2021, was considered ‘strong’ for the majority of the consensus statements. Conclusions: The guidance provided here in the form of consensus statements derived from published data combined with real-world experience aims to provide key stakeholders essential advice on the promotion and delivery of smoking cessation in Saudi Arabia, a country in which tobacco consumption remains high.

The Effects of Higher-Stakes Teacher Evaluation on Office Disciplinary Referrals

The effects of imposing accountability pressures on public school teachers are empirically indeterminate. In this paper, we study the effects of accountability in the context of teacher responses to student behavioral infractions in the aftermath of teacher evaluation reforms. We leverage cross-state variation in the timing of state policy implementation to estimate whether teachers change the rate at which they remove students from their classrooms. We find that higher-stakes teacher evaluation had no causal effect on the rates of disciplinary referrals, and we find no evidence of heterogeneous effects for grades subject to greater accountability pressures or in schools facing differing levels of disciplinary infractions. Our results are precisely estimated and robust to a battery of assumption and specification checks.

Effects of the Growth of Intangible Capital Value on Firms

This paper discusses the effects of the growth of intangible capital value on firms after a thorough synthesis of over 20 sources. It begins by noting how the increased importance and prevalence of intangible assets and intellectual property, such as patents, trademarks, and copyrights, in the world economy over the past few decades has influenced various business activities and corporate decisions. These impacts range from changes in the competitive landscape within sectors to how firms borrow and choose targets for acquisition. From these impacts, it is hypothesized that the burgeoning growth of intangible capital will affect firms’ ability to borrow, how and why they decide to merge or produce new products, and international trade deals. With these changes, it is imperative that there will be further policies enacted to cover intangible capital and intellectual property usage during international trade agreements due to their heightened importance, changes within anticompetitive and antitrust legislation that take intangible capital into greater account, and a furthering of new legislation that pushes back against anticompetitive intellectual property rights and patent trolls. Lastly, this paper concludes by highlighting the disparate influence of intangible capital on two unique industries: fashion and technology, along with suggestions on how to better protect intangible assets in the future.

Effects of the Growth of Intangible Capital Value on Firms

This paper discusses the effects of the growth of intangible capital value on firms after a thorough synthesis of over 20 sources. It begins by noting how the increased importance and prevalence of intangible assets and intellectual property, such as patents, trademarks, and copyrights, in the world economy over the past few decades has influenced various business activities and corporate decisions. These impacts range from changes in the competitive landscape within sectors to how firms borrow and choose targets for acquisition. From these impacts, it is hypothesized that the burgeoning growth of intangible capital will affect firms’ ability to borrow, how and why they decide to merge or produce new products, and international trade deals. With these changes, it is imperative that there will be further policies enacted to cover intangible capital and intellectual property usage during international trade agreements due to their heightened importance, changes within anticompetitive and antitrust legislation that take intangible capital into greater account, and a furthering of new legislation that pushes back against anticompetitive intellectual property rights and patent trolls. Lastly, this paper concludes by highlighting the disparate influence of intangible capital on two unique industries: fashion and technology, along with suggestions on how to better protect intangible assets in the future.

RGN-Net: A Global Contextual and Multiscale Information Association Network for Medical Image Segmentation

Segmentation of medical images is a necessity for the development of healthcare systems, particularly for illness diagnosis and treatment planning. Recently, convolutional neural networks (CNNs) have gained amazing success in automatically segmenting medical images to identify organs or lesions. However, the majority of these approaches are incapable of segmenting objects of varying sizes and training on tiny, skewed datasets, both of which are typical in biomedical applications. Existing solutions use multi-scale fusion strategies to handle the difficulties posed by varying sizes, but they often employ complicated models more suited to broad semantic segmentation computer vision issues. In this research, we present an end-to-end dual-branch split architecture RGN-Net that takes the benefits of the two networks into greater account. Our technique may successfully create long-term functional relationships and collect global context data. Experiments on Lung, MoNuSeg, and DRIVE reveal that our technique reaches state-of-the-art benchmarks in order to evaluate the performance of RGN-Net.

Fast Fashion for 2030: Using the Pattern of the Sustainable Development Goals (SDGs) to Cut a More Gender-Just Fashion Sector

AbstractThe 2013 collapse of the Rana Plaza in Bangladesh brought global visibility to the human rights abuses experienced by women workers in the garment sector. As the spotlight on this incident dims, the need to hold the fashion sector accountable remains. In this article, we suggest that greater accountability could be achieved through the application of a human rights-informed understanding of the Sustainable Development Goals (SDGs) to promote gender justice in the sector. By drawing on international women’s rights law and sustainable fashion, we demonstrate how sustainability and gender justice are intimately connected, and illustrate what role the SDGs can play in promoting sustainable outcomes that are gender-just. The article unpacks concepts such as sustainability, the circular economy, social responsibility, and ethical fashion, and places the experiences of women workers within this context. Its principal contribution is a set of six requirements to ensure a gender perspective to the fashion industry’s role in implementing the SDGs.

Nursing Communication Bundle: Behavior Standards

Changing healthcare delivery systems demand greater accountability from hospital organizations and healthcare providers (Briggs et al., 2018). The radical restructuring of the healthcare system that is required to reduce spiraling healthcare costs and make healthcare accessible to all citizens will necessitate ongoing changes in healthcare organizations. The challenge for hospital organizations is to improve quality and service delivery through an ongoing process of innovation, restructuring of systems and processes, and implementation of aligned service behaviors to increase patient satisfaction and enhance clinical outcomes (Figure 1.0). Patient satisfaction scores serve as system indicators for financial reimbursement from government and private insurance agencies and as impetus for hospital organizations to choose the functional system of delivering care to improve quality, achieve desired outcomes, and enhance the patient care experience. Given the macroeconomic nature of the impact of patient satisfaction scores on hospital reimbursement, the challenge for healthcare organizations is to improve quality and service delivery through an ongoing process of innovation, restructuring systems and processes, and implementation of aligned standardized service behaviors to increase patient satisfaction and enhance clinical outcomes. Hospitals under the current healthcare landscape are rewarded for the quality of care provided; thus, better outcomes indicate hospitals’ financial viability (Centers for Medicare and Medicaid Services, 2018).Managing service delivery across a highly divergent and fast-paced healthcare system requires sharp focus on execution and standardized operational excellence. Continuous quality improvement (CQI) has been shown to be a powerful tool to help make health care organizations more effective. CQI is a structured system for creating organization-wide participation and partnership in planning and implementing continuous improvement methods to understand, meet, or exceed patient needs and expectations. Developing a culture of excellence and quality in care can create an enthusiasm for change, passion for results, and drive for innovation equating to better service to healthcare consumers and better patient satisfaction scores.

Listening to community concerns in the COVID-19 infodemic: A WHO digital approach

Abstract Background The Infodemic (too much information including false or misleading information in digital and physical environments) during the COVID-19 pandemic has led to confusion, risk-taking and behaviors that can amplify outbreaks, and reduce effectiveness of pandemic response efforts. To address this challenge, the WHO Information Network for Epidemics (EPI-WIN), in collaboration with research partners, developed a public health Infodemic intelligence analysis methodology for weekly analysis of digital media data to identify, categorize, and understand key concerns expressed in online conversations. Methods Thirty-five keyword-based searches (per language) using Meltwater Explore and Google Trends were created and grouped according to a set of pandemic public health taxonomy categories developed specifically for this analysis. The taxonomy has five thematic categories of conversation about COVID-19 and public health response: (1) the cause of the illness, (2) the illness, (3) the treatment, (4) the interventions and (5) Information. Results The two most recurring topics to attract increasing interest were Vaccines and Asymptomatic transmission followed by Immunity, Cause of the virus, Vulnerable communities and Reduction of movement, and Risk factors based on demographics and risk of misinformation. Conclusions The application of this taxonomy to online social listening week-on-week resulted in a better in-time understanding of the evolution and dynamics of high velocity conversations about COVID-19 globally during the pandemic and proposes a quantifiable approach to support planning of risk communication response. Key messages Describe widespread innovation in social listening methods for greater accountability to affected populations. Formulate insights into how digital media can be better utilized for more rapidly responding to the evolving needs of communities.

Advances in real-time social listening for an adaptive public health response: WHO’s EARS platform

BackgroundCOVID-19 pandemic was accompanied by an Infodemic (overabundance of information, including misinformation and disinformation, both online and offline); in response to this Infodemic, WHO launched the EARS platform (Early AI-assisted Response with Social Listening), showing real-time information about how people are talking about COVID-19 online. This information is intended to serve health information professionals to understand narratives and needs of the general public, in order to inform policy or communications decisions.MethodsData is collected daily from online conversations in publicly available sources, including Twitter, online forums, and blogs in English, French, Spanish and Portuguese, for 20 pilot countries. Once the data is collected, it is processed and classified into 39 categories, according to a set of pandemic public health taxonomy. The classification is made based on semi-supervised machine learning.ResultsTop 5 categories across regions are Covid-19 vaccine, Transmission settings, Personal measures, Testing and Industry (industry refers to the impact of the pandemic on the economy). We find that conversations around Covid-19 vaccines usually rank in the second or third position in all regions and represent 9%-12% of the conversation.ConclusionsThe configuration and application of the EARS platform has enabled progress towards more scalable and sustainable social listening to inform Infodemic management and response, compared to previous methods which were more manual, required data scientists in the team, or had fewer analytics capabilities. Future work will focus on gradually adding more data sources which can expand coverage and representativity.Key messages Discuss social listening methods for greater accountability to affected populations.Formulate insights into how digital media and information technology can be better utilized for more rapidly responding to the evolving needs of communities.

Democracy and Corruption

I examine the relationship between democracy and the perceived risk of corruption in a panel of 130 countries. My panel model controls for country fixed effects and enables the estimation of a within-country relationship between democracy and corruption. My main finding is that democracy significantly reduces the risk of corruption, but only in countries where ethnic fractionalization is low. In strongly fractionalized countries a transition from autocracy to democracy does not significantly reduce corruption. One explanation for these findings is that the corruption-reducing effect of greater accountability of politicians under democracy is undermined by the common pool problem; fractionalization increases the severity of the common pool problem.

Impact of Corporate Attributes on Human Resource Disclosure Practices, Evidences from Commercial Banks of Bangladesh

The present study intends to investigate the impact of corporate attributes in disclosing Human Resource information from the lens of Stakeholder theory. A sample of 100 annual reports of 20 commercial banks operating in Bangladesh for five years starting from 2015 to 2019 has been considered for this research. Content analysis and multiple linear regression have been used to meet the objectives. The results reveal that large firms disclose more information due to higher social reputation and greater accountability towards stakeholders. Further, human resource cost and human resource disclosures (HRDs) are positively related. It implies that corporations that invest more in human capital disclosure it in the annual report to let people know about it and enhance their credibility. The findings also demonstrate a negative relationship between HRDs and the firm’s age, which implies that, to be trustworthy, reliable, and retain public confidence, young firms disclose more information. In contrast, established firms tend to disclose less information. The findings of the study may exert remarkable contribution in devising corporate policy and setting measures of regulatory and accounting standard-setting bodies.

“A Dumping Ground for the South”: Race, Place, and Poverty in Newburgh, New York (1945-1961)

This article explores the urban politics that led to the outbreak of the Newburgh, New York, welfare controversy in 1961. It uncovers the intricate interplay between race, place, and poverty that led to the early backlash against social welfare from the immediate postwar years to the early 1960s. Newburgh officials engineered their welfare reform as a political response to the economic, demographic, and urban transformations the city underwent in the 1950s. Race was central to their concerns as they scapegoated newly arrived African American migrants and blamed them for the city’s population loss and slowing economy. Welfare reform served at once as a tool for migratory, demographic, and racial regulation. The Newburgh story demonstrates that welfare regulation was used by city officials to enforce racial hierarchies in the Jim Crow North and suggests that city politics should be taken into greater account in the history of the American welfare state.

Female American in-house counsel are no more likely to reach senior ranks than female counterparts in law firms

PurposeThe authors wanted to find out if women in-house lawyers were treated more equitably than their counterparts in law firms and, therefore, reached higher ranks more often.Design/methodology/approachThe authors examined 10 years of data about public companies in the ExecuComp dataset. The information includes name, age, gender, job category and numerous compensation measures. Public companies must report their top five earners. The authors narrowed their focus to 2,154 lawyers of whom 1,851 were men and 303 were women.FindingsAnalysis supported hypothesis 1, showing women are underrepresented in senior legal roles in large corporations. Hypothesis 2, however, was not supported. It was expected that women would be more likely to hold senior positions in female-dominated industries, but this was not the case. Finally, hypothesis 3 was not supported either. It suggested in-house women counsel would earn comparable compensation to their male counterparts. But analysis showed women earned 92.6pc of men earn and their bonuses were only 73.2pc of men’s.Originality/valueThe authors say the research has important practical lessons for companies. Many of the remedies for gender disparities in law firms apply also to in-house counsel, they say. A primary mechanism is to integrate more women into senior leadership positions. This will tend to lead to reductions in compensation disparities, as well as greater accountability and transparency.

Higher Education Institution\u2013Community Partnerships: Measuring the Performance of Sustainability Science Initiatives

The enterprise of sustainability science extends beyond the academy to address pressing environmental issues through collaboration. It coincides with trends in higher education institutions (HEIs) towards an expanded mission for addressing societal challenges as well as greater accountability. In this paper, we aim to establish an instrument for assessing the performance of sustainability science initiatives in HEIs. The performance of three HEI–community partnerships for sustainability science in Ontario, Canada (the Brock-Lincoln Living Lab, the Excellence in Environmental Stewardship Initiative, and Niagara Adapts) were examined using the HEI–Community Partnership Performance Index (HCPPI). Our preliminary results suggest that the HCPPI is a reliable, valid, and easy-to-administer tool for accurately assessing the performance of HEI–community partnerships for sustainability science. Incorporating systemic performance assessments into HEI–community partnerships promotes accountability, transparency, and continuous improvement. It also serves as a vital feedback mechanism by fostering reflection, adaptation, and learning—critical components to sustainability science.

Taking Your Team Behind the Curtain: The Effects of Leader Feedback-Sharing and Feedback-Seeking on Team Psychological Safety

Although scholars have highlighted the benefits of psychological safety, relatively few studies have examined how leaders establish it. Whereas existing research points to the importance of seeking feedback, we draw on theories of self-disclosure, trust, and implicit voice to propose that leaders can also promote psychological safety by sharing feedback—openly discussing criticisms and suggestions they have already received about their own performance. In Study 1, naturally-occurring feedback-seeking and feedback-sharing by CEOs independently predicted board member ratings of top management team psychological safety. In Study 2, a longitudinal field experiment, randomly assigning leaders to share feedback had a positive effect on team psychological safety one year later, whereas assigning leaders to seek feedback did not. In Study 3, to explore the processes through which feedback-sharing had an enduring effect but feedback-seeking did not, we conducted qualitative interviews with participating leaders and employees two years later. We found that leaders initiated vulnerability through seeking feedback, but it dissolved due to defensiveness and inaction. In contrast, sharing feedback normalized and crystallized vulnerability as leaders made a public commitment to keep sharing and employees reciprocated, which opened the door for more actionable feedback, greater accountability, and ongoing practices that allowed psychological safety to endure. Our research suggests that to achieve enduring improvements in psychological safety, it may be particularly effective for leaders to share criticism they have received—and that doing so does not jeopardize their reputations as effective and competent.

Working for Justice in Food Systems on Stolen Land? Interrogating Food Movements Confronting Settler Colonialism

The evolving practice and scholarship surrounding food movements aim to address social, political, economic and ecological crises in food systems. However, limited interrogation of settler colonialism remains a crucial gap. Settler colonialism is the ongoing process of invasion that works to systematically erase and replace Indigenous Peoples with settler populations and identities. While many progressive and well-intentioned food movements engage directly with issues of land, water, identity, and power, critics argue they have also reified capitalism, white supremacy, agro-centrism and private property that are central to the ongoing dispossession of Indigenous Peoples. Scholars and advocates have called for greater accountability to the contradictions inherent in working towards social and ecological justice on stolen land. We write this paper as three settler activist-scholars to interrogate ways that social movements are responding to this call. A community-engaged methodology was used to conduct semi-structured interviews with individuals working in settler-led food movement organizations in Northwestern Ontario, Canada and in Southern Australia. We present our findings through three intersecting categories: 1) Expressions of settler inaction; 2) Mere inclusion of Indigenous Peoples and ideas; and, 3) Productive engagements and visions to confront settler colonialism. To explore the possibility of deeper engagements that confront settler colonialism, we suggest a continuum that moves from situating our(settler)selves within the framework of settler colonialism to (re)negotiating relationships with Indigenous Peoples to actualizing productive positions of solidarity with Indigenous struggles. We argue that this work is essential for food movements that aim to transform relationships with the land, each other, and ultimately forge more sustainable and equitable food futures.

\u201cI am here for the students\u201d: principals\u2019 perception of accountability amid work intensification

Increasing job duties and responsibilities associated with the changing role of school principals have prompted even greater accountability. As a result, principals are faced with competing demands and expectations in various forms of accountability from multiple stakeholders. This study examines principals’ perception of accountability in the context of work intensification with a particular focus on the question of “accountable to whom and why.” A total of 1434 practicing principals responded to an online survey that sought to determine the groups and individuals to whom principals feel accountable, and why principals feel accountable to those particular individuals or groups. The survey achieved a response rate of 52.68%. The research results show balancing competing accountabilities concerning students has become a daunting task for school principals. The competing if not conflicting expectations from (federal and state/provincial) educational authorities, teachers, parents, students, and various interest groups often pose significant challenges to principals’ work and add to the complexity of principals’ role. The unrealistic expectations imposed on principals make it imperative to critically examine the changing role of school principals and identify essential and legislatively mandated duties and responsibilities of principalship to better reflect and address their intensified work realities.

A reconsideration of Lean Six Sigma in healthcare after the COVID-19 crisis

PurposeThe purpose of this study is to reflect upon the ramifications of two decades of Lean Six Sigma implementations in Dutch healthcare institutions in the light of the current COVID-19 pandemic.Design/methodology/approachThe authors provide an evaluation of the impact that Lean Six Sigma implementations have had on the ability of Dutch healthcare institutions to respond adequately to healthcare needs during the COVID-19 crisis.FindingsProcess improvement in healthcare has had a tendency to cut capacity and flexibility which are needed to deal with excessive demand shocks, such as during a pandemic. The main reason for this failure seems to be an overly strong focus on cost reduction instigated by Lean Six Sigma during stable times.Research limitations/implicationsBesides the research method being an inferential procedure, the research focuses on the Netherlands and so the generalizability might be limited. However, using Lean Six Sigma to improve healthcare processes has found broad acceptance, so the implications may well carry over to other countries.Practical implicationsThe authors call for a more comprehensive approach of process improvement within healthcare that takes flexibility and buffering in anticipation of excess variability and disruption into greater account. Therefore, this study provides a new perspective on how and to which aim Lean Six Sigma should be applied in healthcare.Originality/valueAn assessment is given of the impact of Lean Six Sigma implementations on the ability to respond to the COVID-19 crisis. This is done by identifying the focus points of improvement projects and considering the impact on the resilience of healthcare operations.

‘Who’ or ‘what’ is the rule of law?

The standard account of the relation between democracy and the rule of law focuses on law’s liberty-enhancing role in constraining official action. This is a faint echo of the complex, constitutive relation between the two. The Greeks used one word – isonomia – to describe both. If democracy is the system in which people have an equal say in determining the rules that govern social life, then the rule of law is simultaneously before, after, concurrent and synonymous with democracy: It contributes to the formation of citizens with the capacity for self-governance, serves as the instrument through which democratic decisions are implemented, functions as one of the central social practices that constitute citizens as equals and addresses the question of how to ensure that government by the people operates for the people. The rule of law has many independently valuable qualities, including impartiality and predictability. But, to valorise the rule of law for its own sake is to fetishize authority. The fundamental values of the rule of law are as the instrument of democratic self-governance and the expression of the equal dignity of all persons. Democracy thus entails the rule of law, but both implicate the yet more comprehensive ideal of equality. Core rule-of-law values require political norms and conditions of equality, generality and comprehensiveness. In a modern, differentiated society, however, the constitutive relation between democracy and the rule of law is fractured and law becomes the agent of authority. Courts in the modern constitutional state have contributed to the decline of rule-of-law values, supporting role specialization through judge-made immunity doctrines that protect officials at all levels. The crisis of police violence against minorities is a symptom of this breakdown. Greater accountability can ameliorate the problem. But an effective solution requires the fair and equal distribution of political power.

What a Monster!

The water industry is working to improve communications by focusing on messaging that enhances public confidence in our water systems, yet it often seems like an uphill battle. While safe, reliable water supplies are available to a great majority in North America, it's understood that there are still some systems that struggle. But while these communities and governments have a lot of work to do to, the approach of broadly attacking tap water doesn't help those struggling systems, and only harms the overall perception of a sector that is pretty successful. As a recent example, the US federal government proposed efforts to ensure clean, safe drinking water for all communities by replacing the nation's lead pipes and service lines and upgrading its water systems. This mission is fantastic and commendable—I just wish the administration didn't start their messaging by broadly stating, “Across the country, pipes and treatment plants are aging and polluted drinking water is endangering public health.” The message starts off focusing correctly on the assets that need to be better managed, but it leaves out the crucial connection to the policies behind them, jumping right to an image of a drinking water monster that's threatening the public. But where water infrastructure is made into a monster like this, I think the unfortunate victim is our broader perception of safe drinking water. Bad water services are monstrous, but the water itself is more like Dr. Frankenstein's creation, innocent to start but suffering from another's decisions and actions. In fact, in this famous story by Mary Shelley, the “monster” laments, “Of my creation and creator I was absolutely ignorant, but I knew that I possessed no money, no friends, no kind of property. I was, besides, endued with a figure hideously deformed and loathsome. . . .” We can't shy away from our challenges, and while struggling water systems need support to ensure they're not making “monsters,” we also need to better communicate our industry's strengths and successes. It takes great talent and accountability to make a water system work well, but it also takes great talent to strengthen a community's connection to its water and the systems behind the services. Vilifying water won't stop any time soon, so in addition to helping every system succeed, water professionals must ensure the public knows its water is safe so that no one sees a water monster when they open their tap. This issue of Journal AWWA features an interview with the A.P. Black Research Award winner Dr. Issam Najm, with additional feature articles spotlighting bench-scale, pilot-scale, and full-scale research. Please consider sharing your perspectives and experiences with water professionals across the globe by writing me at journaleditor@awwa.org.