scholarly journals “Why Do I Need to Sign it? Issues in Carrying Out Child Assent in School-Based Prevention Research Within a First Nation Community

2020 ◽  
Vol 6 (1) ◽  
pp. 99-113 ◽  
Author(s):  
Lola Baydala ◽  
Sherry Letendre ◽  
Lia Ruttan ◽  
Stephanie Worrell ◽  
Fay Fletcher ◽  
...  
Keyword(s):  
Decision Making ◽  
Well Being ◽  
First Nation ◽  
Cultural Norms ◽  
Community Members ◽  
Ethical Frameworks ◽  
Culturally Adapted ◽  
Community Continuity ◽  
Extrinsic Risk ◽  
Past Experiences

The practice of and procedures for obtaining child assent in research involving children are based in Western conceptions of individual decision-making rights, free from any form of coercion including that of parents. In the context of obtaining assent for children involved in research in an Alberta First Nation, the issue can become more complex given respect for ethical frameworks based in collective decision-making and the responsibility of Elders and families to protect children in interactions with Western institutions. This article explores the results of a focus group held to discuss our experience with child assent in research taking place with a community-initiated and culturally-adapted substance abuse prevention program being taught in the community school. In this case the process of being asked to sign written individual assent in the classroom was perceived as bearing extrinsic risk. Given collective cultural norms, the communities past experiences with the safety of signatures, and the proper roles of Elders and family, the children asked “Why do I have to sign it” when asked to sign their assent for participation in the project. A process that involved gathering child assent with children surrounded by family and community was recommended. Greater researcher and REB responsiveness to the issue of non-malfeasance is needed, in this case, by not asking researchers and community members to act in ways that violate culturally-based ethical norms and protocol all of which are important to community continuity, self-determination, and well-being.

scholarly journals Transforming social norms to improve girl-child health and well-being: a realist evaluation of the Girls’ Holistic Development program in rural Senegal

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anjalee Kohli ◽  
Bryan Shaw ◽  
Mathilde Guntzberger ◽  
Judi Aubel ◽  
Mamadou Coulibaly ◽  
...  
Keyword(s):  
Decision Making ◽  
Reproductive Health ◽  
Social Norms ◽  
Well Being ◽  
Realist Evaluation ◽  
Intergenerational Communication ◽  
Community Members ◽  
Girl Child ◽  
Holistic Development ◽  
Development Approach

Abstract Background Early adolescence is a critical period where social norms, attitudes, and behaviors around gender equality form. Social norms influence adolescent choices and behaviors and are reinforced by caregivers and community members, affecting girls’ reproductive health and educational opportunities. Understanding how to shift these often-interconnected norms to delay child marriage, pregnancy and keep girls in school requires understanding of the structure and dynamics of family and community systems. The Senegalese and American non-governmental organization, the Grandmothers Project—Change through Culture, seeks to address these intertwined factors through innovative community change strategies that build on the specific structure and values of West African collectivist cultures. Methods The Girls’ Holistic Development approach in rural Vélingara, Senegal posits that by increasing recognition, knowledge and empowerment of elder community women and reinforcing intergenerational communication and decision-making, community members including girls will support and advocate on behalf of girls’ interests and desires. We assessed the Girls Holistic Development approach using Realist Evaluation with a mixed-method, quasi-experimental design with a comparison population. We examined differences in intergenerational communication, decision-making and descriptive and injunctive norms related to early marriage, pregnancy and schooling. Results After 18 months, intergenerational communication was more likely, grandmothers felt more valued in their communities, adolescent girls felt more supported with improved agency, and norms were shifting to support delayed marriage and pregnancy and keeping girls in school. Grandmothers in intervention villages were statistically significantly more likely to be perceived as influential decision-makers by both VYA girls and caregivers for marriage and schooling decisions compared to girls and caregivers in comparison villages. Conclusions This realist evaluation demonstrated shift in social norms, particularly for VYA girls, in intervention villages favoring delaying girls’ marriage, preventing early pregnancy and keeping girls in school along with increased support for and action by grandmothers to support girls and their well-being related to these same outcomes. These shifts represent greater community social cohesion on girl-child issues. This research helps explain the linkage between social norms and girls’ reproductive health and education outcomes and demonstrates that normative shifts can lead to behavior change via collective community action mechanisms.

scholarly journals The Potential Impacts of Religion and Spirituality on First Nation Teenage Fertility

2013 ◽  
Vol 4 (1) ◽  
Author(s):  
Marc Fonda
Keyword(s):  
Decision Making ◽  
First Nations ◽  
Teenage Pregnancy ◽  
Contextual Information ◽  
Well Being ◽  
First Nation ◽  
Religion And Spirituality ◽  
Fertility Rates ◽  
Sexual Decision Making ◽  
Teenage Fertility

After reviewing some American research on the impacts religion has on adolescent sexual decision making and teenage pregnancy, this article considered the few instances of Canadian research addressing this topic. With this contextual information in place, it then moves on to report on analysis comparing the 2001 Census figures on religions declared by Canadian First Nation communities to teen fertility rates and the Community Well-Being Index (CWB). It finds that First Nations teen fertility rates are related to relative socio-economic deprivation, but also that religion has impacts on sexual decision making at the individual level and those First Nations communities showing no major religious adherence have teenage fertility rates of up to 140 per 1000, as compared to those communities showing one major tradition whose fertility rates are closer to 109 per 1000 adolescent First Nation women.

The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction

2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Clinical Decision Making ◽  
Hearing Aid ◽  
Well Being ◽  
Self Report ◽  
Self Management ◽  
Hearing Aid Benefit ◽  
The Relationship

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.

A moral analysis of intelligent decision-support systems in diagnostics through the lens of Luciano Floridi’s information ethics

Human Affairs ◽  
2021 ◽  
Vol 31 (2) ◽  
pp. 149-164
Author(s):  
Dmytro Mykhailov
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Medical Diagnosis ◽  
Moral Agency ◽  
Moral Agent ◽  
Well Being ◽  
Medical Diagnostics ◽  
Intelligent Decision ◽  
Luciano Floridi ◽  
Intelligent Decision Support

Abstract Contemporary medical diagnostics has a dynamic moral landscape, which includes a variety of agents, factors, and components. A significant part of this landscape is composed of information technologies that play a vital role in doctors’ decision-making. This paper focuses on the so-called Intelligent Decision-Support System that is widely implemented in the domain of contemporary medical diagnosis. The purpose of this article is twofold. First, I will show that the IDSS may be considered a moral agent in the practice of medicine today. To develop this idea I will introduce the approach to artificial agency provided by Luciano Floridi. Simultaneously, I will situate this approach in the context of contemporary discussions regarding the nature of artificial agency. It is argued here that the IDSS possesses a specific sort of agency, includes several agent features (e.g. autonomy, interactivity, adaptability), and hence, performs an autonomous behavior, which may have a substantial moral impact on the patient’s well-being. It follows that, through the technology of artificial neural networks combined with ‘deep learning’ mechanisms, the IDSS tool achieves a specific sort of independence (autonomy) and may possess a certain type of moral agency. Second, I will provide a conceptual framework for the ethical evaluation of the moral impact that the IDSS may have on the doctor’s decision-making and, consequently, on the patient’s wellbeing. This framework is the Object-Oriented Model of Moral Action developed by Luciano Floridi. Although this model appears in many contemporary discussions in the field of information and computer ethics, it has not yet been applied to the medical domain. This paper addresses this gap and seeks to reveal the hidden potentialities of the OOP model for the field of medical diagnosis.

scholarly journals The Psychosocial and Somatic Effects of Relocation from Remote Canadian First Nation Communities to Urban Centres on Indigenous Peoples with Chronic Kidney Disease (CKD)

2021 ◽  
Vol 18 (7) ◽  
pp. 3838
Author(s):  
Denise Genereux ◽  
Lida Fan ◽  
Keith Brownlee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Indigenous Peoples ◽  
Health Care Professionals ◽  
Medical Condition ◽  
Geographical Location ◽  
Well Being ◽  
First Nation ◽  
Urban Centre ◽  
The Impact

Chronic kidney disease, also referred to as end-stage renal disease (ESRD), is a prevalent and chronic condition for which treatment is necessary as a means of survival once affected individuals reach the fifth and final stage of the disease. Dialysis is a form of maintenance treatment that aids with kidney functioning once a normal kidney is damaged. There are two main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). Each form of treatment is discussed between the patient and nephrologist and is largely dependent upon the following factors: medical condition, ability to administer treatment, supports, geographical location, access to necessary equipment/supplies, personal wishes, etc. For Indigenous Peoples who reside on remote Canadian First Nation communities, relocation is often recommended due to geographical location and limited access to both health care professionals and necessary equipment/supplies (i.e., quality of water, access to electricity/plumbing, etc). Consequently, the objective of this paper is to determine the psychosocial and somatic effects for Indigenous Peoples with ESRD if they have to relocate from remote First Nation communities to an urban centre. A review of the literature suggests that relocation to urban centres has negative implications that are worth noting: cultural isolation, alienation from family and friends, somatic issues, psychosocial issues, loss of independence and role adjustment. As a result of relocation, it is evident that the impact is profound in terms of an individuals’ mental, emotional, physical and spiritual well-being. Ensuring that adequate social support and education are available to patients and families would aid in alleviating stressors associated with managing chronic kidney disease.

scholarly journals HESR innovation in analysis that supports decision making and action

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Barr
Keyword(s):  
Decision Making ◽  
Health Equity ◽  
Social Protection ◽  
Well Being ◽  
Status Report ◽  
Policy Performance ◽  
European Health ◽  
The Individual ◽  
Health And Well Being ◽  
Inform Decision Making

Abstract The European Health Equity Status Report makes innovative use of microdata, at the level of the individual, to decompose the relative contributions of five essential underlying conditions to inequities in health and well-being. These essential conditions comprise: (1) Health services (2) Income security and social protection (3) Living conditions (4) Social and human capital (5) Employment and working conditions. Combining microdata across over twenty sources, the work of HESRi has also produced disaggregated indicators in health, well-being, and each of the five essential conditions. In conjunction with indicators of policy performance and investment, the HESRi Health Equity Dataset of over 100 indicators is the first of its kind, as a resource for monitoring and analysing inequities across the essential conditions and policies to inform decision making and action to reduce gaps in health and well-being.

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