Child Health and Business Training with Credit

2018 ◽  
pp. 114-124
Author(s):  
Dean Karlan ◽  
Jacob Appel
Keyword(s):  
Child Health ◽  
Integrated Model ◽  
Front Line ◽  
Business Training ◽  
Staff Members ◽  
Poor Women ◽  
Microfinance Institution ◽  
Loan Officers ◽  
Competing Priorities ◽  
To Receive

This chapter examines a study conducted by a microfinance institution (MFI) where they began developing educational supplements for their client base of poor women on the topics of infant/child health and business training. With tailored materials ready, the MFI launched the program in about half of its branches, using an “integrated model” in which loan officers delivered the trainings during their weekly repayment meetings. As it turned out, only a portion of the groups assigned to receive training were actually receiving it, and often at lower intensity than was intended. The underlying failure is that both problems—missed trainings and trainings given to the wrong groups—went unchecked for so long. Moreover, front-line staff members involved in the study faced competing priorities. If loan officers had been more aware of and invested in the research or managers more vigilant, they might have caught these challenges and addressed them before it was too late.

Credit and Financial Literacy Training

2018 ◽  
pp. 73-83
Author(s):  
Dean Karlan ◽  
Jacob Appel
Keyword(s):  
Education Program ◽  
Financial Literacy ◽  
Financial Education ◽  
Proper Role ◽  
Partner Organization ◽  
Development Tool ◽  
Use Of Technology ◽  
Microfinance Institution ◽  
Loan Officers ◽  
Competing Priorities

This chapter examines a study conducted with the Peruvian microfinance institution Arariwa, which explores a number of questions regarding technology's potential and proper role as a development tool by implementing and testing a multimedia financial education program for clients. In this case, there are two major areas of failures: research setting and partner organization challenges. There were a few distinct instances of the former. First, the field sites presented challenges to the use of technology. Second, the intervention itself was deceptively complex. Finally, there was an element of bad timing in the flooding that caused repayment problems for some clients, thus adding stress to loan officers' already full plates. Indeed, competing priorities were a key partner organization challenge in this case. Loan officers were expected to deliver trainings without any lapses in, or relief from, their basic duties.

scholarly journals Barriers to Development of an App for Improving Staff-Family Communication at Israeli Geriatric Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 192-193
Author(s):  
Rinat Cohen ◽  
Gal Maydan ◽  
Shai Brill ◽  
Jiska Cohen-Mansfield
Keyword(s):  
Mobile App ◽  
Institutional Review Boards ◽  
Staff Members ◽  
Institutional Review ◽  
Implementation Planning ◽  
Institutional Adoption ◽  
Communication Needs ◽  
The University ◽  
And Control ◽  
To Receive

Abstract Family caregivers (FCs) of institutionalized noncommunicative older persons reported multiple unmet communication needs focusing on the need to receive reliable and regular updates on the patient’s condition. We have developed a mobile app for improving communication between FCs and healthcare professionals (HPs), based on 152 interviews with FCs and 13 discussion groups with HPs from four Israeli geriatric facilities. Both parties participated in app planning, tailoring it to their needs and abilities. App use implementation encountered major obstacles including the bureaucratic process concerning signing contracts between the university and software development firms, which hindered the process for a full year; data security department required disproportionate security levels that interfered with user experience and delayed the development process; the study’s definition varied across different ethics/Helsinki committees (Institutional Review Boards; IRBs), which led to different demands, e.g., insurance for medical clinical trials although no drugs or medical device were involved; lack of cooperation by mid-level staff members despite the institutional adoption of the app project; low utilization by HPs resulted in FCs not receiving timely responses. Despite these and other obstacles, we tested app use for 15 months in one facility in a pre-post-design with intervention and control groups, and we have since begun testing it in another facility. FCs who had used the app had positive feedback and wished to continue using it. App use optimization requires implementation planning, assimilating changes in each facility’s work procedures and HP’s engagement and motivation and thus depends on institutional procedures and politics.

Loan officer rotation and credit access: evidence from Madagascar

2019 ◽  
Vol 80 (1) ◽  
pp. 51-67
Author(s):  
Yaw Sarfo ◽  
Oliver Musshoff ◽  
Ron Weber
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Frequency Effect ◽  
Content Type ◽  
Credit Access ◽  
Loan Officer ◽  
Microfinance Institution ◽  
Lending Decisions ◽  
Loan Officers ◽  
Loan Approval

Purpose With exclusive data from a commercial microfinance institution (MFI) in Madagascar, the purpose of this paper is to investigate if loan officer rotation (change of loan officer) has an effect on credit access (loan approval) in rural and in urban areas. The authors further analyze how the frequency of loan officer rotation affects credit access in rural and in urban areas. Design/methodology/approach The authors apply propensity score matching to compare credit access between loan applicants who experienced loan officer rotation and loan applicants who experienced no loan officer rotation in rural and in urban areas. Findings Results show that loan officer rotation has a positive and statistically significant effect on credit access. The authors observe further that loan officer rotation has a different effect on credit access in rural and in urban areas. Whilst rural loan applicants who experienced loan officer rotation are more likely to have credit access, urban loan applicants show no statistically significant effect of loan officer rotation on credit access. For the frequency effect on credit access, the authors observe that one loan officer rotation has a positive and statistically significant effect on credit access whereas results are mixed for two loan officer rotations. Research limitations/implications Even though the authors can show that loan officer rotation can improve credit access to loan applicants, especially in rural areas, the conditions in Madagascar are unique. Therefore, results need to be verified in other countries and institutional contexts. Practical implications From the perspective of MFI, the authors recommend that the management of MFI needs to provide better tools to loan officers to improve on the evaluation of agricultural loan products or standardize the assessment of agricultural loan products to improve on lending decisions. Further, if applicable, the authors recommend that MFI should consider using credit worthiness assessment procedures which rely less on loan officer’s judgment for loan evaluation, such as automated systems. From the perspective of loan applicants, the authors recommend that loan applicants should request for a change of loan officer if they experience successive loan applications rejection. Originality/value To the authors’ knowledge, this paper is the first to provide empirical evidence on the effect and frequency of loan officer rotation on credit access in Sub-Sahara Africa, and Madagascar, in particular.

scholarly journals Muḍārabah and mushārakah as micro-equity finance: perception of Selangor’s disadvantaged women entrepreneurs

2020 ◽  
Vol 12 (2) ◽  
pp. 217-237
Author(s):  
Reazul Islam ◽  
Rubi Ahmad
Keyword(s):  
Women Entrepreneurs ◽  
Structural Equation ◽  
Islamic Law ◽  
Profit Sharing ◽  
Equity Financing ◽  
Content Type ◽  
Disadvantaged Women ◽  
Poor Women ◽  
Microfinance Institution ◽  
Equity Finance

Purpose This study aims to gain the perception of Selangor’s disadvantaged women on the Sharīʿah (Islamic law) rules on two micro-equity financing instruments, namely, muḍārabah (profit sharing) and mushārakah (profit-and-loss sharing) (M&M). Design/methodology/approach A survey was carried out in the rural area of Selangor district in Malaysia by administering a self-generated structured questionnaire. A total of 330 completed questionnaires were retrieved from the members of an Islamic microfinance institution (IsMFI), namely, Amanah Ikhtiar Malaysia (AIM). The data were analysed by using structural equation modelling. Findings The female borrowers of AIM perceive the Sharīʿah rules of M&M requiring high moral and ethical values and diligent repayment performance. They are aware of some other underlying provisions such as business liquidation, share transfer, information discloser and business termination. The overall findings of this study suggest that the perceived Sharīʿah rules are akin to those that are commonly used in general partnership businesses between Muslims. It also indicates that disadvantaged entrepreneurs would accept the rules that are easy to comprehend as well as favourable to their interests. It further suggests that respondents’ experiences of microfinance and business operation do not have a significant influence on their perception of M&M instruments. Research limitations/implications This study was limited to Selangor. So, the perception of Muslim women surveyed may not represent the views of all women in Malaysia. However, it can offer a primary understanding of the said issue. Practical implications The findings of this study can help IsMIFs take initiatives to offer M&M as micro-equity finance to poor women entrepreneurs. Originality/value So far, limited studies have been carried out on M&M-based microfinancing. This paper offers new insights presenting disadvantaged women entrepreneurs’ perception of these financing instruments.

High-dose chemotherapy followed by autologous bone marrow transplantation versus dexamethasone, cisplatin, and cytarabine in aggressive non-Hodgkin's lymphoma with partial response to front-line chemotherapy: a prospective randomized italian multicenter study.

1996 ◽  
Vol 14 (2) ◽  
pp. 534-542 ◽  
Author(s):  
M Martelli ◽  
M Vignetti ◽  
P L Zinzani ◽  
F Gherlinzoni ◽  
G Meloni ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Line Treatment ◽  
Front Line ◽  
Line Therapy ◽  
Autologous Bone ◽  
To Receive

PURPOSE To evaluate, in a prospective multicentric study, the efficacy of a conventional salvage chemotherapy (dexamethasone, cisplatin, and cytarabine [DHAP]) versus high-dose chemotherapy (carmustine, etoposide, cytarabine, and cyclophosphamide [BEAC]) followed by autologous bone marrow transplantation (ABMT) in patients with aggressive non-Hodgkin's lymphoma (NHL) in clinical partial response (PR) after two thirds of a conventional front-line therapy. PATIENTS AND METHODS From August 1988 to August 1991, 286 patients with aggressive NHL were randomized in seven Italian institutions to receive fluorouracil, methotrexate, cytarabine, cyclophosphamide, doxorubicin, vincristine, and prednisone (F-MACHOP) or methotrexate with leucovorin, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) as front-line therapy. Of the 286 patients enrolled onto the trial, 77 (27%) were considered in PR after two thirds of the front-line therapy, and 49 of 77 (64%) were randomized: 27 to receive DHAP chemotherapy and 22 to receive BEAC followed by ABMT. RESULTS The response after second-line treatment was as follows: in the DHAP group, four patients (15%) achieved a complete remission (CR), 12 (44%) remained in stable PR, and 11 (41%) showed progressive disease; in the ABMT group, three patients (14%) obtained a CR, 18 (82%) obtained a stable PR, and one (4%) progressed, with an overall response (CR + stable PR) of 59% and 96% (P < .001) in the DHAP and ABMT groups, respectively. The overall survival was 59% versus 73% and the progression-free survival (PFS) was 52% versus 73% in the DHAP and ABMT groups, respectively (P, not significant). The toxicity was mild, particularly in the ABMT group, and no treatment-related deaths occurred in either group. CONCLUSION Because of the small number of patients randomized, we were unable to determine whether ABMT or a standard salvage regimen (DHAP) is superior for PR patients. However, we confirmed that myeloablative treatment is a safe and well-tolerated procedure in this category of patients and this may enable us to evaluate its role as part of a front-line treatment in poor-risk NHL patients.

She Who Shall Not Be Named: The Women That Women's Organizations Do (and Do Not) Represent in the Rulemaking Process

2018 ◽  
Vol 15 (03) ◽  
pp. 572-598 ◽  
Author(s):  
Ashley English
Keyword(s):  
Women Of Color ◽  
Women's Organizations ◽  
Target Population ◽  
Policy Debates ◽  
Sexual Orientations ◽  
Poor Women ◽  
Marginalized Women ◽  
And Gender ◽  
To Receive ◽  
Women’S Organizations

AbstractThough the concept of intersectionality has been in circulation for nearly 30 years and women's organizations have long been criticized for failing to prioritize the concerns of women of color, poor women, and LGBTQ women, more research is needed to determine precisely why women's organizations do and do not discuss those intersectional identities during policy debates. This study analyzes 1,021 comments that women's organizations submitted to rulemakers to test a series of hypotheses about how women's organizations’ references to women's intersectional identities increase or decrease depending on the organization's primary constituency and ideology, the proposed rule's target population, and other features of the policy-making context. Using automated text analysis and a series of models, it shows that women's organizations do discuss intersectionally marginalized women in their comments. However, not all subgroups of women are equally represented during the process. Women's organizations focus on women's sexual orientations and gender identities more than their races, ethnicities, nationalities, or socioeconomic statuses. Intersectionally marginalized women also tend to receive the most attention when commenters are from organizations that are explicitly focused on representing intersectionally marginalized women and when bureaucrats include references to intersectionally marginalized women in their proposed rules.

scholarly journals Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry

2019 ◽  
Vol 143 (1) ◽  
pp. 40-50 ◽  
Author(s):  
Frederick Lansigan ◽  
Steven M. Horwitz ◽  
Lauren C. Pinter-Brown ◽  
Steven T. Rosen ◽  
Barbara Pro ◽  
...  
Keyword(s):  
T Cell ◽  
Initial Treatment ◽  
Cell Lymphoma ◽  
Single Agent ◽  
Front Line ◽  
Peripheral T Cell Lymphoma ◽  
Line Therapy ◽  
Best Response ◽  
Relapsed Disease ◽  
To Receive

Background: Outcomes for patients with peripheral T-cell lymphoma (PTCL) who fail to achieve complete response (CR) or relapse after front-line therapy are poor with lack of prospective outcomes data. Objectives: COMPLETE is a prospective registry of 499 patients enrolled at academic and community sites in the United States detailing patient demographics, treatment and outcomes for patients with aggressive T cell lymphomas. We report results for patients with primary refractory and relapsed disease. Methods: Primary refractory disease was defined as an evaluable best response to initial treatment (induction ± maintenance or consolidation/transplant) other than CR, and included a partial response, progressive disease, or no response/stable disease. Relapsed disease was defined as an evaluable best response to initial treatment of CR, followed by disease progression at a later date, irrespective of time to progression. Patients were included in the analysis if initial treatment began within 30 days of enrollment and treatment duration was ≥4 days. Results: Of 420 evaluable patients, 97 met the definition for primary refractory and 58 with relapsed disease. In the second-line setting, relapsed patients received single-agent therapies more often than refractory patients (52 vs. 28%; p = 0.01) and were more likely to receive single-agent regimens (74 vs. 53%; p = 0.03). The objective response rate to second-line therapy was higher in relapsed patients (61 vs. 40%; p = 0.04) as was the proportion achieving a CR (41 vs. 14%; p = 0.002). Further, relapsed patients had longer overall survival (OS) compared to refractory patients, with a median OS of 29.1 versus 12.3 months. Conclusions: Despite the availability of newer active single agents, refractory patients were less likely to receive these therapies and continue to have inferior outcomes compared to those with relapsed disease. PTCL in the real world remains an unmet medical need, and improvements in front-line therapies are needed.

Randomized Comparison of Cladribine Containing Regimens and COP in Previously Untreated Patients with Small Lymphocytic, Marginal Zone and Follicular Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4739-4739
Author(s):  
Ewa Kalinka ◽  
Jaroslaw Wajs ◽  
Kazimierz Sulek ◽  
Tadeusz Robak ◽  
Maria Blasinska-Morawiec ◽  
...  
Keyword(s):  
Side Effects ◽  
Overall Response Rate ◽  
Marginal Zone ◽  
Response Rate ◽  
Low Grade ◽  
Front Line ◽  
Histological Subtypes ◽  
First Line ◽  
To Receive

Abstract The aim of the study was to comparatively assess first-line treatment with cladribine alone or in combination with cyclophosphamide (CCR, cladribine-containing regimens) and COP (cyclophosphamide, vincristine, prednisone) in different subtypes of low-grade lymphoma. End points were complete remission (CR), overall response rate (ORR), incidence of chemotherapy-related side effects as well as freedom from progression (FFP) and overall survival (OS). From June’2000 to June’2005, 178 previously untreated patients (pts) were randomly allocated to receive 6 monthly courses of either CCR or COP in 17 centers in Poland. This analysis included 107 pts who have completed scheduled chemotherapy, including 45 pts with small lymphocytic (SLL, median age=64 years), 26 marginal zone (MZL, median age=58 years) and 36 follicular (FL, median age=65 years) lymphoma. Compared to COP, CCR induced higher CR rates in all treated groups (65% vs 15%, p=.005; 57% vs 10%, p=.02; 58% vs 12%, p=.03, respectively) but differences in ORR were not significant (92% vs 69%; 92% vs 60%; 79% vs 62%, respectively). Incidence of side effects did not differ significantly in CCR- as compared to COP-treated pts, e.i. infections (10% vs 7%; 14% vs 20%; 15% vs 0%, respectively), myelosuppression (31% vs 7%; 21% vs 20%; 30% vs 0%, respectively), and non-hematological adverse events (10% vs 14%; 7% vs 30%; 7% vs 22%, respectively). With a median follow-up of 12 months, median FFP was superior in CCR- as compared to COP-treated treated pts with SLL (43 vs 12 months, log-rank p<.03) or MZL (37 vs 7 months, log-rank p<.03) but not with FL (17 vs 22 months). Although the median OS has not been reached in any of the histological group so far, no difference in its duration is detected between CCR- or COP-treated pts. In summary, for pts with SLL, MZL and FL, first-line CCR regimens provided better CR and similar toxicity rates as compared to COP, which translated into longer FFP in SLL and MZL but not in FL pts. Although these results warrant larger number of pts and longer follow-up, they might suggest the choice of different front-line chemotherapy with or without immunotherapy in particular histological subtypes of low-grade lymphoma.

Safety and efficacy of maintenance therapy (MT) with a nonspecific cytochrome-P 17 inhibitor (CYP17i) after response/stabilization to docetaxel in metastatic castratation-resistant prostate cancer (mCRPC) patients.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 145-145
Author(s):  
Ignacio Gil-Bazo ◽  
Ainhoa Castillo ◽  
Maria E. Zudaire ◽  
Estefania Arevalo ◽  
Omar Esteban Carranza ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Abiraterone Acetate ◽  
Front Line ◽  
Free Survival ◽  
The Usa ◽  
Small Cohort ◽  
Daily Prednisone ◽  
To Receive

145 Background: ACRPC causes >30,000 deaths/year in the USA. The front-line treatment consists of docetaxel-based chemotherapy (D). 50% of patients (pts) show at least a 50% PSA decline during D and >15% show a partial response (R) in measurable disease. However, most of these pts present progression (P) after a median of 6-8 months (m). mCRPC remains driven by ligand-dependent androgen (A) receptor signaling. Ketoconazole (K) is a nonspecific cytochrome-P 17 inhibitor (CYP17i) able to block adrenal A synthesis. Low-dose K (LDK), (200 mg, t.d.s) has shown interesting activity in mCRPC after P to androgen deprivation therapy (ADT). The FDA recently granted approval to Abiraterone acetate, a selective CYP17i showing a survival benefit after P to D. The role of a CYP17i in the maintenance setting after response/stabilization to D has never been studied. Methods: 38 mCRPC pts starting D after P to ADT maintained LHRHa and additionally received a median of 7 cycles (3-12) of front-line three-weekly D (75 mg/m2) plus daily prednisone (10 mg). 20/38 pts showing no progression to D were enrolled. One month after the last D cycle 10 pts were assigned to MT with LDK plus prednisone (10 mg daily) and continued to receive LHRHa while the 10 pts in the control arm continued on LHRHa alone. Progression-free survival (PFS) was the primary endpoint of the study. Results: After a median follow-up of 27 m, all pts in the control arm progressed after D treatment while 8/10 pts progressed to MT. PFS from D initiation was 11.4 m for MT and 8.9 m for control arm (p=0.025). Toxicity profiles showed no significant differences between both arms. No pts discontinued LDK for toxicity reasons. Conclusions: To our knowledge, this is the first study testing a CYP17i for MT after response/stabilization to D in mCRPC. Although this is a small cohort of pts and a longer follow-up is needed, these preliminary data show a significant benefit in PFS of more than 2 months with LDK MT compared to no MT after D with a favorable toxicity profile. Thus, a further analysis in a larger series and the potential impact of this PFS benefit on the overall survival is warranted.

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