Search results for: national health insurance program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15208

Search results for: national health insurance program

14878 The 'Human Medium' in Communicating the National Image: A Case Study of Chinese Middle-Class Tourists Visiting Japan

Authors: Abigail Qian Zhou

Abstract:

In recent years, the prosperity of mass tourism in China has accelerated the breadth and depth of direct communication between countries, and the national image has been placed in a new communication context. Outbound tourists are not only directly involved in the formation of the national image, but are also the most direct medium and the most active symbol representing the national image. This study uses Chinese middle-class tourists visiting Japan as a case study, and analyzes, through participant observation and semi-structured interviews, the communication function of the national image transmitted by 'human medium' in tourism activities. It also explores the 'human medium' in the era of mass tourism. This study hopes to build a bridge for tourism research and national image and media studies. It will provide a theoretical basis and practical guidance for promoting the national image, strengthening exchanges between tourists and local populations, and expanding the tourism market in the future.

Keywords: human medium, national image, communication, Chinese middle class, outbound tourists

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14877 Web-Based Learning in Nursing: The Sample of Delivery Lesson Program

Authors: Merve Kadioğlu, Nevin H. Şahin

Abstract:

Purpose: This research is organized to determine the influence of the web-based learning program. The program has been developed to gain information about normal delivery skill that is one of the topics of nursing students who take the woman health and illness. Material and Methods: The methodology of this study was applied as pre-test post-test single-group quasi-experimental. The pilot study consisted of 28 nursing student study groups who agreed to participate in the study. The findings were gathered via web-based technologies: student information form, information evaluation tests, Web Based Training Material Evaluation Scale and web-based learning environment feedback form. In the analysis of the data, the percentage, frequency and Wilcoxon Signed Ranks Test were used. The Web Based Instruction Program was developed in the light of full learning model, Mayer's research-based multimedia development principles and Gagne's Instructional Activities Model. Findings: The average scores of it was determined in accordance with the web-based educational material evaluation scale: ‘Instructional Suitability’ 4.45, ‘Suitability to Educational Program’ 4.48, ‘Visual Adequacy’ 4.53, ‘Programming Eligibility / Technical Adequacy’ 4.00. Also, the participants mentioned that the program is successful and useful. A significant difference was found between the pre-test and post-test results of the seven modules (p < 0.05). Results: According to pilot study data, the program was rated ‘very good’ by the study group. It was also found to be effective in increasing knowledge about normal labor.

Keywords: normal delivery, web-based learning, nursing students, e-learning

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14876 A Survey on Students' Intentions to Dropout and Dropout Causes in Higher Education of Mongolia

Authors: D. Naranchimeg, G. Ulziisaikhan

Abstract:

Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.

Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate

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14875 Human-Tiger Conflict in Chitwan National Park, Nepal

Authors: Abishek Poudel

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Human-tiger conflicts are serious issues of conflicts between local people and park authority and the conflicting situation potentially play negative role in park management. The study aimed (1) To determine the trend and nature of human-tiger conflicts (2) To understand people's perception and mitigation measures towards tiger conservation. Both primary and secondary information were used to determine human- tiger conflicts in Chitwan National Park. Systematic random sampling with 5% intensity was done to collect the perception of the villagers regarding human-tiger conflicts. The study sites were selected based on frequencies of incidences of human attacks and livestock depredation viz. Rajahar and Ayodhyapuri VDCs respectively. The trend of human casualties by tiger has increased in last five year whereas the trend of livestock has decreased. Reportedly, between 2008 and 2012, tigers killed 22 people, injured 10 and killed at least 213 livestock. Conflict was less common in the park and more intense in the sub-optimal habitats of Buffer Zone. Goat was the most vulnerable livestock followed by cattle. The livestock grazing and human intrusion into tiger habitat were the causes of conflicts. Developing local stewardship and support for tiger conservation, livestock insurance, and compensation policy simplification may help reduce human-tiger conflicts.

Keywords: livestock depredation, sub optimal habitat, human-tiger, local stewardship

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14874 Formal Thai National Costume in the Reign of King Bhumibol Adulyadej

Authors: Chanoknart Mayusoh

Abstract:

The research about Formal Thai National Costume in the reign of King Bhumibol Adulyadej is an applied research that aimed to study the accurate knowledge concerning to Thai national costume in the reign of King Rama IX, also to study origin of all costumes in the reign of King Rama IX and to study the style, material used, and using accasion. This research methodology which are collect quanlitative data through observation, document, and photograph from key informant of costume in the reign of King Rama IX and from another who related to this field. The formal Thai national costume of the reign of King Bhumibol Adulyadej originated from the visit of His Majesty the King to Europe and America in 1960. Since Thailand had no traditional national costume; Her Majesty the Queen initiated the idea to create formal Thai national costumes. In 1964, Her Majesty the Queen selected 8 styles of formal Thai national costume. Later, Her Majesty the Queen confered another 3 formal Thai national costume for men. There are 8 styles of formal Thai national costume for women: Thai Ruean Ton, Thai Chit Lada, Thai Amarin, Thai Borom Phiman, Thai Siwalia, Thai Chakkri, Thai Dusit, and Thai Chakkraphat. There are 3 styles of formal Thai national costume for men: short-sleeve shirt, long-sleeve shirt, and long-sleeve shirt with breechcloth. The costume is widely used in formal ceremony such as greeting ceremony for official foreign visitors, wedding ceremony, or other auspicious ceremonies. Now a day, they are always used as a bridal gown as well. The formal Thai national costume is valuable art that shows Thai identity and, should be preserved for the next generation.

Keywords: formal Thai national costume for women, formal Thai national costume for men, His Majesty King Bhumibol Adulyadej the Great King Rama IX, Her Majesty Queen Sirikit Queen

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14873 Pandemic-Era WIC Participation in Delaware, U.S.: Participants' Experiences and Challenges

Authors: McKenna Halverson, Allison Karpyn

Abstract:

Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.

Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC

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14872 State and Determinant of Caregiver’s Mental Health in Thailand: A Household Level Analysis

Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

Abstract:

The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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14871 Prenatal Can Reduce the Burden of Preterm Birth and Low Birthweight from Maternal Sexually Transmitted Infections: US National Data

Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

Abstract:

We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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14870 National Project 'Environment' of Russian Federation as a Management Tool in Achieving SDGs

Authors: Ekaterina Posokhova, Boris Gavrilov

Abstract:

Priority national projects have become an essential phenomenon in the Russian Federation. Both regional and local government institutions and a significant part of the society have been involved in their implementation. The scale and multispectricity of the national projects give a reason to believe that their concept is beyond the scope of the individual state programs. The national project “environment” contains federal projects on waste management, water, and air quality, ecotourism development, and biodiversity conservation highlights the importance of the preservation and restoration of Volga River and Lake Baikal ecosystems. This study assesses the national projects according to their relativeness with the current SDGs (i.e., SGD 14 and 15), evaluates the methodology of the projects. The paper considers the peculiarities of the national projects as strategic management tools as well as the possibility of amending the project objective indicators. Conclusion on the effectiveness of NP in terms of achieving SDGs is provided.

Keywords: management, SDP, russia, conservation, law

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14869 A Transformational Ecology Model of School Based Universal Mental Health Development

Authors: Cheryl M. Bowen

Abstract:

Understanding that children thrive in a multi-systems approach to mental health development, a growing number of schools often promote school-based positive youth development however, there is scant empirical evidence investigating effective school-based “wraparound” mental health services for low income, Latinx children and their families. This 10-month case study utilizes a sample of 281 low-income, Latinx parents and their children, and 23 K-5th grade teachers living in northern California to test the hypothesis that a school-based mental health program can strengthen students’ developmental asset attainment and positively impact the school environment. The study utilized triangulated data to ascertain the effects of two program levels - (a) mental health and (b) positive child development services. All services were site-based and meant to target a wide variety of families. Findings from the study report that the universal mental health program increased the developmental asset attainment in 5 out of 8 thriving indicators thus transforming the child within his/her environment. Data collected from the administrative referral report demonstrate that the project also positively impacted the school climate. Parents and teachers felt more connected to the school, and referrals were down for discipline (35%), academics (66%), and suspensions (51%). The study concludes that a transformational ecology model of positive child development is the most effective means to nurture connections to all socializing agencies in a child’s ecosystem.

Keywords: case study, child development, positive youth development, developmental assets, ecological systems theory

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14868 'English in Tourism' in the Project 'English for Community'

Authors: Nguyen Duc An

Abstract:

To the movement towards learning community, creating friendly, positive and appropriate learning environments which best suit the local features is the most salient and decisive factor of the development and success of that learning society. With the aim at building such an English language learning community for the inhabitants in Moc Chau - the national tourist zone, Tay Bac University has successfully designed and deployed the program ‘English in Tourism’ in the project ‘English for Community’. With the strong attachment to the local reality and close knit to the certain communicative situations, this program which was carefully designed and compiled with interesting and practical activities, has greatly helped the locals confidently introduce and popularize the natural beauty, unique culture and specific characteristics of Moc Chau to the foreign tourists; in addition, reinforce awareness of the native culture of the local people as well as improve the professional development in tourism and service.

Keywords: English for community, learning society, learning community, English in tourism

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14867 Educational Leadership Preparation Program Review of Employer Satisfaction

Authors: Glenn Koonce

Abstract:

There is a need to address the improvement of university educational leadership preparation programs through the processes of accreditation and continuous improvement. The program faculty in a university in the eastern part of the United States has incorporated an employer satisfaction focus group to address their national accreditation standard so that employers are satisfied with completers' preparation for the position of principal or assistant principal. Using the Council for the Accreditation of Educator Preparation (CAEP) required proficiencies, the following research questions are investigated: 1) what proficiencies do completers perform the strongest? 2) what proficiencies need to be strengthened? 3) what other strengths beyond the required proficiencies do completers demonstrate? 4) what other areas of responsibility beyond the required proficiencies do completers demonstrate? and 5) how can the program improve in preparing candidates for their positions? This study focuses on employers of one public school district that has a large number of educational leadership completers employed as principals and assistant principals. Central office directors who evaluate principals and principals who evaluate assistant principals are focus group participants. Construction of the focus group questions is a result of recommendations from an accreditation regulatory specialist, reviewed by an expert panel, and piloted by an experienced focus group leader. The focus group session was audio recorded, transcribed, and analyzed using the NVivo Version 14 software. After constructing folders in NVivo, the focus group transcript was loaded and skimmed by diagnosing significant statements and assessing core ideas for developing primary themes. These themes were aligned to address the research questions. From the transcript, codes were assigned to the themes and NVivo provided a coding hierarchy chart or graphical illustration for framing the coding. A final report of the coding process was designed using the primary themes and pertinent codes that were supported in excerpts from the transcript. The outcome of this study is to identify themes that can provide evidence that the educational leadership program is meeting its mission to improve PreK-12 student achievement through well-prepared completers who have achieved the position of principal or assistant principal. The considerations will be used to derive a composite profile of employers' satisfaction with program completers with the capacity to serve, influence, and thrive as educational leaders. Analysis of the idealized themes will result in identifying issues that may challenge university educational leadership programs to improve. Results, conclusions, and recommendations are used for continuous improvement, which is another national accreditation standard required for the program.

Keywords: educational leadership preparation, CAEP accreditation, principal & assistant principal evaluations, continuous improvement

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14866 Management and Evaluation of Developing Medical Device Software in Compliance with Rules

Authors: Arash Sepehri bonab

Abstract:

One of the regions of critical development in medical devices has been the part of the software - as an indispensable component of a therapeutic device, as a standalone device, and more as of late, as applications on portable gadgets. The chance related to a breakdown of the standalone computer program utilized inside healthcare is in itself not a model for its capability or not as a medical device. It is, subsequently, fundamental to clarify a few criteria for the capability of a stand-alone computer program as a medical device. The number of computer program items and therapeutic apps is persistently expanding and so as well is used in wellbeing education (e. g., in clinics and doctors' surgeries) for determination and treatment. Within the last decade, the use of information innovation in healthcare has taken a developing part. In reality, the appropriation of an expanding number of computer devices has driven several benefits related to the method of quiet care and permitted simpler get to social and health care assets. At the same time, this drift gave rise to modern challenges related to the usage of these modern innovations. The program utilized in healthcare can be classified as therapeutic gadgets depending on the way they are utilized and on their useful characteristics. In the event that they are classified as therapeutic gadgets, they must fulfill particular directions. The point of this work is to show a computer program improvement system that can permit the generation of secure and tall, quality restorative gadget computer programs and to highlight the correspondence between each program advancement stage and the fitting standard and/or regulation.

Keywords: medical devices, regulation, software, development, healthcare

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14865 Assessment Client Satisfaction with Family Physician in Health Care Centers of Jiroft County and Its Relationship with Physician’ Demographic Variables

Authors: Babak Nemat Shahrbabaki, Arezo Fallahi, Masoomeh Hashemian

Abstract:

Introduction: Health and safety are basic components of civil right. Health care systems in different countries were influenced by political, economic and cultural circumstances. In order to health services to people, these systems are organized with different forms, methods such as: prevention, treatment and rehabilitation and in this among, public satisfaction with the services provided is important. This study aimed to determine client satisfaction with family physician and relationship with physician’ demographic variables in health care centers of Jiroft county, Iran. Methods: This is a descriptive-analytical study. The collective data tool was a self-made questionnaire with two parts. The first part comprised demographic characteristics, and the second part contained 11 items for the assessment of satisfaction with family physician from different aspects. In addition, questionnaire, reliability and validity were confirmed. Random simple sampling method was used to determine samples. 234 people referred to the health centers filled questionnaire. The data were analyzed using SPSS software, and inferential statistical analysis was performed. Findings: The majority of the study population were women, married, and aged between 18 and 62 years (mean= 30.09±10.71). Total average satisfaction score was 42.63±3.68. Overall satisfaction averages were 9.47% very high, 30.04% high, 33.09% moderate, 15.12% low, and 12.28% very low. Except lodge on of family physician none of physician’ demographic variables did not effect on satisfaction index. Discussion & Conclusion: The Results showed that mean of satisfaction indexes of family physicians was high and lodge on of family physician effected on this index. Informing people about the main goals of family-doctor program will help to promote the quality of program and increase people satisfaction.

Keywords: family physician program, satisfaction, health-care centers, client

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14864 A Holistic Approach to Institutional Cyber Security

Authors: Mehmet Kargaci

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It is more important to access information than to get the correct information and to transform it to the knowledge in a proper way. Every person, organizations or governments who have the knowledge now become the target. Cyber security involves the range of measures to be taken from individual to the national level. The National institutions refer to academic, military and major public and private institutions, which are very important for the national security. Thus they need further cyber security measures. It appears that the traditional cyber security measures in the national level are alone not sufficient, while the individual measures remain in a restricted level. It is evaluated that the most appropriate method for preventing the cyber vulnerabilities rather than existing measures are to develop institutional measures. This study examines the cyber security measures to be taken, especially in the national institutions.

Keywords: cyber defence, information, critical infrastructure, security

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14863 Effects of the Affordable Care Act On Preventive Care Disparities

Authors: Cagdas Agirdas

Abstract:

Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

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14862 Need of National Space Legislation for Space Faring Nations

Authors: Muhammad Naveed, Yang Caixia

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The need for national space legislation is pivotal, particularly in light of the fact that in recent years space activities have grown immensely both in volume and diversity. Countries are progressively developing capabilities in space exploration and scientific discoveries, market their capabilities to manufacture satellites, provide launch services from their facilities and are looking to privatize and commercialize their space resources. Today, nations are also seeking to comprehend the technological and financial potential of the private sector and are considering to share their financial burdens with them and to limit their exposures to risks, but they are lagging behind in legal framework in this regard. In the perspective of these emerging developments, it is therefore, felt that national space legislation should be enacted with the goal of building and implementing a vibrant and transparent legal framework at the national level to hasten investments and to ensure growth in this capital intensive - highly yield strategic sector. This study looks at (I) the international legal framework that governs space activities; (II) motivation behind making national space laws; and (III) the need for national space legislation. The paper concludes with some recommendations with regards to the conceivable future direction for national space legislation, in particular space empowered sub-areas for countries.

Keywords: international conventions, national legislation, space faring nations, space law

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14861 Frailty Patterns in the US and Implications for Long-Term Care

Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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14860 Suicide Prevention among Young People: Findings from the Evaluation of Youth Aware of Mental Health in Australian Secondary Schools

Authors: Lauren McGillivray, Michelle Torok, Alison Calear

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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

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14859 Effectiveness of an Early Intensive Behavioral Intervention Program on Infants with Autism Spectrum Disorder

Authors: Dongjoo Chin

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The purpose of this study was to investigate the effectiveness of an Early Intensive Behavioral Intervention (EIBI) program on infants with autism spectrum disorder (ASD) and to explore the factors predicting the effectiveness of the program, focusing on the infant's age, language ability, problem behaviors, and parental stress. 19 pairs of infants aged between 2 and 5 years who have had been diagnosed with ASD, and their parents participated in an EIBI program at a clinic providing evidence-based treatment based on applied behavior analysis. The measurement tools which were administered before and after the EIBI program and compared, included PEP-R, a curriculum evaluation, K-SIB-R, K-Vineland-II, K-CBCL, and PedsQL for the infants, and included PSI-SF and BDI-II for the parents. Statistical analysis was performed using a sample t-test and multiple regression analysis and the results were as follows. The EIBI program showed significant improvements in overall developmental age, curriculum assessment, and quality of life for infants. There was no difference in parenting stress or depression. Furthermore, measures for both children and parents at the start of the program predicted neither PEP-R nor the degree of improvement in curriculum evaluation measured six months later at the end of the program. Based on these results, the authors suggest future directions for developing an effective intensive early intervention (EIBI) program for infants with ASD in Korea, and discuss the implications and limitations of this study.

Keywords: applied behavior analysis, autism spectrum disorder, early intensive behavioral intervention, parental stress

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14858 The Persistent English Language Gap between the Direct Entry and Foundation Program University Students: Empirical Evidence from the UAE

Authors: Eda Orhun

Abstract:

This paper studies the IELTS exit scores of Emirati university students before graduation and specifically compares the IELTS exit performance of the English foundation program (FP) students to direct entry (DE) students. Direct entry (DE) students are the students who were able to directly start with the undergraduate program without the need to attend English foundation program courses as they were able to prove a sufficient level of English at the university admittance. The results clearly show that the gap that existed already between these two groups of students at the start does not seem to disappear at the end of university studies, as DE students’ IELTS exit scores are significantly higher compared to FP students. Further work of a regression analysis exhibits that GPA and CMATH scores do have a positive and significant effect on IELTS exit scores. In addition, while the College of Education students are found to have the lowest performance in every sub-section of the IELTS exam across colleges, students of the College of Humanities and Social Sciences and the College of Natural and Health Sciences seem to have the best reading skills. Another important determinant of IELTS exit scores is found to be the English level of students at inception. With these results, the study offers important policy implications regarding the public education system of the UAE and sheds light on the main roots of the problem.

Keywords: English proficiency, higher education, IELTS exit scores, English foundation program, United Arab Emirates

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14857 Readiness Assessment to Implement Net-Zero Energy Building Program of Government Buildings in the Philippines

Authors: Patrick T. Aquino, Jimwel B. Balunday, Cephas Olivier V. Cabatit, Mary Grace Q. Razonable

Abstract:

In 2023, the Philippine Department of Energy (PDOE) published the National Energy Efficiency and Conservation Plan (NEECP) and Roadmap 2023-2050 to be the basis of a comprehensive program for the efficient supply and economical use of energy. The building sector, as one of the most energy-intensive sectors, shall conform to the energy-conserving design to reduce the use of energy. The concept of Net-Zero Energy Building (NZEB), and its definitions promote to improve energy efficiency of the buildings. The PDOE partnered with Meralco Power Academy to survey and conduct focus group discussions to establish the readiness into NZE-aspiring buildings of government entities. This paper outlines important NZEB principles, best practices from other countries, issues and gaps relating to energy management program, and the recommendations on the development of a framework for NZEB under government building in the Philippines. Results revealed the limitation on specific data to establish a baseline building energy efficiency performance index and significant energy uses; the need to update the Guidelines for Energy Conservation Design of Buildings, including NZEB definition and requirements; appropriate enabling infrastructures and programs to transition government buildings into NZE-aspiring buildings to Nearly Zero Energy Buildings by 2050.

Keywords: NZEB, energy efficiency, buildings, Philippines

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14856 Research on the Planning and Design of National Park Gateway Communities from the Perspective of Nature Education

Authors: Yulin Liang

Abstract:

Under the background of protecting ecology, natural education is an effective way for people to understand nature. At the same time, it is a new means of sustainable development of eco-tourism, which can improve the functions of China's protected areas and develop new business formats for the development of national parks. This study takes national park gateway communities as the research object and uses literature review, inductive reasoning and other research methods to sort out the development process of natural education in China and the research progress of natural education design in national park gateway communities. Finally, we discuss how gateway communities can use natural education to transform their development methods and provide a theoretical and practical basis for the development of gateway communities in national parks.

Keywords: natural education, gateway communities, national parks, sustainable development

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14855 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi

Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

Abstract:

Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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14854 Defence Ethics : A Performance Measurement Framework for the Defence Ethics Program

Authors: Allyson Dale, Max Hlywa

Abstract:

The Canadian public expects the highest moral standards from Canadian Armed Forces (CAF) members and Department of National Defence (DND) employees. The Chief, Professional Conduct and Culture (CPCC) stood up in April 2021 with the mission of ensuring that the defence culture and members’ conduct are aligned with the ethical principles and values that the organization aspires towards. The Defence Ethics Program (DEP), which stood up in 1997, is a values-based ethics program for individuals and organizations within the DND/CAF and now falls under CPCC. The DEP is divided into five key functional areas, including policy, communications, collaboration, training and education, and advice and guidance. The main focus of the DEP is to foster an ethical culture within defence so that members and organizations perform to the highest ethical standards. The measurement of organizational ethics is often complex and challenging. In order to monitor whether the DEP is achieving its intended outcomes, a performance measurement framework (PMF) was developed using the Director General Military Personnel Research and Analysis (DGMPRA) PMF development process. This evidence-based process is based on subject-matter expertise from the defence team. The goal of this presentation is to describe each stage of the DGMPRA PMF development process and to present and discuss the products of the DEP PMF (e.g., logic model). Specifically, first, a strategic framework was developed to provide a high-level overview of the strategic objectives, mission, and vision of the DEP. Next, Key Performance Questions were created based on the objectives in the strategic framework. A logic model detailing the activities, outputs (what is produced by the program activities), and intended outcomes of the program were developed to demonstrate how the program works. Finally, Key Performance Indicators were developed based on both the intended outcomes in the logic model and the Key Performance Questions in order to monitor program effectiveness. The Key Performance Indicators measure aspects of organizational ethics such as ethical conduct and decision-making, DEP collaborations, and knowledge and awareness of the Defence Ethics Code while leveraging ethics-related items from multiple DGMPRA surveys where appropriate.

Keywords: defence ethics, ethical culture, organizational performance, performance measurement framework

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14853 Research on Community-based Nature Education Design at the Gateway Communities of National Parks

Authors: Yulin Liang

Abstract:

Under the background of protecting ecology, natural education is an effective way for people to understand nature. At the same time, it is a new means of sustainable development of eco-tourism, which can improve the functions of China 's protected areas and develop new business formats for the development of national parks. This study takes national park gateway communities as the research object and uses literature review, inductive reasoning and other research methods to sort out the development process of natural education in China and the research progress of natural education design in national park gateway communities. Finally, it discuss how gateway communities can use natural education to transform their development methods and provide theoretical and practical basis for the development of gateway communities in national parks.

Keywords: nature education, gateway communities, national park, sustainable development

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14852 The Antecedents of Thai Women's Entry into National Politics in Thailand

Authors: Somsak Assavasirisilp

Abstract:

The purposes of this research were to study the level of participation in the politic activities of Thai women, to study the factors influencing the Thai women’s entry into national politics, and to study the problems and obstacles to prevent women from enter national politics. This was a mixed research method of both qualitative and quantitative technique. The findings revealed that there were many problems and obstacles, especially culture and social norm, to prevent women from enter national politics and did not have many factors to support Thai women to become successful women politician.

Keywords: culture, social norm, national politics, Thai women

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14851 Culture Dimensions of Information Systems Security in Saudi Arabia National Health Services

Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

Abstract:

The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified six cultural dimensions: Saudi national culture, Saudi health service leadership, employees’ trust, technology, multicultural interactions and employees’ job roles. The research also identified a set of cultural sub-dimensions. These include working values and norms, tribe values and norms, attitudes towards women, power sharing, vision, social interaction, respect and understanding, hospital intra-net, hospital employees’ language(s) used, multi-national culture, communication system, employees’ job satisfaction and job security. The research identified that (a) the human behaviour towards medical information in SA is one of the main threats to information security and one of the main challenges to SA health authority, (b) The current situation of SA hospitals’ IS cultures is falling short in protecting medical information due to the current value and norms towards information security, (c) Saudi national culture and employees’ job role are the main dimensions playing major roles in the employees’ attitude, and technology is the least important dimension playing a role in the employees’ attitudes.

Keywords: cultural dimension, electronic health record, information security, privacy

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14850 A Holistic Conceptual Measurement Framework for Assessing the Effectiveness and Viability of an Academic Program

Authors: Munir Majdalawieh, Adam Marks

Abstract:

In today’s very competitive higher education industry (HEI), HEIs are faced with the primary concern of developing, deploying, and sustaining high quality academic programs. Today, the HEI has well-established accreditation systems endorsed by a country’s legislation and institutions. The accreditation system is an educational pathway focused on the criteria and processes for evaluating educational programs. Although many aspects of the accreditation process highlight both the past and the present (prove), the “program review” assessment is "forward-looking assessment" (improve) and thus transforms the process into a continuing assessment activity rather than a periodic event. The purpose of this study is to propose a conceptual measurement framework for program review to be used by HEIs to undertake a robust and targeted approach to proactively and continuously review their academic programs to evaluate its practicality and effectiveness as well as to improve the education of the students. The proposed framework consists of two main components: program review principles and the program review measurement matrix.

Keywords: academic program, program review principles, curriculum development, accreditation, evaluation, assessment, review measurement matrix, program review process, information technologies supporting learning, learning/teaching methodologies and assessment

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14849 Multi-Sectoral Prioritization of Zoonotic Diseases in Uganda, 2017: The Perspective of One Health Experts

Authors: Musa Sekamatte

Abstract:

Background: Zoonotic diseases continue to be a public health burden in countries around the world. Uganda is especially vulnerable due to its location, biodiversity, and population. Given these concerns, the Ugandan government in collaboration with the Global Health Security Agenda conducted a zoonotic disease prioritization workshop to identify zoonotic diseases of concern to multiple Ugandan ministries. Materials and Methods: The One Health Zoonotic Disease Prioritization tool, developed by the U.S. Centers for Disease Control and Prevention (CDC), was used for prioritization of zoonotic diseases in Uganda. Workshop participants included voting members representing human, animal, and environmental health ministries as well as key partners who observed the workshop. Over 100 articles describing characteristics of these zoonotic diseases were reviewed for the workshop. During the workshop, criteria for prioritization were selected, and questions and weights relevant to each criterion were determined. Next steps for multi-sectoral engagement for the prioritized zoonoses were then discussed. Results: 48 zoonotic diseases were considered during the workshop. Criteria selected to prioritize zoonotic diseases in order of importance were (1) severity of disease in humans in Uganda, (2) availability of effective control strategies, (3) potential to cause an epidemic or pandemic in humans or animals, (4) social and economic impacts, and (5) bioterrorism potential. Seven zoonotic diseases were identified as priorities for Uganda: anthrax, zoonotic influenza viruses, viral hemorrhagic fevers, brucellosis, African trypanosomiasis, plague, and rabies. Discussion: One Health approaches and multi-sectoral collaborations are crucial in the surveillance, prevention, and control strategies for zoonotic diseases. Uganda used such an approach to identify zoonotic diseases of national concern. Identifying these priority diseases enables the National One Health Platform and the Zoonotic Disease Coordinating Office to address the diseases in the future.

Keywords: national one health platform, zoonotic diseases, multi-sectoral, severity

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