Search results for: Chinese healthcare system reform
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19360

Search results for: Chinese healthcare system reform

18790 On the Road towards Effective Administrative Justice in Macedonia, Albania and Kosovo: Common Challenges and Problems

Authors: Arlinda Memetaj

Abstract:

A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of both effective public administration and administrative justice system has been for a long period of time among the most ‘important and urgent’ final strategic objectives of almost any country in the Balkans region, including Macedonia, Albania and Kosovo. Closely related to this is their common strategic goal to enter the membership in the European Union, which requires fulfilling of many criteria and standards as incorporated in EU acquis communautaire. The latter is presently done with the framework of the Stabilization and Association Agreement which each of these countries has concluded with the EU accordingly. To above aims, each of the three countries has so far adopted a huge series of legislative and strategic documents related to any aspects of their individual administrative justice system. ‘Changes and reforms’ in this field have been thus the most frequent terms being used in any of these countries. The three countries have already established their own national administrative judiciary, while permanently amending their laws on the general administrative procedure introducing thereby considerable innovations concerned. National administrative courts are expected to have crucial important role within the broader judiciary systems-related reforms of these countries; they are designed to check the legality of decisions of the state administration with the aim to guarantee an effective protection of human rights and legitimate interests of private persons through a regular, conform, fast and reasonable judicial administrative process. Further improvements in this field are presently an integral crucial part of all the relevant national strategic documents including the ones on judiciary reform and public administration reform, as adopted by each of the three countries; those strategic documents are designed among others to provide effective protection of their citizens` rights` of administrative justice. On the basis of the later, the paper finally is aimed at highlighting selective common challenges and problems of the three countries on their European road, while claiming (among others) that the current status quo situation in each of them may be overcome only if there is a proper implementation of the administrative courts decisions and a far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main methods used in this paper include the analytical and comparative ones due to the very character of the paper itself.

Keywords: administrative courts , administrative justice, administrative procedure, benefit, effective administrative justice, human rights, implementation, monitoring, reform

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18789 Bilingual Experience Influences Different Components of Cognitive Control: Evidence from fMRI Study

Authors: Xun Sun, Le Li, Ce Mo, Lei Mo, Ruiming Wang, Guosheng Ding

Abstract:

Cognitive control plays a central role in information processing, which is comprised of various components including response suppression and inhibitory control. Response suppression is considered to inhibit the irrelevant response during the cognitive process; while inhibitory control to inhibit the irrelevant stimulus in the process of cognition. Both of them undertake distinct functions for the cognitive control, so as to enhance the performances in behavior. Among numerous factors on cognitive control, bilingual experience is a substantial and indispensible factor. It has been reported that bilingual experience can influence the neural activity of cognitive control as whole. However, it still remains unknown how the neural influences specifically present on the components of cognitive control imposed by bilingualism. In order to explore the further issue, the study applied fMRI, used anti-saccade paradigm and compared the cerebral activations between high and low proficient Chinese-English bilinguals. Meanwhile, the study provided experimental evidence for the brain plasticity of language, and offered necessary bases on the interplay between language and cognitive control. The results showed that response suppression recruited the middle frontal gyrus (MFG) in low proficient Chinese-English bilinguals, but the inferior patrietal lobe in high proficient Chinese-English bilinguals. Inhibitory control engaged the superior temporal gyrus (STG) and middle temporal gyrus (MTG) in low proficient Chinese-English bilinguals, yet the right insula cortex was more active in high proficient Chinese-English bilinguals during the process. These findings illustrate insights that bilingual experience has neural influences on different components of cognitive control. Compared with low proficient bilinguals, high proficient bilinguals turn to activate advanced neural areas for the processing of cognitive control. In addition, with the acquisition and accumulation of language, language experience takes effect on the brain plasticity and changes the neural basis of cognitive control.

Keywords: bilingual experience, cognitive control, inhibition control, response suppression

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18788 A Conceptual Framework for Assessing the Development of Health Information Systems Enterprise Architecture Interoperability

Authors: Prosper Tafadzwa Denhere, Ephias Ruhode, Munyaradzi Zhou

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Health Information Systems (HISs) interoperability is emerging to be the future of modern healthcare systems Enterprise Architecture (EA), where healthcare entities are seamlessly interconnected to share healthcare data. The reality that the healthcare industry has been characterised by an influx of fragmented stand-alone e-Health systems, which present challenges of healthcare information sharing across platforms, desires much attention for systems integration efforts. The lack of an EA conceptual framework resultantly crates the need for investigating an ideal solution to the objective of Health Information Systems interoperability development assessment. The study takes a qualitative exploratory approach through a design science research context. The research aims to study the various themes withdrawn from the literature that can help in the assessment of interoperable HISs development through a literature study. Themes derived from the study include HIS needs, HIS readiness, HIS constraints, and HIS technology integration elements and standards tied to the EA development architectural layers of The Open Group Architecture Framework (TOGAF) as an EA development methodology. Eventually, the themes were conceptualised into a framework reviewed by two experts. The essence of the study was to provide a framework within which interoperable EA of HISs should be developed.

Keywords: enterprise architecture, eHealth, health information systems, interoperability

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18787 Building a Framework for Digital Emergency Response System for Aged, Long Term Care and Chronic Disease Patients in Asia Pacific Region

Authors: Nadeem Yousuf Khan

Abstract:

This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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18786 A Cross-Cultural Analysis of Ethical Standards in Social and Behavioral Research

Authors: Xiwu Feng

Abstract:

The paper is to analyze research ethics in social and behavioral sciences from a cross-cultural perspective. A multi-phase study investigated implementations of ethical standards and guidelines in higher institutions in China. Institutional policies and procedures on human subject research and perceptions of human subject protection were assessed in the Chinese research universities from different regions. The findings of the study indicate that the implementations of ethical standards and guidelines vary from institution to institution and from region to region. Education and cultural backgrounds of the participants influence their perceptions of the welfare and privacy of human subjects. The results of the study reveal great differences and complexities in ethical standards for the protection of human subjects of research in contrast to the Western world. The Chinese collectivistic values and the cooperative-harmonious democracy play a significant role in perceiving and implementing ethical guidelines. Chinese researchers find themselves a long way to go before seeing implementations of regulations and guidelines on human subject research in social and behavioral sciences.

Keywords: ethical standards, human subjects, research ethics, social and behavioral research

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18785 Leisure Time Physical Activity during Pregnancy and the Associated Factors Based on Health Belief Model: A Cross Sectional Study

Authors: Xin Chen, Xiao Yang, Rongrong Han, Lu Chen, Lingling Gao

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Background: Leisure time physical activity (LTPA) benefits both pregnant women and their fetuses. The guidelines recommended that pregnant women should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week. The aim of this study was to investigate the rate of LTPA participation among Chinese pregnant women and to identify its predictors based on the health belief model. Methods: A cross-sectional study was conducted from June 2019 to September 2019 in Changchun, China. A total of 225 pregnant women aged 18 years or older with no severe physical or mental disease were recruited in the obstetric clinic. Self-administered questionnaires were used to collect data. LTPA was assessed by a pregnant physical activity questionnaire (PPAQ). A revised pregnancy physical activity health belief scale and social-demographic and perinatal characteristics factors were collected and used to predict LTPA participation. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: The participants had a high level of perceived susceptibility, perceived severity, perceived benefits, and action clues, with mean item scores above 3.5. The predictors of LTPA in Chinese pregnant women were pre-pregnancy exercise habits [OR 3.236 (95% CI:1.632, 6.416)], perceived susceptibility score [OR 2.083 (95% CI:1.002, 4.331)], and perceived barriers score [OR 3.113 (95%CI:1.462, 6.626)]. Conclusions: The results of this study will lead to better identification of pregnant women who may not participate in LTPA. Healthcare professionals should be cognizant of issues that may affect LTPA participation among pregnant women, including pre-pregnancy exercise habits, perceived susceptibility, and perceived barriers.

Keywords: pregnancy, health belief model., leisure time physical activity, factors

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18784 Design and Implementation of an Affordable Electronic Medical Records in a Rural Healthcare Setting: A Qualitative Intrinsic Phenomenon Case Study

Authors: Nitika Sharma, Yogesh Jain

Abstract:

Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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18783 Exploring Acceptance of Artificial Intelligence Software Solution Amongst Healthcare Personnel: A Case in a Private Medical Centre

Authors: Sandra So, Mohd Roslan Ismail, Safurah Jaafar

Abstract:

With the rapid proliferation of data in healthcare has provided an opportune platform creation of Artificial Intelligence (AI). AI has brought a paradigm shift for healthcare professionals, promising improvement in delivery and quality. This study aims to determine the perception of healthcare personnel on perceived ease of use, perceived usefulness, and subjective norm toward attitude for artificial intelligence acceptance. A cross-sectional single institutional study of employees’ perception of adopting AI in the hospital was conducted. The survey was conducted using a questionnaire adapted from Technology Acceptance Model and a four-point Likert scale was used. There were 96 or 75.5% of the total population responded. This study has shown the significant relationship and the importance of ease of use, perceived usefulness, and subjective norm to the acceptance of AI. In the study results, it concluded that the determining factor to the strong acceptance of AI in their practices is mostly those respondents with the most interaction with the patients and clinical management.

Keywords: artificial intelligence, machine learning, perceived ease of use, perceived usefulness, subjective norm

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18782 How Different Are We After All: A Cross-Cultural Study Using the International Affective Picture System

Authors: Manish Kumar Asthana, Alicia Bundis, Zahn Xu, Braj Bhushan

Abstract:

Despite ample cross-cultural studies with emotional valence, it is unclear if the emotions are universal or particular. Previous studies have shown that the individualist culture favors high-valence emotions compared to low-valence emotions. In contrast, collectivist culture favors low-valence emotions compared to high-valence emotions. In this current study, Chinese, Mexicans, and Indians reported valence and semantic-contingency. In total, 120 healthy participants were selected by ethnicity and matched for age and education. Each participant was presented 45 non-chromatic pictures, which were converted from chromatic pictures selected from International Affective Picture Database (IAPS) belonging to five-categories, i.e. (i) less pleasant, (ii) high pleasant, (iii) less unpleasant (iv) high unpleasant (v) neutral. The valence scores assigned to neutral, less-unpleasant, and high-pleasant pictures differed significantly between Chinese, Indian, and Mexicans participants. Significant effects demonstrated from the two-way ANOVAs, confirmed main significant effects of valence (F(1,117) = 24.83, p =0.000) and valence x country (F(2,117) = 2.74, p = 0.035). Significant effects emerging from the one-way ANOVAs were followed up through Bonferroni’s test post-hoc comparisons (p < 0.01). This analysis showed significant effect of neutral (F(2,119) = 6.50, p =0.002), less-unpleasant (F(2,119) = 13.79, p =0.000), and high-unpleasant (F(2,119) = 5.99, p =0.003). There were no significant differences in valence scores for the less-pleasant and more-pleasant between participants from three countries. The IAPS norms require modification for their appropriate application in individualist and collectivist cultures.

Keywords: cultural difference, affective processing, valence, non-chromatic, international affective picture system (IAPS)

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18781 Beliefs about the Use of Extemporaneous Compounding for Paediatric Outpatients among Physicians in Yogyakarta, Indonesia

Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

Abstract:

Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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18780 Exploring Key Elements of Successful Distance Learning Programs: A Case Study in Palau

Authors: Maiya Smith, Tyler Thorne

Abstract:

Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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18779 Examining the Role of Willingness to Communicate in Cross-Cultural Adaptation in East-Asia

Authors: Baohua Yu

Abstract:

Despite widely reported 'Mainland-Hong Kong conflicts', recent years have witnessed progressive growth in the numbers of Mainland Chinese students in Hong Kong’s universities. This research investigated Mainland Chinese students’ intercultural communication in relation to cross-cultural adaptation in a major university in Hong Kong. The features of intercultural communication examined in this study were competence in the second language (L2) communication and L2 Willingness to Communicate (WTC), while the features of cross-cultural adaptation examined were socio-cultural, psychological and academic adaptation. Based on a questionnaire, structural equation modelling was conducted among a sample of 196 Mainland Chinese students. Results showed that the competence in L2 communication played a significant role in L2 WTC, which had an influential effect on academic adaptation, which was itself identified as a mediator between the psychological adaptation and socio-cultural adaptation. Implications for curriculum design for courses and instructional practice on international students are discussed.

Keywords: L2 willingness to communicate, competence in L2 communication, psychological adaptation, socio-cultural adaptation, academic adaptation, structural equation modelling

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18778 Understanding Knowledge, Skills and Competency Needs in Digital Health for Current and Future Health Workforce

Authors: Sisira Edirippulige

Abstract:

Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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18777 An Event-Related Potentials Study on the Processing of English Subjunctive Mood by Chinese ESL Learners

Authors: Yan Huang

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Event-related potentials (ERPs) technique helps researchers to make continuous measures on the whole process of language comprehension, with an excellent temporal resolution at the level of milliseconds. The research on sentence processing has developed from the behavioral level to the neuropsychological level, which brings about a variety of sentence processing theories and models. However, the applicability of these models to L2 learners is still under debate. Therefore, the present study aims to investigate the neural mechanisms underlying English subjunctive mood processing by Chinese ESL learners. To this end, English subject clauses with subjunctive moods are used as the stimuli, all of which follow the same syntactic structure, “It is + adjective + that … + (should) do + …” Besides, in order to examine the role that language proficiency plays on L2 processing, this research deals with two groups of Chinese ESL learners (18 males and 22 females, mean age=21.68), namely, high proficiency group (Group H) and low proficiency group (Group L). Finally, the behavioral and neurophysiological data analysis reveals the following findings: 1) Syntax and semantics interact with each other on the SECOND phase (300-500ms) of sentence processing, which is partially in line with the Three-phase Sentence Model; 2) Language proficiency does affect L2 processing. Specifically, for Group H, it is the syntactic processing that plays the dominant role in sentence processing while for Group L, semantic processing also affects the syntactic parsing during the THIRD phase of sentence processing (500-700ms). Besides, Group H, compared to Group L, demonstrates a richer native-like ERPs pattern, which further demonstrates the role of language proficiency in L2 processing. Based on the research findings, this paper also provides some enlightenment for the L2 pedagogy as well as the L2 proficiency assessment.

Keywords: Chinese ESL learners, English subjunctive mood, ERPs, L2 processing

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18776 Chinese Early Childhood Parenting Style as a Moderator of the Development of Social Competence Based on Mindreading

Authors: Arkadiusz Gut, Joanna Afek

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The first issue that we discuss in this paper is a battery of research demonstrating that culture influences children’s performance in tasks testing their theory of mind, also known as mindreading. We devote special attention to research done within Chinese culture; namely, studies with children speaking Cantonese and Mandarin natively and growing up in an environment dominated by the Chinese model of informal home education. Our attention focuses on the differences in development and functioning of social abilities and competences between children from China and the West. Another matter we turn to is the description of the nature of Chinese early childhood education. We suggest that the differences between the Chinese model and that of the West reveal a set of modifiers responsible for the variation observed in empirical research on children’s theory of mind (mindreading). The modifiers we identify are the following: (1) early socialization – that is, the transformation of the child into a member of the family and society that set special value by the social and physical environment; (2) the Confucian model of education – that is, the Chinese alphabet and tradition that determine a certain way of education in China; (3) the authoritarian style of upbringing – that is, reinforcing conformism, discouraging voicing of private opinions, and respect for elders; (4) the modesty of children and protectiveness of parents – that is, obedience as a desired characteristic in the child, overprotectiveness of parents, especially mothers; and (5) gender differences – that is, different educational styles for girls and boys. In our study, we conduct a thorough meta-analysis of empirical data on the development of mindreading and ToM (children’s theory of mind), as well as a cultural analysis of early childhood education in China. We support our analyses with questionnaire and narrative studies conducted in China that use the ‘Children’s Social Understanding Scale’ questionnaire, conversations based on the so-called ‘Scenarios Presented to Parents’, and questions designed to measure the ‘my child and I’ relation. With our research we aim to identify the factors in early childhood education that serve as moderators explaining the nature of the development and functioning of social cognition based on mind reading in China. Additionally, our study provides a valuable insight for comparative research of social cognition between China and the West.

Keywords: early childhood education, China, mindreading, parenting

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18775 The Cost of Healthcare among Malaysian Community-Dwelling Elderly with Dementia

Authors: Roshanim Koris, Norashidah Mohamed Nor, Sharifah Azizah Haron, Normaz Wana Ismail, Syed Mohamed Aljunid Syed Junid, Amrizal Muhammad Nur, Asrul Akmal Shafie, Suraya Yusuff, Namaitijiang Maimaiti

Abstract:

An ageing population has huge implications for virtually every aspect of Malaysian societies. The elderly consume a greater volume of healthcare facilities not because they are older, but because of they are sick. The chronic comorbidities and deterioration of cognitive ability would lead the elderly’s health to become worst. This study aims to provide a comprehensive estimate of the direct and indirect costs of health care used in a nationally representative sample of community-dwelling elderly with dementia and as well as the determinants of healthcare cost. A survey using multi-stage random sampling techniques recruited a final sample of 2274 elderly people (60 years and above) in the state of Johor, Perak, Selangor and Kelantan. Mini Mental State Examination (MMSE) score was used to measure the cognitive capability among the elderly. Only the elderly with a score less than 19 marks were selected for further analysis and were classified as dementia. By using a two-part model findings also indicate household income and education level are variables that strongly significantly influence the healthcare cost among elderly with dementia. A number of visits and admission are also significantly affect healthcare expenditure. The comorbidity that highly influences healthcare cost is cancer and seeking the treatment in private facilities is also significantly affected the healthcare cost among the demented elderly. The level of dementia severity is not significant in determining the cost. This study is expected to attract the government's attention and act as a wake-up call for them to be more concerned about the elderly who are at high risk of having chronic comorbidities and cognitive problems by providing more appropriate health and social care facilities. The comorbidities are one of the factor that could cause dementia among elderly. It is hoped that this study will promote the issues of dementia as a priority in public health and social care in Malaysia.

Keywords: ageing population, dementia, elderly, healthcare cost, healthcare utiliztion

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18774 Meaningful General Education Reform: Integrating Core Curricula and Institutional Values

Authors: Michael W. Markowitz

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A central element of higher education today is the “core” or “general education” curriculum: that configuration of courses that often encompasses the essence of liberal arts education. Ensuring that such offerings reflect the mission and values of the institution is a challenge faced by most college and universities, often more than once. This paper presents an action model of program planning designed to structure the processes of developing, implementing and revising core curricula in a manner consistent with key institutional goals and objectives. Through presentation of a case study from a university in the United States, the elements of needs assessment, stakeholder investment and collaborative compromise are shown as key components of a planning strategy that can produce a general education program that is comprehensive, academically rigorous, assessable and mission consistent. The paper concludes with recommendations for both the implementation and evaluation of such programs in practice.

Keywords: academic assessment, academic program planning, curriculum development, general education reform

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18773 Study on the Legend of Dayi in China

Authors: Zhiguo Ju

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Both ancient written documents and archaeological studies showed that the ancient Chinese was people who worshiped the Sun God. There is a legend of Dayi in China, however, told a story of Dayi, an ancient hero who sacrificed his life to shoot nine suns out of the ten in the sky, restored the order of the universe, and saved the people’s life. By investigating its oral inheritance and folk customs, we found that the story was originated from Rizhao, the east coralline in east China. This could provide valuable cultural resources and could be used in local tourism. How the Sun-worshipping-people developed such a contradictory legend, how was it be carried by generations, and how to use it as a cultural source to promote the local tourism was discussed.

Keywords: Legend of Dayi, sun worship, ancient Chinese, China

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18772 Yu Kwang-Chung vs. Yu Kwang-Chung: Untranslatability as the Touchstone of a Poet

Authors: Min-Hua Wu

Abstract:

The untranslatability of an established poet’s tour de force is thoroughly explored by Matthew Arnold (1822-1888). In his On Translating Homer (1861), Arnold lists the four most striking poetic qualities of Homer, namely his rapidity, plainness and directness of style and diction, plainness and directness of ideas, and nobleness. He concludes that such celebrated English translators as Cowper, Pope, Chapman, and Mr. Newman are all doomed, due to their respective failure in rendering the totality of the four Homeric poetic qualities. Why poetic translation always amounts to being proven such a mission impossible for the translator? According to Arnold, it is because there constantly exists a mist interposed between the translator’s own literary self-obsession and the objective artistic qualities that reside in the work of the original author. Foregrounding such a seemingly empowering yet actually detrimental poetic mist, he explains why the aforementioned translators fail in their attempts to bring the Homeric charm to the British reader. Drawing on Arnold’s analytical study on Homeric translation, the research attempts to bring Yu Kwang-chung the poet vis-à-vis Yu Kwang-chung the translator, with an aim not so much to find any similar mist as revealed by Arnold between his Chinese poetry and English translation as to probe into a latent and veiled literary and lingual mist interposed between Chinese and English, if not between Chinese and English literatures. The major work studied and analyzed for this study is Yu’s own Chinese poetry and his own English translation collected in The Night Watchman: Yu Kwang-chung 1958-2004. The research argues that the following critical elements that characterizes Yu’s poetics are to a certain extent 'transformed,' if not 'lost,' in his English translation: a. the Chinese pictographic and ideographic unit terms which so unfailingly characterize the poet’s incredible creativity, allowing him to habitually and conveniently coin concrete textual images or word-scapes almost at his own will; b. the subtle wordplay and punning which appear at a reasonable frequency; c. the parallel contrastive repetitive syntactic structure within a single poetic line; d. the ambiguous and highly associative diction in the adjective and noun categories; e. the literary allusion that harks back to the old times of Chinese literature; f. the alliteration that adds rhythm and smoothness to the lines; g. the rhyming patterns that bring about impressive sonority and lingering echo to the ears of the reader; h. the grandeur-imposing and sublimity-arousing word-scaping which hinges on the employment of verbs; i. the meandering cultural heritage that embraces such elements as Chinese medicine and kung fu; and j. other features of the like. Once we appeal to the Arnoldian tribunal and resort to the strict standards of such a Victorian cultural and literary critic who insists 'to see the object as in itself it really is,' we may serve as a potential judge for the tug of war between Yu Kwang-chung the poet and Yu Kwang-chung the translator, a tug of war that will not merely broaden our understating of Chinese poetics but deepen our apprehension of Chinese-English translatology.

Keywords: Yu Kwang-chung, The Night Watchman, poetry translation, Chinese-English translation, translation studies, Matthew Arnold

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18771 Beyond Inclusion: The Need for Health Equity for Women with Disabilities

Authors: Jaishree Ellis

Abstract:

The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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18770 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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18769 A Risk Management Approach to the Diagnosis of Attention Deficit-Hyperactivity Disorder

Authors: Lloyd A. Taylor

Abstract:

An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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18768 Study Case of Spacecraft Instruments in Structural Modelling with Nastran-Patran

Authors: Francisco Borja de Lara, Ali Ravanbakhsh, Robert F. Wimmer-Schweingruber, Lars Seimetz, Fermín Navarro

Abstract:

The intense structural loads during the launch of a spacecraft represent a challenge for the space structure designers because enough resistance has to be achieved while maintaining at the same time the mass and volume within the allowable margins of the mission requirements and inside the limits of the budget project. In this conference, we present the structural analysis of the Lunar Lander Neutron Dosimetry (LND) experiment on the Chang'E4 mission, the first probe to land on the moon’s far side included in the Chinese’ Moon Exploration Program by the Chinese National Space Administration. To this target, the software Nastran/Patran has been used: a structural model in Patran and a structural analysis through Nastran have been realized. Next, the results obtained are used both for the optimization process of the spacecraft structure, and as input parameters for the model structural test campaign. In this way, the feasibility of the lunar instrument structure is demonstrated in terms of the modal modes, stresses, and random vibration and a better understanding of the structural tests design is provided by our results.

Keywords: Chang’E4, Chinese national space administration, lunar lander neutron dosimetry, nastran-patran, structural analysis

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18767 Effects of Work Stress and Chinese Indigenous Ren-Qing Shi-Ku Social Wisdom on Emotional Exhaustion, Work Satisfaction and Well-Being of Insurance Workers

Authors: Wang Chung-Kwei, Lo Kuo Ying

Abstract:

This study is aimed to examine main and moderation effect of Chinese traditional social wisdom ‘Ren-qing Shi-kuo’ on the adjustment of insurance workers. Rationale: Ren-qing Shi-ku as a social wisdom has been emphasized and practiced by collective-oriented Chinese for thousand years. The concept of‘Ren-qing Shi-ku’includes values, beliefs and behavior rituals, which helps Chinese to cope with interpersonal conflicts in a sophisticated and closely tied collective society. Based on interview and literature review, we found out Chinese still emphasized the importance of ‘Ren-qing Shi-ku’. The concepts contains five factors, including ‘proper emotion display’, ‘social ritual abiding’, ‘ make empathetic concession’, ‘harmonious and proper behavior’ and ‘tolerance for the interest of the whole’. We developed an indigenous ‘Ren-qing Shi-ku’scale based on interview data and a survey on social worker students. Research methods: We conduct a dyad survey between 294 insurance worker and their supervisors. Insurance workers’ response on ‘Ren-qing Shi-ku,emotion labor, emotional exhaustion, work stress and load, work satisfaction and well-being were collected. We also ask their supervisors to rate these workers ‘empathy, social rule abiding, work performance, and Ren-qing Shi-ku performance. Results: Students’self-ratings on Ren-qing Shi-ku scale are positively correlated with rating from their supervisors on all above indexes. Workers who have higher Ren-qing Shi-ku score also have lower work stress and emotion exhaustion, higher work satisfaction and well-being, more emotion deep acting. They also have higher work performance, social rule abiding, and Ren-qing Shi-ku performance rating from their supervisor. The finding of this study suggested Ren-qing Shi-ku is an effective indicator on insurance workers ‘adjustment. Since Ren-qing Shi-ku is trainable, we suggested that Ren-qing Shi-ku training might be beneficial to service industry in a collective-oriented culture.

Keywords: work stress, Ren-qing Shi-ku, emotional exhaustion, work satisfaction, well-being

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18766 Implementing Critical Friends Groups in Schools

Authors: S. Odabasi Cimer, A. Cimer

Abstract:

Recently, the poor quality of education, low achieving students, low international exam performances and little or no effect of the education reforms on the teaching in the classrooms are the main problems of education discussed in Turkey. Research showed that the quality of an education system can not exceed the quality of its teachers and teaching. Therefore, in-service training (INSET) courses are important to improve teacher quality, thereby, the quality of education. However, according to the research conducted on the evaluation of the INSET courses in Turkey, they are not effective in improving the quality of teaching in the classroom. The main reason for this result is because INSET courses are conducted and delivered in limited time and presented theoretically, which does not meet the needs of teachers and as a result, the knowledge and skills taught are not used in the classrooms. Recently, developed countries have been using Critical Friends Groups (CFGs) successfully for the purpose of school-based training of teachers. CFGs are the learning groups which contain 6-10 teachers aimed at fostering their capacities to undertake instructional and personal improvement and schoolwide reform. CFGs have been recognized as a critical feature in school reform, improving teaching practice and improving student achievement. In addition, in the USA, teachers have named CFGs one of the most powerful professional development activities in which they have ever participated. Whereas, in Turkey, the concept is new. This study aimed to investigate the implications of application, evaluation, and promotion of CFGs which has the potential to contribute to teacher development and student learning in schools in Turkey. For this purpose, the study employed a qualitative approach and case study methodology to implement the model in high schools. The research was conducted in two schools and 13 teachers working in these schools participated. The study lasted two years and the data were collected through various data collection tools including interviews, meeting transcripts, questionnaires, portfolios, and diaries. The results of the study showed that CFGs contributed professional development of teachers and their students’ learning. It also contributed to a culture of collaborative work in schools. A number of barriers and challenges which prevent effective implementation were also determined.

Keywords: critical friends group, education reform, science learning, teacher education

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18765 Designing a Patient Monitoring System Using Cloud and Semantic Web Technologies

Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G. M. Petrakis

Abstract:

Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called effective disorders, which is characterized by great mood swings.We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s non-response to treatment. We propose an architecture, as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: bipolar disorder, intelligent systems patient monitoring, semantic web technologies, healthcare

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18764 Translation Training in the AI Era

Authors: Min Gao

Abstract:

In the past year, the advent of large language models (LLMs) has brought about a revolution in the language service industry, making it possible to efficiently produce more satisfactory and higher-quality translations. This is groundbreaking news for commercial companies involved in language services since much of a translator's work can now be completed by machines. However, it may be bad news for universities that provide translation training programs. They need to confront the challenges posed by AI in education by reconsidering issues such as the reform of traditional teaching methods, the translation ethics of students, and the new demands of the job market for their graduates. This article is an exploratory study of these issues based on the author's experiences in translation teaching. The research combines methods in the form of questionnaires and interviews. The findings include: (1) students may lose their motivation to learn in the AI era, but this can be compensated for by encouragement from the lecturer; (2) Translation ethics are not a serious problem in schools, considering the strict policies and regulations in place; (3) The role of translators has evolved in the new era, necessitating a reform of the traditional teaching methods.

Keywords: job market of translation, large language model, translation ethics, translation training

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18763 Auditory Perception of Frequency-Modulated Sweeps and Reading Difficulties in Chinese

Authors: Hsiao-Lan Wang, Chun-Han Chiang, I-Chen Chen

Abstract:

In Chinese Mandarin, lexical tones play an important role to provide contrasts in word meaning. They are pitch patterns and can be quantified as the fundamental frequency (F0), expressed in Hertz (Hz). In this study, we aim to investigate the influence of frequency discrimination on Chinese children’s performance of reading abilities. Fifty participants from 3rd to 4th grades, including 24 children with reading difficulties and 26 age-matched children, were examined. A serial of cognitive, language, reading and psychoacoustic tests were administrated. Magnetoencephalography (MEG) was also employed to study children’s auditory sensitivity. In the present study, auditory frequency was measured through slide-up pitch, slide-down pitch and frequency-modulated tone. The results showed that children with Chinese reading difficulties were significantly poor at phonological awareness and auditory discrimination for the identification of frequency-modulated tone. Chinese children’s character reading performance was significantly related to lexical tone awareness and auditory perception of frequency-modulated tone. In our MEG measure, we compared the mismatch negativity (MMNm), from 100 to 200 ms, in two groups. There were no significant differences between groups during the perceptual discrimination of standard sounds, fast-up and fast-down frequencies. However, the data revealed significant cluster differences between groups in the slow-up and slow-down frequencies discrimination. In the slow-up stimulus, the cluster demonstrated an upward field map at 106-151 ms (p < .001) with a strong peak time at 127ms. The source analyses of two dipole model and localization resolution model (CLARA) from 100 to 200 ms both indicated a strong source from the left temporal area with 45.845% residual variance. Similar results were found in the slow-down stimulus with a larger upward current at 110-142 ms (p < 0.05) and a peak time at 117 ms in the left temporal area (47.857% residual variance). In short, we found a significant group difference in the MMNm while children processed frequency-modulated tones with slow temporal changes. The findings may imply that perception of sound frequency signals with slower temporal modulations was related to reading and language development in Chinese. Our study may also support the recent hypothesis of underlying non-verbal auditory temporal deficits accounting for the difficulties in literacy development seen developmental dyslexia.

Keywords: Chinese Mandarin, frequency modulation sweeps, magnetoencephalography, mismatch negativity, reading difficulties

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18762 Social Security Reform and Management: The Case of Three Member Territories of the Organisation of Eastern Caribbean States

Authors: Cleopatra Gittens

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It has been recognized that some social security and national insurance systems in the Eastern Caribbean are experiencing ageing populations and economic and other crises that will present a financial challenge of being unable to pay pension benefits in fifteen to twenty years. This has implications for the fiscal and economic positions of the countries themselves. Hence, organizations would need to address the issue urgently. The study adds to the body of knowledge on social security systems and social security reforms in small island developing states (SIDS). It also makes recommendations for the types of reforms that social security systems in other SIDS can implement given their special circumstances. Secondary research is used to gather financial and other related information on three social security schemes in the Eastern Caribbean. Actuarial and financial reports and other documents of the social security systems are analysed to obtain financial and static data on each of the schemes. The findings show that the three schemes studied are experiencing steady increases in benefit expenditure versus contributions and increasing pensioner to insured ratios. The schemes will deplete their reserves between 2038 and 2050. Two of the schemes have increased their retirement age while the other has not embarked on any reforms. One scheme has made changes to its contribution percentages. Due to their small size, small populations and other unique circumstances, the social security schemes in the identified territories are not likely to be able to take advantage of all of the reform initiatives that the developed world embarked on when faced with similar problems. These schemes will need to make incremental changes that align with the timeframes recommended by the actuarial studies.

Keywords: benefits, pension, small island developing states, social security reform

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18761 Back to Nature: Addressing the German Nudist Movement’s Colonial Past and Its Repercussions

Authors: Saskia Köbschall

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The idea of ‘being close to nature’ and the ways of achieving this proximity are socially and historically constructed, as are notions of nakedness and nudity. During the colonial period, nudity and clothedness functioned as instruments of racial domination. Nakedness became central to the colonialists’ thinking, to their binary of the ‘civilized’ and those ‘close to nature’, therefore turning the level of perceived unclothedness into a measurement of ‘civilization'. While being ‘one with nature’ continued to be a criterion of backwardness in the colonies, it emerged as a futuristic and avant-garde endeavor in the metropole: In Germany, at the height of its colonial expansion, the Life Reform Movement (Lebensreformbewegung) called for the liberation of the white body from the ‘constraints of civilization’, for its ‘return to nature’ via practices like nudism. Despite this simultaneity, the scholarship of the life reform and the nudist movement in particular does not address the colonial past of the movement or its repercussions in the present. Taking the biography of prominent life reformist Hans Paasche (1881 - 1920) as a starting point, this paper explores the work of imperial legacies in the history and present of the German nudist movement. Paasche started his career as a German colonial officer, participating in the brutal obliteration of the Maji-Maji uprising (1905/06) that claimed the lives of nearly 200.000 people. Once a passionate game hunter, he later became a known nature conservationist; once a self-proclaimed explorer of Africa, he later became one of the most prominent advocates of nudism and vegetarianism. The paper joins conceptual and historical research in order to address the German nudist movement’s colonial past and understand its repercussions in the present.

Keywords: Germany, life reform, colonialism, archives, nudity, nature

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