Search results for: national health insurance program

Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

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Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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Authors: Anna Veres

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People’s ability to adapt to a constantly changing environment is essential. Career adaptability is central to Career Construction Theory, where proper adaptation to new situations, changing environments, and jobs require adequate career development. Based on current career theories and the possibilities offered by digital technology, the primary goal of this study is to develop career adaptability through an online tool. Its secondary goal is to apply for an online career intervention program and explore its developmental possibilities. A total of 132 university students from the bachelor program took part in the study, from which 65 students received a four-week online career intervention, while 67 participants formed the control group. Based on the results, it can state that career adaptability can be developed, and there is a great demand and interest from university students to use career-related programs on online platforms. Career interventions should be performed online as well if there is suitable software and a well-constructed program. Limitations and further implications are discussed.

Keywords: career adaptability, career development, online career intervention, university students

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Authors: Eugene Wong, Felix Chan, Linsey Chen, Joey Cheung

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The widespread use of technologies and cyber/digital means for complex maritime operations have led to a sharp rise in global cyber-attacks. They have generated an increasing number of liability disputes, insurance claims, and legal proceedings. An array of antiquated case law, regulations, international conventions, and obsolete contractual clauses drafted in the pre-technology era have become grossly inadequate in addressing the contemporary challenges. This paper offers a critique of the ambiguity of cybersecurity liabilities under the obligation of seaworthiness entailed in the Hague-Visby Rules, which apply either by law in a large number of jurisdictions or by express incorporation into the shipping documents. This paper also evaluates the legal and technological criteria for assessing whether a vessel is properly equipped with the latest offshore technologies for navigation and cargo delivery operations. Examples include computer applications, networks and servers, enterprise systems, global positioning systems, and data centers. A critical analysis of the carriers’ obligations to exercise due diligence in preventing or mitigating cyber-attacks is also conducted in this paper. It is hoped that the present study will offer original and crucial insights to policymakers, regulators, carriers, cargo interests, and insurance underwriters closely involved in dispute prevention and resolution arising from cybersecurity liabilities.

Keywords: seaworthiness, cybersecurity, liabilities, risks, maritime, transport

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Authors: Doreen Orishaba, Paul Isaac Musasizi, Richard Madanda, Sandy Stevens Tickodri-Togboa

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The world of academia tends to be a very insular place. Consequently, scholars who successfully completed their undergraduate and graduate studies are unpleasantly surprised at how challenging the transition to corporate life can get. This is a global trend even as the students who juggle work with attending some of the most demanding and best graduate programs may not easily adjust to and confirm to the professionalism required for corporate management of the industry. This paper explores the trends in the transition of Kiira EV Project from a predominantly student team to a professional team of a national pride program through mentorship and apprenticeship. The core disciplines within the Kiira EV Project include Electrical and Electronics Engineering, Mechanical Engineering, and Industrial Design.

Keywords: mentorship, apprenticeship, professional, development

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Authors: Egboja Simon Oga

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One of the most important keys to the success of a nation is to ensure steady development and national economic self-sufficiency and independence. It is therefore in this regard that this paper is designed to identify food security to be crucial to all nations’ effort toward sustainable national development. Nigeria as a case study employed various effort by the successive government towards food security. Emphasis were placed on the extent to which government has boosted food security situation on the basis of the identified limitations, conclusion was drawn, recommendation/suggestions proffered, that subsidization of the process of farm inputs like fertilizer, improved seeds and agrochemical, education of farmers on modern methods of farming through extension services, improvisation of village-based food storage mechanism and provision of infrastructural facilities in rural areas to facilitate the preservation and easy evacuation of farm produces are necessary.

Keywords: food, governance, development, security

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Authors: Maria Campos, Alain Massart, Hugo Sarmento

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The Meter Matters Erasmus Sport European Project (ID: 101050372) explores the field of social inclusion in and through sports with the aim of a) proposing appropriate criteria for co-funding sports programs involving people with intellectual and developmental disabilities and other more vulnerable people, primarily in mainstream sports organizations and b) proposing a model for co-funding social inclusion in and through sports at the national level. This European project (2022-2024) involves 6 partners from 3 countries: Univerza V Ljubljani – coordinator and Drustvo Specialna Olimpiada Slovenije (Slovenia); Magyar Specialis Olimpia Szovetseg and Magyar Testnevelesi Es Sporttudomanyi Egyetem (Hungary) and APPDA Coimbra - Associação Portuguesa para as Perturbações do Desenvolvimento e Autismo and Universidade De Coimbra, Faculty of Sport Sciences and Physical Education (Portugal). Equal involvement of all people in sports activities is, in terms of national and international guidelines, enshrined in some conventions and strategies in the field of sports, as well as human rights, social security, physical and mental health, architecture, environment and public administration. However, there is a gap between the practice and EU guidelines in terms of sustainable support for socially inclusive sports programs in the form of co-funding by state and local (municipal) resources. We observe considerable opacity in the regulation of the field. Given that there are both relevant programs and inclusive legislation and policies, we believe that the reason for the missing article is reflected in the undeveloped criteria for measuring social inclusion in sports. Major sports programs are usually co-funded based on crowds (number of involved athletes) and performance (sports score). In the field of social inclusion in sports, the criteria cannot be the same, as it is a smaller population. Therefore, the goals of inclusion in sports should not be the focused on competitive results but on opening equal opportunities for all, regardless of their psychophysical abilities. In the Meter Matters program, we are searching for criteria for co-funding social inclusion in sports through focus groups with coaches, social workers, psychologists and others professionals involved in inclusive sports programs in regular sports clubs and with athletes and their parents or guardians. Moreover, experts in the field of social inclusion in sports were also interviewed. Based on the proposals for measuring social inclusion in sports, we developed a model for co-funding socially inclusive sports programs.

Keywords: European project, meter matters, inclusion, sport

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Authors: Svetlana Polskaya

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The study deals with the issue of using the Content and Language Integrated Learning (CLIL) concept when teaching Master Program students majoring in neuromarketing and entrepreneurship. Present-day employers expect young graduates to conduct professional communication with their English-speaking peers and demonstrate proper knowledge of the industry’s terminology and jargon. The idea of applying CLIL was the result of the above-mentioned students possessing high proficiency in English, thus, not requiring any further knowledge of the English language in terms of traditional grammar or lexis. Due to this situation, a CLIL-type program was devised, allowing learners to acquire new knowledge of entrepreneurship and neuromarketing spheres combined with simultaneous honing their English language practical usage. The case study analyzes CLIL application within this particular program as well as the experience accumulated in the process.

Keywords: CLIL, entrepreneurship, neuromarketing, foreign language acquisition, proficiency level

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Barsharani Maharana

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India is the country that shelters the largest number of poor. One of the major areas of concern in India is the unsatisfactory situation of the poor in social developmental and health parameters, not only in rural areas which are partly devoid of the facilities but also in the urban areas where the facilities are insufficient to provide services of a satisfactory quality. Objectives: 1) to examine the association between the environmental condition and health condition among poor women in urban areas. 2) to find out the significance of the effect of environment on the child health among the poor children. 3) to present the scenario of poor among highly urbanized and less urbanized states with respect to the health and environment. Data: data from National Family Health survey-3 and census are used to fulfill the objectives. Methodology: In this study, the standard of living condition of people living in urban areas is computed by taking some household characteristics and assets. People possessing low standard of living are considered as poor. Bivariate and multivariate analysis are employed to examine the effect of environment on poor women and children. A geographical information system is used to present the health and environmental condition of poor in highly and less urbanized states. Results: The findings reveal that the poor women who are not accessed to improved source of water, and sanitation facility are facing more health problems. Children who are living in a dirty environment and are not accessed to improved source of drinking water, among them prevalence of diarrhea and fever is found to be high. As well, the health condition of poor in highly urbanized states is dreadful. Policy implications: Government should emphasize on the implementation of programs regarding the improvement in the infrastructural facilities and health care treatment of urban poor.

Keywords: environment, urban poor, health, sanitation

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Authors: Akbar Rostamabadi, Adel Mazloumi, Abbas Rahimi Foroushani

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This study aimed to determine the Work Ability Index (WAI) and examine the influence of health dimensions and demographic variables on the work ability of Iranian farmers working in small farm enterprises. A cross-sectional study was conducted among 294 male farmers. The WAI and SF-36 questionnaires were used to determine work ability and health status. The effect of demographics variables on the work ability index was investigated with the independent samples t-test and one-way ANOVA. Also, multiple linear regression analysis was used to test the association between the mean WAI score and the SF-36 scales. The mean WAI score was 35.1 (SD=10.6). One-way ANOVA revealed a significant relationship between the mean WAI and age. Multiple linear regression analysis showed that work ability was more influenced by physical scales of the health dimensions, such as physical function, role-physical, and general health, whereas a lower association was found for mental scales such as mental health. The average WAI was at a moderate work ability level for the sample population of farmers in this study. Based on the WAI guidelines, improvement of work ability and identification of factors affecting it should be considered a priority in interventional programs. Given the influence of health dimensions on WAI, any intervention program for preservation and promotion work ability among the studied farmers should be based on balancing and optimizing the physical and psychosocial work environments, with a special focus on reducing physical work load.

Keywords: farmers, SF-36, Work Ability Index (WAI), Iran

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Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite

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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.

Keywords: workplace exercise, paramedic health, strength training, flexibility training

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Authors: Yuki Matsumoto, Yuma Ishimoto

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Cognitive Behavior Therapy (CBT) with children has shown effective application to various problems such as anxiety and depression. Although there are barriers to access to mental health services including lack of professional services in communities and parental concerns about stigma, school has a significant role to address children’s health problems. Schools are regarded as a suitable arena for prevention and early intervention of mental health problems. In this line, CBT can be adaptable to school education and useful to enhance students’ social and emotional skills. However, Japanese school curriculum is rigorous so as to limit available time for implementation of CBT in schools. This paper describes Brief Cognitive Behavior Therapy (BCBT) with children in a Japanese school setting. The program has been developed in order to facilitate acceptability of CBT in schools and aimed to enhance students’ skills to manage anxiety and difficult behaviors. The present research used a single arm design in which 30 students aged 9-10 years old participated. The authors provided teachers a CBT training workshop (two hours) at two primary schools in Tokyo metropolitan area and recruited participants in the research. A homeroom teacher voluntarily delivered a 6-session BCBT program (15 minutes each) in classroom periods which is called as Kaerinokai, a meeting before leaving school. Students completed a questionnaire sheet at pre- and post-periods under the supervision of the teacher. The sheet included the Spence Child Anxiety Scale (SCAS), the Depression Self-Rating Scale for Children (DSRS), and the Strengths and Difficulties Questionnaire (SDQ). The teacher was asked for feedback after the completion. Significant positive changes were found in the total and five of six sub-scales of the SCAS and the total difficulty scale of the SDQ. However, no significant changes were seen in Physical Injury Fear sub-scale of the SCAS, in the DSRS or the Prosocial sub-scale of the SDQ. The effect sizes are mostly between small and medium. The teacher commented that the program was easy to use and found positive changes in classroom activities and personal relationships. This preliminary research showed the feasibility of the BCBT in a school setting. The results suggest that the BCBT offers effective treatment for reduction in anxiety and in difficult behaviors. There is a good prospect of the BCBT suggesting that BCBT may be easier to be delivered than CBT by Japanese teachers to promote child mental health. The study has limitations including no control group, small sample size, or a short teacher training. Future research should address these limitations.

Keywords: brief cognitive behavior therapy, cognitive behavior therapy, mental health services in schools, teacher training workshop

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Authors: Seyed Salahedin Naghshbandi, Mahnaz Ahmadikhatir, Siavash Hamidzadeh

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The purpose of this study was to investigate the relationship between organizational political behavior and ethical values with the job enthusiasm of the sport personnel of the National Iranian Gas Company. The population of this research included all personnel of the National Iranian Gas Company's sports personnel (150 people). For collecting information, library resources and three questionnaires, organizational political behavior by Kaspar and Carlsen (1997), Lewall's moral values questionnaire (1986) and job enthusiasm questionnaire Schaufeli & Bekker (2003) have been used. Validity of the questionnaires was confirmed by university professors. Using Cronbach alpha correlation coefficient, the reliability of the organizational political behavior questionnaire was 0.92, the moral values questionnaire was 0.86 and the Schaufeli & Baker job enthusiasm questionnaire was 0.91-0.96. The results of this research show a significant, direct and positive relationship between the components of job aspiration with political behavior and ethical values. Therefore, managers of organizations should, as far as possible, remove political behaviors from the organization and be able to institutionalize ethical values in their organization so that they can increase employee eagerness.

Keywords: political behavior, ethical values, job enthusiasm, staff, national Iranian gas company

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Authors: André Pasti

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Historically, the communication sector in Argentina is characterized by intense monopolization and geographical concentration in the city of Buenos Aires. In 2000, the four major media conglomerates in operation – Clarín, Telefónica, America and Hadad – controlled 84% of the national media market. By 2009, new policies were implemented as a result of civil society organizations demands. Legally, a new regulatory framework was approved: the law 26,522 of Audiovisual Communications Services. Supposedly, these policies intend to create new conditions for the development of the audiovisual economy in the territory of Argentina. The regionalization of audiovisual production and the democratization of channels and access to media were among the priorities. This paper analyses the main changes and continuities in the organization of the spatial circuit of the audiovisual industry in Argentina provoked by these new policies. These new policies aim at increasing the diversity of audiovisual producers and promoting regional audiovisual industries. For this purpose, a national program for the development of audiovisual centers within the country was created. This program fostered a federalized production network, based on nine audiovisual regions and 40 nodes. Each node has created technical, financial and organizational conditions to gather different actors in audiovisual production – such as SMEs, social movements and local associations. The expansion of access to technical networks was also a concern of other policies, such as ‘Argentina connected’, whose objective was to expand access to broadband Internet. The Open Digital Television network also received considerable investments. Furthermore, measures have been carried out in order to impose limits on the concentration of ownership as well as to eliminate the oligopolies and to ensure more competition in the sector. These actions intended to force a divide of the media conglomerates into smaller groups. Nevertheless, the corporations that compose these conglomerates resist strongly, making full use of their economic and judiciary power. Indeed, the absence of effective impact of such measures can be testified by the fact that the audiovisual industry remains strongly concentrated in Argentina. Overall, these new policies were designed properly to decentralize audiovisual production and expand the regional diversity of the audiovisual industry. However, the effective transformation of the organization of the audiovisual circuit in the territory faced several resistances. This can be explained firstly and foremost by the ideological and economic power of the media conglomerates. In the second place, there is an inherited inertia from the unequal distribution of the objects needed for the audiovisual production and consumption. Lastly, the resistance also relies on financial needs and in the excessive dependence of the state for the promotion of regional audiovisual production.

Keywords: Argentina, audiovisual industry, communication policies, geographic concentration, regionalization, spatial circuit

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Authors: Rula D. Alshareef, Safa S. Alqathmi, Ghadah K. Alkhouldi, Reem O. Bagabas, Farheen B. Hasan

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Safety engineering is among the most crucial considerations in any work environment. Providing mentally, physically, and environmentally safe work conditions must be the top priority of any successful organization. Company X is a local paint production company in Saudi Arabia; in a month, the factory experienced two significant accidents, which indicates that workers’ safety is overlooked. The aim of the research is to examine the risks, assess the root causes and recommend control measures that will eventually contribute to providing a safe workplace. The methodology used is sectioned into three phases, risk identification, assessment, and finally, mitigation. In the identification phase, the team used Rapid Entire Body Assessment (REBA) and National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) tools to holistically establish knowledge about the current risk posed to the factory. The physical hazards in the factory were assessed in two different operations, which are mixing and filling/packaging. For the risk assessment phase, the hazards were deeply analyzed through their severity and impact. Additionally, through risk mitigation, the Rapid Entire Body Assessment (REBA) score decreased from 11 to 7, and the National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) has been reduced from 5.27 to 1.85.

Keywords: ergonomics, safety, workplace risks, hazards, awkward posture, fatigue, work environment

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Authors: Adedayo Jeremiah Adeyekun, Samuel Oluwagbemiga Ishola,

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This paper is an assessment of factors influencing the cost and time performance of subcontractors and the need for effective performance of subcontractors at the project sites. The factors influencing the performance of subcontractors are grouped, similar to those identified with the project or an organization and on another hand, there are significant factors influencing the performance of the subcontractors. These factors incorporate management level leadership, time required to complete the project, profit, staff capability/expertise, reputation, installment method, organization history, and project procurement method strategy, security, bidding technique, insurance, bond and relationship with the major contractors. The factors influencing the management of subcontractors in building development projects includes performance of significant past projects, standard of workmanship, consistence with guidelines, regular payment to labourers, adherence to program, regularity and viability of communication with main contractor, adherence to subcontract necessities. Other factors comprise adherence to statutory environmental regulations, number of experienced sites administrative staff, inspection and maintenance of good workplace, number of artisans and workers, quality of as-built and shop drawings and ability to carry out the quantity of work and so on. This study also aimed to suggest a way forward to improve the performance of subcontractors which is the reason for exceeding budget at the project sites. To carry out this study, a questionnaire was drafted to derive information on the causes of low performance of subcontractors and the implication to cost.

Keywords: performance, contractor, subcontractors, construction

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Authors: Hyo Jung Lee

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The purpose of this study is to develop a literature appreciation education program for classic literatures and apply them to the field, and to derive the achievements and improvement points. Classic literature is a work of value recognized in the context of literature history and culture history, and learners can develop interest in literature and inherit tradition through appreciation of classic literature. However, in Korean educational environment, classic literature is a means for college entrance examination, and many learners analyze contents and language in textbooks and concentrate on memorizing the whole plot. This study is one of the reasons that classic literature appreciation education is not done properly and it is not able to give an opportunity to appreciate the whole work in the early learning stage. In Korean primary education, classic literature is used as a means to achieve the goals of reading, writing, speaking and listening, rather than being used as a material for its own appreciation. It is problematic to make the piece appreciation experience fragmentary. This study proposes a program to experience classic literatures by linking school education and school library with primary school students in grades 4-6. We work with local primary schools (siheung-si, gyeonggi-do, Korea) to provide appropriate activities and rewards to learners, observe their participation, and introduce student learning outcomes. Through this, we are able to systematically improve the learner 's ability to appreciate the literature and to diversify primary education.

Keywords: classic literature education, primary education, out-of-school program, learning by appreciation experience

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Authors: Dina L. DiSantis

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The Japan-U.S. Teacher Exchange Program for Education for Sustainable Development (ESD) provides an opportunity for teachers from the United States and Japan to travel to each other’s countries in order to experience and learn how each country is implementing efforts to educate for sustainability. By offering programs such as the Japan-U.S. Teacher Exchange Program for Education for Sustainable Development (ESD); teachers from both countries become more aware of what ESD school programs and curricula are being implemented in both countries. Teachers gain a greater sense of global interconnectedness when they are given the opportunity to share in each other’s culture and life. The primary objectives of the program are to foster a mutual exchange between the teachers in the United States and Japan, to increase an understanding of culture and educational systems, to give teachers opportunities to collaborate on lessons and projects in areas of sustainability and to enhance professional development opportunities for both U.S and Japanese teachers. The two areas of focus for teachers, are food education and environmental education. Teachers from both countries collaborate and design curriculum and projects for their students in order to help them become more aware of the importance of global sustainability. An overview of the program and the results of an international collaborative project, encouraging local eating and forging a cultural connection to food will be presented.

Keywords: education for sustainable development, environmental education, food education, international collaboration

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Authors: Dr. Rebecca Kimelman

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Teaching students to self-advocate has become a central topic in special education literature and practice. However, many special education programs do not address this important skill area. To this end, I created and implemented the Self Advocacy Made Easy (S.A.M.E.) program of instruction, intended to enhance the self-advocacy skills of young adults with mild to moderate disabilities. The effectiveness of S.A.M.E., the degree to which self-advocacy skills were acquired and demonstrated by the students, the level of parental support, and the impact of culture on the process, and teachers’ beliefs and attitudes about the role of self-advocacy skills for their students were measured using action research that employed mixed methodology. Conducted at an overseas American International School, this action research study sought answers to these questions by providing an in-depth portrayal of the S.A.M.E. program, as well as the attitudes and perceptions of the stakeholders involved in the study (thirteen students, their parents, teachers and counsellors). The findings of this study were very positive. The S.A.M.E. program was found to be a valid and valuable instructional tool for teaching self-advocacy skills to students with learning disabilities and ADHD. The study showed participation in the S.A.M.E. program led to an increased understanding of the important elements of self-advocacy, an increase in students’ skills and abilities to self-advocate, and a positive increase in students’ feelings about themselves. Inclusion in the Student-Led IEP meetings, an authentic student assessment within the S.A.M.E. program, also yielded encouraging results, including a higher level of ownership of one’s profile and learning needs, a higher level of student engagement and participation in the IEP meeting, and a growing student awareness of the relevance of the document and the IEP process to their lives. Without exception, every parent believed that participating in the Student-Led IEP led to a growth in confidence in their children, including that it taught them how to ‘own’ their disability and an improvement in their communication skills. Teachers and counsellors that participated in the study felt the program was worthwhile, and led to an increase in the students’ ability to acknowledge their learning profile and to identify and request the accommodations (such as extended time or use of a calculator) they need to overcome or work around their disability. The implications for further research are many, and include an examination of the degree to which participation in S.A.M.E. fosters student achievement, the long-term effects of participation in the program, and the degree to which student participation in the Student-Led IEP meeting increases parents’ level of understanding and involvement.

Keywords: self-advocacy, learning disabilities, ADHD, student-led IEP process

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Authors: Elaine Wong Yee-Sing

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Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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Authors: Jose R. Garcia, Lexi Frankel, Amalia Ardeljan, Sergio Medina, Ali Yasback, Omar Rashid

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Background: Helicobacter pylori (H. pylori) is a gram-negative, spiral-shaped bacterium that affects nearly half of the population worldwide and humans serve as the principal reservoir. Infection rates usually follow an inverse relationship with hygiene practices and are higher in developing countries than developed countries. Incidence varies significantly by geographic area, race, ethnicity, age, and socioeconomic status. H. pylori is primarily associated with conditions of the gastrointestinal tract such as atrophic gastritis and duodenal peptic ulcers. Infection is also associated with an increased risk of carcinogenesis as there is evidence to show that H. pylori infection may lead to gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. It is suggested that H. pylori infection may be considered as a systemic condition, leading to various novel associations with several different neoplasms such as colorectal cancer, pancreatic cancer, and lung cancer, although further research is needed. Emerging evidence suggests that H. pylori infection may offer protective effects against Mycobacterium tuberculosis as a result of non-specific induction of interferon- γ (IFN- γ). Similar methods of enhanced immunity may affect the development of bronchogenic carcinoma due to the antiproliferative, pro-apoptotic and cytostatic functions of IFN- γ. The purpose of this study was to evaluate the correlation between Helicobacter pylori infection and the incidence of bronchogenic carcinoma. Methods: The data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with H. pylori using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for the purpose of academic research. Standard statistical methods were used. Results:-Between January 2010 and December 2019, the query was analyzed and resulted in 163,224 in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bronchogenic carcinoma was 1.853% with 3,024 patients in the H. pylori group compared to 4.785% with 7,810 patients in the control group. The difference was statistically significant (p < 2.22x10-16) with an odds ratio of 0.367 (0.353 - 0.383) with a confidence interval of 95%. The two groups were matched by treatment and incidence of cancer, which resulted in a total of 101,739 patients analyzed after this match. The incidence of bronchogenic carcinoma was 1.929% with 1,962 patients in the H. pylori and treatment group compared to 4.618% with 4,698 patients in the control group with treatment. The difference was statistically significant (p < 2.22x10-16) with an odds ratio of 0.403 (0.383 - 0.425) with a confidence interval of 95%.

Keywords: bronchogenic carcinoma, helicobacter pylori, lung cancer, pathogen-associated molecular patterns

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Authors: David P. Horton, Gary Lynch-Wood

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Western populations are aging, prone to various lifestyle health problems, and increasing their demand for health and social care services. This demand has created enormous fiscal and regulatory challenges. In response, government institutions have deployed strategies of behavior modification to encourage people to exercise greater personal responsibility over their health and care needs (i.e., welfare responsibilisation). Policy strategies are underpinned by the assumption that people if properly supported, will make better health and lifestyle selections. Not only does this absolve governments of the responsibility for meeting all health and care needs, but it also enables government institutions to assert fiscal control over welfare spending. Looking at the regulation of health and social care in the UK, the authors identify and outline a suite of regulatory tools that are designed to extract and manage the resources of health and social care services users and to encourage them to make (‘better’) use of these resources. This is important for our understanding of how health and social care regulation is responding to ongoing social and economic challenges. It is also important because there has been a failure to systematically examine the relevance of resources for regulation, which is surprising given that resources are crucial to how and whether regulation succeeds or fails. In particular, drawing from the regulatory welfare state concept, the authors analyse the key legal and regulatory changes and mechanisms that have been introduced since the 2008 financial crisis, focusing on critical measures such as the Health and Social Care Act and regulations introduced under the National Health Service Act. The authors show how three types of user resources (i.e., tangible, labor, and data) are being used to assert fiscal control and increase welfare responsibilisation. Amongst other things, the paper concludes that service users have become more than rule followers and targets of behavioral modification; rather, they are producers of resources that regulatory systems have come to rely on.

Keywords: health care, regulation, resources, social care

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Authors: V. Mathad, S. Shivprasad, P. Shivsharannappa, M. K. Patil

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Introduction: Non-communicable diseases are emerging diseases in India. Government of India launched National Programme for Prevention and Control of Cardiovascular Diseases, Cancer and Stroke (NPCDCS) during the year 2008. The aim of the programme was to reduce the burden of non communicable diseases by health promotion and prompt treatment. Objective: The present study was intended to assess the impact of National Program for prevention and control of Cardiovascular Diseases, Diabetes, Cancer and Stroke Programme on biochemical and physiological factors influencing Type 2 diabetes in Kalaburagi District. Material and Method: NCD Clinic was established at District Hospital during April 2016. All the patients attending District Hospital Kalaburagi above the age of 30 years are screened for Non Communicable Diseases under NPCDCS Programme. A total sample of 7447 patients attending NCD Clinic situated at Kalaburagi district was assessed in this study. Pre structured and pretested schedule seeking information was obtained from all the patients by the counselor working under NPCDCS programme. All the Patients attending District Hospital were screened for Diabetes using Glucometer at NCD clinic. The suspected cases were further confirmed through Biochemical investigations like Fasting Blood glucose, HBA1c, Urine Glucose, Kidney Function test. SPSS 20 version was used for analysis of data. Chi square test, P values and odds ratio was used to study the association of factors. Results: A Total of 7447 patients attended NCD clinic during the year 2017-18 were analyzed, Diabetes was seen among 3028 individuals were as comorbidities along with Hypertension was seen among 757 individuals. The mean age of the population was 50 ± 2.84. 3440(46.2%) were males whereas Female constituted 4007(53.8%) of population. The incidence and prevalence of Diabetes being 8.6 and 12.8 respectively. Diabetes was more commonly seen during the age group of 40 to 69 years. Diabetes was significantly associated with Age group 40 to 69 years, obesity and female gender (p < 0.05). The risk of developing Hypertension and comorbidity conditions of hypertension and Diabetes was 1.224 and 1.305 times higher among males, whereas the risk of diabetes was 1.127 higher among females as compared to males. Conclusion: The screening for NCD has significantly increased after launching of NPCDCS programme. NCD was significantly associated with obesity, female gender, increased age as well as comorbid conditions like hypertension and tuberculosis.

Keywords: non-communicable diseases, NPCDCS programme, type 2 Diabetes, physiological factors

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Authors: Anyaogu Paul

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The study examines the problem of child labour in respect to National security in Nigeria. The current situation reflects a chronic urban poverty, which can compel parents and guardians to send their children and wards of school age to engage in income yielding activities to augment family income. The study sought to explain the basis of child labour, its causes and its effects on its victim and society at large. A social survey research design was employed to select the respondents. A sample size of 250 respondents was selected from targeted population of children below the age of 18 years. A questionnaire instrument was employed to collect data. An accidental sampling technique was employed to select the respondents. The findings revealed that child labour is on the increase and a serious threat to national security and social cohesion. The study recommends that the Nigerian government should enforce the laws on child labour and provide opportunities for job creation for urban dwellers. More so, government should also provide free and compulsory education at primary and secondary school levels of education.

Keywords: child labour, family income, national security, survey research

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Authors: Nirmani Wijenayake, Louise Lutze-Mann, Lucy Jo, John Wilson, Vivian Yeung, Dean Lovett, Kim Snepvangers

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Sessional academic staff at universities have the most influence and impact on student learning, engagement, and experience as they have the most direct contact with undergraduate students. A blended technology-enhanced program was created for the development and support of sessional staff to ensure adequate training is provided to deliver quality educational outcomes for the students. This program combines innovative mixed media educational modules, a peer-driven support forum, and face-to-face workshops to provide a comprehensive training and support package for staff. Additionally, the program encourages the development of learning communities and peer mentoring among the sessional staff to enhance their support system. In 2018, the program was piloted on 100 sessional staff in the School of Biotechnology and Biomolecular Sciences to evaluate the effectiveness of this model. As part of the program, rotoscope animations were developed to showcase ‘typical’ interactions between staff and students. These were designed around communication, confidence building, consistency in grading, feedback, diversity awareness, and mental health and wellbeing. When surveyed, 86% of sessional staff found these animations to be helpful in their teaching. An online platform (Moodle) was set up to disseminate educational resources and teaching tips, to host a discussion forum for peer-to-peer communication and to increase critical thinking and problem-solving skills through scenario-based lessons. The learning analytics from these lessons were essential in identifying difficulties faced by sessional staff to further develop supporting workshops to improve outcomes related to teaching. The face-to-face professional development workshops were run by expert guest speakers on topics such as cultural diversity, stress and anxiety, LGBTIQ and student engagement. All the attendees of the workshops found them to be useful and 88% said they felt these workshops increase interaction with their peers and built a sense of community. The final component of the program was to use an adaptive e-learning platform to gather feedback from the students on sessional staff teaching twice during the semester. The initial feedback provides sessional staff with enough time to reflect on their teaching and adjust their performance if necessary, to improve the student experience. The feedback from students and the sessional staff on this model has been extremely positive. The training equips the sessional staff with knowledge and insights which can provide students with an exceptional learning environment. This program is designed in a flexible and scalable manner so that other faculties or institutions could adapt components for their own training. It is anticipated that the training and support would help to build the next generation of educators who will directly impact the educational experience of students.

Keywords: designing effective instruction, enhancing student learning, implementing effective strategies, professional development

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Authors: Mai Alshareef

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The Saudi government considers the modernisation of the education system as a critical component of the national development plan, Saudi Vision 2030; however, this sudden reform creates tension amongst Saudis. This study examines first the reflection of the social and digital education reform on stakeholders and the general Saudi public, and second, the influence of information and communication technologies (ICTs) on the ethnoreligious conflict in Saudi Arabia. This study employs Cyberconflict theory to examine conflicts in the real world and cyberspace. The findings are based on a qualitative case study methodology that uses netnography, an analysis of 3,750 Twitter posts and semi-structural interviews with 30 individuals, including key actors in the Saudi education sector and Twitter activists during 2019\2020. The methods utilised are guided by thematic analysis to map an understanding of factors that influence societal conflicts in Saudi Arabia, which in this case include religious, national, and gender identity. Elements of Cyberconflict theory are used to better understand how conflicting groups build their identities in connection to their ethnic/religious/cultural differences and competing national identities. The findings correspond to the ethnoreligious components of the Cyberconflict theory. Twitter became a battleground for liberals, conservatives, the Saudi public and elites, and it is used in a novel way to influence public opinion and to challenge the media monopoly. Opposing groups relied heavily on a discourse of exclusion and inclusion and showed ethnic and religious affiliations, national identity, and chauvinism. The findings add to existing knowledge in the cyberconflict field of study, and they also reveal outcomes that are critical to the Saudi Arabian national context.

Keywords: education, cyberconflict, Twitter, national identity

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Authors: Ricardo Chaves, Carlos Vasconcelos

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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.

Keywords: case study, exercise program, Naval Academy, physical fitness

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Authors: Sohail Zafar, Sardar Javaid Iqbal Khan

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We use a parametric approach within a translog cost function framework to estimate the economies of scale in National Bank of Pakistan from 1997 to 2013. The results indicate significant economies of scale throughout the sample at aggregates and disaggregates taking in account size subject to stipulation ownership. The factor markets often produce scale inefficiencies in the banking of developing countries like Pakistan such inefficiencies are common due to distortion in factor markets leading to the use of inappropriate factor proportions. The findings suggest that National Bank of Pakistan diversify their asset portfolios that it has cost advantage, therefore, expansion in size should be encouraged under current technology because it appears to be cost effective. In addition, our findings support the implementation of universal banking model in Pakistan.

Keywords: scale economies, cost function, disaggregates, aggregates

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Authors: Alaa Mostafa, Samuel Dagogo-Jack, Vivian Thieu, Maria Yu, Nan Zhang, Dara Schuster, Luis-Emilio Garcia-Perez

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Dulaglutide (DU), a once-weekly glucagon-like peptide-1 receptor agonist, was studied in the AWARD clinical trial program in adult patients with type 2 diabetes (T2D) and demonstrated significant hemoglobin A1c (A1c) reduction and potential for weight loss. To evaluate the efficacy and safety of DU 1.5 mg and DU 0.75 mg in patients with T2D by baseline A1c <8.5% or ≥8.5%, a post-hoc analysis was conducted on AWARD-1 to -6 and -8 at 6 months. Across 7 studies, 55% to 82% of the DU-treated patients had a baseline A1c <8.5%, and 18% to 45% had a baseline A1c ≥8.5%. The ranges of A1c reductions with baseline A1c <8.5% and ≥8.5%, respectively, were: DU 1.5 mg: -0.67% to -1.25% and -1.22% to -2.37%; DU 0.75 mg: -0.53% to -1.07% and -1.37% to -2.19%. The A1c reduction from the pooled analysis was greater in patients with baseline A1c ≥8.5% than patients with baseline A1c <8.5%, respectively: DU 1.5 mg: -1.86% and -1.02%; DU 0.75 mg: -1.75% and -0.83%. DU treatments were well tolerated among baseline A1c subgroups. Across the AWARD program, DU 1.5 mg and DU 0.75 mg demonstrated significant A1c reduction in both subgroups with an acceptable safety profile. Compared to patients with baseline A1c <8.5%, patients with baseline A1c ≥8.5% had greater A1c reduction. Disclosures: This study was supported and conducted by Eli Lilly and Company, Indianapolis, IN, USA.

Keywords: A1c reduction, dulaglutide, type 2 diabetes, weight loss

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Authors: Wiseman Emmanuel Nkhomah, Chiyembekezo Kachimanga, Moses Banda Aron, Julia Higgins, Manuel Mulwafu, Kondwani Mpinga, Mwayi Chunga, Grace Momba, Enock Ndarama, Dickson Sumphi, Atupere Phiri, Fabien Munyaneza

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Background: Data is key to supporting health service delivery as stakeholders, including NGOs rely on it for effective service delivery, decision-making, and system strengthening. Several studies generated debate on data quality from national health management information systems (HMIS) in sub-Saharan Africa. This limits the utilization of data in resource-limited settings, which already struggle to meet standards set by the World Health Organization (WHO). We aimed to evaluate data quality improvement of Neno district HMIS over a 4-year period (2018 – 2021) following quarterly data reviews introduced in January 2020 by the district health management team and Partners In Health. Methods: Exploratory Mixed Research was used to examine report rates, followed by in-depth interviews using Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). We used the WHO module desk review to assess the quality of HMIS data in the Neno district captured from 2018 to 2021. The metrics assessed included the completeness and timeliness of 34 reports. Completeness was measured as a percentage of non-missing reports. Timeliness was measured as the span between data inputs and expected outputs meeting needs. We computed T-Test and recorded P-values, summaries, and percentage changes using R and Excel 2016. We analyzed demographics for key informant interviews in Power BI. We developed themes from 7 FGDs and 11 KIIs using Dedoose software, from which we picked perceptions of healthcare workers, interventions implemented, and improvement suggestions. The study was reviewed and approved by Malawi National Health Science Research Committee (IRB: 22/02/2866). Results: Overall, the average reporting completeness rate was 83.4% (before) and 98.1% (after), while timeliness was 68.1% and 76.4 respectively. Completeness of reports increased over time: 2018, 78.8%; 2019, 88%; 2020, 96.3% and 2021, 99.9% (p< 0.004). The trend for timeliness has been declining except in 2021, where it improved: 2018, 68.4%; 2019, 68.3%; 2020, 67.1% and 2021, 81% (p< 0.279). Comparing 2021 reporting rates to the mean of three preceding years, both completeness increased from 88% to 99% (in 2021), while timeliness increased from 68% to 81%. Sixty-five percent of reports have maintained meeting a national standard of 90%+ in completeness while only 24% in timeliness. Thirty-two percent of reports met the national standard. Only 9% improved on both completeness and timeliness, and these are; cervical cancer, nutrition care support and treatment, and youth-friendly health services reports. 50% of reports did not improve to standard in timeliness, and only one did not in completeness. On the other hand, factors associated with improvement included improved communications and reminders using internal communication, data quality assessments, checks, and reviews. Decentralizing data entry at the facility level was suggested to improve timeliness. Conclusion: Findings suggest that data quality in HMIS for the district has improved following collaborative efforts. We recommend maintaining such initiatives to identify remaining quality gaps and that results be shared publicly to support increased use of data. These results can inform Ministry of Health and its partners on some interventions and advise initiatives for improving its quality.

Keywords: data quality, data utilization, HMIS, collaboration, completeness, timeliness, decision-making

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