Search results for: model-specific factors

Authors: Chantal Maille

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This paper is about gender-based analysis plus (GBA+), an intersectional gender policy used in Canada to assess the impact of policies and programs for men and women from different origins. It looks at Canada’s political culture to explain the nature of its gender policies. GBA+ is defined as an analysis method that makes it possible to assess the eventual effects of policies, programs, services, and other initiatives on women and men of different backgrounds because it takes account of gender and other identity factors. The ‘plus’ in the name serves to emphasize that GBA+ goes beyond gender to include an examination of a wide range of other related identity factors, such as age, education, language, geography, culture, and income. The point of departure for GBA+ is that women and men are not homogeneous populations and gender is never the only factor in defining a person’s identity; rather, it interacts with factors such as ethnic origin, age, disabilities, where the person lives, and other aspects of individual and social identity. GBA+ takes account of these factors and thus challenges notions of similarity or homogeneity within populations of women and men. Comparative analysis based on sex and gender may serve as a gateway to studying a given question, but women, men, girls, and boys do not form homogeneous populations. In the 1990s, intersectionality emerged as a new feminist framework. The popularity of the notion of intersectionality corresponds to a time when, in hindsight, the damage done to minoritized groups by state disengagement policies in concert with global intensification of neoliberalism, and vice versa, can be measured. Although GBA+ constitutes a form of intersectionalization of GBA, it must be understood that the two frameworks do not spring from a similar logic. Intersectionality first emerged as a dynamic analysis of differences between women that was oriented toward change and social justice, whereas GBA is a technique developed by state feminists in a context of analyzing governmental policies and aiming to promote equality between men and women. It can nevertheless be assumed that there might be interest in such a policy and program analysis grid that is decentred from gender and offers enough flexibility to take account of a group of inequalities. In terms of methodology, the research is supported by a qualitative analysis of governmental documents about GBA+ in Canada. Research findings identify links between Canadian gender policies and its political culture. In Canada, diversity has been taken into account as an element at the basis of gendered analysis of public policies since 1995. The GBA+ adopted by the government of Canada conveys an opening to intersectionality and a sensitivity to multiculturalism. The Canadian Multiculturalism Act, adopted 1988, proposes to recognize the fact that multiculturalism is a fundamental characteristic of the Canadian identity and heritage and constitutes an invaluable resource for the future of the country. In conclusion, Canada’s distinct political culture can be associated with the specific nature of its gender policies.

Keywords: Canada, gender-based analysis, gender policies, political culture

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Authors: Shibei Huang

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In deep energy retrofits, the thermal performance of existing building envelopes is often difficult to determine with a high level of accuracy. For older buildings, the records of existing assemblies are often incomplete or inaccurate. To obtain greater baseline performance accuracy for energy models, in-field measurement tools can be used to obtain data on the thermal performance of the existing assemblies. For a known assembly, these field measurements assist in validating the U-factor estimates. If the field-measured U-factor consistently varies from the calculated prediction, those measurements prompt further study. For an unknown assembly, successful field measurements can provide approximate U-factor evaluation, validate assumptions, or identify anomalies requiring further investigation. Using case studies, this presentation will focus on the non-destructive methods utilizing a set of various field tools to validate the baseline U-factors for a range of existing buildings with various wall assemblies. The lessons learned cover what can be achieved, the limitations of these approaches and tools, and ideas for improving the validity of measurements. Key factors include the weather conditions, the interior conditions, the thermal mass of the measured assemblies, and the thermal profiles of the assemblies in question.

Keywords: existing building, sensor, thermal analysis, retrofit

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Authors: Fernanda Bravo Cornejo, Camilo Cerda Sarabia, Belén Díaz Díaz, Diego Santibañez Oyarce, Esteban Gómez Terán, Hugo Osses Prado, Raúl Caulier-Cisterna, Jorge Vergara-Quezada, Ana Moya-Beltrán

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Streptococcus pyogenes is a gram-positive bacteria involved in a wide range of diseases and is a major-human-specific bacterial pathogen. In Chile, this year the 'Ministerio de Salud' declared an alert due to the increase in strains throughout the year. This increase can be attributed to the multitude of factors including antimicrobial resistance (AMR) and Virulence Factors (VF). Understanding these VF and AMR is crucial for developing effective strategies and improving public health responses. Moreover, experimental identification and characterization of these pathogenic mechanisms are labor-intensive and time-consuming. Therefore, new computational methods are required to provide robust techniques for accelerating this identification. Advances in Machine Learning (ML) algorithms represent the opportunity to refine and accelerate the discovery of VF associated with Streptococcus pyogenes. In this work, we evaluate the accuracy of various machine learning models in predicting the virulence factors and antimicrobial resistance of Streptococcus pyogenes, with the objective of providing new methods for identifying the pathogenic mechanisms of this organism.Our comprehensive approach involved the download of 32,798 genbank files of S. pyogenes from NCBI dataset, coupled with the incorporation of data from Virulence Factor Database (VFDB) and Antibiotic Resistance Database (CARD) which contains sequences of AMR gene sequence and resistance profiles. These datasets provided labeled examples of both virulent and non-virulent genes, enabling a robust foundation for feature extraction and model training. We employed preprocessing, characterization and feature extraction techniques on primary nucleotide/amino acid sequences and selected the optimal more for model training. The feature set was constructed using sequence-based descriptors (e.g., k-mers and One-hot encoding), and functional annotations based on database prediction. The ML models compared are logistic regression, decision trees, support vector machines, neural networks among others. The results of this work show some differences in accuracy between the algorithms, these differences allow us to identify different aspects that represent unique opportunities for a more precise and efficient characterization and identification of VF and AMR. This comparative analysis underscores the value of integrating machine learning techniques in predicting S. pyogenes virulence and AMR, offering potential pathways for more effective diagnostic and therapeutic strategies. Future work will focus on incorporating additional omics data, such as transcriptomics, and exploring advanced deep learning models to further enhance predictive capabilities.

Keywords: antibiotic resistance, streptococcus pyogenes, virulence factors., machine learning

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Authors: Hanieh Mohammadi, Sarah Fraser, Anil Nigam, Frederic Lesage, Louis Bherer

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A chronically higher cerebral pulsatility is thought to damage cerebral microcirculation, leading to cognitive decline in older adults. Although it is widely known that regular physical activity is linked to improvement in some cognitive domains, including executive functions, the mediating role of cerebral pulsatility on this link remains to be elucidated. This study assessed the impact of 6 months of regular physical activity upon changes in an optical index of cerebral pulsatility and the role of physical activity for the improvement of executive functions. 27 older adults (aged 57-79, 66.7% women) with cardiovascular risk factors (CVRF) were enrolled in the study. The participants completed the behavioral Stroop test, which was extracted from the Delis-Kaplan executive functions system battery at baseline (T0) and after 6 months (T6) of physical activity. Near-infrared spectroscopy (NIRS) was applied for an innovative approach to indexing cerebral pulsatility in the brain microcirculation at T0 and T6. The participants were at standing rest while a NIRS device recorded hemodynamics data from frontal and motor cortex subregions at T0 and T6. The cerebral pulsatility index of interest was cerebral pulse amplitude, which was extracted from the pulsatile component of NIRS data. Our data indicated that 6 months of physical activity was associated with a reduction in the response time for the executive functions, including inhibition (T0: 56.33± 18.2 to T6: 53.33± 15.7,p= 0.038)and Switching(T0: 63.05± 5.68 to T6: 57.96 ±7.19,p< 0.001) conditions of the Stroop test. Also, physical activity was associated with a reduction in cerebral pulse amplitude (T0: 0.62± 0.05 to T6: 0.55± 0.08, p < 0.001). Notably, cerebral pulse amplitude was a significant mediator of the link between physical activity and response to the Stroop test for both inhibition (β=0.33 (0.61,0.23),p< 0.05)and switching (β=0.42 (0.69,0.11),p <0.01) conditions. This study suggests that regular physical activity may support cognitive functions through the improvement of cerebral pulsatility in older adults with CVRF.

Keywords: near-infrared spectroscopy, cerebral pulsatility, physical activity, cardiovascular risk factors, executive functions

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Authors: Raied Khayou

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The Hawza Al-'Ilmiyya is a network of religious seminaries in the Shia branch of Islam. This research mainly focuses on the oldest school located in Najaf, Iraq, because its core curriculum and main characteristics have been unchanged since the fourth century of Islam. Relying on a thorough literature review of Arabic and English publications, and interviews with current and previous students of the seminary, the current research outlines the factors proving how this seminary was crucial in keeping the Shia religious identity intact despite sometimes gruesome attempts of interference and persecution. There are several factors that helped the seminary to preserve its central importance. First, rooted in their theology, Shia Muslims believe that the Hawza Al-’Ilmiyya and its graduates carry a sacred authority. Secondly, the financial independence of the Seminary helped to keep it intact from any governmental or political meddling. Third, its unique teaching method, its matchless openness for new students, and its flexible curriculum made it attractive for many students who were interested in learning more about Shia theology and jurisprudence. The Hawza Al-‘Ilmiyya has the exclusive right to train clerics who hold the religious authority of Shia Islamic jurisprudence, and the seminary’s success in staying independent throughout history kept Shia Islamic theology independent, as well.

Keywords: Hawza Al'Ilmiyya, religious seminary, Shia Muslim education, Islamic jurisprudence

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Authors: Pallav Singh, Rajesh Yabaji, Rajesh Dhir, Chanakya Hridaya

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Supply Chain Costs for the Indian Industries have been on an exponential trend due to steep inflation on fundamental cost factors – Fuel, Labour, Rents. In this changing context organizations have been focusing on adopting multiple approaches to keep logistics costs under control to protect the profit margins. The lever of ‘Business to Business (B2B) collaboration’ can be used by organizations to garner higher value. Given the context of Indian Logistics Industry the penetration of B2B Collaboration initiatives have been limited. This paper outlines a structured framework for adoption of B2B collaboration through discussion of a successful initiative between ITC’s Leaf Tobacco Business and a leading Indian Media House. Multiple barriers to such a collaborative process exist which need to be addressed through comprehensive structured approaches. This paper outlines a generic framework approach to B2B collaboration for the Indian Logistics Space, outlining the guidelines for arriving at potential opportunities, identification of collaborators, effective tie-up process, design of operations and sustenance factors. The generic methods outlined can be used in any other industry and also builds a foundation for further research on many topics.

Keywords: business to business collaboration, reverse haul logistics, transportation cost optimization, exports logistics

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Authors: H. Kalboussi, A. Aloui, W. Boughattas, M. Maoua, A. Brahem, S. Chatti, O. El Maalel, F. Debbabi, N. Mrizak, Y. Ben Youssef, A. Khlif, I. Bougmiza

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Background: In recent decades, the incidence of children's hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and Methods: Our study is a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012,and which included children with acute leukemia compared to children unharmed by neoplastic disease . Cases and controls were matched by age and gender. Our objective was to: - Describe the socio-occupational characteristics of the parents of children with acute leukemia. - Identify potential occupational factors implicated in the genesis of acute leukemia. Result: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0,009, OR = 3.9; CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5; ICa = [1.09 -11.6]. 25.7 % of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006), OR = 1.46, IC = [1.38 - 1.56]. The parental occupational exposures associated to the occurrence of acute leukemia in children were: - Pesticides with a statistically significant difference (p = 0.03), OR = 2.94, IC = [1.06 - 8.13]. This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75; ICa = [1.27 - 11.03]. - Cement without a statistically non-significant difference (p = 0.2). This difference has become significant after adjustment with the different variables pa = 0.03; ORa = 2.67; ICa = [1.06 - 6.7]. Conclusion: Parental exposure to occupational risk factors may play a role in the pathogenesis of acute leukemia in children.

Keywords: hematological malignancies, children, parents, occupational exposure

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Authors: Xue Xiao, Sun Hao, Liu Donghua

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E-commerce is experiencing rapid development and evolution, but traditional research methods are difficult to fully demonstrate the relationship between micro factors and macro evolution in the development process of e-commerce, which cannot provide accurate assessment for the existing strategies and predict the future evolution trends. To solve these problems, this paper presents the concept of e-commerce service ecosystem based on the characteristics of e-commerce and business ecosystem theory, describes e-commerce environment as a complex adaptive system from the perspective of ecology, constructs a e-commerce service ecosystem model by using Agent-based modeling method and Java language in RePast simulation platform and conduct experiment through the way of computational experiment, attempt to provide a suitable and effective researching method for the research on e-commerce evolution. By two experiments, it can be found that system model built in this paper is able to show the evolution process of e-commerce service ecosystem and the relationship between micro factors and macro emergence. Therefore, the system model constructed by Agent-based method and computational experiment provides proper means to study the evolution of e-commerce ecosystem.

Keywords: e-commerce service ecosystem, complex system, agent-based modeling, computational experiment

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Authors: Horesh Reinman Netta

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Early research on child sexual abuse (CSA) attempted to assess its possible effects. Researchers found that victims of CSA are prone to a host of emotional disorders, including post-traumatic stress disorder, depression, dissociative disorders, anxiety disorders and suicidality later in life. The study examined the development of symptoms over a two-year period at base line and after six months. Factors including the age at the onset of abuse, the gender of the abused child and academic achievements were also examined. Other variables examined include the complex association among self-disclosure, self-esteem, the child’s attachment and coping styles, and psychological adjustment. The abused child’s domestic environment has been found to have a relevant impact on the psychological outcomes of CSA. The study examined inter-parental conflicts, cohesion in the child’s home, parental attachment styles and psychopathology. To the best of our knowledge, no investigation of this nature has yet been performed. Hence, the study makes a major contribution to research in this field. In addition, a combined examination of abuse characteristics, child characteristics, domestic environment and therapeutic history will facilitate enhanced understanding of the interactions among CSA, mediating factors and psychological outcomes.

Keywords: sexual abuse, follow up, victimization, children

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Authors: Hamza Ikhlaq, Stephen Franks

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Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.

Keywords: PCOS, ethnicity, BMI, clinical

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Authors: Napasri Suwanajote

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The purposes of this research were to analyse and evaluate successful factors in OTOP production process for the developing of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The research has been designed as a qualitative study to gather information from 30 OTOP producers in Bangkontee District, Samudsongkram Province. They were all interviewed on 3 main parts. Part 1 was about the production process including 1) production 2) product development 3) the community strength 4) marketing possibility and 5) product quality. Part 2 evaluated appropriate successful factors including 1) the analysis of the successful factors 2) evaluate the strategy based on Sufficiency Economic Philosophy and 3) the model of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The results showed that the production did not affect the environment with potential in continuing standard quality production. They used the raw materials in the country. On the aspect of product and community strength in the past 1 year, it was found that there was no appropriate packaging showing product identity according to global market standard. They needed the training on packaging especially for food and drink products. On the aspect of product quality and product specification, it was found that the products were certified by the local OTOP standard. There should be a responsible organization to help the uncertified producers pass the standard. However, there was a problem on food contamination which was hazardous to the consumers. The producers should cooperate with the government sector or educational institutes involving with food processing to reach FDA standard. The results from small group discussion showed that the community expected high education and better standard living. Some problems reported by the community included informal debt and drugs in the community. There were 8 steps in developing the model of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality.

Keywords: production process, OTOP, sufficiency economic philosophy, marketing management

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Authors: Tran Le Na, Didit Novianto, Yoshiaki Ushifusa, Weijun Gao

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This paper introduces the characteristics of Japanese residential lifestyle and Japanese Architectural housing design, meanwhile, summarizes the results from an analysis of energy use of 12 households in electric-only multi dwellings in Higashida Smart Community, Kitakyushu, Japan. Using hourly load and daily load data collected from smart meter, we explore correlations of energy use in households according to the incentive of different levels of architectural characteristics and lifestyle, following three factors: Space (Living room, Kitchen, Bedroom, Bathroom), Time (daytime and night time, weekdays and weekend) and User (Elderly, Parents, Kids). The energy consumption reports demonstrated that the essential demand of household’s response to variable factors. From that exploratory analysis, we can define the role of housing equipment layout and spatial layout in residential housing design. Likewise, determining preferred spaces and time use can help to optimize energy consumption in households. This paper contributes to the application of Smart Home Energy Management System in Smart Community in Japan and provides a good experience to other countries.

Keywords: smart community, energy efficiency, architectural housing design, residential lifestyle

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Authors: B. Khorsandi Talab, M. Kordi

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It is highly deplorable that every year, theft behavior among employees of the insurance industry is growing throughout the world. A very significant source of contraction (despite many costly technological and widespread security measures) needs to be addressed and prevented. Employee and agent theft cannot be ignored as it causes significant losses to employers. This study investigates the workplace factors that affect the insurance employee and agent theft behavior. Although identifying theft is difficult, this study will help employers to further understand employees’ theft behavior. This study was conducted in two service small and medium organizations (two branches of insurance companies) in ALBORZ’s capital city, KARAJ. Data has been collected via questionnaire from 30 employees and agents consisting employees and supervisors of branches and agencies. According to the results, it must be acknowledged that compensation, organizational justice, internal control systems, penalties and personal characteristics were associated with employees' theft behavior, it is despite the fact that, no effect could be assumed for organizational ethics and requirement in this case. Nevertheless, poor financial status cannot be considered as the driving factor in pushing employees to steal property as well as increasing their theft behavior. As mentioned earlier, the purpose of this study was to determine the factors contributing to employees’ theft (insurance employees and agencies) behavior in insurance organizations in Karaj.

Keywords: service theft, employee theft behavior, work theft, insurance agency, SMEs

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Authors: Faisal G. Khamis, Ghaleb A. El-Refae

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Many researchers have studied socioeconomic, health, and security variables in the developed countries; however, very few studies used multivariate analysis in developing countries. The current study contributes to the scarce literature about the determinants of the variance in socioeconomic, health, and security factors. Questions raised were whether the independent variables (IVs) of governorate and year impact the socioeconomic, health, and security dependent variables (DVs) in Jordan, whether the marginal mean of each DV in each governorate and in each year is significant, which governorates are similar in difference means of each DV, and whether these DVs vary. The main objectives were to determine the source of variances in DVs, collectively and separately, testing which governorates are similar and which diverge for each DV. The research design was time series and cross-sectional analysis. The main hypotheses are that IVs affect DVs collectively and separately. Multivariate and univariate analyses of variance were carried out to test these hypotheses. The population of 12 governorates in Jordan and the available data of 15 years (2000–2015) accrued from several Jordanian statistical yearbooks. We investigated the effect of two factors of governorate and year on the four DVs of divorce rate, mortality rate, unemployment percentage, and crime rate. All DVs were transformed to multivariate normal distribution. We calculated descriptive statistics for each DV. Based on the multivariate analysis of variance, we found a significant effect in IVs on DVs with p < .001. Based on the univariate analysis, we found a significant effect of IVs on each DV with p < .001, except the effect of the year factor on unemployment was not significant with p = .642. The grand and marginal means of each DV in each governorate and each year were significant based on a 95% confidence interval. Most governorates are not similar in DVs with p < .001. We concluded that the two factors produce significant effects on DVs, collectively and separately. Based on these findings, the government can distribute its financial and physical resources to governorates more efficiently. By identifying the sources of variance that contribute to the variation in DVs, insights can help inform focused variation prevention efforts.

Keywords: ANOVA, crime, divorce, governorate, hypothesis test, Jordan, MANOVA, means, mortality, unemployment, year

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Authors: Adjebli Ahmed, Messis Abdelaziz, Ayeche Riad, Tighilet Karim, Talbi Melissa, Smaili Yanis, Lehri Mokrane, Louardiane Mustapha

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Colorectal cancer is one of the most common types of cancer worldwide, and its incidence has been increasing in recent years. Data and fecal samples from colorectal cancer patients were collected at the Amizour Public Hospital's oncology department (Bejaia, Algeria). Microbiological and cohort study were conducted at the Biological Engineering of Cancers laboratory at the Faculty of Medicine of the University of Bejaia. All the data showed that patients aged between 50 and 70 years were the most affected by colorectal cancer, while the age categories of [30-40] and [40-50] were the least affected. Males were more likely to be at risk of contracting colorectal cancer than females. The most common types of colorectal cancer among the studied population were sigmoid cancer, rectal cancer, transverse colon cancer, and ascending colon cancer. The hereditary factor was found to be more dominant than other risk factors. Bacterial identification revealed the presence of certain pathogenic and opportunistic bacterial genera, such as E. coli, K. pneumoniae, Shigella sp, and Streptococcus group D. These results led us to conclude that dysbiosis of the intestinal microbiome is strongly present in colorectal cancer patients at the EPH of Amizour.

Keywords: microbiome, colorectal cancer, risk factors, bacterial identification

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Authors: Farwa Rizvi, Joanne Williams, Humaira Maheen, Elizabeth Hoban

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There is an increase in risky sexual behavior and unsafe sex in adolescent girls and young women aged 15 to 24 years in Cambodia, which negatively affects their reproductive health by increasing the risk of contracting sexually transmitted infections and unintended pregnancies. Risky sexual behavior includes ‘having sex at an early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs, and unprotected sexual behaviors’. A systematic review of quantitative research conducted in Cambodia was undertaken, using the theoretical framework of the Social Ecological Model to identify the personal, social and cultural factors associated with risky sexual behavior and unsafe sex in young Cambodian women. PRISMA guidelines were used to search databases including Medline Complete, PsycINFO, CINAHL Complete, Academic Search Complete, Global Health, and Social Work Abstracts. Additional searches were conducted in Science Direct, Google Scholar and in the grey literature sources. A risk-of-bias tool developed explicitly for the systematic review of cross-sectional studies was used. Summary item on the overall risk of study bias after the inter-rater response showed that the risk-of-bias was high in two studies, moderate in one study and low in one study. The search strategy included a combination of subject terms and free text terms. The medical subject headings (MeSH) terms included were; contracept* or ‘birth control’ or ‘family planning’ or pregnan* or ‘safe sex’ or ‘protected intercourse’ or ‘unprotected intercourse’ or ‘protected sex’ or ‘unprotected sex’ or ‘risky sexual behaviour*’ or ‘abort*’ or ‘planned parenthood’ or ‘unplanned pregnancy’ AND ( barrier* or obstacle* or challenge* or knowledge or attitude* or factor* or determinant* or choic* or uptake or discontinu* or acceptance or satisfaction or ‘needs assessment’ or ‘non-use’ or ‘unmet need’ or ‘decision making’ ) AND Cambodia*. Initially, 300 studies were identified by using key words and finally, four quantitative studies were selected based on the inclusion criteria. The four studies were published between 2010 and 2016. The study participants ranged in age from 10-24 years, single or married, with 3 to 10 completed years of education. The mean age at sexual debut was reported to be 18 years. Using the perspective of the Social Ecological Model, risky sexual behavior was associated with individual-level factors including young age at sexual debut, low education, unsafe sex under the influence of alcohol and substance abuse, multiple sexual partners or transactional sex. Family level factors included living away from parents, orphan status and low levels of family support. Peer and partner level factors included peer delinquency and lack of condom use. Low socioeconomic status at the society level was also associated with risky sexual behaviour. There is scant research on sexual and reproductive health of adolescent girls and young women in Cambodia. Individual, family and social factors were significantly associated with risky sexual behaviour. More research is required to inform potential preventive strategies and policies that address young women’s sexual and reproductive health.

Keywords: adolescents, high-risk sex, sexual activity, unplanned pregnancies

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Authors: Robert H. Bradley, Robert F. Corwyn

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There is abundant research showing that socio-economic status is implicated in parenting. However, additional factors such as family context, parent personality, parenting history and child behavior also help determine how parents enact the role of caregiver. Each of these factors not only helps determine how a parent will act in a given situation, but each can serve to moderate the influence of the other factors. Personality has long been studied as a factor that influences parental behavior, but it has almost never been considered as a moderator of family contextual factors. For this study, relations between three maternal personality characteristics (agreeableness, extraversion, neuroticism) and four aspects of parenting (harshness, sensitivity, stimulation, learning materials) were examined when children were 6 months, 36 months, and 54 months old and again at 5th grade. Relations between these three aspects of personality and the overall home environment were also examined. A key concern was whether maternal personality characteristics moderated relations between household income and the four aspects of parenting and between household income and the overall home environment. The data for this study were taken from the NICHD Study of Early Child Care and Youth Development (NICHD SECCYD). The total sample consisted of 1364 families living in ten different sites in the United States. However, the samples analyzed included only those with complete data on all four parenting outcomes (i.e., sensitivity, harshness, stimulation, and provision of learning materials), income, maternal education and all three measures of personality (i.e., agreeableness, neuroticism, extraversion) at each age examined. Results from hierarchical regression analysis showed that mothers high in agreeableness were more likely to demonstrate sensitivity and stimulation as well as provide more learning materials to their children but were less likely to manifest harshness. Maternal agreeableness also consistently moderated the effects of low income on parental behavior. Mothers high in extraversion were more likely to provide stimulation and learning materials, with extraversion serving as a moderator of low income on both. By contrast, mothers high in neuroticism were less likely to demonstrate positive aspects of parenting and more likely to manifest negative aspects (e.g., harshness). Neuroticism also served to moderate the influence of low income on parenting, especially for stimulation and learning materials. The most consistent effects of parent personality were on the overall home environment, with significant main and interaction effects observed in 11 of the 12 models tested. These findings suggest that it may behoove professional who work with parents living in adverse circumstances to consider parental personality in helping to better target prevention or intervention efforts aimed at supporting parental efforts to act in ways that benefit children.

Keywords: home environment, household income, learning materials, personality, sensitivity, stimulation

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Authors: Maria de Nazaré Moraes Soares, Silvia Maria Dias Pedro Rebouças, José Carlos Lázaro

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The Solidarity Economy (SE) acts in the re-articulation of the economic field to the other spheres of social action. The significant participation of women in SE resulted in the formation of a national network of self-managed enterprises in Brazil: The Solidarity and Feminist Economy Network (SFEN). The objective of the research is to identify factors of gender justice and feminist self-management practices that adhere to the reality of women in SE enterprises. The conceptual apparatus related to feminist studies in this research covers Nancy Fraser approaches on gender justice, and Patricia Yancey Martin approaches on feminist management practices, and authors of postcolonial feminism such as Mohanty and Maria Lugones, who lead the discussion to peripheral contexts, a necessary perspective when observing the women’s movement in SE. The research has a quantitative nature in the phases of data collection and analysis. The data collection was performed through two data sources: the database mapped in Brazil in 2010-2013 by the National Information System in Solidary Economy and 150 questionnaires with women from 16 enterprises in SFEN, in a state of Brazilian northeast. The data were analyzed using the multivariate statistical technique of Factor Analysis. The results show that the factors that define gender justice and feminist self-management practices in SE are interrelated in several levels, proving statistically the intersectional condition of the issue of women. The evidence from the quantitative analysis allowed us to understand the dimensions of gender justice and feminist management practices intersectionality; in this sense, the non-distribution of domestic work interferes in non-representation of women in public spaces, especially in peripheral contexts. The study contributes with important reflections to the studies of this area and can be complemented in the future with a qualitative research that approaches the perspective of women in the context of the SE self-management paradigm.

Keywords: feminist management practices, gender justice, self-management, solidarity economy

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Authors: Fawad Ali

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Toxic heavy metal contamination has a negative impact on soil quality which ultimately pollutes the agriculture system. In the current work, we analyzed uptake of various heavy metals by dietary vegetables grown in wastewater irrigated areas of Swabi city. The samples of soil and vegetables were analyzed for heavy metals viz Cd, Cr, Mn, Fe, Ni, Cu, Zn and Pb using Atomic Absorption Spectrophotometer. High levels of metals were found in wastewater irrigated soil and vegetables in the study area. Especially the concentrations of Pb and Cd in the dietary vegetable crossed the permissible level of World Health Organization. Substantial positive correlation was found among the soil and vegetable contamination. Transfer factor for some metals including Cr, Zn, Mn, Ni, Cd and Cu was greater than 0.5 which shows enhanced accumulation of these metals due to contamination by domestic discharges and industrial effluents. Linear regression analysis indicated significant correlation of heavy metals viz Pb, Cr, Cd, Ni, Zn, Cu, Fe and Mn in vegetables with concentration in soil of 0.964 at P≤0.001. Abelmoschus esculentus indicated Health Risk Index (HRI) of Pb >1 in adults and children. The source identification analysis carried out by Principal Component Analysis (PCA) and Cluster Analysis (CA) showed that ground water and soil were being polluted by the trace metals coming out from industries and domestic wastes. Hierarchical cluster analysis (HCA) divided metals into two clusters for wastewater and soil but into five clusters for soil of control area. PCA extracted two factors for wastewater, each contributing 61.086 % and 16.229 % of the total 77.315 % variance. PCA extracted two factors, for soil samples, having total variance of 79.912 % factor 1 and factor 2 contributed 63.889 % and 16.023 % of the total variance. PCA for sub soil extracted two factors with a total variance of 76.136 % factor 1 being 61.768 % and factor 2 being 14.368 %of the total variance. High pollution load index for vegetables in the study area due to metal polluted soil has opened a study area for proper legislation to protect further contamination of vegetables. This work would further reveal serious health risks to human population of the study area.

Keywords: health risk, vegetables, wastewater, atomic absorption sepctrophotometer

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Authors: Chun-Lang Chang, Chun-Kai Liu

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In this study, the patients that have undergone total knee replacement surgery from the 2010 National Health Insurance database were adopted as the study participants. The important factors were screened and selected through literature collection and interviews with physicians. Through the Cross Entropy Method (CE), Genetic Algorithm Logistic Regression (GALR), and Particle Swarm Optimization (PSO), the weights of the factors were obtained. In addition, the weights of the respective algorithms, coupled with the Excel VBA were adopted to construct the Case Based Reasoning (CBR) system. The results through statistical tests show that the GALR and PSO produced no significant differences, and the accuracy of both models were above 97%. Moreover, the area under the curve of ROC for these two models also exceeded 0.87. This study shall serve as a reference for medical staff as an assistance for clinical assessment of infections in order to effectively enhance medical service quality and efficiency, avoid unnecessary medical waste, and substantially contribute to resource allocations in medical institutions.

Keywords: Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization, Total Knee Replacement Surgery

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Authors: Weera Weerasophon

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This research aims to study and survey a potential in the areas affecting development and study of management factors affecting cultural tourism for Suansunandha Rajabhat University in a model of a qualitative research as a survey research. The sample population includes executives, faculty members, and persons related to university management of Suansunandha Rajabhat University, the total number is 5 persons. The researcher distributed in-depth interview form for tools used in the research. The obtained data was brought to conduct content analysis by brainstorming from expert academician to persons related to university management of Suansunandha Rajabhat University in order to consider readiness in cultural tourism management for Suansunandha Rajabhat University, to analyze and develop to be a guideline for the development of Suansunandha Rajabhat University for promoting cultural tourism. From the study results, it is found that the factors of readiness in management, planning, organizing, personnel management, leadership and guiding, coordination, controlling, budgeting and marketing could influence to be a guideline for development of Suansunandha Rajabhat Universiy in order to promote cultural tourism; therefore, the university should prepare more plans concerning related matters, as well as development, determining form and policy of Suansunandha Rajabhat University.

Keywords: cultural tourism, Suansunandha Rajabhat University, tourism management, guideline of development

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

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Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in the control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, and the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: Fadwa Al Bawardi

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In March 2021, the Saudi Arabian Council of Ministers issued a decision to form a committee called the "Higher Committee for Research, Development and Innovation," a committee linked to the Council of Economic and Development Affairs, chaired by the Chairman of the Council of Economic and Development Affairs, and concerned with the development of the research, development and innovation sector in the Kingdom. In order to talk about the dimensions of this wonderful step, let us first try to answer the following questions. Is there a difference between creativity and innovation..? What are the factors of creativity in the individual. Are they mental genetic factors or are they factors that an individual acquires through learning..? The methodology included surveys that have been conducted on more than 500 individuals, males and females, between the ages of 18 till 60. And the answer is. "Creativity" is the creation of a new idea, while "Innovation" is the development of an already existing idea in a new, successful way. They are two sides of the same coin, as the "creative idea" needs to be developed and transformed into an "innovation" in order to achieve either strategic achievements at the level of countries and institutions to enhance organizational intelligence, or achievements at the level of individuals. For example, the beginning of smart phones was just a creative idea from IBM in 1994, but the actual successful innovation for the manufacture, development and marketing of these phones was through Apple later. Nor does creativity have to be hereditary. There are three basic factors for creativity: The first factor is "the presence of a challenge or an obstacle" that the individual faces and seeks thinking to find solutions to overcome, even if thinking requires a long time. The second factor is the "environment surrounding" of the individual, which includes science, training, experience gained, the ability to use techniques, as well as the ability to assess whether the idea is feasible or otherwise. To achieve this factor, the individual must be aware of own skills, strengths, hobbies, and aspects in which one can be creative, and the individual must also be self-confident and courageous enough to suggest those new ideas. The third factor is "Experience and the Ability to Accept Risk and Lack of Initial Success," and then learn from mistakes and try again tirelessly. There are some tools and techniques that help the individual to reach creative and innovative ideas, such as: Mind Maps tool, through which the available information is drawn by writing a short word for each piece of information and arranging all other relevant information through clear lines, which helps in logical thinking and correct vision. There is also a tool called "Flow Charts", which are graphics that show the sequence of data and expected results according to an ordered scenario of events and workflow steps, giving clarity to the ideas, their sequence, and what is expected of them. There are also other great tools such as the Six Hats tool, a useful tool to be applied by a group of people for effective planning and detailed logical thinking, and the Snowball tool. And all of them are tools that greatly help in organizing and arranging mental thoughts, and making the right decisions. It is also easy to learn, apply and use all those tools and techniques to reach creative and innovative solutions. The detailed figures and results of the conducted surveys are available upon request, with charts showing the %s based on gender, age groups, and job categories.

Keywords: innovation, creativity, factors, tools

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Authors: Tsai-Yun Liao, Fang-Yi Hsu

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Consumer behavior and consumption patterns have changed in reacting to the threat of COVID-19 pandemic situations. In order to explore the factors affecting customers’ purchase intention under the influence of the COVID-19 pandemic, this research uses structural equation modeling to explore the effect of media effect, conformity, and personality on customers’ purchase intention. Four essential objectives are investigated: how does media affect the conformity and perceived value of customers; the effect of media effect, conformity, and personality on customers’ purchase intention; the moderating effect of personality; and the mediating effect of perceived value toward purchase intention. By convenience sampling method, 428 questionnaires were collected, and the total number of valid samples was 406. Data analysis and results indicate that: (1) The media effect positively affects conformity. (2) The media effect positively affects perceived value. (3) Both conformity and perceived value positively affect purchase intention. (4) Consumer’s personality of openness to experience moderates the relationship between conformity and purchase intention. (5) Media effect affects purchase intention through the mediating effect of perceived value. This study contributes to the research by providing the factors affecting customers’ purchase intention and to the enterprises by maintaining incumbent customers and attracting potential customers.

Keywords: COVID-19, media effect, conformity, personality, purchase intention

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Authors: Adekunle Saheed Ajisebiyawo, Christie Omoduwa Achime

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In Nigerian society, women have very little or no involvement in the decision-making process and this is large because women are objectified as effective means of reproduction and provision of emotional support to the society. Despite the movements and awareness by international, national and local bodies to promote and encourage women's empowerment, there are still many factors daunting to the efforts of women in society. This paper examined the critical role of feminism in the quest for women's emancipation in public life. Guided by African feminism theory, this paper utilizes both historical and descriptive methods to examine these factors. The paper argues that gender bias in Nigeria's public life is often traced to the onset of colonialism in Nigeria. Thus the Western cultural notion of colonialism woven around male superiority is reflected in their relations with Nigerians. The study outlines how women have strategized pathways through patriarchal structures by deploying their femininity. The paper concludes that women are strong, courageous, natural leaders and indeed have a major strategic role to play in public life; thus, women's movements and groups remain an important and necessary means of social cohesion and strength, especially in a country such as Nigeria.

Keywords: African feminism, democratic governance, feminism, patriarchy, women emancipation.

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Authors: Amardass Dhami, Clare Samuelson

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Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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Authors: Salinee Thumronglaohapun

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The proper number and appropriate locations of service centers can save cost, raise revenue and gain more satisfaction from customers. Establishing service centers is high-cost and difficult to relocate. In long-term planning periods, several factors may affect the service. One of the most critical factors is uncertain demand of customers. The opened service centers need to be capable of serving customers and making a profit although the demand in each period is changed. In this work, the capacitated location-allocation problem with stochastic demand is considered. A mathematical model is formulated to determine suitable locations of service centers and their allocation to maximize total profit for multiple planning periods. Two heuristic methods, a local search and genetic algorithm, are used to solve this problem. For the local search, five different chances to choose each type of moves are applied. For the genetic algorithm, three different replacement strategies are considered. The results of applying each method to solve numerical examples are compared. Both methods reach to the same best found solution in most examples but the genetic algorithm provides better solutions in some cases.

Keywords: location-allocation problem, stochastic demand, local search, genetic algorithm

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Authors: E. Hegazy, S. Anderberg, J. Krook

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The city's wire-based infrastructure systems (WBIS) are responsible for the delivery of electricity, telecommunications, sanitation, drainage, and district heating and are a necessity for sustainable modern urban life. Maintaining the functionality of these structures involves high costs and, brings disturbance to the local community and effects on the environment. One key reason for this is that the cables and pipes are placed under streets, making system parts easily worn and their service lifetime reduced, and all maintenance and renewal rely on recurrent needs for excavation. In Sweden, a significant part of wire-based infrastructure is already outdated and will need to be replaced in the coming decades. The replacement of these systems will entail massive costs as well as important traffic disruption and environmental disturbance. However, this challenge may also open a unique opportunity to introduce new, more sustainable technologies and management practices. The transformation of WBIS management for long-term sustainability and meeting maintenance and renewal needs does not have a comprehensive approach. However, a systemic approach may inform WBIS management. This approach considers both technical and non-technical aspects, as well as time-related factors. Nevertheless, there is limited systemic knowledge of how different factors influence current management practices. The aim of this study is to address this knowledge gap and contribute to the understanding of what factors influence the current practice of WBIS management. A case study approach is used to identify current management practices, the underlying factors that influence them, and their implications for sustainability outcomes. The case study is based on both quantitative data on the local system and data from interviews and workshops with local practitioners and other stakeholders. Linköping was selected as a case since it provided good accessibility to the water administration and relevant data for analyzing water infrastructure management strategies. It is a sufficiently important city in Sweden to be able to identify challenges, which, to some extent, are common to all Swedish cities. By uncovering current practices and what is influencing Linköping, knowledge gaps and uncertainties related to sustainability consequences were highlighted. The findings show that goals, priorities, and policies controlling management are short-termed, and decisions on maintenance and renewal are often restricted to finding solutions to the most urgent issues. Sustainability transformation in the infrastructure area will not be possible through individual efforts without coordinated technical, organizational, business, and regulatory changes.

Keywords: case study, infrastructure, management, practice, Sweden

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Authors: Abosede Mosunmola Odeseye

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The sustainability of nations’ economies today have proven to be unrealistic in a constantly changing world without appropriate accordance to entrepreneurship role and its processes. This role has therefore proven to be a product of the available and discoverable opportunities by an individual/organisation in any pattern – innovation, discovery, diffusion, imitation amidst possible challenges. In light of these, this paper examined the relationship between opportunity development and entrepreneurial processes as well as the factors determining individual’s opportunity development and the success of entrepreneurial processes. Systematic review method was adopted for selecting relevant academic materials. The theoretical base of this paper was anchored on Schumpeter’s entrepreneurial innovation model and Drucker and Stevenson’s opportunity-based entrepreneurship theory. Based on the reviewed literature, it was discovered that rough business idea “opportunity” in any form – techniques/product encounter various obstacles to achieve its development, acceptability and sustainability. In essence, the findings revealed that the birth of every opportunity is as a result of the individual/organisation and environmental factors to be able to scale through the whole process successfully. Due to the outcome of this paper, it was recommended that the organisations/government should endeavour to create an enabling environment for a rough business idea to come to life amidst the hurdles of the entrepreneurial process.

Keywords: entrepreneurial process, entrepreneurship, opportunity, opportunity development, organisation, sustainability

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Authors: Hsueh Ping Peng

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End-stage renal disease most commonly occurs in the elderly population. Elderly people are approaching the end of their lives, and when facing major life-threatening situations, apart from aggressive medical treatment, they can also choose treatment methods such as hospice care to improve their quality of life. The purpose of this study was to investigate factors associated with the awareness and willingness to sign hospice and palliative care consent forms in elderly with end-stage renal disease. This study used both quantitative, cross-sectional study designs. In the quantitative section, 110 elderly patients (aged 65 or above) with end-stage renal disease receiving conventional hemodialysis were recruited as study participants from a medical center in Taipei City. Data were collected using structured questionnaires. Study tools included basic demographic data, questionnaires on the awareness and perception of hospice and palliative care, etc. After collecting the data, data analysis was conducted using SPSS 20.0 statistical software, including descriptive statistics, chi-square test, logistic regression, and other inferential statistics. The results showed that the average age of participants was 71.6 years old, more males than females, average years of dialysis was 6.1 years and most subjects rated their self-perceived health status as fair. Results of the study are summarized as follows: Elderly people with end-stage renal disease did not have sufficient knowledge and awareness about hospice and palliative care. Influencing factors included level of education, marital status, years of dialysis and age, etc. Demographic factors influencing the signing of consent forms included gender, marital status, and age, which all showed significant impacts. Factors taken into consideration when signing consent forms included awareness of hospice care, understanding the relevant definitions of hospice care, and understanding that consent may be modified or cancelled at any time; it was predicted that people who knew more about ways to receive hospice care or more related definitions were more willing to sign the consent forms. In the qualitative study section, 10 participants who signed the consent form, five male, and 5 female, between the ages of 65-90, have completed the semi-structured interviews. Analysis of the interviews revealed six themes: (1) passing away peacefully, (2) autonomy on arrangements of life and death, (3) unwillingness to increase family and social burden, (4) friends and relatives’ experience influencing the decision to give consent, (5) sharing information to facilitate the giving of consent, (6) facing each day with ease, to reflect the experience and factors of consideration for elderly with end-stage renal disease when signing consent forms. The results of this study provides the awareness, thoughts and feelings of elderly with end-stage renal disease on signing consent forms, and serve as a future reference for the dialysis unit to enhance the promotion of hospice and palliative care and related caregiving measures, thereby improving the quality of life and care for elderly people with end-stage renal disease.

Keywords: end-stage renal disease, hemodialysis, hospice and palliative care, awareness, willingness

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