Search results for: elderly abuse
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1044

Search results for: elderly abuse

864 Cold Tomato Paste as an Alternative Therapy for Elderly Clients with Exacerbation of Arthritis

Authors: Mary Therese G. Caluna, Mark Justin B. Campanero, Erlin Maris T. Cantiller, Claudine Mae A. Cantillo, Nerissa L. Caño

Abstract:

Objective: The study determined the effectiveness of cold tomato paste in relieving pain caused by exacerbation of arthritis in the elderly, specifically on clients 60 years old and above. The study focused on alternative, cost-effective and non-pharmacological techniques in relieving pain experienced by the older people with osteoarthritis and rheumatoid arthritis. Methods: Using purposive non-probability sampling, the researchers gathered a total number of 40 subjects that passed the inclusion criteria provided by the researchers. The subjects were divided into two groups, experimental group (20 subjects) and control groups (20 subjects). The Numeric Rating 11-point Scale (NRS-11) was utilized to assess the pain level of the subject prior the application of the treatment and after the application of the treatment. Key findings: There is a significant difference in the pain levels of the experimental group before and after the application of cold tomato paste. This indicates that that the application of cold tomato paste alleviates the pain experienced by elderly clients with exacerbation of arthritis. Conclusion: The effectiveness of cold tomato paste in relieving pain experienced by elderly clients who are in exacerbation of arthritis was proven to be evidence-based. The cold tomato paste application has significant impact in the field of nursing and therefore, can be used in both clinical trials and practices. The effectiveness of cold tomato application promotes innovation in the field of nursing, thus encouraging further researches regarding other uses of tomato and other herbal interventions to relieve the pain caused by osteoarthritis and rheumatoid arthritis.

Keywords: alternative therapy, arthritis, cold tomato paste, elderly clients, exacerbation

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863 Examining Media Literacy Strategies through Questionnaires and Analyzing the Behavioral Patterns of Middle-Aged and Elderly Persons

Authors: Chia Yen Li, Wen Huei Chou, Mieko Ohsuga, Tsuyoshi Inoue

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The evolution of the digital age has led to people’s lives being pervaded by both facts and misinformation, challenging media literacy (ML). Middle-aged and elderly persons (MEPs) are prone to disseminating large amounts of misinformation, which often endangers their lives due to erroneously believing such information. At present, several countries have actively established fact-checking platforms to combat misinformation, but they are unable to keep pace with the rapid proliferation of such information on social media. In this study, the questionnaire survey method was used to collect data on MEPs’ behavior, cognition, attitudes, and concepts of social media when using a mobile instant messaging app called LINE; analyze their behavioral patterns and reasons for sharing misinformation; and summarize design strategies for improving their ML. The findings can serve as a reference in future related research.

Keywords: media literacy, middle-aged and elderly persons, social media, misinformation

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862 Interior Designing Suggestions and Guidelines for Dementia Patients in Taiwan for Their Wellbeing

Authors: Rina Yadav, Lih-Yau Song

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The claim for elderly care center has increased enormously with the world demographic revolution as the number of senior citizens increased in the 21st century. As per the world progress into contemporaneousness, a large number of people are engaged in daily routine to bring about the senior citizens to lose the care that they in fact need. New design suggestions have been made on the basis of available guidelines and two case studies in Taiwan. Interior design can provide positive and sensory stimulation through memory stimulation, and by creating a friendly and comfortable environment for demented older people, which can reduce patient anxiety and reduce stress on caregivers. This report pursues to reveal the better design of an elderly care center with a new tactic in a direction to offer better service for demented elderly people which could upraise their living standard.

Keywords: daycare center, dementia patients, interior designing, older adults

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861 Activation-TV® to Reduce Elderly Loneliness and Insecurity

Authors: Hannele Laaksonen, Seija Nyqvist, Kari Nurmes

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Objectives: In the year 2011 the City of Vaasa started to develop know-how in the technology and the introduction of services for aging people in cooperation with the Polytechnic Novia University of Applied Sciences and VAMK, University of Applied Sciences. The project´s targets included: to help elderly people to maintain their ability to function, to provide them social and physical activities, to prevent their social exclusion, to decrease their feelings of loneliness and insecurity and to develop their technical know-how. Methods: The project was built based on open source code, tailor-made service system and user interface for the elderly living at home and their families, based on the users´ expectations and experiences of services. Activation-TV®-project vas carried out 1.4.2011-31.3.2014. A pilot group of eight elderly persons, who were living at home, were selected to the project. All necessary technical means as well as guidance and teaching equipment were provided to the pilot group. The students of University of Applied Sciences (VAMK, Novia) and employees of Center of Ageing were made all programs to the Activation-TV®. The project group were interviewed after and before intervention. The data were evaluated both qualitatively and quantitatively. Results: The built service includes a video library, a group room for interactive programs and a personal room for bilateral meetings and direct shipment. The program is bilingual and produced in both national languages. The Activation TV® reduced elderly peoples´ (n=8) feelings of emptiness, added mental well-being and quality of life with social contacts. Relatives felt, that they were able to get in to older peoples´ everyday life with Activation TV®. Discussion: The built application was tailored to the model that has not been developed elsewhere in Finland. This model can be copied from one server to another and thus transferred to other municipalities but the program requires its own personnel system management and maintenance as well as program production cooperation between the different actors. This service can be used for the elderly who are living at home without dementia.

Keywords: mental well-being, quality of life, elderly people, Finland

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860 “The Effectiveness of Group Logo Therapy on Meaning and Quality of Life of Women in Old Age Home”

Authors: Sophia Cyril Vincent

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Background: As per the Indian Census 2011, there is nearly 104 million elderly population aged above 60 years (53 million females and 51 males), and the count is expected to be 173 million by the end of 2026. Nearly 5.5% of women and 1.5% of men are living alone.1 In India, even though it is the moral duty of the children to take care of aged parents, many elders are landing in old age homes due to the social transformation factors like mushrooming of nuclear families, migration of children, cultural echoes, differences in mindset and values. Nearly 728 old age homes are seen across the country, out of which 78 old age homes with approximately 3000 inmates are seen only in Bangalore2. The existing literature shows that elderly women residing in old age homes experience the challenges like- loneliness, health issues, rejection from children, grief, death anxiety, etc, which leads to mental and physical wellbeing in numerous and tangible ways3. Hence the best and cost-effective way to improve the meaning and quality of life among elderly females is logotherapy, a type of psychotherapeutic analysis and treatment, motivating and driving force4 within the human experience to lead a decent life. Aim: The current research is aimed at studying the effectiveness of a logotherapy intervention on meaning and quality of life among elderly women of old age homes. Samples:200 women aged < 60 years and staying in the old age home for more than 1 year were randomly allocated to the control group and experimental group. Methodology: Using the Meaning in life questionnaire (MLQ)and the World health organization quality of life (WHOQOL) questionnaire, meaning and quality of life were assessed among both groups' women. Intensive Logotherapy and meaning in life program for five days were provided for the experimental group and the control group, with no treatment. Result: Under analysis. Conclusion: It is the right of the elderly woman to lead a happy and peaceful life till her death irrespective of the residing place. Hence, continuous monitoring and effective management are necessary for elderly women.

Keywords: quality of life, meaning of life, logo therapy, old age home

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859 Dermatological Study on Risk Factors for Pruritic Skin: Skin Properties of Elderly

Authors: Dianis Wulan Sari, Takeo Minematsu, Mikako Yoshida, Hiromi Sanada

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Introduction: Pruritus is diagnosed as itching without macroscopic abnormalities on skin. It is the most skin complaint of elderly people. In the present study, we conducted a dermatological study to examine the risk factors of pruritic skin and predicted how to prevent pruritus especially in the elderly population. Pruritus is caused several types of inflammation, including epidermal innate immunity based on keratinocyte responses and acquired immunity regulated by type 1 or 2 helper T (Th) cells. The triggers of pruritus differ among inflammation types, therefore we did separately assess the pruritus-associated factors of each inflammation type in an effort to contribute to the identification of intervention targets for preventing pruritus. Therefore, this study aimed to investigate the factors related with actual condition of pruritic skin by examine the skin properties. Method: This study was conducted in elderly population of Indonesian nursing home. Basic characteristics and behaviors were obtained by interview. The properties of pruritic skin were collected by examination of skin biomarker using skin blotting as novel method of non-invasive skin assessment method and examination of skin barrier function using stratum corneum hydration and skin pH. Result: The average age of participants was 74 years with independent status was 66.8%. Age (β = -0.130, p = 0.044), cumulative lifetime sun exposure (β = 0.145, p = 0.026), bathing duration (β = 0.151, p = 0.022), clothing change frequency (β = 0.135, p = 0.029), and clothing type (β = -0.139, p = 0.021) were risk factors of pruritic skin in multivariate analysis. Conclusion: Risk factors of pruritic skin in elderly population were caused by internal factors such as skin senescence and external factors such as sun exposure, hygiene care and skin care behavior.

Keywords: aging, hygiene care, pruritus, skin care, sun exposure

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858 Effects of Listening to Pleasant Thai Classical Music on Increasing Working Memory in Elderly: An Electroencephalogram Study

Authors: Anchana Julsiri, Seree Chadcham

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The present study determined the effects of listening to pleasant Thai classical music on increasing working memory in elderly. Thai classical music without lyrics that made participants feel fun and aroused was used in the experiment for 3.19-5.40 minutes. The accuracy scores of Counting Span Task (CST), upper alpha ERD%, and theta ERS% were used to assess working memory of participants both before and after listening to pleasant Thai classical music. The results showed that the accuracy scores of CST and upper alpha ERD% in the frontal area of participants after listening to Thai classical music were significantly higher than before listening to Thai classical music (p < .05). Theta ERS% in the fronto-parietal network of participants after listening to Thai classical music was significantly lower than before listening to Thai classical music (p < .05).

Keywords: brain wave, elderly, pleasant Thai classical music, working memory

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857 Gender Differences in the Impact and Subjective Interpretation of Childhood Sexual Abuse Survivors

Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera

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Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.

Keywords: abuse, child, gender differences, sexual

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856 Factors Influencing the Use of Psychoactive Substance among Senior Secondary Students in Ibadan South-West Local Government, Oyo State, Nigeria

Authors: Olajumoke Temilola Fatimat, Fasasi Fausat Kikelomo, Ishola Ganiyat Folasayo, Omayeka Mary

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Psychoactive substances are chemical substances that affect the normal functioning of the brain and cause changes in behavior, mood, and consciousness. Psychoactive substance abuse constitutes one of the most important risk–taking behavior among adolescents and young adults in secondary schools. The study, therefore, assessed the factors influencing the use of psychoactive substances among senior secondary students in Ibadan South–West Local Government Area, Oyo State. A descriptive non-experimental design was adopted; purposive and simple random sampling techniques were used to select 330 respondents, while questionnaires were used for data collection. The descriptive statistics of frequency count, percentages, inferential statistics of chi-square, and analysis of variance were used for the analysis. The results revealed that the majority of the respondents had heard of the term substance abuse before 226 (75.3%); it was also revealed that the majority of the respondents had good knowledge of psychoactive substances, 67.8%. There was no significant relationship between age and knowledge of psychoactive substances among senior secondary students, with a p-value of 0.199. The outcome of this study indicates that drug abuse is increasing day by day among secondary school students and may have greatly contributed to poor performance in examinations as well as undermining academic ability and performance among students. It was recommended that efforts should be made by the school authorities of the secondary schools in Ibadan South–West Local Government Area, Oyo State, and in Oyo State generally in collaboration with health personnel to educate adolescents on psychoactive substance abuse. This is to ensure that adolescents are adequately educated and updated on knowledge of psychoactive substance abuse.

Keywords: factors, influence, psychoactive substance, secondary school

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855 Effect of the Community Chair-Based Exercise Programme on the Balance of the Elderly in Hong Kong

Authors: Wai Sang Wu, Florence Pik Sze Mok

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Introduction: Ageing population is one of the hot topics nowadays in the world and this phenomenon is believed to exacerbate continuously in the future. According to the latest information from World Health Organization (WHO) in 2016, the proportion of people aged more than 60 years is projected to be doubled from 12% in 2015 to 22% in 2050 of the world's population. Similarly, according to figures released by the Census and Statistic Department of Hong Kong in 2015, the contribution of elderly aged more than 65 years olds is projected to increase from 15% in 2014 to 34% in 2064 in local community. On the other hand, falls in elderly is a common problem, and it can bring along many negative consequences among elders, such as reducing their mobility level as well as their quality of life. In addition, it can also increase the caring stress of their family caregivers and as well increase the reliance and burden on the medical care system of Hong Kong. Therefore, appropriate measures should be implemented in order to minimize the risk of fall among elders. The objective of this study is to evaluate the effectiveness of the chair-based exercise programme in affecting the balance of the elderly in Hong Kong. Methods: Thirteen healthy subjects (males = 2; females = 11; mean age: 76.2 ± 7.8 years old) were recruited from an elderly social centre in the community to participate in a structural chair-based exercise programme for 6 weeks (1 session per week; 60-minutes per session). Subjects were being assessed on their balance ability using three commonly used clinical assessments, namely, 1) single leg stance (SLS) test, 2) functional reach test, and 3) 360-degree turn test, before and after their participation in the chair-based exercise programme. Pre and post within-subject comparison was adopted to assess the effectiveness of the programme. Results: There was significant improvement (p < 0.05) in all balance parameters of the subjects after their participation in the exercise programme. Elderly demonstrated significant improvement in SLS (p < 0.012), functional reach (p < 0.030) and 360 degree turn (p < 0.043). Conclusions: This study showed that a community chair-based exercise programme is effective in improving the balance ability of the elders. It seems to be another exercise regime that should be promoted among the elders in order to minimize their risk of falls and its negative consequence.

Keywords: balance, chair-based exercise programme, community, elderly

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854 Development and Effects of Transtheoretical Model Exercise Program for Elderly Women with Chronic Back Pain

Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

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The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

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853 Electromyography Analysis during Walking and Seated Stepping in the Elderly

Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

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The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

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852 The Effect of Exercise on the Mental Health of Elderly People

Authors: Vivek Kumar

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The effects of physical activity on the human body have been well understood. It just not only keeps us healthy and away from many diseases but also helpful in delay ageing. Those who exercise every day are physically as well as mentally strong. As the age advance, we often see that there is a loss of memory in the elderly people and their retention power weaken with time. The association between physical health and mental health of elderly people nowadays is an important topic of research. Many people at their old age who all were suffering from Alzheimer or Parkinson disease or were at the stage of dementia have been benefited significantly on exercise at daily basis. We would conduct a randomized control trial, where we will select a number of old age people (65 years old or above). These selected old age people will have some sorts of mental illness and currently receiving treatment for the same. We will divide them into 3 groups. The first group of people will receive their normal treatment i.e. taking medicines. The second group of people will receive medicine as well as will do exercise for 45 minutes every day in the early morning, the 3rd group of people will do exercise everyday for 45 minutes but will be given placebo instead of medicine. All the member of these groups will be monitored carefully for 6 months of time and making this sure that all the members of the group are taking medicines or doing exercise according to the group they belong to. The mental status of all the participants will be measured; the data will be analyzed accordingly. Expected results- This research will be helpful in establishing the effect of exercise on the mental health of the old age people. Also, it will be examined that whether the medicines along with regular exercise for can months can cure the mental illness significantly.

Keywords: mental health, elderly people, physical activity, randomized control trial

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851 Probability Sampling in Matched Case-Control Study in Drug Abuse

Authors: Surya R. Niraula, Devendra B Chhetry, Girish K. Singh, S. Nagesh, Frederick A. Connell

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Background: Although random sampling is generally considered to be the gold standard for population-based research, the majority of drug abuse research is based on non-random sampling despite the well-known limitations of this kind of sampling. Method: We compared the statistical properties of two surveys of drug abuse in the same community: one using snowball sampling of drug users who then identified “friend controls” and the other using a random sample of non-drug users (controls) who then identified “friend cases.” Models to predict drug abuse based on risk factors were developed for each data set using conditional logistic regression. We compared the precision of each model using bootstrapping method and the predictive properties of each model using receiver operating characteristics (ROC) curves. Results: Analysis of 100 random bootstrap samples drawn from the snowball-sample data set showed a wide variation in the standard errors of the beta coefficients of the predictive model, none of which achieved statistical significance. One the other hand, bootstrap analysis of the random-sample data set showed less variation, and did not change the significance of the predictors at the 5% level when compared to the non-bootstrap analysis. Comparison of the area under the ROC curves using the model derived from the random-sample data set was similar when fitted to either data set (0.93, for random-sample data vs. 0.91 for snowball-sample data, p=0.35); however, when the model derived from the snowball-sample data set was fitted to each of the data sets, the areas under the curve were significantly different (0.98 vs. 0.83, p < .001). Conclusion: The proposed method of random sampling of controls appears to be superior from a statistical perspective to snowball sampling and may represent a viable alternative to snowball sampling.

Keywords: drug abuse, matched case-control study, non-probability sampling, probability sampling

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850 The Study of Self-Care Regarding to the Valuable Living in Thai Elderly

Authors: Pannathorn Chachvarat, Smarnjit Piromrun

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Aging is the reality for the future world. An urgent priority for the development of the elderlies’ quality living is needed. The promotion of quality the elderly to live longer in their dignity and being independence are essential. The objective of this descriptive research was to study the self-care regarding to the valuable living in Thai elderly. The randomized sample was 100 elderly who live in Muang district of Phayao province. The tools included 2 parts; 1) Personal data (gender, age, income, occupation, marital status, living condition and disease), and 2) the self-care regarding to the valuable living questionnaire consisted of 3 domains, physical (21items), spiritual (13 items) and social domain (12 items). The content validity tool was tested the IOC ranged between 0.60 – 1.00 and the reliability test, Cronbach Alpha was 0.82. The research found that; The most participants were female (60 %), Farmer (37%), and underlying disease (65 %). The range of age was 68 years. Overall of the self-care regarding to the valuable living of physical, spiritual and social were at the high level.The highest level of physical activities was self-taking bath twice a day (morning and evening), and slept at least 5-6 hours at night time.The highest level of spirit activities was a good member of the family, contributions to persons in family, good emotion. Additionally were enjoyable, accepting changes in the body such as the dry skin and the blurred vision, accepting the roles and duties in taking care of house and grandchildren, selecting the applicable activities and practice according to religious Buddhateachingfor the happiness and meditated life.The highest of the social activities were the good relationship between other elderlies and family members, happy to help social activities as of their capacity, and being happy to help other people who have problems.

Keywords: self-care, valuable living, elderly, Thai

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849 Violent, Psychological, Sexual and Abuse-Related Emergency Department Usage amongst Pediatric Victims of Physical Assault and Gun Violence: A Case-Control Study

Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

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848 Developmental Differences of Elementary School Children in Knowledge Acquisition Following a Sexual Abuse Prevention Program

Authors: Chrysanthi Nega, Fotini-Sonia Apergi

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Child sexual abuse (CSA) in Greece is a highly prevalent phenomenon and yet remains largely underreported. CSA can negatively impact cognitive, emotional and psychosocial development, as well as personality formation and capacity for initiation and maintenance of healthy interpersonal relationships. It is particularly important for school-based prevention programs to be implemented early in elementary school, as they are reportedly effective in lowering abuse incidences and providing knowledge for coping in threatening environments. The purpose of the current study was to test the effectiveness of a school-based CSA prevention program (Safe-Touches) on Greek elementary school students (grades 1-3, N=272) and explore the effect of age and time of testing (academic term). There was a significant effect of age in the knowledge of Inappropriate Touch, when comparing pre and post-intervention assessments, with third graders showing greatest gains in knowledge, followed by second and first graders. Time of testing during the academic year also had a significant effect, as first graders tested later in the school year, scored higher on knowledge of Inappropriate Touch. The findings of the current study provide insight into the optimal timing to implement CSA prevention programs. Exposure to such programs and incorporation in the school curricula could largely benefit children of the Greek community in terms of safety and awareness.

Keywords: child sexual abuse, Safe-Touches, school-based prevention, schooling

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847 Elderly for Elderly: The Role of Community Volunteer, a Case Study from the Great East Japan Earthquake and Tsunami in Kesennuma, Japan

Authors: Kensuke Otsuyama

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The United Nation World Conference on Disaster Risk Reduction was held in Sendai, Japan, in 2015 and priorities for actions until 2030 were adopted for the next 15 years. Although one of these priorities is to ‘build back better’, there is neither a consensus definition of better recovery, nor indicators to measure better recovery. However, the community is considered as a key driver of recovery nowadays, and participation is a key word for effective recovery. In order to understand more about participatory community recovery, the author investigated recovery from the Great East Japan Earthquake and Tsunami (GEJET) in Kesennuma, a severely affected city. The research sought to: 1) Identify the elements that contribute to better recovery at the community level, and 2) analyze the role of community volunteers for disaster risk reduction for better recovery. A Participatory Community Recovery Index (PCRI) was created as a tool to measure community recovery. The index adopts seven primary indicators and 20 tertiary indicators, including: socio-economic aspect, housing, health, environment, self-organization, transformation, and institution. The index was applied to nine districts in Kesennuma city. Secondary and primary data by questionnaire surveys with local residents’ organization leaders and interviews with crisis management department officials in city government were also obtained. The indicator results were transformed into scores among 1 to 5, and the results were shown for each district. Based on the result of PCRI, it was found that the s Local Social Welfare Council played an important role in facilitating better recovery, enhancing community volunteer involvement to allow elderly residents to initiate local volunteer work for more affected single-living elderly people. Volunteers for the elderly by the elderly played a crucial role to strengthen community bonding in Kesennuma. In this research, the potential of community volunteers and inter-linkage with DRR activities are discussed.

Keywords: recovery, participation, the great East Japan earthquake and tsunami, community volunteers

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846 Study on Environmental Capacity System of the Aged Care Villages Influenced by Tourists

Authors: Yuan Fang, Wang-Ming Li, Yi-Chen Ruan

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Rural healthy old-age care for urban elderly who go to surrounding villages on vacation is a new mode of old-age care in developed coastal areas of China. Such villages that receive urban elderly can be called old-caring villages. Due to the popularity of healthy old-age care in rural areas, more and more urban elderly people participate in the ranks of rural old-age care, resulting in excessive number of tourists in some old-caring villages, exceeding the carrying capacity of the village. Excessive passenger flow may damage the ecological environment, social environment, and facilities environment of the village, and even affect the development potential of the village pension industry. On the basis of on-site investigation and questionnaire survey, this paper summarizes the willingness and behavioral characteristics of the urban elderly population and finds that it will have a certain impact on the old-caring villages in the process of pension vacation in the aspects of ecology, construction, society, and economy. According to the influence of tourists, the paper constructs a system of capacity restriction factors of the old-caring villages, which includes four types: ecological environment capacity, policy environment capacity, perceived congestion capacity, and village service capacity, and fourteen specific indicators. It will provide a theoretical basis for reasonable control of the development scale of the old-caring villages.

Keywords: old-caring villages, restriction factors system, tourists' influence, environmental capacity

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845 The Mediation Effect of PTSD and Aggression on the Relationship of Childhood Physical Abuse and Suicidal Behavior in Homeless People

Authors: Jina Hong, Seongeun Ryu, Sungeun You

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Suicide rate among homeless people are much higher than one in the general population. The purpose of this study was to examine the mediating effect of PTSD and aggression in the relationship between childhood physical abuse and suicidal behavior among homeless people. One hundred one homeless were recruited from street and shelters in Korea. Face-to-face interviews were conducted by master’s level graduate students or facility employees of shelters. All participants completed the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Life History of Aggression Questionnaire (LHAQ), Primary Care PTSD (PC-PTSD), and Traumatic Life Events Questionnaire (TLEQ). The average age of homeless people participated in the study was 55.2 years (SD = 10.7) with the age range of 30 to 87. Results indicated that PTSD symptoms and aggression fully mediated the relationship between childhood physical abuse and suicidal behavior among the homeless. These findings suggest the need for trauma-informed care for the homeless, and warrant the need for psychological services for PTSD and aggression in order to reduce suicide risk among homeless people.

Keywords: aggression, homeless, PTSD, suicidal behavior

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844 Implementation of Hybrid Curriculum in Canadian Dental Schools to Manage Child Abuse and Neglect

Authors: Priyajeet Kaur Kaleka

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Introduction: A dentist is often the first responder in the battle for a patient’s healthy body and maybe the first health professional to observe signs of child abuse, be it physical, emotional, and/or sexual mistreatment. Therefore, it is an ethical responsibility for the dental clinician to detect and report suspected cases of child abuse and neglect (CAN). The main reasons for not reporting suspected cases of CAN, with special emphasis on the third: 1) Uncertainty of the diagnosis, 2) Lack of knowledge of the reporting procedure, and 3) Child abuse and neglect somewhat remained the subject of ignorance among dental professionals because of a lack of advance clinical training. Given these epidemic proportions, there is a scope of further research about dental school curriculum design. Purpose: This study aimed to assess the knowledge and attitude of dentists in Canada regarding signs and symptoms of child abuse and neglect (CAN), reporting procedures, and whether educational strategies followed by dental schools address this sensitive issue. In pursuit of that aim, this abstract summarizes the evidence related to this question. Materials and Methods: Data was collected through a specially designed questionnaire adapted and modified from the author’s previous cross-sectional study on (CAN), which was conducted in Pune, India, in 2016 and is available on the database of PubMed. Design: A random sample was drawn from the targeted population of registered dentists and dental students in Canada regarding their knowledge, professional responsibilities, and behavior concerning child abuse. Questionnaire data were distributed to 200 members. Out of which, a total number of 157 subjects were in the final sample for statistical analysis, yielding response of 78.5%. Results: Despite having theoretical information on signs and symptoms, 55% of the participants indicated they are not confident to detect child physical abuse cases. 90% of respondents believed that recognition and handling the CAN cases should be a part of undergraduate training. Only 4.5% of the participants have correctly identified all signs of abuse due to inadequate formal training in dental schools and workplaces. Although nearly 96.3% agreed that it is a dentist’s legal responsibility to report CAN, only a small percentage of the participants reported an abuse case in the past. While 72% stated that the most common factor that might prevent a dentist from reporting a case was doubt over the diagnosis. Conclusion: The goal is to motivate dental schools to deal with this critical issue and provide their students with consummate training to strengthen their capability to care for and protect children. The educational institutions should make efforts to spread awareness among dental students regarding the management and tackling of CAN. Clinical Significance: There should be modifications in the dental school curriculum focusing on problem-based learning models to assist graduates to fulfill their legal and professional responsibilities. CAN literacy should be incorporated into the dental curriculum, which will eventually benefit future dentists to break this intergenerational cycle of violence.

Keywords: abuse, child abuse and neglect, dentist knowledge, dental school curriculum, problem-based learning

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843 Direct and Indirect Effects of Childhood Traumas, Emotion Regulation Difficulties and Age on Tendency to Violence

Authors: Selin Kara-Bahçekapılı, Bengisu Nehir Aydın

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Objective: In this study, it is aimed to examine the relationship between childhood traumas (overprotection-control, emotional/physical/sexual abuse, emotional/physical neglect), age, emotional regulation difficulties, and the tendency of violence in adults. In the study, the direct and indirect effects of 6 sub-factors of childhood traumas, emotion regulation difficulties, and age on tendency to violence are evaluated on a model that theoretically reveals. Method: The population of this cross-sectional study consists of individuals between the ages of 18-65 living in Turkey. The data from 527 participants were obtained by online surveys and convenience sampling method within the scope of the study. As a result of exclusion criteria and then outlier data analysis, the data of 443 participants were included in the analysis. Data were collected by demographic information form, childhood trauma scale, emotion regulation difficulty scale, and violence tendency scale. Research data were analyzed by SPSS and AMOS using correlation, path analysis, direct and indirect effects. Results: According to the research findings, the variables in the model explained 28.2% of the variance of the mean scores of the individuals' tendency to violence. Emotion regulation difficulties have the most direct effect on the tendency to violence (d=.387; p<.01). The effects of excessive protection and control, emotional neglect, and physical neglect variables on the tendency to violence are not significant. When the significant and indirect effects of the variables on tendency to violence over emotion regulation difficulties are examined, age has a negative effect, emotional neglect has a positive effect, emotional abuse has a positive effect, and overprotection-control has a positive effect. The indirect effects of sexual abuse, physical neglect, and physical abuse on tendency to violence are not significant. Childhood traumas and age variables in the model explained 24.1% of the variance of the mean scores of the individuals’ emotion regulation difficulties. The variable that most affects emotion regulation difficulties is age (d=-.268; p<.001). The direct effects of sexual abuse, physical neglect, and physical abuse on emotion regulation difficulties are not significant. Conclusion: The results of the research emphasize the critical role of difficulty in emotion regulation on the tendency to violence. Difficulty in emotion regulation affects the tendency to violence both directly and by mediating different variables. In addition, it is seen that some sub-factors of childhood traumas have direct and/or indirect effects on the tendency to violence. Emotional abuse and age have both direct and indirect effects on the tendency to violence over emotion regulation difficulties.

Keywords: childhood trauma, emotion regulation difficulties, tendency to violence, path analysis

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842 Emergency Surgery in the Elderly, What Particularities

Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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841 Quality of Life of Elderly People in Urban West Bengal, India

Authors: Debalina Datta, Pratyaypratim Datta, Kunal Kanti Majumdar

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Introduction: In India 8.1% of total population is elderly. The standard of living and meaningfulness of life are indirectly measured by assessing quality of life of elderly. So, it is important to improve quality of life. Quality of life is an individual’s understanding of his/ her life situation with respect to his/ her values and cultural context as well as in relation to his/her goals, expectations and concerns. The present study was planned to assess the quality of life of geriatric people in urban West Bengal, India. Materials and methods: It was a community based cross sectional observational study conducted among people aged 60 years and above in Kolkata and Sonarpur region of West Bengal, India. Data collection was done by house to house visit using Quality of Life- BREF questionnaire (WHOQOL-BERF) developed by WHO. Analysis of quality of life of physical, psychological, social relationship and environmental domain was done using SPSS (version 16.0). Results: Transformed score (0-100 scale) was used for each domain. Mean of physical, psychological, social relationship and environmental domain were found to be 42.25, 40.84, 39.62 and 48.36 respectively. There was no significant difference in score between Kolkata and Sonarpur people in any domain except social relationship domain, where people living at Sonarpur scored significantly better. Conclusion: Rehabilitation of old age people can be done by improving their quality of life. Social interaction with people of all ages, allowing them to take important family decision, engaging them in different social activities can help a lot.

Keywords: quality of life, elderly, Urban West Bengal, India

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840 Conservative Treatment Versus Percutaneous Wire Fixation in treatment of Distal Radial Fracture in Elderly

Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim

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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.

Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic

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839 Analyzing the Effectiveness of Elderly Design and the Impact on Sustainable Built Environment

Authors: Tristance Kee

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With an unprecedented increase in elderly population around the world, the severe lack of quality housing and health-and-safety provisions to serve this cohort cannot be ignored any longer. Many elderly citizens, especially singletons, live in unsafe housing conditions with poorly executed planning and design. Some suffer from deteriorating mobility, sight and general alertness and their sub-standard living conditions further hinder their daily existence. This research explains how concepts such as Universal Design and Co-Design operate in a high density city such as Hong Kong, China where innovative design can become an alternative solution where government and the private sector fail to provide quality elderly friendly facilities to promote a sustainable urban development. Unlike other elderly research which focuses more on housing policies, nursing care and theories, this research takes a more progressive approach by providing an in-depth impact assessment on how innovative design can be practical solutions for creating a more sustainable built environment. The research objectives are to: 1) explain the relationship between innovative design for elderly and a healthier and sustainable environment; 2) evaluate the impact of human ergonomics with the use of universal design; and 3) explain how innovation can enhance the sustainability of a city in improving citizen’s sight, sound, walkability and safety within the ageing population. The research adopts both qualitative and quantitative methodologies to examine ways to improve elderly population’s relationship to our built environment. In particular, the research utilizes collected data from questionnaire survey and focus group discussions to obtain inputs from various stakeholders, including designers, operators and managers related to public housing, community facilities and overall urban development. In addition to feedbacks from end-users and stakeholders, a thorough analysis on existing elderly housing facilities and Universal Design provisions are examined to evaluate their adequacy. To echo the theme of this conference on Innovation and Sustainable Development, this research examines the effectiveness of innovative design in a risk-benefit factor assessment. To test the hypothesis that innovation can cater for a sustainable development, the research evaluated the health improvement of a sample size of 150 elderly in a period of eight months. Their health performances, including mobility, speech and memory are monitored and recorded on a regular basis to assess if the use of innovation does trigger impact on improving health and home safety for an elderly cohort. This study was supported by district community centers under the auspices of Home Affairs Bureau to provide respondents for questionnaire survey, a standardized evaluation mechanism, and professional health care staff for evaluating the performance impact. The research findings will be integrated to formulate design solutions such as innovative home products to improve elderly daily experience and safety with a particular focus on the enhancement on sight, sound and mobility safety. Some policy recommendations and architectural planning recommendations related to Universal Design will also be incorporated into the research output for future planning of elderly housing and amenity provisions.

Keywords: elderly population, innovative design, sustainable built environment, universal design

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838 Religiosity and Social Factors on Alcohol Use among South African University Students

Authors: Godswill Nwabuisi Osuafor, Sonto Maria Maputle

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Background: Abounding studies found that religiosity and social factors modulate alcohol use among university students. However, there is a scarcity of empirical studies examining the protective effects of religiosity and other social factors on alcohol use and abuse in South African universities. The aim of this study was therefore to assess the protective effects of religiosity and roles of social factors on alcohol use among university students. Methodology: A survey on the use of alcohol among 416 university students was conducted using structured questionnaire in 2014. Data were sourced on religiosity and contextual variables. Students were classified as practicing intrinsic religiosity or extrinsic religiosity based on the response to the measures of religiosity. Descriptive, chi square and binary logistic analyses were used in processing the data. Result: Results revealed that alcohol use was associated with religiosity, religion, sex, family history of alcohol use and experimenting with alcohol. Reporting alcohol abuse was significantly predicted by sex, family history of alcohol use and experimenting with alcohol. Religiosity mediated lower alcohol use whereas family history of alcohol use and experimenting with alcohol promoted alcohol use and abuse. Conclusion: Families, religious groups and societal factors may be the specific niches for intervention on alcohol use among university students.

Keywords: religiosity, alcohol use, protective factors, university students

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837 World War II Vaccination Scheme as a Determinant of Gender-Specific Differences in Anti-Tetanus Antibody Levels in the British Elderly Population

Authors: Myrto Vlazaki

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Tetanus is a non-transmissible, preventable bacterial disease with high mortality. In the U.K., the demographic group systematically accounting for a large proportion of the infections notified to the authorities over the years have been the elderly (> 60 years old). The 2009 seroepidemiological study for tetanus in England reports a gender-age interaction for the +70, with males having significantly higher anti-tetanus antibody levels than females. A systematic review of the literature was carried out to characterise: I. the seroepidemiology of tetanus in economically developed countries with similar immunisation schemes to the U.K., introduced in the 1960’s. II. the factors leading to differential vaccine uptake between males and females in 1910-1945 (corresponding to ages of 60-95 in 2005). III. the immune response elicited by anti-tetanus immunisation in males and females IV. the value of catch-up immunisation in the elderly Similar age- and gender- differences in anti-tetanus antibody levels are noted in other countries. Gender differences in immune responses elicited by vaccination are not consistent with the finding that elder females are less well protected against tetanus compared to their male counterparts. Attention is drawn to the selective anti-tetanus immunisation scheme introduced in the U.K. in 1938, specific to the World War II conscripts. The age-specific immunity gap observed amongst the +70 could be explained as the by-product of that early scheme targetting mostly males. Introducing anti-tetanus vaccination in the +70 in the U.K. could help bridge the immunity gap between males and females and reduce the overall tetanus susceptibility of this age group.

Keywords: elderly, immunisation, gender-specific differences, seroepidemiology, tetanus, World War II

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836 Investigation of Online Child Sexual Abuse: An Account of Covert Police Operations Across the Globe

Authors: Shivalaxmi Arumugham

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Child sexual abuse (CSA) has taken several forms, particularly with the advent of internet technologies that provide pedophiles access to their targets anonymously at an affordable rate. To combat CSA which has far-reaching consequences on the physical and psychological health of the victims, a special act, the Protection of Children from Sexual Offences (POCSO) Act, was formulated amongst the existing laws. With its latest amendment criminalizing various online activities about child pornography also known as child sexual abuse materials in 2019, tremendous pressure is speculated on law enforcement to identify offenders online. Effective investigations of CSA cases help in not only to detect perpetrators but also in preventing the re-victimization of children. Understanding the vulnerability of the child population and that the offenders continue to develop stealthier strategies to operate, it is high time that traditional investigation, where the focus is on apprehending and prosecuting the offender, must make a paradigm shift to proactively investigate to prevent victimization at the first place. One of the proactive policing techniques involves understanding the psychology of the offenders and children and operating undercover to catch the criminals before a real child is victimized. With the fundamental descriptive approach to research, the article attempts to identify the multitude of issues associated with the investigation of child sexual abuse cases currently in practice in India. Then, the article contextualizes the various covert operations carried out by numerous law enforcement agencies across the globe. To provide this comprehensive overview, the paper examines various reports, websites, guidelines, protocols, judicial pronouncements, and research articles. Finally, the paper presents the challenges and ethical issues that are to be considered before getting into undercover operations either in the guise of a pedophile or as a child. The research hopes to contribute to the making of standard operating protocols for investigation officers and other relevant policymakers in this regard.

Keywords: child sexual abuse, cybercrime against children, covert police operations, investigation of CSA

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835 Experience Marketing and Behavioral Intentions: An Exploratory Study Applied to Middle-Aged and Senior Pickleball Participated in Taiwan

Authors: Yi Yau, Chia-Huei Hsiao

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The elderly society is already a problem of globalization, and Taiwan will enter a super-aged society in 2025. Therefore, how to improve the health of the elderly and reduce the government's social burden is an important issue at present. Exercise is the best medical care, and it is also a healthy activity for people to live a healthy life. Facing the super-aged society in the future, it is necessary to attract them to participate in sports voluntarily through sports promotion so that they can live healthy and independent lives and continue to participate in society to enhance the well-being of the elderly. Experiential marketing and sports participation are closely related. In the past, it was mainly aimed at consumer behavior at the commercial level. At present, there are not many study objects focusing on participant behavior and middle-aged and elderly people. Therefore, this study takes the news emerged sport-Pickleball that has been loved by silver-haired people in recent years as the research sport. It uses questionnaire surveys and intentional sampling methods. The purpose of the group is to understand the middle-aged and elderly people’s experience and behavior patterns of Pickleball, explore the relationship between experiential marketing and participants' intentional behaviors, and predict which aspects of experiential marketing will affect their intentional behaviors. The findings showed that experience marketing is highly positively correlated with behavioral intentions, and experience marketing has a positive predictive power for behavioral intentions. Among them, "ACT" and "SENSE" are predictive variables that effectively predict behavioral intentions. This study proves the feasibility of pickleball for middle-aged and senior sports. It is recommended that in the future curriculum planning, try to simplify the exercise steps, increase the chances of contact with the sphere, and enhance the sensory experience to enhance the sense of success during exercise, and then generate exercise motivation, and ultimately change the exercise mode or habits and promote health.

Keywords: newly emerged sports, middle age and elderly, health promotion, ACT, SENSE

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