Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators' attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.
In order to practically activate women's policies, it is necessary above all to develop programs for women's empowerment and to activate women's centers, which serve as a base for promoting women's welfare. To this end, the problems of the Women's Center were considered, and the history, function, and operation aspects of the Gyeonggi Women's Center were analyzed. Looking at the results of the analysis, first, the Gyeonggi Women's Center uses its current functions to spread the awareness of gender equality, and in order to promote women's social activities and welfare, it is necessary to integrate functions and form a network from a paradigm perspective. Second, in order for the Gyeonggi Women's Center to take the lead in the role of an integrated community center, it is necessary to explore the vitalization of city and county networks. Third, the development and support of internal and external resources is necessary to establish women's governance, and the Gyeonggi Women's Center needs to be responsible for the coordinator's role. Fourth, Gyeonggi Women's Center should strive to resolve regional imbalances through close communication with the Gyeonggi Women's Center Council. Based on the results of this analysis, a plan for the Gyeonggi Women's Center was suggested.
The study examined the mediating effect of internalized shame on the relationship between affiliate stigma and interpersonal anxiety among adolescents with siblings who had autism spectrum disorder (ASD) and the moderated mediating effect of mother-adolescent communication openness. The participants consisted of 139 adolescents (boys 48.9%, high-school students 79.8%) who had siblings with ASD. Interpersonal anxiety, affiliate stigma, internalized shame, and mother-adolescent communication openness were measured using the Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998), the Affiliate Stigma Scale (Mak & Cheung, 2008), the Internalized Shame Scale (Cook, 1988), and the Parent-Adolescent Communication Scale (Barnes & Olson, 1982), respectively. The data were analyzed using descriptive statistics and Pearson's correlation coefficients. Process Macro Models 4 and 7 were used to examine the mediating effect and the moderated mediating effect. The results indicated that internalized shame mediated the effect of affiliate stigma on interpersonal anxiety among adolescents who had siblings with ASD. However, there was no significant moderated mediating effect of mother-adolescent communication openness on the relationship between affiliate stigma, internalized shame and interpersonal anxiety. These findings suggest that it is necessary to improve social awareness of individuals with ASD and their family members to prevent adolescents who have siblings with ASD from having affiliate stigma and to help them reduce interpersonal anxiety. The results also highlight the importance of counseling programs for adolescents with siblings with ASD as a way of preventing or alleviating their interpersonal anxiety by reducing internalized shame, even where they experience affiliate stigma.
Ayman Hasan Asfoor;Hairoladenan kasim;Aliza Binti Abdul Latif;Fiza Binti Abdul Rahim
Asia pacific journal of information systems
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v.33
no.4
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pp.863-898
/
2023
Previous studies have shown that insiders pose risks to the security of organisations' secret information. Information security policy (ISP) intentional violation can jeopardise organisations. For years, ISP violations persist despite organisations' best attempts to tackle the problem through security, education, training and awareness (SETA) programs and technology solutions. Stopping hacking attempts e.g., phishing relies on personnel's behaviour. Therefore, it is crucial to consider employee behaviour when designing strategies to protect sensitive data. In this case, organisations should also focus on improving employee behaviour on security and creating positive security perceptions. This paper investigates the role of psychological capital (PsyCap), punishment and organisational security resources in influencing employee behaviour and ultimately reducing ISP violations. The model of the proposed study has been modified to investigate the connection between self-efficacy, resilience, optimism, hope, perceived sanction severity, perceived sanction certainty, security response effectiveness, security competence and ISP violation. The sample of the study includes 364 bank employees in Jordan who participated in a survey using a self-administered questionnaire. The findings show that the proposed approach acquired an acceptable fit with the data and 17 of 25 hypotheses were confirmed to be correct. Furthermore, the variables self-efficacy, resilience, security response efficacy, and protection motivation directly influence ISP violations, while perceived sanction severity and optimism indirectly influence ISP violations through protection motivation. Additionally, hope, perceived sanction certainty, and security skills have no effect on ISP infractions that are statistically significant. Finally, self-efficacy, resiliency, optimism, hope, perceived severity of sanctions, perceived certainty of sanctions, perceived effectiveness of security responses, and security competence have a substantial influence on protection motivation.
Mihyun Chung;Oakyoung Han;Kapsu Kim;Seungki Shin;Jaehyoun Kim
Journal of Internet Computing and Services
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v.24
no.6
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pp.57-64
/
2023
This study analyzed the perceptions of elementary and secondary school teachers regarding the importance of SW/AI education in fostering students' fundamental knowledge and the necessity of integrating SW/AI into education. A total of 830 elementary and secondary school teachers were selected as study subjects using the judgment sampling method. The analysis of survey data revealed that elementary and secondary teachers exhibited a strong awareness of the importance and necessity of SW/AI education, irrespective of school characteristics, region, educational experience, or prior involvement in SW and AI education. Nevertheless, the primary reasons for not implementing SW/AI education were identified as excessive workload and a lack of pedagogical expertise. An analysis of opinions on the essential conditions for implementing SW/AI education revealed that workload reduction, budget support, teacher training to enhance teacher competency, content distribution, expansion of subject-linked courses, and dedicated instructional time allocation were the major influencing factors. These findings indicate a significant demand for comprehensive instructional support and teacher capacity-building programs.
The Journal of the Convergence on Culture Technology
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v.9
no.6
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pp.419-427
/
2023
This study attempted to provide basic data for developing strategies to improve the multicultural efficacy of nursing university students by identifying the mediating effect of emotional intelligence on the relationship between multicultural perception and multicultural efficacy of nursing university students. The subjects of the study were 179 nursing students at two universities in J province and G city. The SPSS/23.0 program was used to analyze the data with descriptive statistics; an independent t-test, analysis of variance ANOVA, Pearson's correlation coefficient, and mediating effect analysis were performed using Process Macro 4.0. As a result of the study, nursing students multicultural efficacy was found to be positively correlated with multicultural awareness(r=.596, p<.001) and a positive correlation with emotional intelligence(r=.620, p<.001). Emotional intelligence showed a mediating effect on the relationship between multicultural perception and multicultural efficacy(β=.471, p<.001). Based on the results of this study, it is necessary to development and apply systematic programs to increase multicultural perception and increase emotional intelligence for improving the multicultural efficacy of nursing university students.
The Journal of Korean Academic Society of Nursing Education
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v.30
no.1
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pp.61-70
/
2024
Purpose: This study aimed to identify the factors influencing nursing students' intentions to report child abuse. Methods: The participants of this study were 151 nursing students who were currently enrolled in nursing departments in Korea and who were at least 18 years of age or older. This study used a descriptive cross-sectional design, and the data were collected from February 16, to March 13, 2023, using an online self-administered survey. The questionnaire included general characteristics, empathy ability, child rights recognition, child abuse perception, and intention to report child abuse. The data were analyzed with descriptive statistics, an independent t-test, one-way ANOVA, Scheffé test, and multiple regression analysis using SPSS Statistics 29.0. Results: The intention to report child abuse showed statistically significant positive correlations with empathy ability (r=.23, p<.001), child rights recognition (r=.34, p<.001), and child abuse perception (r=.63, p<.001). In the multiple regression analysis, the factors significantly related to nursing students' intention to report child abuse were as follows: awareness of mandatory reporting (yes) (β=.16, p=.021) and child abuse perception (β=.56, p<.001). The explanatory power of these factors was 45.0% (F=20.03, p<.001). Conclusion: Considering the findings of this study, it is necessary to develop and implement educational programs for improving the perception of child abuse and thus enhancing nursing students' intention to report child abuse.
Su Su Hlaing;Satoko Kubota;Kohei Makita;Ye Tun Win;Hnin Thidar Myint;Hiroichi Kono
Animal Bioscience
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v.37
no.3
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pp.547-554
/
2024
Objective: This study aimed to identify the relationship between bovine brucellosis prevalence, farmers' knowledge, attitude, practice (KAP), and social factors on migratory draft cattle and smallholder dairy farms in the central dry zone of Myanmar. Methods: This cross-sectional study was conducted on 54 migratory and 38 dairy cattle farms between August 2020 and February 2021. A structured questionnaire was used to identify farmers' behaviors. Bulk milk was sampled and tested using indirect enzyme-linked immunosorbent assay (I-ELISA). STATA 17 was used for all the analyses. Results: Migratory cattle farms had a higher farm level brucellosis prevalence (14.8%) than dairy farms (2.6%; χ2 = 3.75; df = 1; p = 0.05). Only 2.8% of the farmers had knowledge about brucellosis, while 39.1% and 41.6% had attitudes and farm practices with respect to brucellosis, respectively in the study area. Socio-economic attribute of training in animal husbandry (p<0.01), raising system (p<0.01), practice of separating the aborted cow (p<0.01) were negatively associated to brucellosis. The overall farm level brucellosis prevalence was strongly associated with cattle herd size (p = 0.01), free movement grazing practices (p<0.01), practice of self-removal of placental debris without using personal protective equipment (p<0.01) and farmers' attitudes towards eating cow placenta debris (p<0.01). Conclusion: Farmers had little knowledge of brucellosis. Attitudes and practices differed significantly between migratory and dairy farmers. Training and extension programs are necessary to make farmers aware of their KAP situation since livestock migration and the custom of eating cow placental debris contribute to the spread of brucellosis. Persistent efforts are required to reduce the adverse effects of brucellosis. Therefore, the study suggests that a feasible control intervention and public awareness campaigns need to be conducted regarding methods of preventing human exposure to brucellosis.
International Journal of Computer Science & Network Security
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v.24
no.3
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pp.135-141
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2024
The article examines the key constants of reengineering the modern educational cluster, associated with the processes of digital transformation of all spheres of modern socio-cultural space. The first constant is the strategic rethinking of the educational process organization and awareness of the new roles of all participants (tutors, applicants, controlling elements, etc.). The other constant involves practical re-design of the system of educational services, which consists in the reorientation from the traditional model of education functioning for society to the implementation of the educational format in the form of new projects (structural, target, business). Consequently, the purpose of the study is to highlight the attitudes relevant to the modern realities of information and technological support of education in the context of socio-economic interactions of society. The criteria for the reengineering of educational concepts and the structural organization of the educational sphere are defined. The modern world is going through a period of complete digital transformation of all spheres of public activity. The scientific intelligence notes that education is no exception in these processes, as the dependence of educational realities on information and computer technologies is now noted. The COVID-19 pandemic, for all its tragedy, was also a kind of trigger, clearly marking the new components that have become defined in the organization of the educational process. The conclusion is made that the use of digital technologies in the organization of the educational institution or in the organization of the educational process has become not an auxiliary element, but a dominant factor. Mobility, dynamism, interdisciplinarity, synergy - all these aspects are relevant for socio-economic interactions of society and should be provided by educational programs. The results of the study can be used in the reorganization processes of educational institutions and institutions. Further research requires aspects of the analysis of the foreign experience of reengineering in education, carried out taking into account digital transformations of modern sociocultural space.
Objectives: The Chepang people, an indigenous ethnic group in Nepal, experience substantial marginalization and socioeconomic disadvantages, making their communities among the most vulnerable in the region. This study aimed to determine the prevalence and factors associated with adolescent pregnancy in the Chepang communities of Raksirang Rural Municipality, Makwanpur District, Bagmati Province, Nepal. Methods: A cross-sectional study was conducted from October 2022 to April 2023 among 231 Chepang women selected using simple random sampling from Raksirang Rural Municipality. A semi-structured questionnaire was used for interviewing the mothers. Bivariate and multivariate logistic regression analyses were performed, using odds ratios with 95% confidence intervals (CIs). Variables with a variation inflation factor of more than 2 and a p-value of more than 0.25 were excluded from the final model. Results: The study revealed that the prevalence rate of adolescent pregnancy among Chepang women was 71.4% (95% CI, 65.14 to 77.16). A large percentage of participants (72.7%) were married before the age of 18 years. Poor knowledge of adolescent pregnancy (adjusted odds ratio [aOR], 10.3; 95% CI, 8.42 to 14.87), unplanned pregnancy (aOR, 13.3; 95% CI, 10.76 to 19.2), and lack of sex education (aOR, 6.57; 95% CI, 3.85 to 11.27) were significantly associated with adolescent pregnancy. Conclusions: The prevalence of adolescent pregnancy among the Chepang community was high. These findings highlighted the importance of raising awareness about the potential consequences of adolescent pregnancy and implementing comprehensive sexuality education programs for preventing adolescent pregnancies within this community.
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