Free Membership Research Articles

Rationale and design of the KP ENRICH trial: A food is medicine intervention in low-income high-risk adults with diabetes within Kaiser Permanente

BackgroundFood insecurity is associated with poor glycemic control and increased risk for diabetes-related complications. The clinical benefit of addressing these challenges through a medically supportive grocery prescription (GRx) program in patients with type 2 diabetes mellitus (T2D) remains unclear. We report the aims and design of a randomized clinical trial to evaluate the effectiveness of a 6-month GRx intervention on hemoglobin A1c (HbA1c) levels among low-income adults with T2D. MethodsThe Kaiser Permanente Evaluating Nutritional Interventions in Food-Insecure High-Risk Adults (KP ENRICH) Study is a pragmatic randomized trial enrolling 1100 participants within Kaiser Permanente Northern California and Southern California, two integrated health care delivery systems serving >9 million members. Medicaid-insured adults with T2D and baseline HbA1c ≥7.5% will be randomized at a 1:1 ratio to either GRx, delivered as $100 per month for select items from among a curated list of healthful food groups in an online grocery ordering and home-delivery platform along with biweekly digital nutrition educational materials, or control, consisting of free membership and deliveries from the online grocery platform but without curated food groups or purchasing dollars. The primary outcome is 6-month change in HbA1c. Secondary outcomes include 12-month change in HbA1c, and 6- and 12-month change in medical resource utilization, food security, nutrition security, dietary habits, diabetes-related quality of life, and dietary self-efficacy. ConclusionsThe results of this large randomized clinical trial of GRx will help inform future policy and health system-based initiatives to improve food and nutrition security, disease management, and health equity among patients with T2D.

Validation of a Community-Based Approach Toward Personalized Dementia Risk Reduction: The Kimel Family Centre for Brain Health and Wellness

Background/ObjectivesThe Kimel Family Centre for Brain Health and Wellness is a research-driven community centre testing the efficacy of personalized dementia risk reduction programming on dementia risk and cognition. The objective of this protocol is to validate this approach by following people for two years.Design/SettingParticipants will receive a comprehensive dementia risk assessment, including nonmodifiable and modifiable risk factors, from which they will receive a Personalized Dementia Risk Report and Program Strategy, indicating their health conditions increasing and their risk level in five modifiable risk domains: physical activity, brain-healthy eating, cognitive engagement, social connections, and mental wellbeing. Equipped with this information, participants will enroll in programs within the Centre to address their risk factors. Changes to their dementia risk, cognition, and Personalized Program Strategy will be communicated through re-assessments of risk factors every six months (risk and cognition) and every year (comprehensive assessment).ParticipantsParticipants (n = 450) will be 50 years of age or older, without a diagnosis of dementia, and sufficiently fluent in English to complete the assessments and understand program instructors. One goal is that our participant sample will include people of low income (with fundraising providing free community centre membership), and from various ethnoracial backgrounds.InterventionParticipants will select programs to meet their Personalized Program Strategy. For physical activity, they will gradually work toward the Canadian Society for Exercise Physiology guidelines. For brain-healthy eating, they will learn about the Brain Health Food Guide and food label reading, and then take additional programs. For cognitive engagement and mental wellbeing, they will take at least one hour of relevant programming per week. Social connections will be reinforced throughout all programs. All participants will also have access to the Canadian Consortium on Neurodegeneration’s CAN-THUMBS Up online, educational program on modifiable dementia risk factors, called Brain Health PRO.MeasurementsThe comprehensive assessment includes numerous dementia risk factors, but the primary measures are risk in the five domains, health conditions proximal to those five risk domains, and cognition, and how these are affected by adherence and quality of goal-directed future simulation. We hypothesize a reduced risk in the five domains within six months, improvements in health biomarkers within a year, and maintenance of cognition within two years, with these benefits accruing with greater adherence, but only up to a point, at which benefits will plateau, and greater benefits among participants whose goal-directed simulations are more vivid, personally-relevant, achievable, and positive.ConclusionsThis innovative approach overcomes a number of limitations present in prior multidomain dementia prevention trials. Adapting a preference clinical trial that is embedded in a community centre, where participants have autonomy to choose programs to address their modifiable dementia risk factors, has real-world applicability in the global effort to reduce dementia risk.

A Study of Indonesian Perspectives on the Future of the South China Sea: Navigating the Dynamics of Asymmetric Warfare

This article explores the shifting global dynamics, focusing on the rise of East Asia, particularly China, and its impact on the Asia Pacific region. The South China Sea (SCS) emerges as a critical area with territorial disputes, notably China's assertive claims and the U.S.'s involvement, leading to heightened tensions. Indonesia's strategic position becomes pivotal in navigating these geopolitical shifts. The analysis emphasizes Indonesia's role in promoting a peaceful SCS region through its free and active policy and ASEAN membership. The Kantian Triangle, rooted in Liberalism theory, serves as a conceptual framework, highlighting the importance of democracy, economic interdependence, and international organizations in conflict resolution. Indonesia's engagement in regional organizations, especially ASEAN, is crucial for resolving SCS conflicts. The ASEAN Outlook On The Indo-Pacific (AOIP) reflects a commitment to inclusive cooperation, prioritizing shared interests. The article underscores Indonesia's efforts to balance relations with the U.S. and China through economic cooperation, contributing to regional stability. Indonesia's economic ties with both nations, guided by the principles of the Kantian Triangle, aim to foster cooperation and reduce the potential for conflict in the SCS. In conclusion, Indonesia's strategic positioning and active diplomatic role positions it as a key mediator, contributing to lasting peace in the SCS amidst the competition between major powers.

Population-based interventions for preventing falls and fall-related injuries in older people.

Population-based interventions for preventing falls and fall-related injuries in older people.

The impacts of U.S. right‐to‐work laws on free riding, unionization, and compensation

AbstractRight‐to‐work (RTW) laws are theorized to precipitate union decline by inducing free riding among union‐covered workers; however, this relationship has not been empirically explored. This paper uses recent policy variation and Current Population Survey (CPS) data to identify the impact of state RTW laws on union status (free riding, membership, and coverage), wages, and benefits among private and public sector workers. Doubly robust difference‐in‐difference estimates suggest RTW laws are associated with substantial increases in free riding, decreases in union membership, and decreases in union coverage. Thus, RTW laws weaken unions through combinations of increased free riding and decreased coverage, though effects vary by state and sector. While RTW laws are not associated with changes in wage differentials, state fixed effects estimates suggest that unions provide some excludable advantages to members in the face of RTW legislation, through higher earnings (union wage premium) and fringe benefits (union benefit premium).

An Evaluation of Online Complaints About Qur’an Courses for 4-6-Year Olds: The Case of sikayetvar.com

The number of Qur’an courses for 4-6-year-olds affiliated with the Presidency of Religious Affairs has significantly increased since its pilot launch in 2013-2014. Parents, who send their children on these courses, anticipate a specific standard and quality from these educational institutions for their children. However, when these expectations aren’t met, parents often voice their dissatisfaction, sharing complaints within their social circles in the micro field and to a larger audience in the macro area. In Turkey, the platform “sikayetvar.com” is one avenue for publishing such grievances. This platform was chosen because it is the country’s first complaint platform, has a free membership option, and a user-friendly complaint-sharing interface. In this respect, the study uses qualitative research methods to analyze and evaluate themes related to complaints about 4-6-year-old Qur’an courses published on “sikayetvar.com” from 2019 to the present. The data analysis involved document scanning and content analysis. The nature of developments and changes enables individuals to shape their service-related preferences and choices. Hence, there is a belief that contributing to the advancement of the 4-6 age group Qur’an courses offered by the Presidency of Religious Affairs, alongside identifying and evaluating the complaints expressed by parents sending their children to these courses, would ultimately enhance the institution’s organizational structure and the quality of services provided. Initially, 166 complaints concerning the 4-6 age group Qur’an courses were compiled into a Word document from the mentioned website. Subsequently, these complaints were categorized under four distinct themes: registration and fees, personnel, facilities, and others. The theme of registration and fees (n:74, %44.5) encompassed complaints centered around the limitations imposed by quotas and course fees. Complaints associated with the personnel theme (n:76, 45.7%) focused on issues concerning course managers, instructors, assistants, and personnel in other capacities. Under the facilities theme (n:15, 9%), the predominant concerns were physical facilities, hygiene, noise, and transportation. The remaining complaints were grouped under the others themes (n:13, 7.8%). The themes of registration and fees, as well as personnel, garnered the most complaints. When viewed from an institutional standpoint, the complaints can be regarded as constructive feedback aimed at enhancing both the quality of service and overall user experience. Following the expression of dissatisfaction in the form of a complaint, it is expected that the dissatisfaction will be considered, evaluated, and resolved, leading to the elimination of the discontent. Indifference towards complaints and non-solution-oriented approaches can weaken and damage the connection/relationship between citizens and the institution, affecting the institution's perceived competence in one of the most sensitive matters, which is the perspective on religion, and leading to questioning the institution’s authority in religious matters. In cases of trust and loyalty erosion, citizens, considering the challenges posed by the accuracy and source of information in today's context, may rely on the opinions and claims of different individuals. This situation can affect social unity and solidarity, potentially leading to marginalization and othering. Based on this, it can be said that to improve service quality and meet expectations and demands continuously, careful management of complaints is needed.

Women's Romantic Jealousy Predicts Risky Appearance Enhancement Effort.

Human appearance enhancement effort has recently been considered from an evolutionary perspective as an adaptive and sexually dimorphic strategy for effective female intrasexual and intersexual competition. Most writing and research on the topic to date has focused on appearance enhancement as a means of mate attraction, with relatively less research examining its role in mate retention. The present study considered whether romantic jealousy, as a negative emotion experienced in response to perceived threat to a desired relationship, predicts costly and/or risky appearance enhancement independent of the closely related emotion of envy. In a sample of 189 undergraduate women, results showed that romantic jealousy and dispositional envy were positively correlated with one another. Results further demonstrated that romantic jealousy predicted women's positive attitude toward cosmetic surgery, willingness to use a one-week free tanning membership, willingness to use a risky diet pill, and intent on spending a greater proportion of their income on appearance enhancement, but not intended use of facial cosmetics. Results held independent of participants' dispositional envy, suggesting that romantic jealousy is a unique predictor of women's efforts at enhancing their physical appearance, which could extend into costly and physically risky mate retention efforts.

Do New Luxury Hotel Promotions Harm Member Customers?

Will customers regret their loyalty to a hotel and look for alternatives if the hotel neglects to communicate with them? Empirical research on this question is limited in the hospitality literature. To accurately determine the direction of future customer behavior, we investigate the impact of sales promotions on customer regret and switching intention, demonstrating that sales promotions can dilute customer loyalty. Using an experimental design study (n = 227) in Korea, our findings indicate that sales promotions have no effect on customer regret and switching intention. In particular, we find that customers’ regret of paying for a hotel membership is more salient than their regret of obtaining a free membership in the new luxury hotel context, regardless of the absence or presence of sales promotions. Moreover, the findings show that VIP club members tend to experience more regret and have greater switching intentions than free online membership customers. The higher the degree of customer regret, the more sensitive the customers’ reactions are to mixed promotions, leading to a rapid increase in switching intentions among customers. This study expands sale promotion knowledge by offering ample evidence of customer behavior and provides sustainable insights for hospitality managers responding to member customers’ demands.

Global economic meltdown and healthcare financing in Ghana.

Global economic meltdown and healthcare financing in Ghana.

YMCA And Healthcare System Collaboration On Lifestyle Change Program: A Pilot Study

PURPOSE: To determine the impact of a lifestyle change program on the health of employees of a healthcare system. A secondary purpose is to determine the feasibility of providing this program to the general public. METHODS: Emails were sent to all employees of the healthcare system describing the project with links to click on to register. Participants came to an initial screening of body composition, height, weight, resting blood pressure, total cholesterol, triglycerides, blood glucose, LDL-C, and HgbA1c. After receiving their assessment results, participants met with a physician for a 30-minute consultation. All participants received a free YMCA membership for the duration of the program (10 weeks). All participants met with a trainer once per week in a small group, and with a lifestyle coach once per week in the same small group. The lifestyle change program covered setting personal goals to achieve overall health, healthy eating, and increasing physical activity. Participants also received periodic group physician consults. RESULTS: Fifteen individuals began the program. One participant did not have full data, therefore, their data was not utilized. Body fat decreased an average of 1.4% (not statistically significant), while fat mass decreased an average of 4.4 lbs., p = 0.056. Body weight decreased an average of 4.3 lbs., p = 0.0009. Total cholesterol decreased an average of 20.9 points, p = .015. HgbA1c decreased an average of 0.4%, p = 0.0003. Many blood samples were not fasting, therefore, glucose, triglycerides, and LDL were not considered accurate. CONCLUSIONS: An intensive, supportive lifestyle change program can produce improvements in individual’s overall health. Healthcare providers and community groups can work together to provide guidance and support for individuals to improve their overall health.

Secondary analysis of a university-based weight loss program in on-campus versus off-campus employees.

Many barriers prevent individuals from regularly engaging in physical activity (PA), including lack of time and access to facilities. Providing free gym membership close to one's work may alleviate both time and financial barriers, increase PA, and result in greater weight loss. The purpose of this secondary analysis was to determine if gym usage, self-reported leisure PA, and weight loss differed between participants working on the University of Colorado Anschutz Medical Campus (ON) versus working off-campus (OFF) during a 6-month weight loss trial. 117 adults (ON, n=62; OFF, n=55) with overweight or obesity received free gym memberships for the duration of trial. Average gym check ins/week, self-report leisure PA, weight, and fat and lean mass were compared between groups. ON reported more check-ins than OFF (ON, 0.93±0.16 times/week; OFF, 0.55±0.10 times/week p=0.038). Both groups reported increased leisure PA, with ON reporting more leisure PA than OFF at month 4. Both groups had reductions in weight and fat mass, which were similar between groups. Gym usage in both groups was low, suggesting that convenient and free gym access only marginally promoted use of provided facilities, likely having little additional impact on PA and weight change. The parent trial was registered at clinicaltrials.gov: NCT02627105.

The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS)

ABSTRACTBackgroundThe effect of diet on age-related brain atrophy is largely unproven.ObjectivesWe aimed to explore the effect of a Mediterranean diet (MED) higher in polyphenols and lower in red/processed meat (Green-MED diet) on age-related brain atrophy.MethodsThis 18-mo clinical trial longitudinally measured brain structure volumes by MRI using hippocampal occupancy score (HOC) and lateral ventricle volume (LVV) expansion score as neurodegeneration markers. Abdominally obese/dyslipidemic participants were randomly assigned to follow 1) healthy dietary guidelines (HDG), 2) MED, or 3) Green-MED diet. All subjects received free gym memberships and physical activity guidance. Both MED groups consumed 28 g walnuts/d (+440 mg/d polyphenols). The Green-MED group consumed green tea (3–4 cups/d) and Mankai (Wolffia-globosa strain, 100 g frozen cubes/d) green shake (+800 mg/d polyphenols).ResultsAmong 284 participants (88% men; mean age: 51 y; BMI: 31.2 kg/m2; APOE‐ε4 genotype = 15.7%), 224 (79%) completed the trial with eligible whole-brain MRIs. The pallidum (−4.2%), third ventricle (+3.9%), and LVV (+2.2%) disclosed the largest volume changes. Compared with younger participants, atrophy was accelerated among those ≥50 y old (HOC change: −1.0% ± 1.4% compared with −0.06% ± 1.1%; 95% CI: 0.6%, 1.3%; P < 0.001; LVV change: 3.2% ± 4.5% compared with 1.3% ± 4.1%; 95% CI: −3.1%, −0.8%; P = 0.001). In subjects ≥ 50 y old, HOC decline and LVV expansion were attenuated in both MED groups, with the best outcomes among Green-MED diet participants, as compared with HDG (HOC: −0.8% ± 1.6% compared with −1.3% ± 1.4%; 95% CI: −1.5%, −0.02%; P = 0.042; LVV: 2.3% ± 4.7% compared with 4.3% ± 4.5%; 95% CI: 0.3%, 5.2%; P = 0.021). Similar patterns were observed among younger subjects. Improved insulin sensitivity over the trial was the parameter most strongly associated with brain atrophy attenuation (P < 0.05). Greater Mankai, green tea, and walnut intake and less red and processed meat were significantly and independently associated with reduced HOC decline (P < 0.05). Elevated urinary concentrations of the polyphenols urolithin-A (r = 0.24; P = 0.013) and tyrosol (r = 0.26; P = 0.007) were significantly associated with lower HOC decline.ConclusionsA Green-MED (high-polyphenol) diet, rich in Mankai, green tea, and walnuts and low in red/processed meat, is potentially neuroprotective for age-related brain atrophy.This trial was registered at clinicaltrials.gov as NCT03020186.

Virtual teaching in the COVID era: Providing surgical core trainee teaching via online webinars and videoconferencing

ObjectiveDuring the COVID-19 pandemic, regular teaching for core surgical trainees (CSTs) in Northern Ireland was cancelled at short notice, leaving a significant gap in training. We aimed to develop an effective core surgical teaching programme, within the remit of government regulations, to ensure training was not negatively affected by COVID-19. Design, setting and participantsA novel virtual teaching programme was designed and implemented regionally across Northern Ireland. One-year free Affiliate Membership to the Royal College of Surgeons of Edinburgh (RCSEd) was provided for Northern Ireland CSTs, allowing access to RCSEd online webinars. A weekly teaching schedule based on the Member of the Royal College of Surgeons (MRCS) exam curriculum and accompanied by a webinar was created and disseminated to trainees. Senior surgeons were recruited to conduct a virtual teaching session via videoconferencing. ResultsTen teaching sessions were conducted over three months. Feedback was collated, with positive results and requests for virtual teaching to continue. As such, the Northern Ireland Medical and Dental Training Agency (NIMDTA) adopted the teaching programme as their new primary method of central teaching for Northern Ireland CSTs during the pandemic. ConclusionA novel, highly successful teaching programme was developed in Northern Ireland to meet the training needs of CSTs resulting in a sustained change to training. Virtual surgical teaching can be as effective as face-to-face didactic learning and may be imperative in a foreseeably socially distanced world.

The Use of an Incentive to Improve Breastfeeding Outcomes: The Effectiveness of Offering a Free Family YMCA Membership to Increase Support Group Participation.

Suboptimal breastfeeding can result in negative health consequences for mother and infant and economic consequences for families and communities. Breastfeeding outcomes improve when multifaceted interventions spanning the perinatal period are implemented. Incentives to increase participation in effective, existing community-based breastfeeding support programs have the potential to create behavioral change and improve breastfeeding outcomes but results to date are inconclusive. The aim of this pilot study was to investigate the effectiveness of offering a Young Men's Christian Association membership as an incentive to increase attendance at an existing breastfeeding support program to improve breastfeeding duration and exclusivity. This was a two-group, quasi-experimental study using demographic information and pre- and post-intervention participant surveys. Attendance at a breastfeeding support program was incentivized with an offer of a free family Young Men's Christian Association membership. Surveys and demographic information were used to compare attendance, maternal interest, and perceived significant other and family support for attendance with a non-incentivized control group in an adjacent city. The groups differed demographically and socioeconomically. Significantly more at-risk participants both attended the incentivized group and perceived support from their families to attend. There was a significant increase in the incentivized group's attendance: 62% (n = 26) of participants in the incentivized group attended three or more times compared to 36% (n = 50) of participants in the control group (p = .03). Both groups exceeded national breastfeeding averages for exclusive breastfeeding at six months. Offering an incentive increased breastfeeding support group attendance by participants at risk for suboptimal breastfeeding and improved their breastfeeding outcomes, thus closing the breastfeeding disparity gap in this population.

Pharmacists fleeing war and conflict take up free RPS membership

A total of 12 people have taken up free Royal Pharmaceutical Society (RPS) membership under a scheme to support people arriving in Great Britain after fleeing war and conflict. Ten of those pharmacists come from Ukraine, one comes from Sudan and one is from Syria. Under the scheme, which was launched in April 2022, pharmacists, […]

THE ROLE OF PROFESSIONAL SOCIETIES AT THE LEVEL OF INDUSTRIAL DEVELOPMENT

Nowadays, the role of the majority of professional engineering communities, unfortunately, is devalued in Russia. It does not lead to the required development of engineering activities due to the disunity of individual specialists the lack of motivation to coordinated decision of professional issues, the lack of participation in the general professional labor market, the impossibility of direct communication with leaders in a particular field of knowledge, etc. The number of members in professional society with significant work experience is constantly decreasing. Professional communities that have not been able to build the structure of their work and become interesting for specialists usually disappear or have a formal status. The paper describes the successful world experience of the professional communities existence, considers the basic principles of the activities of such communities as: ASCE (American Society of Civil Engineers) and BGA (British Geotechnical Association). The success of these communities is evidenced by the fact that ASCE has unified a global community of engineers since 1852, with more than 150,000 members. The BGA has functioned since 1949 with over 60 collective members representing the UK's proponent geotechnical agencies. The advantages of membership in these societies for both professional engineers and students are given, including: rapid career growth supported by the community; active participation in the life of society, based on individual and social benefits; establishing personal contacts and obtaining first-hand information on topics of interest; great benefits or free membership for students; a large amount of events held under the auspices of ASCE and BGA , etc.

Project GYM: A randomized feasibility study investigating effect on motivation of personal trainer‐led exercise in young men with hemophilia

IntroductionMany young men with hemophilia engage in physical activity and sport but face challenges to participation because of their hemophilia. Project GYM aimed to investigate the feasibility of a hemophilia‐specific fitness program led by a personal trainer (PT) and its impact on gym activity, motivation, and adherence to exercise. MethodsThis was a nonblinded, randomized feasibility study, recruiting participants aged 18 to 25 years with hemophilia A or B (all severities, ± inhibitor) from three London hemophilia centers. All participants were given an activity tracker and free gym membership. Participants were randomized to a “gym only” or “gym and PT” arm. Participants completed questionnaires evaluating motivation to exercise, quality of life, physical activity levels, self‐efficacy, and self‐esteem at study start and study end. ResultsOf 142 eligible individuals, 19 agreed to participate. Participants were healthy, with mean body mass index and adiposity slightly lower than the UK average. They reported low bleed numbers and had good joint health (median Hemophilia Joint Health Score [HJHS], 0; range, 0‐13). The gym and PT group had more gym attendance than the gym‐only group. Seven participants increased their activity levels and nine stayed the same, with no statistical difference between groups. HJHS scores improved in 3 participants and were unchanged in 12. There was no bleeding associated with gym activity. ConclusionProject GYM has demonstrated the safety and feasibility of a tailored physical training program in young men with hemophilia. Increased gym attendance, with and without support from a PT, is associated with increased physical activity.

786 Virtual Teaching in the COVID Era: Providing Surgical Trainee Teaching Via Online Webinars and Video Conferencing

IntroductionCore surgical training is dependent on a balance of lecture-based and procedure-based teaching. Due to the COVID-19 pandemic, from March 2020 teaching provided by the Northern Ireland Medical and Dental Training Agency (NIMDTA) for Core Surgical Trainees (CSTs) was cancelled. In lieu of this, a virtual teaching programme was developed to ensure this vital aspect of training was not neglected.MethodFirstly, one-year free Affiliate membership to the Royal College of Surgeons of Edinburgh (RCSEd) was provided for all Northern Ireland CSTs, allowing access to RCSEd online webinars. Second, a weekly teaching schedule was developed with accompanying webinar – this was based on the MRCS curriculum. Third, consultants and senior registrars were recruited to conduct a virtual teaching session via videoconferencing. Feedback was collated and used to guide future topics covered. The teaching sessions were recorded for trainee dissemination with consent from the tutors.ResultsTen teaching sessions were conducted over three months. While attendance was variable, overall feedback was very positive with requests for this virtual teaching to continue. As such, NIMDTA adopted the teaching programme as their new primary method of lecture-based teaching for all Northern Ireland CSTs.ConclusionsAlthough prepared in a short space of time, a novel, highly successful teaching programme was developed in Northern Ireland to meet the training needs of CSTs. This has resulted in a sustained change to training in Northern Ireland and may be imperative in supporting surgical training in a foreseeably socially distanced world.

Boost Participation With a Free Membership Contest

Boost Participation With a Free Membership Contest

The application of gravity equation while accessing the environment of Pakistan-ASEAN technological trade flows

International trade, an important economic activity, has affected the human environment in varying degrees since its beginning. This research will carry out calculations and analyses on Pakistan-ASEAN bilateral and technological trade flows at a disaggregated level over 1995-2018. The current study found that medium-tech, high-tech, and low-tech trade flows, enhance economic growth in Pakistan and ASEAN, negatively impacting geographical distance by all technological trade flows. Similarly, the proportional element endowment confirms the Hecksher-Ohlin hypothesis. Yet, the perspective argues that countries with high production levels can exchange faster than their countries with lower output levels. Due to the variety in consumers’ taste, increased similarity yields increased technological trade volumes, highest values received by medium-tech trade flow, and total bilateral trade flow. Depreciation in exchange rates showing a positive sign for total bilateral trade, low-tech trade, and high-tech trade, whereas unenthusiastic in the case of medium-tech trade flow between Pakistan-ASEAN nations. Free trade agreement and WTO membership will also foster trade activities in conscientious and economic association in ecumenical. Pakistan trade patterns are different from ASEAN trade patterns, which increased the opportunity to enhance business activities.