Search results for: innovation competence of the staff

Authors: Napasri Suwanajote

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

Keywords: production process, OTOP, sufficiency economic philosophy, language choice

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Authors: P. S. Jagadeesh Kumar, S. Meenakshi Sundaram

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With the increase of prevailing non-traditional rivalry, mobile banking experiences an ever changing commercial backdrop. Substantial customer demands have established to be more intricate as customers request more expediency and superintend over their banking services. To enterprise advance and modernization in mobile banking applications, it is gradually obligatory to deeply leapfrog the scuffle using business model transformation. The dramaturgical vicissitudes taking place in mobile banking entail advanced traditions to exploit security. By reforming and transforming older back office into integrated mobile banking applications, banks can engender a supple and nimble banking environment that can rapidly respond to new business requirements over cloud computing. Cloud computing is transfiguring ecosystems in numerous industries, and mobile banking is no exemption providing services innovation, greater flexibility to respond to improved security and enhanced business intelligence with less cost. Cloud technology offer secure deployment possibilities that can provision banks in developing new customer experiences, empower operative relationship and advance speed to efficient banking transaction. Cloud adoption is escalating quickly since it can be made secured for commercial mobile banking transaction through backend as a service in scrutinizing the security strategies of the cloud service provider along with the antiquity of transaction details and their security related practices.

Keywords: cloud adoption, backend as a service, business intelligence, secured mobile banking

Procedia PDF Downloads 237

Authors: Srećko Favro, Dora Mužinić

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The eastern coast of the Adriatic Sea has been a significant part of the most important traffic corridors since Antiquity due to its position as the deepest indented bay of the Mediterranean and numerous bays on the coast and is-lands. The central place throughout history was occupied by the central part - Split-Dalmatia County, with its center in Antica in Salona and later in Split. Nowadays, in addition to its traffic and economic importance, this area is also important for tourism, an area where Croatia develops its economy and realizing its economic growth. Nautical tourism is the most important form of the tourist economic sector that uses the geographical features of the Croatian Adriatic water area and achieves the greatest growth based on tour-ist trends in the world (coronavirus - separation from the masses, adventure tourism - own arrangements) and thus opens up the possibility of develop-ment for other parts of the tourist economy. This will be described in the ex-ample of the business of the Split-Dalmatia County shipping company from Krilo Jesenice, which operates as a mini-cruising service provider, the lead-ing form of cruising in Croatia. The advantages that this type of tourism provides to travelers in terms of customized itineraries, high-quality services, an intimate atmosphere, and a unique experience through familiarization with local culture and tradition will be considered. Through direct primary research and analysis of available secondary research data, an attempt will be made to show how traditional Croatian mini cruisers manage to stand out in a competitive tourist environment. Their impact on the local economy, sus-tainability, and environmental protection will be considered, as well as how they are integrated into the tourist offer of other destinations in Croatia. In addition, the challenges and opportunities that arise in the maintenance and development of traditional Croatian mini cruisers will be discussed, includ-ing issues such as infrastructure, staff training, and market trends.

Keywords: croatia, adriatic, cruising, nautical tourism, mini cruise

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Authors: Amir Ahmadi, Hossein Ahmadi, Alireza Ahmadi

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Emotional Intelligence (EI) has been defined as the ability to empathize, persevere, control impulses, communicate clearly, make thoughtful decisions, solve problems, and work with others in a way that earns friends and success. These abilities allow an individual to recognize and regulate emotion, develop self-control, set goals, develop empathy, resolve conflicts, and develop skills needed for leadership and effective group participation. Due to the increasing complexity of organizations and different ways of thinking, attitudes and beliefs of individuals, conflict as an important part of organizational life has been examined frequently. The main point is that the conflict is not necessarily in organization, unnecessary; but it can be more creative (increase creativity), to promote innovation. The purpose of this study was to investigate the relation between principals emotional intelligence as one of the factors affecting conflict management among teachers. This relation was analyzed through cluster sampling with a sample size consisting of 120 individuals. The results of the study showed that at the 95% level of confidence, the two secondary hypotheses (i.e. relation between emotional intelligence of principals and use of competition and cooperation strategies of conflict management among teachers) were confirmed, but the other three secondary hypotheses (i.e. the relation between emotional intelligence of managers and use of avoidance, adaptation and adaptability strategies of conflict management among teachers) were rejected. The primary hypothesis (i.e. relation between emotional intelligence of principals with conflict management among teachers) is supported.

Keywords: emotional intelligence, conflict, conflict management, strategies of conflict management

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Authors: Vilma Zydziunaite, Gitana Balezentiene, Vilma Zydziunaite

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Teaching is one of most responsible profession, and it is not only a job of an artisan. This profes-sion needs a developed ability to identify oneself with the chosen teaching profession. Research questions: How teachers characterize their authentic individual professional identity? What factors teachers exclude, which support and limit the professional identity? Aim was to develop the grounded theory (GT) about teacher’s professional identity (TPI). Research methodology is based on Charmaz GT version. Data were collected via semi-structured interviews with the he sample of 12 teachers. Findings. 15 extracted categories revealed that the core of TPI is teacher’s professional calling. Premises of TPI are family support, motives for choos-ing teacher’s profession, teacher’s didactic competence. Context of TPI consists of teacher compli-ance with the profession, purposeful preparation for pedagogical studies, professional growth. The strategy of TPI is based on teacher relationship with school community strengthening. The profes-sional frustration limits the TPI. TPI outcome includes teacher recognition, authority; professional mastership, professionalism, professional satisfaction. Dimensions of TPI GT the past (reaching teacher’s profession), present (teacher’s commitment to professional activity) and future (teacher’s profession reconsideration). Conclusions. The substantive GT describes professional identity as complex, changing and life-long process, which develops together with teacher’s personal identity and is connected to professional activity. The professional decision "to be a teacher" is determined by the interaction of internal (professional vocation, personal characteristics, values, self-image, talents, abilities) and external (family, friends, school community, labor market, working condi-tions) factors. The dimensions of the TPI development includes: the past (the pursuit of the teaching profession), the present (the teacher's commitment to professional activity) and the future (the revi-sion of the teaching profession). A significant connection emerged - as the teacher's professional commitment strengthens (creating a self-image, growing the teacher's professional experience, recognition, professionalism, mastery, satisfaction with pedagogical activity), the dimension of re-thinking the teacher's profession weakens. This proves that professional identity occupies an im-portant place in a teacher's life and it affects his professional success and job satisfaction. Teachers singled out the main factors supporting a teacher's professional identity: their own self-image per-ception, professional vocation, positive personal qualities, internal motivation, teacher recognition, confidence in choosing a teaching profession, job satisfaction, professional knowledge, professional growth, good relations with the school community, pleasant experiences, quality education process, excellent student achievements.

Keywords: grounded theory, teacher professional identity, semi-structured interview, school, students, school community, family

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Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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Authors: Ahmed Deen

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The introduction of the mobile devices which were equipped with internet access and a camera, as well as the messaging services, has become a major inspiration for the use of the mobile devices in the growth in the reporting of news. Mobile journalism (MOJO) was a creation of modern technology, especially the use of mobile technology for video journalism purposes. MOJO, thus, is the process by which information is collected and disseminated to society, through the use of mobile technology, and even the use of the tablets. This paper seeks to better understand the ethics of Saudi mobile journalists towards news coverage. Also, this study aims to explore the relationship between minimizing harms and truth-seeking efforts among Saudi mobile journalists. Three main ethics were targeted in this study, which are seek truth and report it, minimize harm, and being accountable. Diffusion of innovation theory applied to reach this study’s goals. The non- probability sampling approach, ‘Snowball Sampling’ was used to target 124 survey participants, an online survey via SurveyMonkey that was distributed through social media platforms as a web link. The code of ethics of the Society of Professional Journalists has applied as a scale in this study. This study found that the relationship between minimizing harm and truth-seeking efforts is significantly moderate among Saudi mobile journalists. Also, it is found that the level journalistic experiences and using smartphones to cover news are weakly and negatively related to the perceptions of mobile journalism among Saudi journalists, while Saudi journalists who use their smartphone to cover the news between 1-3 years, were the majority of participants (55 participants by 51.4%).

Keywords: mobile journalism, Saudi journalism, smartphone, Saudi Arabia

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Authors: Lindsay Crystabelle A. Gillamac, Lemuel Roy Amarillo, Al Leonard Joseph B. Aca-Ac, Felipe V. Lula Jr.

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Hangover is the unpleasant psychological and physiologic effects after heavy consumption of alcoholic beverages. In awareness of the need to have a remedy for hangover occurrence in Iligan City, the authors aimed to determine the most preferred and effective local remedy to the hangover and inform people, bars and food establishments that there are available remedies to the hangover in the locality. The study utilizes qualitative data gathered through an interview on four different age groups with 50 random individuals each group as to what symptom determines they are experiencing the hangover. Then, quantitative data gathered through an online and written survey was done as to what local hangover remedy do they intake after drinking to ameliorate the most experienced symptom provided from the first assessment. After data tabulation of hangover symptoms on different age groups, we have found out that the most common determinant that you have a hangover has a headache. Thus, we queried the respondents again to what was effective the most in relieving them of a headache and their other felt symptoms depending on their varying age groups. The results of the evaluations showed that most respondents from different age groups preferred Halang-halang Soup, a spicy beef soup in the locality. As part of the hospitality industry concerned with welfare of customers, Bars in Iligan City should include on their menu these hang-over remedies in anticipation of guest needs given the fact that there are no more stores open at late hours in Iligan City. Placards should also be posted within the bar area to orient the guests about hang-over cures available inside the bar. Bartenders and other staff being directly in-contact with guests should take part in orienting guests about these aforementioned remedies. Added to that, we would like to promote Halang-halang Soup as a Health beneficial cuisine in the Philippines and help in the growth of the Tourism Industry of Iligan City by making the Halang-halang place a tourist destination.

Keywords: alcohol, alcohol consumption, alcohol hangover, anticipation of needs, bar, cure, hangover, headache, hospitality industry, local remedy, menu, menu development, menu improvement, remedy, Philippines

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Authors: Greg Fetzer

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One of the fundamental tensions of creative work is between the need to be passionate and persistent in advancing novel and risky ideas and the need to be flexible, revising, or even abandoning ideas in favor of others. The tension becomes fraught in part because of the attachment that creators have toward their ideas. Idea attachment is defined here as a multifaceted concept referring to affection, passion, and connection toward a target—in this case, one’s projects or ideas. Yet feeling attached can make creators resistant to feedback, making them less flexible and leading them to escalate commitment. Despite a growing understanding of how attachment develops and evolves in response to project changes, feedback, and creative jolts, we still know relatively little about the organizational dynamics that may shape idea attachment. Through a qualitative, inductive study of early-stage R&D scientists in the pharmaceutical industry, this research finds that scientists develop bounded attachment, a mindset that limits emotional attachment to ideas while still fostering engagement in idea development. This research develops a process model of how bounded attachment is developed and enacted across three stages of the creative process, idea generation, idea evaluation, and outcome assessment, as well as the role that organizational practices and professional identity play in shaping this process: these collective practices provided structures to ensure ideas were evaluated in a rational (i.e. non-emotional way) while also providing socioemotional support in the face of setbacks. Together, this process led to continued creative engagement across ideas in a portfolio and helped scientists construct a sense of meaningful work despite a high likelihood (and frequency) of failure.

Keywords: creativity, innovation, organizational practices, qualitative, attachment

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Authors: Bahareh Mostofian

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Foreign Direct Investment (FDI) has long been recognized as a crucial driver of economic growth and development in less-developed countries and their integration into Global Production Networks (GPNs). FDI not only brings capital from the core countries but also technology, innovation, and know-how knowledge that can upgrade the capabilities of host automotive industries. On the other hand, FDI can also have negative impacts on host countries if it leads to significant import dependency. In the case of the Iranian automotive sector, the industry greatly benefited from FDI, with Western carmakers dominating the market. Over time, various types of know-how knowledge, including joint ventures (JVs), trade licenses, and technical assistance, have been provided, helping Iran upgrade its automotive industry. While after the severe geopolitical obstacles imposed by both the EU and the U.S., the industry became over-reliant on the car and spare parts imports, and the lack of emphasis on knowledge transfer further affected the growth and development of the Iranian automotive sector. To address these challenges, current research has adopted a descriptive-analytical methodology to illustrate the gradual changes accrued with foreign suppliers through FDI. The research finding shows that after the two-phase imposed sanctions, the detrimental linkages created by overreliance on the car and spare parts imports without any industrial upgrading negatively affected the growth and development of the national and assembled products of the Iranian automotive sector.

Keywords: less-developed country, FDI, GPNs, automotive industry, Iran

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Authors: Renan Caseiro De Almeida, Mateus Mello Garrute

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The world walks to be ever more globalised. This trend promotes an increase on the number of transnational commercial transactions. The main modal for carriage of goods is by sea, and many countries have their economies dependent on the maritime freightage – it could be because they exercise largely this activity or because they follow the tendency of using the maritime logistic widely. Among these ones, Brazil is included. This nation counts with sixteen ports with good capacities, which receive most of the international income by sea. It is estimated that 85 per cent of the total influx of goods in Brazil is by maritime modal, leaving mere 15 per cent for the other ones. This made it necessary to develop maritime law in international and national basis, to create a standard to be applied with the intention to harmonize the transnational carriage of goods by sea. Maritime contracts are very specific and have interesting peculiarities, but in their range, little research has been made on what causes the main divergences when it comes to international contracts: the jurisdiction conflict. Likewise any other international contract, it is common for the parties to set a forum selection clause to choose the forum which will be able to judge the litigations that could rise from a maritime transport contract and, consequently, also which law should be applied to the cases. However, the forum choice in Brazil has always been somewhat polemical – not only in the maritime law sphere - for sometimes national tribunals overlook the parties’ choice and call the competence for themselves. In this sense, it is interesting to mention that the Mexico Convention of 1994 about the law applicable to international contracts did not gain strength in Brazil, nor even reached the Congress to be considered for ratification. Furthermore, it is also noteworthy that Brazil has a new Civil Procedure Code, which was put into reinforcement in 2016 bringing new legal provisions specifically about the forum selection. This represented a mark in the national legal system in this matter. Therefore, this paper intends to give an insight through Brazilian jurisprudence, making an analysis of how this issue has been treated on litigations about maritime contracts in the national tribunals, as well as the solutions found by the Brazilian legal system for the jurisdiction conflicts in those cases. To achieve the expected results, the hypothetical-deductive method will be used in combination with researches on doctrine and legislations. Also, jurisprudential research and case law study will have a special role, since the main point of this paper is to verify and study the position of the courts in Brazil in a specific matter. As a country of civil law, the Brazilian judges and tribunals are very attached to the rules displayed on codes. However, the jurisprudential understanding has been changing during the years and with the advent of the new rules about the applicable law and forum selection clause, it is noticeable that new winds are being blown.

Keywords: applicable law, forum selection clause, international business, international maritime contracts, litigation in courts

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Authors: Keenoo Bibi Sumera, Alsheikh Mona, Mubarak Jan Beebee Zeba Mahetaab

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Background: Due to the busy schedule of the practicing clinicians at the hospitals, students may not always be attended to, which is to their detriment. The clinicians at the hospitals are also not always acquainted with teaching and/or supervising students on their placements. Additionally, there is a high student-patient ratio. Since they are the prospective clinical doctors under training, they need to reach the competence levels in clinical decision-making skills to be able to serve the healthcare system of the country and to be safe doctors. Aims and Objectives: A reflective portfolio was used to provide a means for students to learn by reflecting on their experiences and obtaining continuous feedback. This practice is an attempt to compensate for the scarcity of lack of resources, that is, clinical placement supervisors and patients. It is also anticipated that it will provide learners with a continuous monitoring and learning gap analysis tool for their clinical skills. Methodology: A hardcopy reflective portfolio was designed and validated. The portfolio incorporated a mini clinical evaluation exercise (mini-CEX), direct observation of procedural skills and reflection sections. Workshops were organized for the stakeholders, that is the management, faculty and students, separately. The rationale of reflection was emphasized. Students were given samples of reflective writing. The portfolio was then implemented amongst the undergraduate medical students of years four, five and six during clinical clerkship. After 16 weeks of implementation of the portfolio, a survey questionnaire was introduced to explore how undergraduate students perceive the educational value of the reflective portfolio and its impact on their deep information processing. Results: The majority of the respondents are in MD Year 5. Out of 52 respondents, 57.7% were doing the internal medicine clinical placement rotation, and 42.3% were in Otorhinolaryngology clinical placement rotation. The respondents believe that the implementation of a reflective portfolio helped them identify their weaknesses, gain professional development in terms of helping them to identify areas where the knowledge is good, increase the learning value if it is used as a formative assessment, try to relate to different courses and in improving their professional skills. However, it is not necessary that the portfolio will improve the self-esteem of respondents or help in developing their critical thinking, The portfolio takes time to complete, and the supervisors are not useful. They had to chase supervisors for feedback. 53.8% of the respondents followed the Gibbs reflective model to write the reflection, whilst the others did not follow any guidelines to write the reflection 48.1% said that the feedback was helpful, 17.3% preferred the use of written feedback, whilst 11.5% preferred oral feedback. Most of them suggested more frequent feedback. 59.6% of respondents found the current portfolio user-friendly, and 28.8% thought it was too bulky. 27.5% have mentioned that for a mobile application. Conclusion: The reflective portfolio, through the reflection of their work and regular feedback from supervisors, has an overall positive impact on the learning process of undergraduate medical students during their clinical clerkship.

Keywords: Portfolio, Reflection, Feedback, Clinical Placement, Undergraduate Medical Education

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Authors: Renate Verkaik, Mieke Rijken, Hennie Boeije

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Elderly who are living alone and who are having one or more impairments are vulnerable for a loss of wellbeing and institutionalization. Physical exercise and social activities together with peers have the potential to make them more resilient. The Dutch program ‘More Resilience, Longer at Home’ initiated by FNO funded 126 local projects to stimulate vulnerable older citizens to participate in exercise and social activities, and as such to improve wellbeing and independent living. The program evaluation addressed the following questions: (1) what are the effects of the program on older (65+) participants exercise behavior, social activities and what is the relationship with wellbeing?, (2) which factors contribute to successful implementation of the projects and their outcomes? A mixed method approach was used. Effects on participants were assessed with a short survey, containing questions on exercise, social engagement, daily functioning, loneliness and life satisfaction. Results of the participants were compared with those of a reference group from the Dutch national population. Perceived influencing factors were investigated with a questionnaire for project leaders. This questionnaire was based on site visits and interviews with project leaders, volunteers and participating elderly. Preliminary results show that social engagement of the participating elderly rises significantly (p ≤ .05) as do their exercise levels and daily functioning. They experience less social loneliness, but not less emotional loneliness. Additionally, there is a positive association between daily functioning and life satisfaction and between exercise and life satisfaction. Perceived influencing factors that contribute to successful implementation of the projects can be categorized in 4 types: (1) characteristics of the activities; (2) profiles of the involved staff (professionals and volunteers), (3) characteristics of the organization, (4) the social political environment. Conclusions are that local projects have been successful in stimulating older citizens to participate in exercise and social activities. Multiple factors need to be addressed to ensure sustainability and scaling-up of the good practices.

Keywords: elderly living alone in the community, exercise and social activities, resilience, quality of life

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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Authors: Arsalan Ghaderi

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Introduction: Inactivity is one of the most important risk factors for cardiovascular disease. According to the study prevalence of inactivity in Iran, about 67.5% and in the staff, and especially nurses, are similar. The inflammatory index (HS-CRP) is highly predictive of the progression of these diseases. Physical activity education is very important in preventing these diseases. One of the modern educational methods is web-based theory-based education. Methods: This is a semi-experimental interventional study which was conducted in Isfahan and Kurdistan universities of medical sciences in two stages. A cross-sectional study was done to determine the status of physical activity and its predictive factors. Then, intervention was performed, and six months later the data were retrieved. The data was collected using a demographic questionnaire, an integrative model of behavior prediction constructs, a standard physical activity questionnaire and (HS-CRP) test. Data were analyzed by SPSS software. Results: Physical activity was low in 66.6% of nurses, 25.4% were moderate and 8% severe. According to Pearson correlation matrix, the highest correlation was found between behavioral intention and skill structures (0.553**), subjective norms (0.222**) and self-efficacy (0.198**). The relationship between age and physical activity in the first study was reverse and significant. After intervention, there was a significant change in attitudes, self-efficacy, skill and behavioral intention in the intervention group. This change was significant in attitudes, self-efficacy and environmental conditions of the control group. HS-CRP index decreased significantly after intervention in both groups, but there was not a significant relationship between inflammatory index and physical activity score. The change in physical activity level was significant only in the control group. Conclusion: Despite the effect of educational intervention on attitude, self-efficacy, skill, and behavioral intention, the results showed that if factors such as environmental factors are not corrected, training and changing structures cannot lead to physical activity behavior. On the other hand, no correlation between physical activity and HS-CRP showed that this index can be influenced by other factors, and this should be considered in any intervention to reduce the HS-CRP index.

Keywords: HS-CRP, integrative model of behavior prediction, physical activity, nurses, web-based education

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Authors: Dragana Gnjatovic

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Assessment is a burning topic in education policy and practice due to measurement-driven neoliberal agendas of quality and standardisation of assessment practice through high stakes standardised testing systems that are now influencing early childhood education. This paper presents a collaborative, arts-informed action research project which places children at the centre of their learning, with assessment as an integral part of play-based learning processes. It aims to challenge traditional approaches to assessment that are often teacher-led and decontextualised from the processes of learning through exploring approaches where children's voices are central, and their creative arts expressions are used to assess learning and development. The theoretical framework draws on Vygotsky's sociocultural theory and Freire's critical pedagogy, which indicate the importance of socially constructed reality where knowledge is the result of collaboration between children and adults. This reality perceives children as competent agents of their own learning processes. An interpretive-constructivist and critical-transformative paradigm underpin collaborative action research in a three to five-year-old setting, where creative methods like storytelling, play, drama, drawing are used to assess children's learning. As data collection and analysis are still in process, this paper will present the methodology and some data vignettes, with the aim of stimulating discussion about innovation in assessment and contribution of the collaborative enquiry in the field of Early Childhood Education and Care.

Keywords: assessment for learning, creative methodologies, collaborative action research, early childhood education and care

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Authors: Evelyn Kropfreiter, Roland Bernhard

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There has been an increased interest in school-based whole-child development in the Austrian education system in the last few years. Although there is a consensus among academics that teachers' beliefs are an essential component of their professional competence, there are hardly any studies in the German-speaking world examining teachers' beliefs about school-based character education. To close this gap, we are conducting a mixed methods study combining qualitative interviews and a questionnaire in Austria (doctoral thesis at the University of Salzburg). In this paper, we present preliminary insights into the quantitative strand of the project. In contrast to German-speaking countries, the Anglo-Saxon world has a long tradition of explicit character education in schools. There has been a rising interest in approaches focusing on a neo-Aristotelian form of character education in England. The Jubilee Centre strongly influences the "renaissance" of papers on neo-Aristotelian character education for Character and Virtues, founded in 2012. The quantitative questionnaire study (n = 264) is an online survey of teachers and school principals conducted in four different federal states in spring 2023. Most respondents (n = 264) from lower secondary schools (AHS-Unterstufe and Mittelschule) believe that character education in schools for 10-14-year-olds is more important for society than good exam results. Many teachers state that they consider themselves prepared to promote their students' personal development and life skills through their education and to attend further training courses. However, there are many obstacles in the education system to ensure that a comprehensive education reaches the students. Many teachers state that they consider themselves prepared to promote their students' character strengths and life skills through their education and to attend further training courses. However, there are many obstacles in the education system to ensure that a comprehensive education reaches the students. Among the most cited difficulties, teachers mention the time factor associated with an overcrowded curriculum and a strong focus on performance, which often leaves them needing more time to keep an eye on nurturing the whole person. The fact that character education is not a separate subject, and its implementation needs to be monitored also makes it challenging to implement it in everyday school life. Austrian teachers prioritize moral virtues such as compassion and honesty as character strengths in everyday school life and resilience and commitment in the next place. Our results are like those reported in other studies on teacher's beliefs about character education. They indicate that Austrian teachers want to teach character in their schools but see systemic constraints such as the curriculum, in which personality roles play a subordinate role, and the focus on performance testing in the school system and the associated lack of time as obstacles to fostering more character development in students.

Keywords: character education, life skills, teachers' beliefs, virtues

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Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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Authors: L. K. Shitole

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Usually on the face of it, personality is regarded as the external appearance of an individual. In psychology, the personality is not viewed merely as self or external appears, but it adds much more. Human resources development encompasses the personality development of the students. The student’s development starts right from the childhood and gradually continues right up to the completion of education in professional courses. This paper attempts to find out the role of the educational institutions in shaping the personality of the students from the rural area. Schools and colleges have infrastructural limitations, obtaining good quality and devoted teaching staff poses problems and even outside the school environment there are no private classes which may take care of this deficiency. The researcher has used the standardized test namely “Vyaktitva Shodhika” developed by Gyan Prabodhini, Pune for the students in Daund Taluka. There are 68 objective types of questions in the said questionnaire. Totally a sample size of 4191 students was selected. The sample was quite representative. It is observed that by and large the response indicates that the educational institutions are taking sincere efforts in shaping the personality of the students. In the semi-urban area i.e. at educational institutions of all levels, the performance on this front is excellent and at rest of Daund Taluka there is scope for improvement. Educational institutions of all levels are showing excellent performance in ensuring availability of the requisite infrastructure conducive for the development of the personality of the students. In rest of Daund Taluka there is ample scope for improving the situation. As far as data relating to role of co-curricular activities and sports programs in mental and physical development at various educational institutions is concerned Daund educational institutions have repeated their performance in securing “A” category, while in the rural area of Daund Taluka, there is need to step up the efforts in this regard. In today’s world of knowledge industry, one cannot ignore the importance of education and thereby the personality growth of the students. Accordingly, the educational institutions should undertake consistent research and extension activities in the area of personality development.

Keywords: personality, attitude, infrastructure, quality of education, learning environment, teacher’s contribution, family and society’s role

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Authors: Jeremiah Madzimure

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In order to stay competitive in business and improve performance, Small and Medium Enterprises (SMEs) need to make use of business networking and logistics integration. Strategic networking and logistics integration in business companies have become critical as they allow supplier partnering, exchange of vital information/ access to valuable resources allowing innovation, gaining access to additional resources, sharing risks and costs which is required for enhancing company performance. The purpose of this study was to examine the influence of strategic networks and logistics integration on company performance: the case of small and medium enterprises in South Africa. A quantitative research design was adopted in this study, and 137 SMEs owners and managers completed and returned the survey questionnaire. Confirmatory Factor Analysis (CFA) was conducted using the Analysis of Moment Structures (AMOS), version 24.0 to assess psychometric properties of the measurement scales. Path modelling techniques were used to test the proposed hypothesis. Three research hypotheses were postulated. The results indicate that strategic networks had a positive and significant influence on logistics integration and company performance. As well logistics integration had a strong positive and significant influence on company performance. This study provides a useful model for analysing the relationship between strategic networks and logistics integration on company performance. Moreover, the findings of the study provide useful insights into how SMEs should benefit from business networking and logistics integration so as to improve their performance. The implications of the study are discussed, and finally, limitations and recommendations are indicated.

Keywords: strategic networking, logistics integration, company performance, SMEs

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Authors: Alvaro Aguinaga, Carlos Avila, Edgar Cando

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This article proposes a n-layer architecture, with a web client as a front-end, for the development of a virtual platform for process simulation on CNC machines. This Open-Source platform includes a CAD-CAM interface drawing primitives, and then used to furnish a CNC program that triggers a touch-screen virtual simulator. The objectives of this project are twofold. First one is an educational component that fosters new alternatives for the CAD-CAM/CNC learning process in undergrad and grade schools and technical and technological institutes emphasizing in the development of critical skills, discussion and collaborative work. The second objective puts together a research and technological component that will take the state of the art in CAD-CAM integration to a new level with the development of optimal algorithms and virtual platforms, on-line availability, that will pave the way for the long-term goal of this project, that is, to have a visible and active graduate school in Ecuador and a world wide Open-Innovation community in the area of CAD-CAM integration and operation of CNC machinery. The virtual platform, developed as a part of this study: (1) delivers improved training process of students, (2) creates a multidisciplinary team and a collaborative work space that will push the new generation of students to face future technological challenges, (3) implements industry standards for CAD/CAM, (4) presents a platform for the development of industrial applications. A protoype of this system was developed and implemented in a network of universities and technological institutes in Ecuador.

Keywords: CAD-CAM integration, virtual platforms, CNC machines, multi-layer based architecture

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Authors: Florence Awde

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In 2023, it was expected 350 parents in Arizona would have a child receive a cancer diagnosis (Welcome Arizona Cancer Foundation For Children, n.d.). The news of a child’s diagnosis with cancer can be overwhelming and confusing, especially for those lucky enough to lack a personal tie to the disease that takes approximately 1800 children’s lives each year in the United States (Deegan et al., n.d.). A parent’s beliefs, attitudes, and understandings surrounding cancer are vital for medical staff to provide adequate and culturally competent care for each patient, especially across cultural and ethnic lines in regions housing multicultural populations. Arizona's cultural/linguistic mosaic houses many White and Latino populations and English and Spanish speakers. Variations in insurance coverage, from those insured through public insurance programs (e.g., Medicaid) or private insurance plans (e.g., employee-sponsored insurance) versus those uninsured, also factor into health-seeking attitudes and behaviors. To further understand parental attitudes, understandings, and beliefs towards childhood cancer, 22 parents (11 of Latino ethnicity, 11 of White ethnicity) were interviewed on these facets of childhood cancer, despite 21 of the 22 never having a child receive a cancer diagnosis. The exploration of these perceptions across ethnic lines revealed a higher report of fear-orientated beliefs amongst Latino parents--hypothesized to be rooted in the starkly contrasting lack of belief in the possibility of recovering for children with cancer, compared to their white counterparts who displayed more optimism in the recovery process. Further, this study’s results lay the foundation for future scholarship to explore avenues of information dispersal to Latino parents that correct misconceptions of health outcomes and enable earlier intervention to be possible, ultimately correlating to better health and treatment outcomes by increasing parental health literacy rates for childhood cancer in the Phoenix Metropolitan.

Keywords: Childhood Cancer, Parental Beliefs, Parental Attitudes, Parental Understandings, Phoenix Metropolitan, Culturally Competent Care, Health Disparities, Health Inequities

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Authors: Daniela Ribeiro, Silvia Lenyra Meirelles Campos Titotto

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Nature has long served as inspiration for humans, since various technologies present in society are a mirror of the natural world. This is due to the fact that nature has adapted for millions of years to possess the characteristics they have today. In this sense, man takes advantage of this situation and uses it to produce his own objects and solve his problems. This concept, which is known as biomimetics, is something relatively new, once it was only denominated in 1957. Nature, in turn, responds directly and consistently to environmental conditions. For example, plants that have touch sensitivity contract with this stimulus. Such a situation resembles a technology that has been gaining ground in the contemporary world of scientific innovation: 4D printing. 4D printing technology emerged in 2012 as a complement to 3D printing and presents numerous benefits since it provides a deficiency in the second kind of printing mentioned. This type of technology reaches several areas, since it is capable of producing materials that change over time, be it in its composition, form or properties and is such a characteristic that determines the additional dimension of the material. Precisely because of these factors, this type of impression resembles nature and is related to biomimetics. However, only certain types of ‘intelligent’ materials are generally employed in this type of impression, since only they will respond well to such stimuli, one of which is the hydrogel. The hydrogel is a biocompatible polymer that presents several applications, these in turn will be briefly mentioned in this article to exemplify its importance and the reason for choosing this material as object of study. In addition, aspects that configure 4D printing will be treated here, such as the importance of architecture, programming language and the reversibility of printed materials.

Keywords: 4D printing, biomimetic, hydrogel, materials

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Authors: C.Ardil

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Open Science translates the understanding and application of various theories and practices in open science philosophy, systems, paradigms and epistemology. Open Science originates with the premise that universal scientific knowledge is a product of a collective scholarly and social collaboration involving all stakeholders and knowledge belongs to the global society. Scientific outputs generated by public research are a public good that should be available to all at no cost and without barriers or restrictions. Open Science has the potential to increase the quality, impact and benefits of science and to accelerate advancement of knowledge by making it more reliable, more efficient and accurate, better understandable by society and responsive to societal challenges, and has the potential to enable growth and innovation through reuse of scientific results by all stakeholders at all levels of society, and ultimately contribute to growth and competitiveness of global society. Open Science is a global movement to improve accessibility to and reusability of research practices and outputs. In its broadest definition, it encompasses open access to publications, open research data and methods, open source, open educational resources, open evaluation, and citizen science. The implementation of open science provides an excellent opportunity to renegotiate the social roles and responsibilities of publicly funded research and to rethink the science system as a whole. Open Science is the practice of science in such a way that others can collaborate and contribute, where research data, lab notes and other research processes are freely available, under terms that enable reuse, redistribution and reproduction of the research and its underlying data and methods. Open Science represents a novel systematic approach to the scientific process, shifting from the standard practices of publishing research results in scientific publications towards sharing and using all available knowledge at an earlier stage in the research process, based on cooperative work and diffusing scholarly knowledge with no barriers and restrictions. Open Science refers to efforts to make the primary outputs of publicly funded research results (publications and the research data) publicly accessible in digital format with no limitations. Open Science is about extending the principles of openness to the whole research cycle, fostering, sharing and collaboration as early as possible, thus entailing a systemic change to the way science and research is done. Open Science is the ongoing transition in how open research is carried out, disseminated, deployed, and transformed to make scholarly research more open, global, collaborative, creative and closer to society. Open Science involves various movements aiming to remove the barriers for sharing any kind of output, resources, methods or tools, at any stage of the research process. Open Science embraces open access to publications, research data, source software, collaboration, peer review, notebooks, educational resources, monographs, citizen science, or research crowdfunding. The recognition and adoption of open science practices, including open science policies that increase open access to scientific literature and encourage data and code sharing, is increasing in the open science philosophy. Revolutionary open science policies are motivated by ethical, moral or utilitarian arguments, such as the right to access digital research literature for open source research or science data accumulation, research indicators, transparency in the field of academic practice, and reproducibility. Open science philosophy is adopted primarily to demonstrate the benefits of open science practices. Researchers use open science applications for their own advantage in order to get more offers, increase citations, attract media attention, potential collaborators, career opportunities, donations and funding opportunities. In open science philosophy, open data findings are evidence that open science practices provide significant benefits to researchers in scientific research creation, collaboration, communication, and evaluation according to more traditional closed science practices. Open science considers concerns such as the rigor of peer review, common research facts such as financing and career development, and the sacrifice of author rights. Therefore, researchers are recommended to implement open science research within the framework of existing academic evaluation and incentives. As a result, open science research issues are addressed in the areas of publishing, financing, collaboration, resource management and sharing, career development, discussion of open science questions and conclusions.

Keywords: Open Science, Open Science Philosophy, Open Science Research, Open Science Data

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Authors: Ida Zubaidah

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With the advancement of information and communication technologies, in many cases, geographical distance is no longer considered as a main barrier in distance education. Geographical distance, even from a continent to another, between students and their instructor or students and their campus can be connected by the Internet, telephone or any other means of communication technology. Managing distance learning in an archipelagic country like Indonesia, however, has some different stories. Comprising more than 17,000 islands and 6.000 of them inhabited, Indonesia is considered as one of the most archipelagic countries in the world. In some areas or islands that have adequate public transportation and communication facilities the courses can be delivered quite well. In other areas that geographically very remote and dispersed islander, Universitas Terbuka, an open university in Indonesia, has to have very different strategies in overcoming the specific and even emergency situations in learning delivery. This ongoing research paper aims to share experiences of how Universitas Terbuka makes serious and unique efforts in overcoming the barriers and obstacles in providing educational service in part of difficult areas, especially in eastern areas of Indonesia. The data collection methods are observation of sample areas and in-depth interview with the head of regional offices of Universitas Terbuka in eastern Indonesia, staff, and tutors. Conducting educational deliveries in in difficult areas with no regular and adequate transportation has made the regional office have specific strategies in making the learning process run as smooth as possible. Sending a tutor to an area to meet some students and conducting a series of tutorial, which are supposed to be weekly, in several days is one of the strategies. Recruiting local people to manage the students in the area is another strategy. The absence of regular transportation from island to island, high tides, hurricanes, are among the obstacles faced by the regional offices in doing their job. Non geographical barriers such as unavailability of qualified tutor, inadequate tutor payment, are problems as well. The learning process, however, has to be done in any way, otherwise the distance education mission to reach unreachable cannot be achieved.

Keywords: distance education, Terbuka University, difficult area, geographical barrier, learning services

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Authors: T. R. Hidayat, G. Irawan, F. Kurniawan, E. H. I. Prasetya, Suharto, T. F. Ridwan, A. Pitoyo, A. Juniantoro, R. T. Hidayat

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Swab activities is an activity to lift fluid from inside the well with the use of a sand line that aims to find out fluid influx after conducting perforation or to reduce the level of fluid as an effort to get the difference between formation pressure with hydrostatic pressure in the well for underbalanced perforation. During the swab activity, problems occur frequent problems occur with the rubber swab. The rubber swab often breaks and becomes a fish inside the well. This rubber swab fishing activity caused the rig operation takes longer, the swab result data becomes too late and create potential losses of well operation for the company. The average time needed for fishing the fractions of rubber swab plus swab work is 42 hours. Innovation made for such problems is to modify the rubber swab tool. The rubber swab tool is modified by provided a series of brushes at the end part of the tool with a thread of connection in order to improve work safety, so when the rubber swab breaks, the broken swab will be lifted by the brush underneath; therefore, it reduces the loss time for rubber swab fishing. This tool has been applied, it and is proven that with this rubber swab tool modification, the rig operation becomes more efficient because it does not carry out the rubber swab fishing activity. The fish fractions of the rubber swab are lifted up to the surface. Therefore, it saves the fuel cost, and well production potentials are obtained. The average time to do swab work after the application of this modified tool is 8 hours.

Keywords: rubber swab, modifikasi swab, brush, fishing rubber swab, saving cost

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Authors: Mosaad Attia Elkasaby

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The crude oil contains paraffines, aromatics, and asphaltenes in addition to some organic impurities, with increasing demands to reduce the cost of crude oil production, the uses of a pour point depressant is mandatory to maintain good flow rate. The wax materials cause many problems during production, storage, and transport, especially at low temperature, as these waxes tend, at low temperatures, to precipitate on the wall lines, thus leads to the high viscosity of crude oil and impede the flow rate, which represents an additional burden for crude oil pumping system from the place of production to the refinery. There are many ways to solve this problem, including, but not limited to, heat the crude and the use of organic solvents. But one of the most important disadvantages of these methods is the high economic cost. The aim of this innovation is to manufacture some polymeric materials (polymers based on aniline) that are processed locally that can be used as a pour point depressant of crude oil. For the first time, polymer based on aniline is modified and used with a number of organic solvents and tested with solvent (Styrene). It was found that the polymer based on aniline, when modified, had full solubility in styrene, unlike other organic solvent that was used in the past, such as chloroform and toluene. We also used a new solvent (PONA) that is obtained from the process of hydrotreating and separation of straight run naphtha to dissolve polymer based on aniline as a pour point depressant of crude oil. This innovative include studies conducted on highly paraffinic crude oil (C.O.1 and C.O.2). On using concentration (2500 ppm) of polymer based on aniline, the pour point of crude oil has decreased from +33 to - 9°C in case of crude oil (C.O.1) and from + 42 to – 6°C in case crude oil (C.O.2) at the same concentration.

Keywords: PPD, aniline, paraffinic crude oils, polymers

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

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