Administrative System Research Articles

An Investigation into the Causes of Tax Evasion and Avoidance by Small and Medium Enterprises (SMEs) and Their Effect on the Zambian Economy in Chililabombwe District

This study was purposed to investigate the causes of tax evasion and avoidance and its effect on the Zambian economy in Chililabombwe District of the Copperbelt Province. It had two-fold objectives: to examine the causes of tax evasion and avoidance in Chililabombwe District by SMEs, and to determine the effect of tax evasion and avoidance in Chililabombwe District on the Zambian economy. The study used a mixed method approach combining both qualitative and quantitative paradigms in which 110 sample size was targeted. One Hundred and ten (110) questionnaires were distributed and 79 were returned representing 72%. Purposive and convenient sampling techniques were used. Quantitative data was analysed through the SPSS version 16 while qualitative data was analysed through content analysis focusing on main unfolding themes from the interviews. The study discovered that that there are loopholes in the Zambia Revenue Authority's (ZRA) tax administration system which are due to inefficiencies or inadequate competence of tax collectors, which taxpayers exploit in evading and avoiding tax. The investigation also revealed that on account of the established loopholes, certain revenue collectors collude with taxpayers to commit tax fraud by accepting bribes from them while poor sales, high tax rates, and lack of tax education to SMEs were noted to be among key reasons for tax avoidance. Consequently, the study ascertained with concern that the levels of development in the district, in terms of social amenities, schools, road network, and youth / women empowerment programmes are very low. The study concluded that tax evasion and avoidance were real and rife among the SMEs on account of the factors cited and that mitigative policy measures were required without any further delays. Arising from the results of the study, it was strongly recommended that for tax evasion and avoidance to be mitigated, the revenue authority needs to urgently reform the tax system to make it equitable and fair coupled with rigorous tax education to the traders for sufficient tax knowledge and thereafter digitize tax remittances with ease for the traders to file returns without need for middle persons. Tax morale and ultimately revenue collection can be improved through tax education programs, integrity of tax collectors, and reduction of tax rates chargeable to SMEs. Enhanced training and sensitization to create awareness, reduce compliance cost, and simplify online technology for the overall positive impact on compliance among the SMEs are elements of paramount import for the success of the nation in meeting its socio-economic goals through guaranteed revenue collections by the Revenue House.

Blood Transfusion Procedure: Assessment of Serbian Intensive Care Nurses' Knowledge.

Many patients require administering one or more blood components during hospitalisation in the Intensive Care Unit (ICU). Therefore, nurses' knowledge of who is responsible for immediately administering blood transfusions, monitoring patients, and identifying and managing transfusion reactions is crucial. This cross-sectional descriptive-analytical study aimed to assess the knowledge of ICU nurses in tertiary healthcare institutions about blood transfusion procedures. The questionnaire about the transfusion procedure was designed and reviewed by experts. The questionnaire consisted of 29 items divided into three domains. The scores on the knowledge test ranged from 10 to 27. Generally, 57.7% of nurses had moderate, 23.4% low, and 18.9% high levels of knowledge about the transfusion procedure. Most nurses answered correctly about refreezing fresh frozen plasma, verifying the transfusion product, and identifying the patient. Of the nurses, 91.0% would recognise mild allergic reactions, and 98.2% knew about the supervision of sedated patients. Nurses showed poor knowledge of the length of usage of the same transfusion system for red blood cells, labelling, and transfusion administration in febrile patients. Nurses with higher education and longer working experience had significantly better outcomes (p = 0.000) on the knowledge test. Continuous education of ICU nurses on safe transfusion usage is recommended.

The COVID-19 Pandemic Through the Environmental Discourse: the State, Civil Society, the Problems of Development

This paper examines the response of political communities to the COVID-19 pandemic. Using methodological approaches such as political globalism, world-system and structural-functional analysis, the author examines the political conditions of nation-states for coping with the pandemic and its consequences. Within this framework, the problem of the systemic crisis of the modern state, the effectiveness of public administration and decision-making systems was also addressed. The focus was on issues of political development, considered in the context of the evolution of democracy, civic political participation, the role of non-governmental organisations and elites, and the relationship between values and goals in the global and national political agenda. The article also touches upon the problem of “infodemics.” The paper concludes with recommendations for adding an environmental component to the concept of national security.

Crop Type Mapping and Winter Wheat Yield Prediction Utilizing Sentinel-2: A Case Study from Upper Thracian Lowland, Bulgaria

The aim of this study is to predict and map winter wheat yield in the Parvomay municipality, situated in the Upper Thracian Lowland of Bulgaria, utilizing satellite data from Sentinel-2. The main crops grown in the research area are winter wheat, rapeseed, sunflower, and maize. To distinguish winter wheat fields accurately, we evaluated classification methods such as Support Vector Machines (SVM) and Random Forest (RF). These methods were applied to satellite multispectral data acquired by the Sentinel-2 satellites during the growing season of 2020–2021. In accordance with their development cycles, temporal image composites were developed to identify suitable moments when each crop is most accurately distinguished from others. Ground truth data obtained from the integrated administration and control system (IACS) were used for training the classifiers and assessing the accuracy of the final maps. Winter wheat fields were masked using the crop mask created from the best-performing classification algorithm. Yields were predicted with regression models calibrated with in situ data collected in the Parvomay study area. Both SVM and RF algorithms performed well in classifying winter wheat fields, with SVM slightly outperforming RF. The produced crop maps enable the application of crop-specific yield models on a regional scale. The best predictor of yield was the green NDVI index (GNDVI) from the April monthly composite image.

Financial Constitution Issues in Development of the Basic Law for the Federal Republic of Germany in 1948-1949

This   article   analyzes   the   key   problems of the financial constitution in the development of the Basic Law for the Federal Republic of Germany (FRG) in 1948-1949, based on materials from the Constitutional Convention at Herrenchiemsee and the Parliamentary Council of West Germany. It emphasizes that the relevance of this issue was influenced by Germany’s historical development, which had a long-standing experience in both regional and imperial financial administration. This led to high significance of financial constitution issues in post-war West German politics. It is concluded that the main approaches to this problem were developed at the Herrenchiemsee Convention in October 1948, and the main content of the financial section of the Basic Law was formulated in the financial committee at the beginning of October 1948. A key role in developing the financial constitution was played by parliamentarian H. HöpkerAschoff. However, until May 1949, the parties could not reach a consensus on matters of financial administration system and financial equalization. This was significantly influenced by constant objections from the occupying administrations, the position of the Christian Social Union in Bavaria (CSU), uncertainty in assessing financial conditions, and the Social Democrats’ consistent defense of broad financial powers for the federal center.

Memahami Dinamika Administrasi Publik dan Implementasi Kebijakan

Abstract. This study aims to explore and analyze the factors that lead to the persistent discrepancy between policy formulation and effective implementation in public administration.
 By utilizing secondary data obtained from various scientific sources, this study uses qualitative research methods to provide insight into the complex dynamics that influence the outcome of policy implementation.
 The findings of this study emphasize several key factors influencing policy implementation. First, bureaucratic structure and organizational processes are identified as elements that significantly affect implementation results. This study reveals that inefficient bureaucratic practices and systemic barriers often hinder effective policy translation into practice. Moreover, the role of leadership in ensuring the successful implementation of policies in public administration emerges as another important factor. Effective leadership, with its ability to mobilize resources and inspire commitment, plays a critical role in driving successful policy implementation. Furthermore, political factors were found to greatly influence the dynamics of policy implementation. Research shows that political instability, self-interest, and ideological conflict can hinder effective policy implementation, leading to sub-optimal outcomes. To bridge the gap between policy formulation and implementation, this study outlines the main strategies. This strategy includes improving communication channels, stakeholder engagement, capacity building, and cultivating a culture of accountability and transparency within the administrative system.
 In conclusion, this research sheds light on the complexities surrounding policy implementation in public administration. By understanding the multifaceted nature of the problem and adopting strategic interventions, policymakers can work towards achieving a more effective and efficient policy implementation process.
 Keywords:          Bureaucratic structure; Organizational processes; Policy implementation; Political factors, Public administration

Decisions with general scope in the light of special sectoral regulations in the Hungarian administrative system

AbstractIn the 21st century, the two administrative instruments that have the greatest impact on the legal situation of members of society, administrative enforcement and administrative legislation, have been and are being confronted with a number of social challenges (global economic crisis, refugee crisis, epidemics and pandemics). The challenges of the 21st century require public intervention to provide a rapid, accurate and effective response to the problems that arise, while ensuring legality and the protection of the rights of the citizens. The first responses to social problems are provided by sectoral regulations, which may conflict with general rules of administrative procedure. The study analyses administrative decisions of general scope in the light of special sectoral regulation and review the points of conflict with general rules of administrative procedure. The study concludes with a proposal.

Local Self-Governance and State Power in the Russian Federation: In the Search for a Way Out of the Institutional Trap

The subject of the study is the causes of the contradiction that have arisen in the legal and political field of modern Russia, related to the status of the institution of local self-government. On the one hand, local self-government, in fact, acts as a lower level of public administration, both in political practice and in mass consciousness. But legally, its bodies are not part of the system of state power. The author explains this situation by the institutional trap into which the state power has fallen.
 The author sees the reasons for the emergence of this collision between the needs of political practice and legislative requirements in the coincidence of circumstances caused by the struggle of actors during the political confrontation between the legislative and executive powers in October 1993. The lack of socio-economic support, necessary for the full functioning of the institution, made it inevi that in the future that institution would turn into a "lower floor" of the system of state administration, with the simultaneous camouflaging municipal bodies as a non-governmental organization.
 It is shown that throughout the entire subsequent history of local self-government existence attempts were made to resolve this contradiction. The latest attempt was made in the latest version of the Constitution of the Russian Federation by including state and local self-government bodies into the system of unified public power.
 It is noted that the functioning of nominally self-governing, but basically - state bodies at the local level has a number of negative consequences. Organizational and legal ways out of the "institutional trap" are suggested.

Adrenal-Permissive Germline HSD3B1 Allele and Prostate Cancer Outcomes

The adrenal androgen-metabolizing 3β-hydroxysteroid dehydrogenase-1 enzyme, encoded by the HSD3B1 gene, catalyzes the rate-limiting step necessary for synthesizing nontesticular testosterone and dihydrotestosterone production. The common adrenal-permissive HSD3B1(1245C) allele is responsible for encoding the 3β-HSD1 protein with decreased susceptibility to degradation resulting in higher extragonadal androgen synthesis. Retrospective studies have suggested an association of the HSD3B1 adrenal-permissive homozygous genotype with androgen deprivation therapy resistance in prostate cancer. To evaluate differences in mortality outcomes by HSD3B1 genetic status among men with prostate cancer. This cohort study of patients with prostate cancer who were enrolled in the Million Veteran Program within the Veterans Health Administration (VHA) system between 2011 and 2023 collected genotyping and phenotyping information. HSD3B1 genotype status was categorized as AA (homozygous adrenal-restrictive), AC (heterozygous adrenal-restrictive), or CC (homozygous adrenal-permissive). The primary outcome of this study was prostate cancer-specific mortality (PCSM), defined as the time from diagnosis to death from prostate cancer, censored at the date of last VHA follow-up. Secondary outcomes included incidence of metastases and PCSM in predefined subgroups. Of the 5287 participants (median [IQR] age, 69 [64-74] years), 402 (7.6%) had the CC genotype, 1970 (37.3%) had the AC genotype, and 2915 (55.1%) had the AA genotype. Overall, the primary cause of death for 91 patients (1.7%) was prostate cancer. Cumulative incidence of PCSM at 5 years after prostate cancer diagnosis was higher among men with the CC genotype (4.0%; 95% CI, 1.7%-6.2%) compared with the AC genotype (2.1%; 95% CI, 1.3%-2.8%) and AA genotype (1.9%; 95% CI, 1.3%-2.4%) (P = .02). In the 619 patients who developed metastatic disease at any time, the cumulative incidence of PCSM at 5 years was higher among patients with the CC genotype (36.0%; 95% CI, 16.7%-50.8%) compared with the AC genotype (17.9%; 95% CI, 10.5%-24.7%) and AA genotype (18.5%; 95% CI, 12.0%-24.6%) (P = .01). In this cohort study of US veterans undergoing treatment for prostate cancer at the VHA, the HSD3B1 CC genotype was associated with inferior outcomes. The HSD3B1 biomarker may help identify patients who may benefit from therapeutic targeting of 3β-hydroxysteroid dehydrogenase-1 and the androgen-signaling axis.

The decisive role of the principles of administrative procedure in ensuring effective regulation of administrative acts

This article reveals the importance of the principles of administrative procedure in regulating the process of adoption of administrative acts. The article provides an in-depth analysis of how adherence to these principles is essential to promoting fairness, transparency, and accountability in government decision-making.
 Thearticle aims to provide an understanding of the principles of administrative law, emphasizing their application in regulating administrative procedures for fair and efficient public administration.
 The article highlights the impact of administrative acts on individuals and organizations, emphasizing the need for fair and accountable governance. The article examines the basic principles underlying administrative procedures, including due process, legality, fairness, and impartiality. Highlighting their importance, the article illustrates how these principles act as vital checks and balances, protecting citizens' rights and preventing abuse of power.
 In addition, the article sheds light on the positive effects of transparent and accessible administrative procedures. By promoting public participation and engagement, it highlights the potential for greater collaboration between government and its constituents. The introduction of these principles not only strengthens the legitimacy of administrative acts, but also contributes to the formation of citizens' sense of ownership and responsibility.
 The language of the article strikes a balance between legal rigor and accessibility, making it relevant for policymakers, legal practitioners, and the general public alike. Advocating for the integration and implementation of administrative- procedural principles, the author emphasizes their importance in improving the quality of management and strengthening democratic values.
 Overall, this article is informative for those who seek to understand the indispensable role of principles of administrative procedure in creating a fair, transparent and accountable administrative system. Through his persuasive arguments and comprehensive analysis, he encourages a wider commitment to these principles, ultimately strengthening administrative processes and regulation.

Embracing The Vanguard Role: Obstacles Faced by Health Cadres in Fulfilling Societal Responsibilities

Background: Health cadres play a crucial role in community development, serving as primary health managers responsible for mobilizing communities and fostering self-help initiatives to improve health outcomes. Despite their significance, challenges such as poor communication leading to missed visits by mothers with toddlers hinder program execution. Understanding and addressing these challenges is essential for establishing a resilient healthcare system that optimizes cadre contributions.Method: A qualitative, phenomenological approach was employed in this study. In-depth interviews were conducted with 11 diverse participants, including the Head of the Public Health Center, the Coordinator of Health Cadres, Health Cadres, and Community Members. Informant selection utilized purposive techniques and snowball sampling, with an interview guide containing open-ended questions as the research instrument. The data analysis followed a descriptive approach based on the Miles and Huberman model.Results: Challenges faced by health cadres varied across regions, encompassing factors such as differing community participation levels, heavy administrative tasks, and conflicts among cadres. Despite these challenges, most cadres exhibited high commitment, motivation, and familial support, mitigating potential issues. Each cadre adopted a unique approach to anticipate and address challenges associated with their roles. Regular coaching from Public Health Centers and implementing simplified administrative systems were identified as potential strategies to enhance cadre performance.  

Review on Nasal Drug Delivery System and Their Application

Nasal drug delivery has received a great deal of attention as a convenient, reliable, and promising method for the systemic administration of drugs. It is especially for those molecules which are ineffective orally and only effective if administered by injection. The nasal route of drug delivery has advantages over the other alternative systems of non-invasive drug administration. The present review is an attempt to provide some information concerning nasal drug delivery system such as limitations, advantages, mechanism of drug absorption, anatomy of nasal cavity, factors affecting of nasal drug delivery, strategies to enhance nasal absorption, strategies to extend duration of drug formulations within the nasal cavity, leading to improved nasal drug absorption, novel drug formulations, sorts of nasal drug delivery system with uses of nasal drug delivery in various diseases, and recent advancement of nasal delivery systems.

Analysis of Right to Health Using Queueing Theory: A Critical Overview

The Rajasthan Government has passed a “Right to Health Bill 2023” on March,21 and became the first state to enact a Right to Health Act. The bill gives every resident of the state the right to avail free Out Patient Department (OPD) services and in Patient Department (IPD) services at all public health facilities. The bill sparked massive protests from the medical community. In this article, we analysis the requirement of this bill and problems in implementation of RTH. Does this bill play a significant role to improve health care system at local level? We also discuss the practical situation of hospitals system capacity for these types of revolution. Here we use Queueing theory techniques for manpower planning in hospitals to improve efficiency of healthcare system. This is a theoretical article and provide decision support system for Policymakers and Public administration.

COMMUNITY SERVICE APPLICATIONS FOR VILLAGE OFFICE USING LARAVEL FRAMEWORK

The government has developed a population administration system to support public services, one of the media used by the government is electronic government (e-government). One of the villages that has a large Regional Revenue and Expenditure Budget (APBD) in the Serang district, Banten province is Ranjeng village, Ciruas sub-district. The problem is that data management in villages is still carried out semi-manually, there is no specific application to handle this management so it is not time efficient, reporting and the level of service to the community is less than optimal. To overcome these problems, a system is needed that can help the community in submitting letters and can help the village government to improve services to the community. The system design used in this research is using the Waterfall method so that it is easier to develop and using UML (Unified Modelling Language) for visual system modelling, while the programming language used is PHP using the Laravel framework. The final result of this research is a system that can improve the services of the Ranjeng Village Office to the community to be optimal.

The Comprehensive Review: Exploring Future Potential of Nasopulmonary Drug Delivery Systems for Nasal Route Drug Administration

This comprehensive review aims to explore the future potential of nasopulmonary drug delivery systems for the administration of drugs through the nasal route. Nasal drug delivery has gained significant attention due to its numerous advantages, including rapid absorption, avoidance of first-pass metabolism, and non-invasive administration. This review provides an overview of the nasal anatomy and physiology, highlighting the factors influencing drug absorption and bioavailability. Additionally, it discusses the various types of nasopulmonary drug delivery systems, such as nasal sprays, powders, and gels, along with their advantages and limitations. Furthermore, the review delves into the challenges associated with nasal drug delivery, including mucociliary clearance, nasal irritation, and formulation issues. The potential applications of nasopulmonary drug delivery systems in the treatment of various diseases, such as allergies, respiratory disorders, and systemic conditions, are also discussed. Finally, the review concludes with an outlook on the future prospects of nasopulmonary drug delivery systems, emphasising the need for further research and development to optimise their efficacy and safety.
 Keywords: nasal pulmonary; nasal spray; nasal mucosa; gels; drops; nasal approaches; nasal route; nasal delivery.

AI Readiness Level in Public Administration: Case of the Russian Federation

The study explores approaches to the analysis of measurable indicators of artificial intelligence and its use in the system of sectoral public administration. As a part of the research the author developed the methodological basis for assessing the likelihood of the emergence of artificial intelligence. The research proposed analysis of the external base, technology, statistical reliability, education, labor market, citizens’ perspectives and development of the index of readiness for the emergence of artificial intelligence in sectoral public administration. The author carried out analysis of state functions and tasks for the introduction of artificial intelligence technologies, monitoring of measurable results of the introduction of artificial intelligence, analysis of government programs and cases of digital transformation based on AI technologies. It is shown, that currently, when using artificial intelligence solutions in the public sector, only individual problem blocks are mainly analyzed. The author states that a comprehensive index and a comprehensive risk analysis are not available both in Russia and abroad. The developed approaches to readiness assessment would help to reduce the costs of public administration and the risks of mistakes in the implementation of AI technologies.

Innovative mechanisms for designing the regional public administration system

Subject. This article discusses the issues of managing complex systems and the feedback quality. Objectives. The article aims to develop a process model for the functioning of the regional public administration system. Methods. For the study, we used a systems analysis. Results. The article presents the design of a single control loop based on the model of a goal-oriented system and the model of an automatic control system and offers complete lists of elements for projects of a regional public administration system. Conclusions. Further development and implementation of the proposed project of the regional management system can help improve the effectiveness of targeted activities.

Refining the survey model of the LADM ISO 19152–2: Land registration

Cadastral surveying involves the delineation of property boundaries and the extent and documentation of easements and restrictions (imposed by private or public law), forming the foundation for Land Administration (LA). Survey models and processes constitute vital parts of Cadastres and Land Administration Systems (LASs). However, these models are often inadequately documented and lack standardization in practice. To address the global diversity and complexity of legal and administrative challenges in LA, standardization efforts have yielded the ISO 19152:2012 (ISO, 2012) Land Administration Domain Model (LADM), the Global Land Tool Network's (GLTN) Social Tenure Domain Model (STDM), and the OGC LandInfra/InfraGML standard. The current edition of the LADM focuses on standardised conceptual modelling of LA-related information, including a dedicated sub-package for Spatial and Surveying representation. As part of the ongoing LADM revision, a refined survey model is being developed to support a broad range of surveying and data acquisition approaches and levels of accuracy. Recognizing that surveying technology is not bound by national practices and regulations, this paper focuses specifically on the surveying aspect of LADM. It illustrates that the proposed refined survey model is applicable not only to conventional real property formation but also to participatory land rights recordation processes. The approach adopted in this research is technology-neutral, accommodating the ongoing evolution of surveying technology. It offers support for a broad range of surveying and data acquisition approaches, with varying levels of accuracy. As the demand for high-precision positioning has been persistent within the land mapping and surveying community, particularly since the initial adoption of GPS, aiming to achieve centimetre-level accuracies (initially confined to local services), the paper addresses the fundamental principles of the High Accuracy Service (HAS) concept within the proposed model. The main results presented in this paper are the conceptual model of the refined survey model of LADM Edition II (ISO19152–2), as well as an abstract, reference, cadastral surveying workflow following the principles of the proposed model.

Mathematical Prediction of Electrical Solar Energy Based on Solar Data for Two Main Cities of Chad: Mongo in the Centre and Pala in the South of Chad

The comparative study of the solar powers between two main cities of Chad is performed in the present work, the city of Mongo in the Centre and that of Pala in the South, with an aim of knowing which one of the two cities is more adequate for an installation of the solar power station, taking into account the regional climatic and environmental conditions of both cities. To do this, the graphical statistical analysis of long-term solar irradiance data and temperature is performed. The data used is that of the decade (2010-2020), based on solar radiation data handed by the National Aeronautics and Space Administration (NASA) and Photovoltaic Geographical Information System (PGIS) for Mongo in the centre and Pala in the south of Chad. The shape of the mean monthly irradiation has been plotted and has been approximated using the sinusoidal function through the mean square analysis. The temperature data has been also obtained by the same process and plotted versus irradiance in order to find the adequate mathematical relationship between them. For the statistical analysis, the maximum entropy principle has been used. As results, it is found that the maximum irradiance is obtained in March, which are 226.26kWh/m<sup>2</sup> for Pala and 219.355kWh/m<sup>2</sup> for Mongo, while the minimum irradiances are obtained in August, which are 151.67kWh/m<sup>2</sup> for Pala and 158.9kWh/m<sup>2</sup> for Mongo. The temperature data is also obtained and the mean monthly data plotted, showing that apart for the months of March and April, the the shapes of irradiation and temperatures are similar for both sites. Then it is found that the frequency and probability density distributions reach their maximum at the same dates.

Predictive modeling of burnout based on organizational culture perceptions among health systems employees: a comparative study using correlation, decision tree, and Bayesian analyses

Burnout is a significant concern, particularly within the healthcare field, affecting both nurses and physicians. It is a common issue in health systems, which encompass a range of healthcare facilities, such as hospitals, physician practices, ambulatory sites, and administrative offices like finance. Despite this, there has not been an extensive exploration of burnout in employees working directly with patients versus those in non-patient-facing roles within these health systems. It is important to note that organizational culture plays a crucial role in influencing various aspects of employees' work-life balance and their experiences of burnout. This study adopts a cross-sectional design, involving the distribution of a 57-question Likert scale survey to employees in health systems. These employees serve in various roles, both patient-facing and non-patient-facing, within jointly owned healthcare organizations, which encompass hospitals, ambulatory sites, and administrative offices. The survey was disseminated through trade organizations and employees at the managerial level and above within these health systems. Data was collected between October 2022 and January 2023, resulting in a total of 67 responses. The study employs correlation analysis to explore the connection between organizational culture and burnout. Furthermore, a decision tree model is constructed to predict burnout scores based on survey responses, specifically the question regarding the perceived positivity of the organizational culture. The decision tree models indicate that perceiving organizational culture as positive, safety-oriented, and supportive predicts various outcomes for individuals, including job retention, positive experiences with patients, increased callousness, and stimulation while working with colleagues. Bayesian analysis, considering the small sample size, reinforces these findings and provides a different perspective, incorporating prior knowledge and credible intervals. An association test suggests a strong link between a positive organizational culture and burnout symptoms, while another test supports a connection with engagement signs. Similar to nurses and physicians, administrative health systems’ personnel are susceptible to burnout. Organizational culture can affect burnout. Therefore, health systems’ leaders should cultivate an organizational culture that protects against burnout.