Service Center Research Articles

Healthcare leadership practice and associated factors among primary healthcare managers in East Gojam Zone, Northwest Ethiopia: a mixed method study

BackgroundLeadership plays a critical role in the delivery of person centered, safe, efficient, and effective healthcare services globally. Poor healthcare leadership contributes to low staff motivation, patient dissatisfaction, and reduced healthcare-seeking behavior. However, there is limited evidence on healthcare leadership practice and associated factors among primary healthcare managers in the study area and at large in Ethiopia. Therefore, the findings of this study will contribute to improved healthcare leadership practices among primary healthcare managers.MethodFacility-based cross-sectional study supplemented with qualitative inquiry was conducted in the East Gojam zone among 532 primary healthcare managers selected by a two-stage stratified random sampling technique. A pre-tested and structured self-administered questionnaire was used to collect the quantitative data. Data were entered into Epi-Data version 4.6 and exported into Stata version 14.0 for analysis. Multiple linear regression analysis was used to identify factors associated with healthcare leadership practice, and statistical significance was declared at a p-value < 0.05 with a 95% CI. Six key informant interviews were conducted, and thematic analysis was used for the qualitative study.ResultThe magnitude of healthcare leadership practice among primary healthcare managers in the East Gojam zone was 45.7% (95% CI: (41.4, 50.0)). Factors associated with healthcare leadership practice were age [β = 0.44, 95% CI: (0.16, 0.71)], training in healthcare leadership practice [β = 1.19, 95% CI: (0.19, 2.20)], experience sharing [β = 1.68, 95% CI: (0.59, 2.76)], organizational communication [β = 0.19, 95% CI: (0.05, 0.33)], managerial working experience [β = 0.94, 95% CI: (0.18, 1.69)] and emotional intelligence [β = 0.35, 95% CI: (0.31, 0.38)].Conclusion and recommendationThe magnitude of healthcare leadership practice among primary healthcare managers in the East Gojam zone was low as compared with a previous study in Ethiopia. It was significantly associated with age, training in leadership, experience sharing, organizational communication, managerial working experience, and emotional intelligence. Thus, human resource managers at primary healthcare level should consider older and more experienced candidates during assigning managers, organize training on healthcare leadership and experience sharing with model managers to improve the leadership practice of primary healthcare managers in the East Gojam zone.

Retraction notice: Application and use of telepresence robots in libraries and information center services: prospect and challenges

Retraction notice: Application and use of telepresence robots in libraries and information center services: prospect and challenges

American Thyroid Association Policy Statement: Impact of Changes in Fine Needle Aspiration Biopsy Reimbursement on Clinical Care of Patients with Thyroid Nodules in the United States.

Introduction: The Clinical Affairs Committee of the American Thyroid Association has developed this statement to describe recent changes in the billing and coding of ultrasound-guided fine needle aspiration procedures of thyroid nodules, and to raise awareness of the adverse consequences that have arisen as a result. Review: A reduction in payment of ultrasound-guided fine needle aspiration procedures was enacted by the Centers for Medicare and Medicaid Services in 2019. The Clinical Affairs Committee has sought to examine the effects of the change in reimbursement on the care of patients with thyroid diseases. Summary: The historical background of the changes in payment structure for ultrasound-guided fine needle aspiration of thyroid nodules is discussed. The years 2019 and 2020 saw a significant decline in claims for ultrasound-guided fine needle aspiration procedures, concomitant with a shift in the performance of these procedures away from non-facility outpatient settings and a rise in costs to the health care system. Conclusion: Several negative consequences of the decrease in reimbursement for ultrasound-guided fine needle aspiration of thyroid nodules have arisen. This has led to significant concern among clinicians who care for patients with thyroid diseases regarding delays in patient access to care and diagnosis, and a diminished pool of qualified thyroid specialists to perform these procedures in the future.

Geographic trends in overall and long-acting opioid prescriptions under Medicaid and Medicare Part D in the United States, 2013–2021

ABSTRACT Background: Amid the national opioid epidemic, it is important to assess trends in opioid prescriptions. Long-acting opioids (LAOs) are of particular interest as they are among the most intensely misused prescription opioids. Moreover, understanding geographic trends in opioid prescriptions may help identify state-level variations, illustrating state-specific disparities. Objectives: The study aims to determine geographic trends in overall and LAO prescriptions under Medicaid and Medicare Part D from 2013 to 2021. Methods: We used data from the Centers for Medicare & Medicaid Services on opioid prescriptions from 2013 to 2021. The opioid prescribing proportion was calculated as the number of opioid claims divided by the total number of overall drug claims. The LAO prescribing proportion was calculated as number of LAO claims divided by total opioid claims. Results: Despite a general decrease nationwide, Medicaid opioid prescribing proportions increased in Iowa, Montana, and Virginia. There was an increasing trend in the national-level Medicaid LAO prescribing proportion from 2017 to 2021, with a 14.1% point increase (p for the annual percent change [APC]<0.05). For Medicare Part D, the overall prescribing proportions fell by 1.7% points from 2013 to 2021, while the LAO prescribing proportion fell by 3% points from 2016 to 2021 (p for APC < .05). Conclusions: The increasing trends in national-level Medicaid LAO prescribing and Medicaid opioid prescribing in Iowa, Montana, and Virginia are concerning, and have implications for clinical opioid prescribing. The decreasing trends in Medicare Part D may reflect ongoing efforts in opioid prescription management.

Spending on anticancer drugs among Medicare beneficiaries: Analyzing predictors of drug expenditures

ObjectiveTo evaluate the factors associated with Medicare spending on newly approved anticancer drugs in the US from 2012 through 2021. Patient and methodsUsing a cross-sectional analysis, we searched US FDA new oncology drug approvals (2012–2021). We analyzed clinical attributes and institutional factors influencing the annual cost of new anticancer drugs in the US. Annual treatment cost was calculated based on average spending per beneficiary from the Centers for Medicare and Medicaid Services, with product factors sourced from the FDA’s annual New Drug Therapy Approval reports and drug package inserts at the time of approval. ResultsOver a ten-year period, 112 new anticancer drugs were approved, of which 97 met the study's criteria. A significant majority, 93 %, received expedited development designations from the FDA. At the time of approval, 40 % of these drugs had data on progression-free survival, and 19 % had data on overall survival; 29 % were first-in-class. The study found a significant relationship between the year of approval and factors associated with the size of the treatment population. No statistically significant relationship was found between the clinical value of a drug and its price. ConclusionsSpending on anticancer drugs by Medicare are predominantly determined by reference pricing and the size of the anticipated treatment population, without an association with therapeutic value. The study advocates for reforms in reimbursement mechanisms for drugs lacking comparator arms and greater transparency for patients treated with these drugs.

The Living CV project: a model of collaborative learning in third space

The Living CV project is a collaborative initiative launched at a south coast university in the UK, which aims to help students develop their employability skills and evidence their learning outcomes. The project is delivered university-wide from a third space hub, where people from different disciplines and backgrounds come together to work on shared goals. It has therefore provided a way for colleagues across the university to collaborate within third space. In this study we focus on the role of the departmental Living CV Champions and their pivotal role in driving forward this third space project. These champions are situated across the university – in academic departments, in the university’s central Learning and Teaching service and in its career service – but all are working across boundaries and drawing collaborators into the third space of the project. We suggest that the Living CV Champions are also collaboration champions for the institution, in the way in which they support the development of staff networks and knowledge sharing, and therefore the collaborative capital of the institution as a whole. We find that third space projects such as the Living CV can contribute to the development of collaborative capital, act as a gateway for staff to wider communities of practice and build confidence for those engaged in them. In this case study we illustrate one route to achieving this, through a champions model which breaks down traditional academic silos and encourages wider collaboration.

Spatial context and informal caregivers’ Well-being: A case study of a Carer Café project in Hong Kong

This paper evaluates how a Hong Kong community Carer Café program reduce the informal (unpaid) caregivers’ navigation burden of social and health care service system. The cafés took place once biweekly at pantries and activity rooms of social service centers, community centers, and churches, which installed temporary decorations to create a café-like environment. his article will use the conceptual framework of spatial context, including spatial propinquity, spatial composition, and spatial configuration, to highlight four mechanisms in the process of informalization. They are (a) changing layout; (b) promoting spatial propinquity of caregivers; (c) creating a spatial composition facilitating social interaction; and (d) allowing the caregivers to use informal spaces flexibly. Qualitative data from 26 respondents, including social workers, project staff, volunteers, and users, sheds light on the details of four mechanisms. Results show that the Carer Cafés were transformed into a safe and caregiver friendly third place by the informalization process. Thus, caregivers from communities visit cafés frequently. These frequent visits facilitate the Cafés become a hub for informal caregivers access different resources and supports. This paper suggest that spatial context would be an important consideration to further explore in the future community caregiver support service practice and policy.

Validating a Pneumatic Tube System for Blood Product Delivery

Abstract Introduction/Objective Timely delivery of blood products can be of utmost importance to providing quality care. We aimed to validate the use of a high-speed pneumatic tube system (PTS) that was already installed at our hospital. By reducing delivery times, patient resuscitation and survivability can be increased. Methods/Case Report We followed the Association for the Advancement of Blood &amp; Biotherapies (AABB) guidelines to validate a PTS in a large tertiary academic medical center. The requirements include: verifying product suitability, ensuring product integrity, temperature monitoring, transportation time measurements, and proper packaging and tracking of product receipt. We validated the transfer of packed red blood cells (PRBC), plasma, platelets, and cryoprecipitate from the central blood transfusion services lab (BTS) to nursing stations in a separate building up to 1500 feet (&amp;gt;1/4 mile) away using a Swisslog Translogic® PTS Inclusion with foam inside the PTS carriers helped reduce bumps during transit and insulated products from heat. Results (if a Case Study enter NA) The mean temperature of the PRBC was 6.6 degrees Celsius and none exceeded the AABB maximum of 10 degrees Celsius. The mean time for blood products transit to the nursing stations was 3 minutes (m) and 33 seconds (s). The median time was 3m 31s, and it ranged from 2m 18s to 5m 38s. The PTS reduced delivery times of blood products by up to 10-12 minutes compared to manual porters. Conclusion Transporting blood products via PTS is an efficient method that reduces the required manpower and leads to better utilization of resources. However, it is essential to validate the PTS system before implementing it operationally.

Towards women's digital health equity: A qualitative inquiry into attitude and adoption of reproductive mHealth services in Bangladesh.

Health equity in Bangladesh faces a large chasm over the economic conditions, socio-cultural factors and geographic location despite the push for digitalization of the health sector. While some research has been conducted assessing the viability of digital health solutions in Bangladesh, gender dynamics of digital healthcare have been absent. This study dived into healthcare equity for women with a focus on reproductive health services delivered through mobile devices. This paper reported the findings of a qualitative study employing in-depth interviews conducted among 26 women about their behavioral intention to use mHealth services for reproductive health and the underlying factors influencing this intention with the help of the Integrative Model of Planned Behavior (IMPB). A snowball sampling technique were used to interview those university educated women, aged 21-31, based on their familiarity and exposure of mHealth services from seven universities in Bangladesh. The findings suggested that users of mHealth services find it more convenient and secure compared to visiting healthcare facilities, especially for trivial issues and inquiries regarding their reproductive health. Although promoting such services is lagging behind traditional healthcare, the attitude toward reproductive health services in Bangladesh is generally favorable resulting increasing adoption and use. Because such information-related mobile services (apps, websites, and social media) served as a first base of knowledge on reproductive health among many young girls and women in Bangladesh, who are generally shy to share or talk about their menstruation or personal health problems with family members, peers, or even health professionals due to socio-cultural factors and stigmatization. Conversely, urban centric services, availability of experts, quality management, security of privacy, authenticity of the information, digital divide, lack of campaign initiatives, lack of equipment and technology, lack of sex education, and outdated apps and websites were identified as obstacles that constrain the widespread use of reproductive mHealth services in Bangladesh. This study also concluded that promotion will be crucial in reforming conservative norms, taboos, and misconceptions about women's health and recommended such endeavors to be initiated by the policy makers as there is a substantive need for a specific policy regulating emerging digital health market in Bangladesh. Notwithstanding, women-only sample, low sample size, narrow focus on mHealth users and absence of perspectives from healthcare providers were among shortcomings of this study which could be addressed in future research. Further quantitative explorations are must to determine the usage patterns of reproductive mHealth services and their effectiveness that would identify implementation challenges in terms of customization and personalization in reproductive healthcare in a developing country like Bangladesh.

MyITS Services Integrated Service Innovation in Higher Education

The demands of higher education today are increasingly various and complicated as they provide technology and information-based services to students, lecturers, education staff, and alumni who need services easily and quickly. One solution is to integrate through the Integrated Service Centre, Institut Teknologi Sepuluh Nopember (ISC-ITS), by developing digitalization services through the myITS Services platform. The stages of innovation begin with legalisation services, translate diplomas, and graduation certificates, while future innovation development plans to expand into human capital services, finance, and cooperation. The purpose of this research is to analyze integrated service innovation in the Integrated Service Centre. This research uses qualitative methods and Albrecht and Zemke’s theory of public service innovation which examines technology-based services, human resources and service recipients. Data were obtained from observations, interviews, and documentation from service providers and recipients. The results of this study show that myITS Services can respond to the challenges of integrated service innovation needs at the Integrated Service Centre, as a university in realizing digital transformation and as an effort to implement Good University Governance (GUG), but that human resources teams must be supported and assistance provided for service recipients. As innovation continues to be carried out in public service, breakthroughs ISC-ITS come in the form of creative original ideas and adaptations and modifications to existing working methods to provide benefits, both directly and indirectly, to stakeholders. Keywords: innovation, public service, myITS Services

How a Novel Approach of Allergy Call Center Improved the Management of the Anti-COVID Vaccination Campaign in Piedmont: Italy.

The anti-COVID vaccination campaign has led to a significant increase in the demand for allergology consultations in patients considered at risk of reaction to anti-COVID-19 vaccines. This study aims to describe the experience of the vaccination campaign held in Piedmont (Italy) which developed a new service of Allergy Call Center (ACC) thus providing for the screening and management of allergy high-risk patients during pandemic. A retrospective analysis was performed on all patients considered at high risk for the development of allergic reactions who were referred by the Immunology and Allergy Unit of Azienda Ospedaliera Ordine Mauriziano in Turin, Italy, between December 2020 and December 2022 and also on ACC consultations. During the COVID-19 pandemic, Piedmont Region instituted the ACC, active from May 10th, 2021 to December 31st 2022, to allow vaccinating doctors to require a telephonic consultation for patients who were considered at high risk for the development of allergic reactions. If further diagnostic evaluations were required, the ACC scheduled a visit with a Consultant of the Unit to better assess the clinical situation of the patient. Furthermore, patients referred by General Practitioners, Occupational Doctors and other consultants were also evaluated by the Unit when required. During the operational period the ACC received a total of 15,865 calls and referred only 336 patients to the unit (27.4% of the total referrals), while General Practitioners referred 499 patients (40.8%), Occupational Doctors referred 61 patients (4.9%), and other consultants referred 326 patients (26.6%). Evaluation and management of a large volume of requests seemed to be facilitated by a proactive framework for screening patients at high risk for allergic reactions as the ones referred by our ACC. This approach led to a prominent decrease in allergological visits to our tertiary care Centre, reducing the waiting times and providing additional support for both patients and healthcare providers, thus allowing the vaccinations to be more easily handled.

Perceptions on service quality at licensing service centres

Organisations in the public sector are faced with challenges in the delivery of high-quality services to clients. This research paper reports on a study conducted to determine clients’ perceptions of service quality at licensing service centres (LCSs) in the City of Tshwane (CoT) Metropolitan Municipality, South Africa. The research adopted a quantitative approach to realise the research objective. A convenience sampling method was used to collect primary data. 262 respondents participated in the research. A structured questionnaire was used to collect primary data from respondents. The research used the SERVPERF instrument to measure service quality. Respondents were asked to rate the level of service at LSCs. The descriptive data analysis method was used to analyse the primary data with the aid of a statistical software package, Statistical Package for Social Sciences (SPSS). Cronbach's alpha values were used to measure the internal consistency and reliability of the measurement scales. The results revealed that all rated service quality dimensions were average, which means that respondents neither agreed nor disagreed with statements about the level of service offered by LSCs. The research paper includes recommendations on the continuous improvement of service quality at LSCs and on future research directions.

Effect of Organization Capabilities on the Growth of Fintech Providers in Kenya

Purpose: The Fintech industry has become a central service sector that has revolutionized financial services provision and fostered financial inclusion. However, the revolutionary nature of the various Fintech firms has resulted in their operations being unclear as their conduct in the market remains unsupervised. Further the Fintechs fail in diversifying their products and services thus limiting their growth within the country. This research sought to establish the effect of organization capabilities on the business growth of fintech providers in Kenya. The specific objectives of the research sought to establish the effect of resource capabilities, marketing capabilities, leadership capabilities and technological capabilities on the business growth of fintech providers in Kenya. The survey was grounded on the dynamic capabilities theory. Methodology: The study used a descriptive cross-section research design with study population drawn from the association of Fintech providers in Kenya. There are a total of 63 firms that was considered in the study with the three senior managers from each of the firm considered as the respondent. The research utilized random sampling in selecting the 189 participant. Data collection was carried out using a structured questionnaire with drop and pick method applied in the study. The research data was analyzed using descriptive, correlation and regression analysis. Findings: The study established that there is a statistically significant relationship between organization capabilities and the business growth of fintech providers in Kenya (R2 = .487, Sig = .000). The findings of the first objective revealed that there was a positive and significant effect of resource capabilities on business growth of fintech providers in Kenya (coefficient β1 = .448, sig = .000&lt;.05). Analysis of the second objective revealed that there was a positive and significant effect of marketing capabilities on business growth (β2 = .049, sig = .001&lt;.05). The results of the third objective revealed that there was a positive and significant effect of leadership capabilities on business growth (β3 = .139, sig = .004&lt;.05). Regression for the fourth variable showed that there was no significant effect of technological capabilities on business growth of Fintech Providers (β4 = .007, sig = .1936&gt;.05). Unique Contribution to Theory, Practice and Policy: Based on the conclusions, the study recommends that the government should develop and maintain robust technology infrastructure that enables fintech providers to innovate and integrate advanced technologies. The study also recommends that fintech firms should continue to encourage open feedback and communication to build strong, collaborative teams. The study further recommends that firms should enhance social media marketing efforts to broaden market reach and engage with potential customers by investing in digital marketing tools.

Research on the Network Communication Strategy of New Energy Vehicle Brand in Xi an China -- Taking NIO as an Example

With the increasing global attention to sustainable development and environmental protection, new energy vehicles have become the main direction of transformation and upgrading of the global automotive industry and green development. As one of the world s largest auto markets, China is also actively promoting the development of the new energy vehicle industry. This project will visit the sales points and service centers of NIO in Xi an market to understand the specific implementation of its network communication strategy. Therefore, this research intends to establish a perceived intention model to analyze the related factors of network communication effect in the light of Technology Acceptance Model (TAM). At the same time, the questionnaire survey method is adopted to collect data on the network communication strategy and consumer feedback of NIO, learn consumers feedback and satisfaction on the network communication strategy of new energy vehicles, provide key market insights, and better understand consumers demands and expectations.

Evaluation of hemoglobin A1c control among Medicare advantage patients not meeting non‐insulin diabetes medication adherence metric

AbstractBackgroundClinical pharmacists are often tasked with improving medication‐related performance metrics such as medication adherence to diabetes medications (MAD). Although the primary goal in patient care is excellent clinical outcomes, it is unknown if poor diabetes disease state control correlates with nonadherence to diabetes medications per the Centers for Medicare and Medicaid Services (CMS) MAD metric specifications. This retrospective study aimed to identify the degree of disease state control in patients identified as nonadherent to their diabetes medications among patients in value‐based Medicare Advantage payer‐provider reimbursement models and its impact on the clinical pharmacist.MethodsPatients attributed to a health system‐employed primary care provider group from January 1, 2022 to December 31, 2022 and identified as non‐adherent (percentage of days covered [PDC] &lt;80%) for non‐insulin diabetic medications were included in the study.ResultsOf the 370 patients who met criteria for study inclusion, 256 (69%) had a controlled hemoglobin A1C of &lt;7.5%; 305 patients also had a previous A1c available in the electronic medical record. Of those, 260 (85%) had an A1C that had improved or was unchanged between the two most recent readings. One hundred sixty (43%) patients had a reason listed for gaps within refill history including verbal dose change, adverse reaction, manufacturer‐supplied medications, fills from Veteran's Affairs pharmacy, provider samples, or nondiabetes diagnosis.ConclusionA large percentage of patients identified as non‐adherent had a high degree of disease state control suggesting an issue with the measurement of adherence rather than a true reflection of patients' adherence with prescribed drug regimens. Strategies to improve diabetes medication adherence based on PDC will likely need to look beyond disease state control.

The Association Between Mental Health Literacy of Parents and Referral of Children and Adolescents to Mental Health Service Centers

Background: Mental health literacy refers to an individual’s knowledge and beliefs about mental health, which can aid in the detection, management, and prevention of mental illnesses. Prompt diagnosis of mental disorders is crucial for timely intervention and treatment. This study aims to investigate the mental health literacy and help-seeking behaviors of parents with children and adolescents under the age of 18. Methods: In this descriptive-analytical study, a cross-sectional design was utilized, and a surveying method was employed. A total of 134 parents of children and adolescents under 18, who were referred to the mental health service centers at Iran University of Medical Sciences and private psychiatric clinics in 2019 and 2020, participated in the study through convenient sampling. Two psychiatrists evaluated the psychiatric disorders of the children, and the parents completed the General Health Questionnaire-28 (GHQ-28) and the Mental Health Literacy Questionnaire. The collected data were analyzed using SPSS version 24. Results: The results of the one-way analysis of variance indicated that the total score of mental health literacy significantly differed among groups with varying levels of maternal education (p=0.001). Conclusion: This study underscores the impact of maternal education on mental health literacy among parents. Notably, parents with higher levels of education exhibited greater mental health literacy. It is essential to consider these findings in developing targeted interventions to improve mental health literacy among parents from diverse educational backgrounds. Further research should explore effective strategies for increasing awareness and knowledge about mental health in communities with varying levels of education.

PREDICTING LAND USE CHANGES USING MARKOV CHAIN ANALYSIS AND HIERARCHICAL ANALYSIS OF PUBLIC SERVICE CENTERS IN BANDA ACEH CITY

The city of Banda Aceh, as the center of development in its region, is faced with a series of complex problems, one of which is the lack of optimal distribution of public service centers throughout the city. Banda Aceh City Central Statistics Agency (BPS) documents 2012-2022 and Banda Aceh City Spatial Plan (RTRW) documents 2009-2029 related to this research. Data in tabulated and descriptive form includes geographical conditions of the research area, land use area, types of facilities and their numbers, population, and distance between areas, and maps related to the research. This study aims to see land use conditions using the markov chain method and provide an overview of the public service center system of Banda Aceh City using the Scalogram method, centrality index, and gravity. Based on Markov chain analysis, land use predictions indicate that residential areas, offices and trade, tourism, worship, and sports facilities will continue to increase, while water bodies, green open spaces (RTH), and non-green open spaces (RTNH) will continue to decline. Predictions until 2039 show that conditions have begun to stabilize. Scalogram analysis takes into account hierarchy based on the type of facilities available, centrality index that calculates hierarchy based on many available facilities, and gravitational interaction that takes into account the strength of interaction between sub-districts shows that Kuta Alam District has the potential to become a major service center in Banda Aceh City. This sub-district has the most complete facilities, supported by the highest interaction value.

"I never thought of it as payment": Qualitative evaluation of workshops with advanced practice registered nurses on pharmaceutical industry payment reporting.

With the expansion of professional autonomy and prescriptive authority of advanced practice registered nurses (APRNs), interactions with industry are under greater scrutiny. As of July 1, 2021, pharmaceutical and medical device companies must publicly report all payments to APRNs through the Centers for Medicare and Medicaid Services' Open Payments website. To gauge APRNs' familiarity with, and perceptions of the Open Payments database and discuss whether and how APRNs should respond. Virtual workshops consisting of a didactic presentation and interactive exercises with APRNs recruited through professional networks, associations, and conferences. Transcripts were analyzed using a qualitative interpretive approach, grounded in an everyday ethics theoretical framework. Thirty-six APRN clinicians, students, and faculty participated in nine workshops. Seeing sponsored meals reported in Open Payments as "payments" prompted participants to see familiar interactions in a new way. Participants valued the enhanced transparency as a way to identify risks of bias but were concerned that reporting might undermine public trust in APRNs. Emphasizing awareness as a precursor to action, participants desired greater preparation for ensuring independence in practice. The importance of tackling the ethical issues associated with industry interactions is heightened within the context of an existing climate of distrust within health care. However, many participants were concerned about the effects of transparency on public trust rather than how APRNs individually or collectively can be more trustworthy. Open Payments can serve as a useful tool to catalyze broader conversations about ethics, integrity in decision making, and health policy advocacy.

Providing TikTok platform to educate public regarding customs

Lack of understanding of regulations related to customs and excise services has resulted in rampant fraud on behalf of the Customs and Excise office and the blocking of imported mobile phones due to unregistered or illegal International Mobile Equipment Identity (IMEI). Community service activities (PKM) aim to educate the public about various rules and IMEI registration of electronic devices as imported goods, including the terms and conditions that the public must meet through the creation and use of the TikTok platform. The method used is AIDA so that the media and content produced are clear, concise, creative, and interesting so that it is easy for the public to understand. The TikTok platform was created and developed as an effective medium for educating the public through disseminating information that can increase awareness and knowledge of the wider community. This approach illustrates the various common fraud modes and how to identify them. There is also content about the Bandung Customs Office call center and office-tour services for official transparency and professionalism in handling various public complaints. The number of followers who support this and like that has increased significantly from time to time. Information using the TikTok platform related to official customs and excise service issues has significantly reduced the number of frauds by irresponsible individuals, and cases of IMEI blocking.

Penambahan Media Kapas Dan Kerikil Pada Multi Tray Aerator Untuk Pengolahan Air Daerah Rususnawa Untan Dalam Mengurangi Kandungan Logam Sebagai Pre-treatment Pada Sistem Membran RO

Rivers are surface water used for public purposes. Rivers are used for water storage, transportation, irrigation, livestock, industry, housing, water availability, fish rearing and recreation. Various activities carried out in the river cause pollution and have an impact on the decline in water quality, such as in Sepakat 2 river water which is used by the surrounding community for daily needs. The purpose of this study was to determine the Fe contained in Sepakat 2 river water and the effectiveness of using multi tray aerators with the addition of cotton and gravel media in reducing iron levels. Processing of Sepakat 2 river water through a pretreatment process using a 5-level multi tray aerator method and 6 perforated trays to drop water to the bottom of the container, then the water that has been aerated is collected in a box and deposited for 1 and 2 hours after which the water is taken and stored using a bottle container to be analyzed by the Pontianak Industrial Standardization and Services Center Laboratory. The results of this study are the quality of river water Sepakat 2 iron levels 6.37 mg / L before processing, after aeration 4.99 mg / L, after settling 1 and 2 hours with the same value of 5.09 mg / L. The efficiency of the multi tray aerator tool to reduce iron parameters from iron by 20.09%, TDS 52.1%, mercury (Hg) 43.08% and salinity is 63.3%.