Facility Constraints Research Articles

The roles of multi-component interventions in reducing mistreatment of women and enhancing respectful maternity care: a systematic review

BackgroundDespite recognition of the adverse impacts of the mistreatment of women during pregnancy, labour and birth, there remains limited evidence on interventions that could reduce mistreatment and build a culture of respectful maternity care (RMC) in health facilities. The sustainability of effective individual interventions and their adaptability to various global contexts remain uncertain. In this systematic review, we aimed to synthesise the best available evidence that has been shown to be effective in reducing the mistreatment of women and/or enhancing RMC during women’s maternity care in health facilities.MethodsWe searched the online databases PubMed, CINAHL, EBSCO Nursing/Academic Edition, Embase, African Journals Online (AJOL), Scopus, Web of Science, and grey literature using predetermined search strategies. We included cluster randomized controlled trials (RCTs) and pre-and-post observational studies and appraised them using JBI critical appraisal checklists. The findings were synthesised narratively without conducting a meta-analysis. The certainty of evidence was assessed using GRADE criteria.ResultsFrom the 1493 identified records, 11 studies from six sub-Sahara African countries and one study from India were included: three cluster RCTs and nine pre- and post-studies. We identified diverse interventions implemented via various approaches including individual health care providers, health systems, and policy amendments. Moderate certainty evidence from two cluster RCTs and four pre- and post-studies suggests that multi-component interventions can reduce the odds of mistreatment that women may experience in health facilities, with odds of reduction ranging from 18 per cent to 66 per cent. Similarly, women’s perceptions of maternity care as respectful increased in moderate certainty evidence from two cluster RCTs and five pre- and post-studies with reported increases ranging from 5 per cent to 50 per cent.ConclusionsMulti-component interventions that address attitudes and behaviors of health care providers, motivate staff, engage the local community, and alleviate health facility and system constraints have been found to effectively reduce mistreatment of women and/or increase respectful maternity care. Such interventions which go beyond a single focus like staff training appear to be more likely to bring about change. Therefore, future interventions should consider diverse approaches that incorporate these components to improve maternal care.

Finding the Financial Margin Expansion Leverage in the Medical Practice

All U.S. medical groups, especially the independents, are under financial pressure from third-party payers, both commercial and governmental. These pressures come in the form of unit price controls, services utilization constraints, and total costs of care oversight, especially for the management of chronic conditions. The only solution to the deterioration of practice operating economics and related financial performance is operating margin expansion strategies—the expansion of the margin that funds the provider compensation pool. Such strategies are available. The principal challenges to margin expansion often are products of entrenched, and frequently intractable, clinical models and related business models, together with facility constraints, and access to investment capital that doesn’t excessively draw down physician compensation.

Ethical Challenges Associated with Caring for Sick Children Based on the Experiences of Nursing Students in Pediatric Wards: A Qualitative Content Analysis

Background: Nurses working in pediatric wards face many challenges when caring for sick children of different ages due to their physical and mental needs, especially if they have not been trained professionally. Nursing students and nurses are faced with ethical challenges in pediatric wards, hence their experiences can help identify the ethical problems in the healthcare setting. Since the explanation of ethical challenges depends on the context and factors such as values, beliefs, and hospital culture, this study aimed to explain the ethical challenges associated with caring for sick children based on the experiences of nursing students. Methods: This qualitative study used conventional content analysis to investigate the experiences of undergraduate and postgraduate nursing students and nurses working in pediatric wards selected by purposive sampling. Data collection tools were interviews and field notes. Data were categorized via MAXQDA10 and analyzed using conventional content analysis. Results: The participants included 3 pediatric nurses and 17 nursing students. The mean age of the participants was 24.9±1.2. The findings of the study revealed the main theme i.e., ethical challenges associated with caring for sick children, was classified into two main categories including care challenges and organizational constraints. Care challenges were classified into the following subcategories: feeling worried when caring for sick children, compassionate care, emotional needs of children, inattention to family-centered care, and insufficient capability of the healthcare team. Organizational constraints were classified into facility constraints and hospital managers’ inattention to the environmental design of pediatric wards. Conclusion: The results of the study showed that the ethical challenges associated with caring for sick children were related to the healthcare team and organizational management. With the provision of appropriate training for nurses, as well as proper planning and implementation of policies to standardize the pediatric wards, nurses can provide nursing care to this age group with the least amount of moral distress.

EVALUASI PELAKSANAAN PROGRAM KEBIJAKAN PELAYANAN OBSTETRI NEONATAL EMERGENSI KOMPREHENSIF (PONEK) DI RSUD MAJENE KABUPATEN MAJENE

Background Maternal and infant mortality rates are still a major regional government's homework, especially for major health workers. In accordance with December 2016 data, the infant mortality rate is 62 people and the mother is 8 people. Maternal mortality cases in Majene Regency in 2018 experienced a significant increase. The amount reaches up to 50 percent. The purpose of this study was to evaluate the implementation of the policy program of the compherensive emergency neonatal obstetric sarvices (CENOS) at Majene General Hospital based on inputs, processes and outputs. MethodeThe research was descriptive in character with the phenomenological approach using triangulation techniques. The total samples comprised 18 person as the informants. The data collection used the techniques of observation, interviews, and documentation. The data were analyzed using qualitative analysis. The research results revealed that at the input stage the availability of the health workers was still inadequate according to the standard number of CENOS force-only 16 of the 29 were available. As for the facilities, the rooms, beds, and WC were still inadequate. Besides, same of the CENOS technical equipments, such as the minimum pipes, injection instruments, and electric pumps were not yet available. Even the opportunities for the CENOS workers to join the CENOS training were still minimum. However, at the process stage, the emergency services carried out to the mother and baby were less than 30 minutes. Also, the CENOS implementation had always used the manual of the CENOS SOP of Majene Local General Hospital as reference. As for the constraints faced in implementing the CENOS SOP were the lacks of the supporting facilities of CENOS program. At the output stage, it was found that MMR and IMR had decreased, though there were still some of the community members preferred to give birth with the shamans rather than in hospitals. The conclusion of this study shows that the CENOS services in the hospital are not optimal due to the constraints of PONEK skills and facilities

Influence of fatigue precracking and specimen size on Master Curve fracture toughness measurements of EUROFER97 and F82H steels

EUROFER97 and F82H steels are two leading reduced-activation ferritic-martensitic (RAFM) steels for fusion first wall and blanket applications. Exposure to the harsh environment of fusion reactors can result in severe degradation of fracture toughness. Thus, the post-irradiation evaluation of fracture toughness is critical for understanding the material behavior. Due to the space constraints of irradiation facilities and challenges in controlling a uniform irradiation condition for large size specimens, the development of small specimen test techniques (SSTT) is indispensable to evaluate the performance of irradiated materials. In this study, we evaluated specimen size effects on the Master Curve fracture toughness of EUROFER97 and F82H steels. A wide variety of specimens, including 0.5 T compact tension (C(T)) specimens, 0.16 T mini-compact tension (miniC(T)) specimens, and 1.65 mm miniature bend bar specimens, were tested. The testing methodology was based on the Master Curve method in the ASTM E1921 standard. No specimen size effect was observed in 0.5 T C(T) and 0.16 T miniC(T) specimens on the Master Curve reference temperature T0, while 1.65 mm miniature bend bar specimens yielded a higher T0Q. A strong effect of fatigue precracking on T0 for 0.5 T C(T) and 0.16 T miniC(T) specimens was observed, such that testing on specimens with skewed fatigue precrack fronts resulted in lower T0 than for specimens with ASTM standard qualified straight fatigue precrack fronts. The results highlight the importance of experimental quality control in developing SSTT for Master Curve fracture toughness testing. Lastly, we also evaluated and provided recommendations on the minimum number of specimens needed for each specimen type for yielding reliable T0Q values.

태권도 지도자 유형에 따른 여가만족 및 여가활동 제약에 대한 탐색적 분석 연구

Objectives This study was intended to provide basic data for improving work and QOL of Taekwondo leaders through an exploratory analysis of leisure satisfaction and leisure activity restrictions according to the types of Taekwondo instructors.
 Methods This study is a study on the leisure satisfaction and leisure activity constraints of Taekwondo instructors. Research subjects were selected through intentional sampling and 128 copies of data were analyzed using the SPSS statistical program. Exploratory factor analysis and reliability analysis were conducted to measure validity and reliability, and t-test, one-way ANOVA, and correlation analysis were conducted for data processing.
 Results This study is a study on leisure satisfaction and leisure activity restrictions according to the type of Taekwondo instructor, and the results of the difference verification and correlation analysis between groups are as follows. First, as a result of verifying the difference according to the Taekwondo instruction target, the life sports group was found to be statistically (.05) higher than the group that combined life sports and elite sports in the personal restriction factor among the leisure activity constraints. Second, as a result of verifying the difference according to the Taekwondo instructor's career, there were statistically significant differences in social satisfaction, psychological satisfaction, and environmental satisfaction factors in leisure satisfaction factors, and personal constraints, facility and program constraints in leisure activity constraint factors. there was a statistically significant (.05) difference in the time constraint factor. Third, as a result of verifying the difference according to the teaching experience of Taekwondo instructors, there was no statistically significant difference (.05) only in the environmental satisfaction factor among leisure satisfaction factors. Fourth, as a result of correlation analysis of the influence of taekwondo instructors' leisure activity constraints on leisure satisfaction, personal constraints among leisure activity constraints were found in all factors of leisure satisfaction, and facility and program constraints were psychological factors and In the environmental factors, time constraints had a statistically significant (.05) effect on the physical satisfaction factors of leisure satisfaction, and social constraint factors on the psychological satisfaction factors of leisure satisfaction.
 Conclusions Based on this study, it is judged that there will be a continuous need for analysis and research on leisure types and leisure satisfaction according to age, player experience, teaching experience, and teaching subject of taekwondo instructors. It is also expected to have a positive impact psychologically, physically, and socially.

Economic and resilient operation of hydrogen-based microgrids: An improved MPC-based optimal scheduling scheme considering security constraints of hydrogen facilities

Optimally scheduling alkaline electrolyzers (AELs) in a hydrogen-based microgrid (HBM) can greatly unleash the operational flexibility of the HBM. However, existing scheduling strategies of AELs mostly utilize a simplified AEL model, which ignores the nonlinear coupling of electric-hydrogen-thermal sectors, violating the AEL’s security constraints thereby making the scheduling scheme infeasible. This paper proposes an improved model predictive control (MPC) based optimal scheduling framework which incorporates a scheduling correction algorithm into the basic MPC structure. This framework is utilized for implementing economic and resilient scheduling of an HBM under normal and emergency conditions, respectively. With the scheduling correction algorithm, this framework can be formulated into a computationally efficient mixed-integer linear programming, meanwhile guaranteeing the solutions strictly satisfy the security constraints of hydrogen facilities (i.e. AEL and hydrogen tank). Case studies are conducted based on real operating data of a Danish energy island Bornholm. The results demonstrate that the proposed scheduling scheme under normal conditions can contribute to significant comprehensive benefits from the daily operation cost saving of 68%, computational time saving of 98%, and satisfying the security constraints of hydrogen facilities, compared to previous scheduling strategies. Besides, it sharply reduces load shedding under emergency conditions by proactively allocating distributed energy sources in the HBM.

OTT 서비스 사용자의 이용특성에 따른 스포츠 관람의도와 관람제약

Purpose: The purpose of this study is to present empirical data through the analysis of sports spectator intention and sports spectator constraints depending on the usage characteristics of OTT service users.BR Method: The subjects of the study were selected from those who had epxerience using OTT services, and finally, 207 parts of the survey were used for the analysis. Data analyses for this study included exploratory factor analysis, one-way analysis of variance (ANOVA) and multiple linear regression analysis for 207 subjects using SPSS version 27.0. The significant level of hypothesis verification was set as α=.05.BR Results: The results of this study are as follows. 1) For the differecne in spectator intention according to the usage pattern of the OTT service, there partially showed a significant difference. 2) Depending on the results of the difference in sports spectator constraints cacording to the characteristics of OTT service usage pattern, some of them showed a significant difference. 3 )As a result of the effect of sports spectator constraints on spectator intention, viewing intention was ofund to affect facility constraints, congestion constraints, social constraints, and climate. In the watching nItention, transport accessibility constraints, ticket constraints, and social constraints had an effect.BR Conclusion: In summary, the findings in this study confirm that there ias significant difference between sports spectator intention and sports spectator constraints according to OTT service usage pattern, and that confirm sports spectator constraints influence sports spetcator intention. Based on these results, it is necessary to consider a marketing strategy so that OTT serviceu sers can increase their interest in sports spectators and come to the stadium.

An initialization-free distributed algorithm for dynamic economic dispatch problems in microgrid: Modeling, optimization and analysis

In this paper, a distributed optimization algorithm is designed for a hybrid microgrid network to minimize the total generation cost in a dynamic economic dispatch problem (DEDP). The hybrid microgrid model is constructed with different types of traditional power resources, renewable energy and energy storage batteries, which are subject to the supply–demand balance, capacity, and ramp-rate constraints of the generation facilities. Meantime, from the perspective of environment protection, the pollutant emissions from traditional generators are considered to reduce its impact on environment. Firstly, we transform the multi-objective optimization problem to a single objective optimization problem through the weight-sum method. Then, compared to the most existing centralized algorithms, we propose a fully distributed algorithm that does not depend on the initialization process to solve the dynamic dispatch problem. Moreover, we assume that the optimization objective functions are convex functions rather than a strictly standard quadratic function, and the convergence of the proposed algorithm is analyzed through convex analysis and a Lyapunov function method. Finally, some experiments with quadratic or non-quadratic cost functions and comparison examples are simulated, the experimental results verify that the optimal solution satisfies the constraints of the supply–demand constraints and capacity inequalities in each time slot.

Constraints of supply chain management of apple production in Kinnaur and Kullu districts of Himachal Pradesh (India)

Study was conducted to assess the impact of Constraints facing in Supply chain Management of Apple Production in Kinnaur and Kullu Districts of Himachal Pradesh, India using data for the period 2021-2022.To identify gaps and challenges in the supply chain of apple production and marketing, a sample of 400 respondents was interviewed through structured interview schedule. Garrett’s ranking model and five point likert scales is used to identify the factors which were determining the constraints of the apple producers for supply chain management. The constraints in supply chain management were further classified in to six different sub components namely grading and packaging constraints, Packaging material constraints, Storage facilities constraints, Transportation constraints, Market information constraints, Malpractices constraints. Apple producers were not so aware about the constraints of the supply chain management Gaps can be reduced by the efficient supply chain management.

Therapeutic pluralism and the politics of disclosure: breast cancer patients' experiences in public healthcare.

Despite the widespread utilisation of complementary and or alternative medicine (CAM) by breast cancer patients in low-and-middle-income countries, few disclose CAM use to their physicians. This study examines disclosure CAM use among a small sample of women attending a breast cancer clinic in a public health hospital in the Western Cape, South Africa. An Interpretative Phenomenological Analysis (IPA) approach was utilised in this study. Semi-structured in-depth interviews were conducted with a convenience sample of 17 women attending a breast clinic in a public hospital. Non-disclosure of CAM use was attributed to minimal time for patient-doctor interactions due to resource constraints in public health facilities and the superior status accorded to biomedical doctors' superior knowledge, associated with paternalism, leading to patients' fear of reproach for using CAM. Consequently, disclosure of CAM only occurred in instances where it was deemed an absolute necessity. Considering the reality of an overstretched public healthcare system, what may be possible is an active attempt to communicate to patients that doctors are aware that patients may use a range of resources (such as CAM), which is their right, and further, recommend patient disclosure of CAM use to their doctors, because of the possibility of drug interactions and other potentially negative effects.

Education on the Role of Learning Motivation in Improving Learning Achievement for Adolescents Assisted by Rumah Zakat Makassar

The obstacles experienced by students with changing the learning system to online during the Covid pandemic caused student learning motivation to decrease. Even though learning motivation is an important factor that can affect student learning performance in class. The low motivation to learn as expressed by youth assisted by partners is caused by several factors such as boring learning methods, facility constraints such as signal interference, quota limitations, or problems with the devices used, and students are easily distracted by games or social media during the learning process. This service activity aims to increase children's learning motivation by providing education to adolescents regarding the role of learning motivation and identifying things that can be a source of motivation in learning. The results of the dedication carried out show that there is a change in knowledge about the concept of motivation and student enthusiasm in learning.

Validation of Extrapolation of Test Performance for Air-to-Air Rotary Energy Exchangers (ASHRAE RP-1799)

Air-to-air energy exchangers are used in buildings to transfer energy between the exhaust air and the incoming outdoor air. Typically, the performance of air-to-air energy exchangers is tested, rated and certified according to industry-accepted standards and procedures. Because of the expenses and facility constraints associated with laboratory testing, performance rating tests of air-to-air energy exchangers are usually performed at a limited number of test conditions for selected products. This paper uses laboratory tests to validate the extrapolation approaches available from the literature. Two sets of air-to-air energy wheels from different manufacturers were tested at the energy recovery testing facility of Intertek. Each set included three wheels of different sizes (i.e., small, medium, and large). The analysis of test results showed an overlap in performance ratings between different wheel sizes after accounting for allowable allowances, which in turn supported the extrapolation approach used by the Air-Conditioning, Heating, and Refrigeration Institute for performance rating. By comparing the test results with the results from the selected effective correlations, it was found that axial heat conduction should be considered when applying the numerical heat and mass transfer models for energy wheels.

Assessment of Health Status of Newborns Discharged From Sick Newborn Care Units of the Five Cyclone Fani Affected Districts of Odisha, India.

This study was undertaken to assess the health status of newborns discharged from Sick Newborn Care Units (SNCU) of the Cyclone Fani affected districts of Odisha, which is amongst the highest neonatal mortality rate states in the country. Cyclone Fani hit the coast of Odisha on May 3, 2019. This cross-sectional study was conducted in 5 districts and targeted the babies discharged from SNCU's from January to May 2019. A telephonic interview of the caregivers was conducted to assess the health status of the newborns. Data was collected in a web-based portal and analyzed by statistical package for social sciences SPSS (IBM Corp., Armonk, New York, USA). We inquired about 1840 babies during the study period but only 875 babies could be followed up, with the highest proportion of the babies from the most affected district. Out of 875 babies, 111 (12.7%) had 1 or more illnesses during follow up. Distance from the health facility and time constraints were the major reasons for not seeking health care. Of the babies, 35.7% were reported as being underweight. Poor breastfeeding (14.1%) and kangaroo mother care (31.7%) practices were reported. Only 32% of the babies were completely immunized. The health status of the babies discharged from the SNCUs was found to be poor. Newborn care can be strengthened by improving home-based and facility-based newborn care.

Microbiologically influenced corrosion: The gap in the field

Microorganisms have evolved to inhabit virtually all environments on the planet, from oceanic hot-seeps to pipelines transporting crude and refined hydrocarbons. Often microbial colonization of man-made structures results in the reduction of their service life requiring preemptive or corrective human intervention. Microbiologically Influenced Corrosion (MIC) is caused by a set of intricate bioelectrochemical interactions between a diverse group of microorganisms and metallic surfaces. The complexity of MIC microbiomes and their mechanisms as well as the logistics constraints of industrial facilities are factors to consider when choosing suitable analytical methods for MIC monitoring. These generally reflect only a partial view of the phenomenon and in consequence, might lead to ineffective mitigation measures. This paper acknowledges the discrepancies between the fieldwork for MIC monitoring and the currently available technological advancements. It also highlights the most pressing issues that operators have in the field in light of the diversity of the microbial key players present in corrosive microbiomes. Finally, it compiles and outlines a strategy for the integration of novel molecular approaches aiming for a practical and accurate assessment of the microbial threat.

Analisis Kesulitan Pemahaman Menulis Cerita Dongeng Pada Pembelajaran E-Learning Bahasa Indonesia Menggunakan Media Zoom Meeting Di Kelas II SD IT Muhammadiyah Palangkaraya

The purpose of this research was to determine the difficulty of understanding student fairy-tale stories during long distance learning using zoom meetings. The method used to do this research is a qualitative method with descriptive type. As for data collection techniques is observation, and interviews. Analysis of research data uses stages consisting of data reduction, display, data collection and verification. Based on the research discovery, it can be concluded, namely (1) there are some students who do not understand the material to write fairy tales. so students are still not able to write fairy tales well (2) found several factors The causes include the lack of student learning interest due to the learning process online, the teacher in delivering the material is still not optimal due to the constraints of signals, school facilities and infrastructure that are inadequate, especially for long-distance learning activities (e-learning).

“Do we even have a voice?” Health providers’ perspective on the patient accommodation strategies in Bangladesh

In a resource-constrained setting like Bangladesh, effective patient-provider communication is critical to the delivery of maternal healthcare services. Using communication accommodation theory, this study tried to understand how providers perceive, engage, and accommodate patients' needs in maternity wards. This qualitative exploratory study used a semi-structured interview guide to conduct in-depth face-to-face interviews of ten healthcare providers in two government-funded public health facilities in Bangladesh. The interview data were analyzed using MAXQDA 2020 software. The thematic analyses revealed that nurses and midwives faced conceivable neglect from patients and their attendees due to possible service and facility constraints, indicating their low status and control within the service operation. Despite efforts to address patients' emotional and psychological concerns, providers appear to avoid (divergence strategy) confronting patients and their irate visitors. Unimodal convergence emerged when providers accepted patients' arguments about the systematic inadequacy of service facilities. Providers have employed interpretability tactics to communicate medical opinions and applied nonverbal cues where necessary. A lack of open communication between healthcare providers and patients necessitated various forms of accommodation. Integrated strategies addressing service restrictions and initiatives fostering patient understanding and cooperation may improve patient-provider communication.

The Implementation of Online English Learning During The Covid-19 Pandemic

The COVID-19 pandemic has had a very significant impact on human life. Various aspects of life are affected, including the realm of education which has turned online and has various impacts on the level of success in its implementation. This study aims to see how the implementation of online English learning during the pandemic. There are various problems including, some students lack facilities to support their online learning; It is difficult for teachers to get grades and catch up with student assignments which are hampered by various facilities constraints; the lack of sensitivity of parents to their important role in every online learning activity and the difficulty of achieving learning goals which are limited to essential materials only. Based on the results of the study, the solution to this problem is to collect assignments offline, provide understanding to parents of students about the importance of mentoring and allocation of aid funds in schools to help students who lack facilities.

Simulating Socio-Technical Transitions of Photovoltaics Using Empirically Based Hybrid Simulation-Optimization Approach

Energy transitions as socio-technical processes involves interactions among different actors such as households, firms, and government, thus requiring an integrated approach to explore the transition’s dynamics. The present study aims to simulate the socio-technical transitions of photovoltaics (PV) in Indonesia using an empirically based hybrid simulation-optimization model. The model involves households’ decision-making, PV supply chain, and government interventions. The hybrid simulation-optimization model consists of integer linear programming to optimize PV’s supply chain configuration which was embedded within agent-based modeling and simulation (ABM). The empirical data involving 413 households from 34 provinces in Indonesia was acquired from a survey that was specifically designed based on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) to specify and parameterize the model. Export tariff regulation, incentives for PV investment, environmental campaigns, and the combinations of those interventions were evaluated. The findings demonstrate that all of the interventions increase the intention toward PV, but the intention is not necessarily translated into adoption due to either financial or facility constraints. The findings highlight the necessity to include both demand and supply aspects endogenously in the transition model. The export tariffs combined with the incentives, followed by the export tariffs combined with the campaigns, is found to be preferable due to low supply chain unit cost and high reduction of greenhouse gas. Managerial implications and future research are discussed.

STUDY OF PRINCIPAL LEADERSHIP IN INCREASING WELFARE THROUGH THE TEACHER'S DISCIPLINE AT SMK REGENCY OF BOGOR (CASE STUDY AT SMK NURUL HIDAYAH 1 AND SMK IBNU AQIL KABUPATEN BOGOR)

Teacher welfare is the success of leaders and the fulfillment of education. Leaders work with five criteria, namely planning, program, implementation, evaluation, constraints and solutions. The purpose of this study was to analyze the program, planning, implementation, evaluation as well as the constraints and solutions of principals in improving teacher welfare through discipline. This study uses a qualitative approach to the interactive inquiry model with descriptive methods and uses interview, observation and case study techniques. The results of the study indicate that the program is implemented by providing incentives for teachers who achieve discipline targets. The planning is through the preparation of a team of policy formats, formulating problems, analyzing the challenges faced by schools, supporting schools, and taking an inventory of decisions. Implementation according to the program, building communication, building a tiered coordination system, motivating and facilitating teachers in improving skills and being active in MGMP, facilitating infrastructure. infrastructure, leadership regeneration, supervision and collaboration with institutions outside the school. Evaluation through monthly formal activities and informal activities. Constraints of low teacher salaries, staffing status and limited facilities The solution is to apply teacher incentives