Form Of Checklist Research Articles

Ecological impact assessment of dam construction: A case study of Diamer Basha Dam Gilgit‐Baltistan, Pakistan

AbstractDam construction poses significant ecological impact, both during the initial construction phase and long after the dam is completed. The Diamer Basha Dam, situated on the River Indus in the Gilgit‐Baltistan district of Pakistan, is receiving significant attention due to the ecological consequences of the proposed and ongoing construction. The Dam is a 272‐m‐tall reservoir with a 9867.912 Mm3 (million cubic meter) capacity and will be the world's highest roller compact concrete dam. The assessment of local ecological impacts was compiled in a checklist and matrices format to discuss the impacts on the status of species diversity in the study area. Using a random sample methodology, line transects, and quadrats were employed to evaluate phytosociological properties of vegetation. The floral parameters recorded were percent cover, species richness, vegetation composition, frequency, and density. The ecological analysis included principal component analysis to compare the distributions of sustained and lost vegetation in response to water flow variables. This research showed that several plant species withstand periods of high peak flow, like Salix tetrasperma, Rumex dentatis, Trifolium resupinatum, and Polygonum. Additionally, visual observations, plot surveys, transects, and published reports were used to compile the faunal data used to determine habitat distribution. According to the analysis, immediate effects of dam construction activities such as blasting, quarrying, and traffic noise cause severe disturbances to existing biodiversity and habitats with high ecological vulnerability, and have long‐term effects on ecological integrity and environmental health in downstream and upstream habitats. The study presents the present status of biological and ecological conditions, as a baseline reference datum for a comparative analysis of the changes caused by the dam's construction.

Clinical Findings of Sydenham Chorea in Pediatric Patients: A Single-Center Retrospective Study

Purpose: Sydenham chorea is known for its rapid, irregular, and aimless involuntary movements and is considered a benign and self-limiting condition among the major manifestations of rheumatic fever. The current study reviewed the demographic, clinical, and paraclinical findings of pediatric patients with Sydenham chorea.Methods: This cross-sectional study was conducted among 22 patients with Sydenham chorea who were admitted to the pediatric wards of Mashhad Imam Reza and Ghaem Hospitals between 2006 and 2016. Data from these patients’ medical records were extracted, organized using checklist forms, and analyzed.Results: Eight patients were male and 14 were female. The average age was 10.09±3.53 years. In 31.8% of patients, chorea was the only sign of rheumatic fever. Chorea was unilateral in 21.1% of patients. The most common clinical findings were, in descending order, jerky movements, facial grimacing, gait disorders, mental disorders, speech disorders, muscle weakness, and milkmaid’s grip. Cardiac auscultation was normal in 76.2% of patients, while a holosystolic murmur was heard in 23.8%. In laboratory exams, 50% of patients were erythrocyte sedimentation rate (ESR)-positive, 31.2% were C-reactive protein (CRP)-positive, and 53.3% were anti-streptolysin O (ASO)-positive. Echocardiography showed the prevalence of mitral regurgitation (63.6%), aortic regurgitation (45.5%), tricuspid regurgitation (22.7%), pulmonary regurgitation (4.5%), and pericardial effusion (4.5%).Conclusion: This study showed that Sydenham chorea can be the only sign of rheumatic fever. This disease typically occurs in children between the ages of 7 and 12. ESR, CRP, and ASO can be the most effective laboratory tests for diagnosis.

Accounting and analytical support for internal control of financial results of agricultural organisations

The effectiveness of internal control over the formation of the financial results of agricultural organisations depends to a large extent on the accounting and analytical support of control measures. In order to improve the effectiveness of control procedures, the allocation of accounting and management components of internal control of financial results is justified, the need for their constant interaction is determined. The expediency of applying rationing as a method of control, not only at the profit or loss calculation stage, but for all operations that generate financial results, has been determined. A checklist form has been developed and proposed for use as a working document for the controller, involving the formulation of control actions and verification of compliance with rationing parameters in the context of activities.

Prevention and control of COVID-19 infection at the community health center during the new normal era

ABSTRACTIntroduction: Due to the coronavirus disease (COVID-19) pandemic, community health center services were limited. It was critical to have health protocols as a reference for the prevention and control of COVID-19 infection during adaptation in the new normal in Bandung City. The purpose of this research was to determine the prevention and control of COVID-19 infection at community health center in the new normal. Methods: A cross-sectional study was conducted utilizing observation through questionnaire with chosen yes (if appropriate) or no (if not appropriate) based questions in checklist form. Inclusion criteria was active dentist in community health center and exclusion criteria dentist was not completely answer question in checklist form. Purposive sampling was used to choose 30 dentists for the research sample. Data analysis uses frequency distribution and is divided into four stages, which are: preparatory, pre-visit, visiting, post-visiting stage. Data analysis uses frequency distribution. Results: At the preparatory stage were appropriate: Air flow setting on average 50%; clean water management 100%; room arrangement and management 50%. At the pre-visit stage were appropriate: Management of tele-dentistry detection and screening average 67%; patient treatment scheduling management 100%. The visiting patient stages were appropriate: detection and screening during patient visit only measurement of patients body temperature 100%; The concept of four handed dentistry 43.3%; implementation of isolation precaution in dentist personal protective equipment average 92.2% and in transmission precaution average 85%. At the post visit patient stages were appropriate: cleaning the workplace average 85%; Medical equipment management 100%; Medical waste treatment average 87.7%. Conclusion: During adaptation of the new normal, the implementation of prevention and control of COVID-19 infection in dental and oral health services community health center is not in accordance with the protocol. Improvements are still needed on several stages.Keywords: Dentist, community health center, prevention and control of COVID-19 infection, new normal.

Pembangunan Aplikasi Android Dalam Membantu Kanak-Kanak Prasekolah Belajar Membaca Sebagai Asas Dalam Bidang TVET

From the perspectives of content design, interaction, and interface, this study was undertaken to design and develop an android application to help preschool children learn to read as a foundation in the field of TVET. This study uses the research design and product development (DDR) method where the researcher focuses on the development of android applications for the teaching and learning process using a quantitative approach and the ADDIE Model teaching design. The researcher employed a random sample technique to identify three academic staff members with an appropriate TVET educational background for the investigation. This academic staff is comprised of two highly skilled and experienced academics in the field of creative android and one academic in the subject of early childhood education from an affiliated educational institution. On the basis of a distributed checklist form, frequency and percentage values were used to collect and analyse data. The classification of each item into a group and the recording of frequency data as a percentage. The study found that the process of determining the functionality of this android application in assisting preschool children to learn to read in terms of content design, interaction, and interface received positive feedback from experts, who believe that this android application is effective as one of the mediums for learning self-directed reading. Each individual can utilise the findings of this study as a reference, especially for fostering the growth of TVET among preschool-aged children.

Decision-makers’ experiences with rapid evidence summaries to support real-time evidence informed decision-making in crises: a mixed methods study

BackgroundThere is a clear need for research evidence to drive policymaking and emergency responses so that lives are saved and resources are not wasted. The need for evidence support for health and humanitarian crisis is even more pertinent because of the time and practical constraints that decision-makers in these settings face. To improve the use of research evidence in policy and practice, it is important to provide evidence resources tailored to the target audience. This study aims to gain real-world insights from decision-makers about how they use evidence summaries to inform real-time decision-making in crisis-settings, and to use our findings to improve the format of evidence summaries.MethodsThis study used an explanatory sequential mixed method study design. First, we used a survey to identify the views and experiences of those who were directly involved in crisis response in different contexts, and who may or may not have used evidence summaries. Second, we used the insights generated from the survey to help inform qualitative interviews with decision-makers in crisis-settings to derive an in-depth understanding of how they use evidence summaries and their desired format for evidence summaries.ResultsWe interviewed 26 decision-makers working in health and humanitarian emergencies. The study identified challenges decision-makers face when trying to find and use research evidence in crises, including insufficient time and increased burden of responsibilities during crises, limited access to reliable internet connection, large volume of data not translated into user friendly summaries, and little information available on preparedness and response measures. Decision-makers preferred the following components in evidence summaries: title, target audience, presentation of key findings in an actionable checklist or infographic format, implementation considerations, assessment of the quality of evidence presented, citation and hyperlink to the full review, funding sources, language of full review, and other sources of information on the topic. Our study developed an evidence summary template with accompanying training material to inform real-time decision-making in crisis-settings.ConclusionsOur study provided a deeper understanding of the preferences of decision-makers working in health and humanitarian emergencies about the format of evidence summaries to enable real-time evidence informed decision-making.

DUKUNGAN KELUARGA DENGAN KEJADIAN PREEKLAMSI PADA IBU HAMIL

Family support during pregnancy is often perceived as an unimportant form, many pregnant women do ante natal care without being accompanied by their families so they feel alone and low motivation to carry out examinations. Ante Natal Care is very necessary to determine health status and detect risks that occur during pregnancy. The purpose of this study was to determine the relationship between family support and the incidence of pre-eclamsia in pregnant women. The research design used correlation with a cross sectional approach with cross sectional data collection methods. The study population was all pregnant women who were at the Kasembon Public Health Center, Malang Regency, respondent 42 personused total sampling technique. The research instrument was a family support questionnaire and a checklist form for the incidence of pre-eclampsia. The results showed that family support was less than 45%, the incidence of mild pre-eclamsia was 45%. Analysis of the relationship using the statistical test Rho Spearman get p value: 0.002 <0.05 so that H0 is rejected H1 is accepted. Family support for pregnant women can increase motivation to perform Ante Natal Care and the health status of the mother is immediately known, especially if pregnancy complications occur. One of the complications of pregnancy is preeclampsia, it can be detected early so that the occurrence of eclampsia can be known. Therefore, it is necessary to increase family support for pregnant women in order to increase their motivation to know health status during pregnancy.

Machine learning-based brief version of the Caregiver-Teacher Report Form for preschoolers

BackgroundThe Caregiver-Teacher Report Form of the Child Behavior Checklist for Ages 1½–5 (C-TRF) is a widely used checklist to identify emotional and behavioral problems in preschoolers. However, the 100-item C-TRF restricts its utility. AimsThis study aimed to develop a machine learning-based short-form of the C-TRF (C-TRF-ML). Methods and proceduresThree steps were executed. First, we split the data into three datasets in a ratio of 3:1:1 for training, validation, and cross-validation, respectively. Second, we selected a shortened item set and trained a scoring algorithm using joint learning for classification and regression using the training dataset. Then, we evaluated the similarity of scores between the C-TRF-ML and the C-TRF by r-squared and weighted kappa values using the validation dataset. Third, we cross-validated the C-TRF-ML by calculating the r-squared and weighted kappa values using the cross-validation dataset. Outcomes and resultsData of 363 children were analyzed. Thirty-six items of the C-TRF were retained. The r-squared values of C-TRF-ML scores were 0.86–0.96 in the cross-validation dataset. Weighted kappa values of the syndrome/problem grading were 0.72–0.94 in the cross-validation dataset. Conclusions and implicationsThe C-TRF-ML had about 60 % fewer items than the C-TRF but yielded comparable scores with the C-TRF.

The biomechanics form and its application to assess student’s physical skills

One of the intended learning outcomes of Physical Education (PE) is for students to develop physical skills. Biomechanics can be used as a discipline to measure the level of physical skill. This study aimed to develop an assessment form to measure the level of physical skill. The movement principle of biomechanics was incorporated into an observation checklist form. The form is meant to help Physical Education Teachers (PET) qualitatively analyze students' physical skills using biomechanics. This study aligns with research and development model which conducted in three phases: need-analysis, development, and model efficiency test. The form was built with two main components: physical skill and biomechanical principles. Physical skill is related to standard movement patterns for a given sporting skill. The biomechanical principle lays the foundation for all movements. This research uses a qualitative approach. A total of 120 PET from 120 secondary schools were involved as subjects in this study. Interviews, observation, and questionnaire were used to collect the data. This research yielded the following result, first, there are problems with integrating biomechanics into an assessment of physical skill. Second, a biomechanics form is developed in the checklist-style observation form to help PET evaluate their students’ learning outcomes. Third, biomechanics form was practical to be used as a learning assessment tool because it met the criteria of validity, practicality, and effectiveness. Keywords: biomechanics assessment; observation checklist; physical education, physical skills

Examining the Degree of Conformity of media formats and artistic aspects of Roshd Nojavan Magazine with the Needs of Students

Background and Aim: This research aimed to investigate the degree of adaptation of media formats and artistic aspects of Roshd Nojavan magazine to the media needs and interests of first-year high school students. Methods: This study is exploratory research in which a qualitative method (content analysis) and a survey (survey of students) were used. The sample in the qualitative part included nine issues of Roshd Nojavan Magazine published during the three years of 2020, 2021, and 2022, and the quantitative was 708 high school students. The research tools were content Checklist forms and semi-structured questionnaires. The reliability of the checklist forms and the questionnaire were 0.8 and 0.7 respectively. To analyze the data, coding of the texts with an inductive approach was used in the qualitative part, and descriptive statistics, one-sample chi-square test, and the Freidman test were used in the quantitative part. Results: In general, the results show that in terms of media formats, the magazine, in the formats of articles, entertainment, humor, and comic strips and headlines were completely in accord with the needs of students, in the formats of reports and notes, there was relative compliance, but in the format of interviews, the performance of the magazine was weak far from students’ expectation. Conclusion: From the artistic and aesthetic aspects of the magazine, the three indicators: letter size, the visualization of the magazine, and the color of the photos, do not fully comply with the needs and interests of the students, and adaptation of the students' need with the size of the photos is average.

Towards adaptive structuring of the lupologist’s consultation to transform the care pathway of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a complex autoimmune disease, which can be clinically heterogeneous in the same patient over the disease process and has an unpredictable evolution. Although its prevalence is increasing, SLE remains a rare disease with frequent extra-articular manifestations managed by multiple specialists. Among these, the internist is a key player in the overall coordination of the care pathway. The dramatic improvement in the short-term prognosis of SLE observed over the past few decades has favoured the emergence of more chronic disease-associated morbidities, especially infectious, cardiovascular and/or related to sequelae, notably renal. Thus, every lupologist is confronted with the difficulty of having to address, in an educational, individualised but also systematic way, a certain number of key items on which the short-, medium- and long-term medical future of patients who develop SLE at a relatively young age depend. In recent years, in addition to the creation of a network of reference centres and the drafting of regularly updated national therapeutic guidelines and therapeutic education programs, international consensus about the factors to consider in SLE patients has been reached, including the definition of therapeutic objectives according to a treat-to-target (T2T) strategy. However, the translation of these new objectives/paradigms in real-life has encountered a number of difficulties. As part of a multidisciplinary team involving SLE patients, we developed practical tools in the form of CHECKLISTs addressing the problems of refractory SLE (D2T), the management of comorbidities and toxicities (BASICs), and, more recently, therapeutic de-escalation with a shared medical decision (T2U). It appears that there is an opportunity to transform the care pathway of SLE patients by allowing the implementation of these tools within adaptive structuring of the consultation, which has the advantage of defining a starting point within the care pathway as a common denominator for lupologists, regardless of their specialty or where they work.

Presenting a Model for Enhancing Psychological Well-being and Reducing Stress among Mine Workers in the Workplace

Objective: The purpose of the current research was to present a model for enhancing the level of psychological well-being and reducing the stress of mine workers in the workplace. Methodology: This study, in terms of its objectives, falls under developmental research and, in terms of methodology for gathering findings, employs a qualitative approach with a research synthesis method based on the six-stage model of Roberts (2009). The research population includes all relevant, credible scientific articles within the time frame (2000-2023) that are registered in both domestic and international specialized and scientific databases. After several stages of screening with criteria for reviewing titles, abstracts, content, and research quality along with the Critical Appraisal Skills Programme (CASP) standards, 25 sources were purposively selected. Data were coded and analyzed through a researcher-made checklist form and thematic analysis method in the MAXQDA software environment. The validation of the research findings was assessed through four criteria by Lincoln and Guba (1985), researcher reflexivity, and agreement between two coders. Findings: Based on the research findings, 287 basic themes as indicators and 22 organizing themes as components of the model, and 4 overarching themes including; psychosocial factors, organizational factors, individual factors, and job-related factors were identified as dimensions of the model for improving the level of psychological well-being and reducing stress among mine workers in the workplace. Conclusions: Considering the findings of the research, it is recommended that stakeholders of mining companies pay attention to the identified themes of this study to improve the mental health of mine workers.

Implementation Of “Jari Sakti Dan Domino (JSD)” With The Liveworksheet Platform To Improve Mathematics Learning Activities In Trigonometry Materials

The purpose of this research is to increase student learning activities on special angles of trigonometry by implementing Jari Sakti dan Domino (JSD) with the Liveworksheet platform. The research on the implementation of Jari Sakti dan Domino (JSD) with the Liveworksheet platform on trigonometry special angles was carried out from April 2 to May 25 2022. The research subjects were class X MIPA 1 - 5 MAN I Mojokerto with a total of 175 students. The research instruments used were observation sheets and questionnaires. Observation of liveliness is carried out when learning takes place in the form of checklists. Observation sheet to get data on the level of student activity. The graphic results state that from the observation data it was found that the level of student learning activity reached 89.51% in the very good category and from the student questionnaire it was found that students felt very happy learning by applying Jari Sakti dan Domino (JSD) reaching 93.14%, very able to apply Jari Sakti dan Domino (JSD) reached 91.43%, easy to practice 90.29% and could say the value of the special angle in quadrants I - IV reached 90.86%. This research has been able to improve the mathematics learning activities of class X MIPA students at MAN I Mojokerto in trigonometry by implementing " Jari Sakti dan Domino (JSD)" with the Liveworksheet platform.

Kesesuaian Aseptik Dispensing Injeksi Antibiotik Pada Pasien Anak Rumah Sakit Umum Daerah dr. Soediran Mangun Sumarso Wonogiri

The use of injection preparations in hospitalized patients has a high prevalence rate so that dispensing injections needs attention because there are many risks that can arise during the mixing process. The purpose of the study was to determine the suitability of the aseptic procedure for dispensing antibiotics in pediatric patients with standard operating procedures applicable at the dr. Sudirman Mangun Sumarso Wonogiri. This study used a retrospective method with descriptive analysis of the data for August – October 2021. Conformity was measured using a checklist form and the percentage of conformity was calculated. The results showed that from 106 antibiotic mixtures consisting of Cefotaxim inj (46%), Ceftriaxon inj (12%), Chloramphenicol inj (3%), and Gentamicin inj (39%) obtained 85.71% according to standard operating procedures. Compliance that has met the standard includes reviewing prescriptions, doing 5 correct, calculating dosage suitability, choosing solvents, calculating solvent volumes, making delivery forms and those that are not appropriate, namely checking the condition of the drug when it is received. Examination of the condition of the drug when it is received should be carried out accompanied by a form so that there is a record that can be used for tracing when a medication error occurs.

Description of Pharmaceutical Services and Levels of Patient Satisfaction with Services at Two Pharmacies in Lahat District

A pharmacy is a place of pharmaceutical practice carried out by pharmacists in pharmaceutical services. 73 of 2016. This type of research is a descriptive quantitative observation of documents and a direct observation of pharmaceutical services in a coherent manner. instrument checklist form and patient satisfaction questionnaire. Overview of services at the Aliifah pharmacy the presence of a pharmacist is more than 5 hours/per day serving 200 doctor's prescriptions per month and in the Mubarak pharmacy, the presence of a pharmacist is less than 5 hours/per day with a total of 150 doctor's prescriptions per month. Pharmacy services at the Aliifah and Mubarok pharmacies are in the less category, while the level of satisfaction with the Aliifah and Mubarok pharmacy services is equally very satisfactory.

Family Literacy Program for Improving the Ability to Know Letters in Early Childhood

The ability of children aged 5-6 years old at Mentari Kindergarten, Tangerang, can recognize letters is still not optimal. Parents also do not understand early childhood reading stimulation at home, so it is necessary to carry out a family literacy program. This study aims to improve the ability of children aged 5-6 years to recognize letters through a family literacy program. This type of research is Action Research. Learning activities carried out at Mentari Kindergarten are still carried out online, namely LFH (Learning from Home) with family due to the COVID-19 pandemic. The research subjects were 13 children, consisting of 5 boys and 8 girls. Evaluation of learning activities before and after receiving improvements in the form of checklists and the output of learning outcomes in the form of worksheets and photo evidence of LFH activities. At the end of the study, there was an increase in children's ability to recognize letters well by 80%. These results have exceeded the research success criteria, so it can be concluded that the family literacy program can improve the ability of early childhood to recognize letters.

Blueprint for Implementing and Improving Eligible Inferior Vena Cava Filter Retrieval Across Institutions.

Placement of removable inferior vena cava filters (rIVCFs) has increased, but this has not been accompanied by timely removal, with retrieval rates as low as 8.5% at some institutions. Failure to remove rIVCFs that were not medically necessary resulted in increased complications. This study discussed the development of an inferior vena cava (IVC) filter follow-up protocol. A method to monitor IVC filter placement and retrieval was developed. A weekly report was generated detailing placement and removal of rIVCFs. A standardized retrieval calculator was utilized to determine efficacy of removal. An IVC filter Retrieval Assessment Form was developed. Managing physicians and patients with medically unnecessary filters were sent letters with a retrieval checklist and order form. If not removed within one year, additional letters were sent. Standardized IVC filter reporting templates were created and utilized after insertion of all filters with retrieval status. Letters eventually were built into the electronic medical record for direct routing. From 2015 to 2020, IVC filters were placed in 719 patients. Of those, 58% were eligible for retrieval. Initial rates of rIVCF removal in eligible patients were as low as 30-33% in 2015. The retrieval rate of eligible filters rose to 44% in September 2018. The rate of retrieval rose to 61% in January 2021. Employing a systemic protocol to aid in follow-up of patients following rIVCF placement may improve rates of retrieval. Regular evaluation and revision of the process demonstrated a significant role in achieving an increase in retrieval rates.

Complications following Permanent Filler Injection: A Prospective Cohort Study and Protocol of Management.

This cohort study was conducted by distributing a checklist form among all patients aged 18 years or older who arrived for a new cosmetic consultation between 2015 and 2019. The primary outcome was the occurrence of complications, which are defined as symptoms induced by the PF. The demographics, type of PF, injection site, the time for the complication to occur, and signs and symptoms were recorded and followed up. In this study, 325 out of 503 (64.61%) patients presented with PF-related complications. About 92.8% were women. All patients with PF-related complications presented with a lump (n = 325, 100%). In regard to the anatomical area of injection, the most common areas were the cheeks (66.6%). The time it took for the complication to occur most commonly ranged from 1-5 years (39.2%, P < 0.001). Complications were significantly higher among patients who received the injection in a nonmedical facility (P < 0.0002). Seventy-seven cases (15.3%, P < 0.0001) underwent PF removal. PF-related complications in the body exhibit a wide range of onset and adverse events. The best method to prevent complications caused by permanent filling materials is to avoid them altogether. When it comes to permanent filling agents, we suggest extreme caution.

Perencanaan Manajemen Pemeliharaan Komponen Arsitektur dan Utilitas Pada Gedung Asrama LPMP Sumatera Barat

The use of the building is to support activities or as infrastructure for building owners or building users in optimally carrying out their daily activities. The building is expected to be flexible following the flow of changes that occur in the activities of building owners or users later. This is what underlies the need for building maintenance activities. In the LPMP Dormitory building, maintenance activities have not been managed properly. In order for maintenance activities to be better, a maintenance management plan is made on the architectural and utility components for the building. Starting from listing the components that are maintained, then making maintenance classifications of these components, namely preventive maintenance and corrective maintenance. Next, make standard operating procedures for each of these components, complete with a flow chart and checklist form. Scheduling is also an important point in maintenance activities, starting from scheduling daily, weekly, monthly, and yearly components. The total preventive maintenance cost for architectural and utility components in the building is Rp. 303,648,000. This fee is the maintenance fee for one year.

Gambaran Ketepatan Pengembalian Rekam Medis Rawat Jalan di Klinik Kebidanan dan Kandungan Rumah Sakit Permata Hati Tangerang

In order to obtain a quality medical record unit performance, the administration of medical records must be carried out properly, including the return of medical records. The standard for returning medical records at Permata Hati Hospital is 1x24 hours. Delays in returning medical records can disrupt the quality of medical services and hinder further activities such as coding. The purpose of this study was to obtain an overview of the return of outpatient medical records at Permata Hati Hospital, Tangerang. The method used is descriptive method. The type of research used is quantitative research. Data collection techniques in the form of interviews, observations and checklists. The results of the study on timely return of medical records were 64% and those that were not on time were 36%. Based on the results of this study, it is known that the return of outpatient medical records has not gone well. The delay in returning outpatient medical records was due to the lack of labor at the obstetrics and gynecology clinic so that there was no checking of borrowed medical records with those returned by clinic officers and medical record officers. Delays in medical records because clinic staff still do not understand and lack of socialization of SOPs related to returning outpatient medical records. One of the efforts made is to provide special training for clinic staff regarding the time limit for returning outpatient medical records.