Funding For Training Research Articles

Clinical Pharmacy Services in Canadian Emergency Departments: A 2022 National Survey.

Support for the role of an emergency department (ED) clinical pharmacy team is evidence-based and recognized in numerous professional guidelines, yet previous literature suggests a low prevalence of ED clinical pharmacy services in Canadian hospitals. To update (from a survey conducted in 2013) the description and quantification of clinical pharmacy services in Canadian EDs. All Canadian hospitals with an ED and at least 50 acute care beds were contacted to identify the presence of dedicated ED pharmacy services (defined as at least 0.5 full-time equivalent [FTE] position). Three separate electronic surveys were distributed by email to ED pharmacy team members (if available), pharmacy managers (at hospitals without an ED pharmacy team), and ED managers (all hospitals). The surveys were completed between November 2021 and January 2022. Of the 254 hospitals identified, 117 (46%) had at least 0.5 FTE clinical pharmacy services in the ED (based on initial telephone screening). Of the 51 (44%) of 115 ED pharmacy team survey responses included in the analysis, 94% (48/51) had pharmacists and 55% (28/51) had pharmacy technicians. The majority of pharmacy managers and ED managers identified the need for ED pharmacy services where such services did not exist. Inadequate funding, competing priorities, and lack of training remain the most commonly reported barriers to providing this service. Personal safety concerns were reported by 20% (10/51) of respondents. Although the establishment of clinical pharmacy services in Canadian EDs has grown over the past 8 years, lack of funding and ED-specific training continue to limit this evidence-supported role in Canadian hospitals.

ШЛЯХИ ПІДВИЩЕННЯ ЕФЕКТИВНОСТІ ФІНАНСУВАННЯ ЗАКЛАДІВ ПРОФЕСІЙНОЇ ОСВІТИ

The article explores the efficiency of funding professional education institutions in Ukraine. Indicators such as economy, productivity, and effectiveness can be applied to measure the socio-economic efficiency of educational activities. Funding for training qualified workers in Ukraine is done through state or local budget funds. Additionally, professional education institutions can independently receive additional funding from funds received for training qualified workers beyond the state order under contracts concluded with legal and natural persons. The statistical data presented allowed for the following conclusions: budget expenditures on professional education increase annually while the number of students decreases. The main problems of professional education functioning are the poor material-technical base of professional education institutions, the low efficiency of managing these institutions, and the content and quality of professional education not meeting the requirements of the modern labour market. However, the critical advantage of professional education is its flexibility and quick response to labour market demands. Education can take place both on a full-time and part-time basis. Improving the quality of graduates from professional education institutions is possible through the establishment of a system of professional qualifications and the creation of a unified educational environment for professional education, the implementation of mechanisms to incentivize employers to participate in the educational process, creating conditions for the development of dual forms of education; popularizing professional education among the population, planning professional development and careers. Dual education was introduced in Germany in the last century in a ratio of "30% theory, 70% practice." The economy provides 73% of dual education funding in Germany. During the 2- to 3-year training period, employers get to know their students well and can better assess their suitability for the enterprise. The school education program in Ukraine needs reform to increase the share of career guidance work and opportunities for students in graduating classes to intern at companies. School education should develop practical skills to help students adapt to employer demands and determine their future profession.

ASBESTOS SAFETY AND HEALTH RISK AWARENESS AMONG MAINTENANCE WORKERS IN KENYAN PUBLIC UNIVERSITIES

This study evaluated asbestos safety and health risks awareness among maintenance workers in public universities in Kenya through four aspects of education, policy, perception and knowledge. The study anchored on positivism philosophy with a descriptive design approach achieved by survey of394 respondents using a semi-structured questionnaire. Both descriptive and inferential statistics were analysed. The regression coefficients model analysis showed that knowledge (beta = .242, p =.000) and perception (beta = .177, p=.002) statistically predicted university awareness for asbestos safety and health risks (p<.05). However, both education (beta = .018, p = .217) and policy (beta =.115, p = .380) had poor significance (p>.05) indicating that the two constructs failed to predict the awareness of asbestos safety and health risks. Overall, majority of the public universities had awareness levels of over 40 percent but all below 50 percent with an average of 44 percent. Having focused on the safety and health risks awareness aspect, the study recommends concerted efforts by public universities in raising awareness over the banned asbestos and asbestos containing materials at the work place. Additionally, public universities need to increase training funds allocation while aiming to improve on the implementation of the safety and health risks policy.

Progress in Food Fortification in Nigeria - Historical Overview, Current Issues, Consumer Perceptions and Awareness, and the Need for Additional Vehicles.

It is already over two decades since the mandatory food fortification program, an industry-based micronutrient intervention initiative commenced with wheat flour, sugar, edible oils, and salt as the major vehicles. There is a need for comprehensive documentation of the historical overview of the initiative to give the right perspective and key learnings to guide similar interventions in the future so as to avoid ‘re-inventing the wheel’. It is also imperative to evaluate the impact of the program considering the huge investments that have been made by major stakeholders such as the government, industry, and various partners. The program impact after over two decades has appeared considerably low, especially with the huge numbers of the population still trapped in the malnutrition web, particularly within the targeted vulnerable groups. This is attributable to various factors such as poor communication and awareness, low inclusiveness of the informal sector, low consumer demand for fortified foods, poor industry compliance in the absence of government incentives, commoditization and poor stability of micronutrient premixes, paucity of funding for local research activities and training, as well as inadequate monitoring and evaluation, all of which are necessary for program sustainability and ownership. Results of an online survey of consumer perception, knowledge, and awareness of the food fortification program within the knowledge community confirm the case for additional mandatory food vehicles, particularly Bouillon cubes which have a wide reach in Nigeria. The rationale for the emergence of these additional vehicles, including rice and tomato paste is discussed to increase the coverage of the program. The need for a Code of Practice, to guide Producers towards better compliance is also discussed as part of the overall strategy to ensure that fortification vehicles reach the target population as expected for better impact.

Simple ways to improve nutrient content and health profile in different types of foodservice products

ABSTRACT This study shows how two foodservice products, French fries with sausage (representing vice food) and vegetable and lentil soup (representing virtue food), can be reformulated to meet the nutritional recommendations without compromising consumer acceptance. The reformulation process involved recipe development and testing, including techniques such as salt reduction, fat quality modifications, and spicing solutions to compensate the flavor changes. The reformulated products were evaluated by both consumers (N = 123) and sensory professionals (N = 9). Consumer testing revealed no significant differences in overall pleasantness between the original and the reformulated products. However, the reformulated versions received higher ratings for smell and pleasantness of appearance. This suggests that it is possible to reformulate products with conventional nutrient profiles without negatively affecting consumer acceptance. The sensory professionals also evaluated the reformulated products similarly. The nutrient content of both products significantly improved following reformulation. The study concludes by recommending the widespread implementation of reformulation techniques in the foodservice industry. Authorities are encouraged to support this by providing funding for training in recipe modification techniques. In addition, closer cooperation and knowledge sharing among stakeholders in the food supply chain are recommended to further enhance the implementation of reformulation practices.

A study on the application of Prepar3D-based Aviation’s Localizer Performance with Vertical Guidance Approach procedures in the teaching of simulated flight training courses

Firstly, the advantages of flight simulators and the three types of flight simulation software widely used by current flight students are briefly described, focusing on the analysis of instrument landing knowledge, how to read the instrument approach procedure charts, and how to use the flight simulation software to implement various instrument landing systems, so as to make the correct operation according to the approach procedure charts. Based on Prepar3D flight simulation software, Cessna C172R G1000 system was used to demonstrate two different types of precision approaches, so that the trainees could be more clearly and intuitively familiarized with the relevant operation procedures of precision approaches. From the results of the demonstration, it can be seen that flight simulation has the advantages of improving training efficiency, saving training funds, ensuring flight safety, and reducing environmental pollution, etc. The advantages of flight simulation software can fundamentally improve the flight skills of the trainees, increase flight experience, and thus reduce the incidence of major safety accidents.

USING COLLECTIVE IMPACT TO ASSESS HOME AND COMMUNITY-BASED SERVICES WORKER TRAINING AND CREDENTIALING

Abstract Older adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 120,000 often poorly paid and inadequately supported direct care workers in North Carolina (NC). The demand for these workers is increasing rapidly, with NC projected to add almost 23,000 new direct care jobs from 2020 to 2030. With the goal of optimizing the workforce pipeline to prepare for the high need for HCBS across NC, we conducted a Medicaid-funded landscape analysis of direct care training/credentialing using Collective Impact (CI). CI is used for diverse collaborations through forming a common agenda, shared measurement, mutually reinforcing activities, continuous communication, and “backbone” support (dedicated coordination team). Engaging with lived experiences is crucial in CI as it leads to sustainable decision-making informed by those affected by policy change. With input from long-term services and support agencies, licensing bodies, advocates, and those with lived experience, we characterized NC HCBS training/credentialing landscape, generating a first-of-its-kind comprehensive crosswalk resource for the state. Findings reveal the complexity of training/requirements, limited portability, lack of flexibility, and a need for more person-centered and relational core competencies. In addition, funding and incentives for additional training are lacking, which limits opportunities for professional development and career advancement. CI is an effective method to analyze direct care worker training/credentialing, it allowing researchers to harness the wisdom of community partners and incorporate lived experiences of the people most impacted by potential policy changes - workers, HCBS recipients, and families.

In-Service Training of Local Servants in Croatian Local Self-Government: between old Habits and new Ideas

The purpose of this paper is to research methods of in-service training of local servants in Croatian local self-government. The research conducted in the paper aims to contribute to scientific literature given that this area is relatively poorly researched and to determine to what extent the in-service training model is in accordance with the strategic model of human potentials development. To determine this, a legal analysis, an assessment of available documents on training programs and reports on local budgets in Croatian cities is being carried out. To examine more deeply the trends in the training of local servants and to answer the paper research question, a questionnaire was sent to Croatian cities. It is concluded that the importance of local servants training, which the scientific and professional literature strongly emphasizes, has not yet been recognized in Croatia as the legal framework does not emphasize the importance of training nor encourage its modernization, while at the same time very little funds for training are allocated from local budgets. The analysis of the questionnaire shows that the new trends in the training of local servants are very poorly represented and that ultimately the traditional (administrative) model of human potentials management still prevails in Croatian local and regional self-government.

Effects of remnant cholesterol on the efficacy of genotype-guided dual antiplatelet in CYP2C19 loss-of -function carriers with minor stroke or transient ischaemic attack: a post-hoc analysis of the CHANCE-2 trial

The atherogenicity of remnant cholesterol (RC), a contributor to residual risk of cardiovascular events, has been underlined by recent guidelines. We aimed to evaluate the relationship between RC levels and the efficacy and safety of genotype-guided dual antiplatelet therapy in the CHANCE-2 trial. This post-hoc study used data from the CHANCE-2 trial, which was a randomised, double-blind, placebo-controlled trial of 6412 patients (aged >40 years) enrolled from 202 hospitals in China, between Sept 23, 2019, and March 22, 2021, who carried CYP2C19 loss-of-function alleles and had either an acute minor stroke or high-risk transient ischaemic attack (TIA), and could start treatment within 24h of symptom onset. Participants received either (1:1) ticagrelor plus aspirin (control) or clopidogrel plus aspirin (intervention) and the effect of reducing the 3-month risk of any new stroke was assessed (ischemic or haemorrhagic, primary outcome). From the CHANCE-2 study population, we enrolled 5890 patients with complete data on RC. The cutoff point of RC for distinguishing patients with greater benefit from ticagrelor-aspirin versus clopidogrel-aspirin was determined with subpopulation treatment effect pattern plot. The primary efficacy and safety outcome was recurrent stroke and severe or moderate bleeding within 90 days, respectively. CHANCE-2 is registered with ClinicalTrials.gov, NCT04078737. The cutoff to define elevated RC was 0.91mmol/L. Ticagrelor-aspirin versus clopidogrel-aspirin was associated with a reduced risk of recurrent stroke in patients with non-elevated RC levels (122 [5.3%] versus 179 [7.8%]; hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.54-0.85), but this benefit was absent in those with elevated RC levels (58 [8.4%] versus 48 [7.3%]; HR, 1.10; 95% CI, 0.73-1.65; P-interaction=0.03). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin on recurrent stroke decreased as RC levels increased. The rates of severe or moderate bleeding between treatment groups were similar across RC categories (0.3% versus 0.3%, P-interaction=0.95). Our post-hoc findings suggest that RC could be a potential biomarker to discriminate patients who received more benefits from ticagrelor-aspirin versus clopidogrel-aspirin therapy in CYP2C19 loss-of-function carriers with minor stroke or TIA. These findings need to be validated in an independent study. The National Key Research and Development Program of China, Beijing Natural Science Foundation Haidian original innovation joint fund, Fund for Young Talents of Beijing Medical Management Center, the high-level public health talents, Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University; and Salubris.

The Effect of a Blended Project-Based Training Program on EFL Teachers’ Implementation of Differentiated Instruction in Jerusalem

Objectives: The current study aimed to investigate the effect of a blended project-based training program on EFL teachers' implementation of differentiated instruction in Jerusalem. Methods: The study used a descriptive-analytical design using quantitative methods; the study used a one-group quasi-experiment that lasted for ten weeks. It involved using a questionnaire instrument adapted from Whipple's (2012) administered both before and after the training program on 35 EFL teachers from Jerusalem. The data was transformed into numerical form and analyzed using the Statistical Package for the Social Sciences (SPSS). As the data was not normally distributed, a nonparametric Wilcoxon test was employed for statistical analysis. Results: The data revealed a positive effect of the training program. Conclusions: There was a significant difference between participants' implementation of differentiated instruction before and after the blended project-based training program. Thus, the researchers offered crucial recommendations to the Ministry of Education, including allocating special funds for teacher training.

A realist evaluation of the development of extended pharmacist roles and services in community pharmacies

BackgroundInternationally, community pharmacy models of care have been moving away from a focus on dispensing to extended, clinically-focused roles for pharmacists. ObjectivesTo identify how community pharmacy strategies were being implemented in Aotearoa New Zealand; how changes were expected to influence health and health system outcomes; what extended services were being delivered; the responses of pharmacists, other health professionals and consumers to these developments; and the contexts and mechanisms supporting the successful implementation of new community pharmacy services. MethodsA realist evaluation methodology was employed, to explore a complex policy intervention. Realist evaluation explores the contexts (C) within which initiatives are introduced and identifies the mechanisms (M) triggered by different contexts to produce outcomes (O). Realist evaluation processes iteratively develop, test, and refine CMO configurations. In this study, initial programme theories were developed through key government and professional policy documents, then refined through key informant interviews, a survey and interviews with pharmacists and intern (pre-registration) pharmacists, and finally, 10 case studies of diverse community pharmacies. ResultsFour intermediate health service outcomes were identified: development of extended community pharmacist services; consumers using extended community pharmacist services; more integrated, collaborative primary health care services; and a fit-for-purpose community pharmacy workforce. Enabling and constraining contexts are detailed for each outcome, along with the mechanisms that they trigger (or inhibit). ConclusionsThere are wide-ranging and disparate levers to support the further development of extended community pharmacy services. These include aligning funding with desired services, undergraduate educators and professional leaders setting expectations for the pharmacists’ role in practice, and the availability of sufficient funding and time for both specific extended service accreditation and broader postgraduate training. However, no simple “fix” can be universally applied internationally, nor even in pharmacies within a single jurisdiction, to facilitate service development.

Service learning via tourism volunteering at university: skill-transformation and SDGs alignment through rite of passage approach

PurposeThis study aims to investigate how university students experience a skill transformation process aligned with the sustainable development goals (SDGs). This transformation occurs through their participation in a service-learning programme alongside an international volunteering project. The theoretical framework for understanding this skill transformation process is based on the “rite of passage”.Design/methodology/approachQualitative methodology is adopted by conducting 23 online surveys with volunteers (virtual and onsite) and five with coordinators across the rite of passage phases. Volunteering was carried out in five Mayan indigenous communities in Mexico as part of an international cooperation project with the goals of supporting community-based tourism development and strengthening volunteers’ skills in accordance with the SDGs.FindingsResults show that international volunteering programmes for university students significantly enhance their interpersonal and professional skills, demonstrating strong potential for implementing the SDGs. These programmes provide learning and education opportunities for both volunteers and local communities. Volunteers gain a broader perspective on gender equality and cultural barriers. Additionally, volunteering supports sustainable tourism, economic worth and collaboration among institutions. Both volunteers’ personal characteristics (educational level and sociocultural context), as well as their sociocultural context, influenced the perception of the skill transformation process and learning about the SDGs. Finally, a new educational university programme in volunteering aligned with SDGs is proposed.Practical implicationsThis research examines the practical ramifications of incorporating volunteer programmes into university courses. Universities must include these initiatives in their educational systems as a means of enhancing student learning.Social implicationsA new educational university programme in volunteering aligned with SDGs is proposed. This study suggests a shift in university mindset, as well as increased funding for training and adherence to the SDGs.Originality/valueThis study pioneers the rite of passage framework in an international volunteer tourism project facilitated by universities, emphasizing volunteering as a valuable tool for SDG implementation, considering the interrelationships between objectives.

Qualification of the Legal Relationships Arising in Connection with the Realization of the Right to Education

The article is devoted to the analysis of legal relations arising during the realization of the right to education, taking into account the variety of forms of interaction and the peculiarities of the legal status of their participants. Based on the results of the analysis of these legal relations, the author concludes that the predominance of private interests of the student in legal relations, which indicates that educational relations belong to the branch of civil law that requires regulation through civil law mechanisms. The author notes that part of the legal relations directly related to training has a civil nature and is implemented in the form of a contractual obligation to provide educational services (both for cases of paid training on the basis of a signed contract, and for cases of training at the expense of budget financing). Based on the conclusions about the legal nature of the relations under consideration, proposals are put forward to amend Chapter 39 of the Civil Code of the Russian Federation, allowing the rules of this chapter to apply to educational relations based on budget financing. The proposed changes are aimed at ensuring equal learning conditions and ways to protect the civil rights of students, regardless of the source of funding for training.

Customer care in selected academic libraries in Ghana

This article reflects on a study done on the state of customer care in five selected academic libraries in Ghana. The study examined the prevailing customer care programmes – the policies, structures, practices, and the effects of customer care on the use of library products and services. Based on a pragmatic assumption, the researchers adopted a mixed-method research approach and a survey design with a sample of 3153 respondents which comprised three strata: students, faculty and library staff from the five selected academic libraries in Ghana. Data was largely collected with questionnaires and interviews were used to gather information from university librarians/heads of customer service. A document review instrument was used to confirm information provided by the respondents. The findings revealed that all five academic libraries had some form of customer care programmes. The article also established that customer care programmes contributed greatly to the improvement of skills, knowledge, experiences, and service performance of the academic library staff, which influenced the patronage of library products and services. However, the researchers identified inadequate financial resources, lack of written customer care policies, shortfalls in the customer care practices and training programmes as some of the challenges facing the implementation of customer care initiatives in academic libraries in Ghana. The article recommends developing written customer service policies and programmes specific to the provision of excellent customer services in academic libraries, adequate funding for regular customer service training of library staff and effective application of modern technology to enhance customer care in academic libraries.

Perspective of an International Medical Graduate in the UK

Creating better training programs, increasing funding for speciality training, taking complaints of bullying and harassment seriously, and providing a stable and supportive work environment are essential steps toward retaining the doctors who have long dreamed of serving in the NHS. By addressing these challenges and supporting IMGs, we can ensure that the NHS continues to provide high-quality care to patients while fostering a welcoming and equitable environment for all doctors, regardless of their country of origin.

Point-of-care ultrasound in geriatrics: a national survey of VA medical centers

BackgroundPoint-of-care ultrasound (POCUS) can aid geriatricians in caring for complex, older patients. Currently, there is limited literature on POCUS use by geriatricians. We conducted a national survey to assess current POCUS use, training desired, and barriers among Geriatrics and Extended Care (“geriatric”) clinics at Veterans Affairs Medical Centers (VAMCs).MethodsWe conducted a prospective observational study of all VAMCs between August 2019 and March 2020 using a web-based survey sent to all VAMC Chiefs of Staff and Chiefs of geriatric clinics.ResultsAll Chiefs of Staff (n=130) completed the survey (100% response rate). Chiefs of geriatric clinics (“chiefs”) at 76 VAMCs were surveyed and 52 completed the survey (68% response rate). Geriatric clinics were located throughout the United States, mostly at high-complexity, urban VAMCs. Only 15% of chiefs responded that there was some POCUS usage in their geriatric clinic, but more than 60% of chiefs would support the implementation of POCUS use. The most common POCUS applications used in geriatric clinics were the evaluation of the bladder and urinary obstruction. Barriers to POCUS use included a lack of trained providers (56%), ultrasound equipment (50%), and funding for training (35%). Additionally, chiefs reported time utilization, clinical indications, and low patient census as barriers.ConclusionsPOCUS has several potential applications for clinicians caring for geriatric patients. Though only 15% of geriatric clinics at VAMCs currently use POCUS, most geriatric chiefs would support implementing POCUS use as a diagnostic tool. The greatest barriers to POCUS implementation in geriatric clinics were a lack of training and ultrasound equipment. Addressing these barriers systematically can facilitate implementation of POCUS use into practice and permit assessment of the impact of POCUS on geriatric care in the future.

Socioeconomic status and individual investors’ behavior during a financial crisis

The COVID-19 pandemic triggered a financial crisis that provides a unique opportunity to examine investor behavior using an administrative dataset of individuals in Israel. The dataset includes information on withdrawals from tax-sheltered training funds, switching to less risky or riskier investment tracks, and individual socioeconomic status (SES). Our analysis reveals that during the peak of the crisis in March 2020, low-SES investors were more likely to withdraw money from their training funds despite incurring a significant tax penalty for so doing. This resulted in a double loss for poorer investors, who were hit by both the stock-market decline and the tax penalty. In contrast, higher-SES investors were less likely to liquidate their funds. Additionally, investors were found to be more likely to increase risk as SES rises and less likely to decrease risk as SES rises.

Training and development in the Visegrad countries during Covid-19

PurposeThe purpose of this paper is to define the impact of training and development (T&D) in the Visegrad countries (V4) as impacted by the Covid-19 pandemic, namely, Hungary, Poland, Slovakia and the Czech Republic. These countries have some political, cultural, social and economic similarities and share some common ground in the human resource development (HRD) sectors.Design/methodology/approachThe authors used the HRD theory and the human capital theory to analyse the context, operations and impact of T&D in the V4 countries due to the Covid-19 pandemic. The research was conducted in 400 companies, 100 from each of the four countries using the computer assisted web interviewing technique. The questionnaire was in a six-point Likert scale format and addressed 12 topics related to T&D: policy, expectations, procedures of diagnosis, preparation, implementation, monitoring, trainees, trainers, investment and expenditures, evaluation, results and controlling.FindingsThe authors concluded that in the Visegrad countries, Covid-19 raised expectations on T&D. This was followed by increased levels of action in diagnosis, preparation, monitoring and implementation, following pre-existing and adjusted policies. Evaluation and control were complicated. Investment and results and the human side of the T&D (trainees and trainers) were the ones for which there were more uncertainties and perplexities.Research limitations/implicationsThe study has the limitation of using only a small sample in four countries. For further research, the authors suggest a larger study extended to all the European Union countries, an in-depth analysis of the current data and the kurtosis on Policy of T&D.Practical implicationsThe results of the research can be used to improve T&D programs after the Covid-19 pandemic. They could also provide information to external trainers to improve and adjust their services according to the opinions of the respondents of the study. The research findings can also serve institutions responsible for policy provision of HRD at a national level by providing possibilities to apply for funding either within national or regional funds like the National Training Fund in Poland or within European Union money at a national level.Originality/valueThe study is original because even if the T&D in V4 countries during the Covid-19 pandemic had already been studied separately (e.g. Mikołajczyk, 2021; Vrabcová, Urbancová 2021; Vinichenko et al., 2021), no empirical, cross-national research analysing specifically the T&D in those countries has been carried out so far. The authors use an innovative methodology, addressing 12 topics and the people involved together with the stages in which a T&D policy is divided. That makes it innovative and very relevant.

Exploring Dimensions of Teacher Education in Nepal: Perspectives, Challenges, and Reform Opportunities

This study evaluates Nepal's English Language Teacher Education (ELTE) reform possibilities and challenges. The study examines teacher education in connection with social contexts, knowledge transformation, and knowledge generation from many perspectives. Reflective teaching, modelling, and research habits improve instructors' professionalism and create effective learning environments. According to the report, English Language Teachers in Nepal face obstacles that must be addressed in teacher education. Content analysis is used to study the diverse literature. Surkhet English teachers and headteachers participate in a focus group. The paper's results and discussion section summarize the literature review and participants' opinions. It covers key concerns such as the absence of physical facilities and funds for teacher training, poor English language ability among instructors, coordination issues between pre-service and in-service training programs, and minimal research on ELT classroom methods. Reforming teacher education to improve topic knowledge, pedagogical skills, and technology expertise is recommended. English language teacher education faces societal inequities, uneven government regulations, and limited access to internet resources and databases. The study also examines technology integration in English language classrooms, online platforms, and the lack of research on ICT integration in Nepalese education. This research article helps to understand ELTE in Nepal and suggests areas for development and additional study.

Knowledge and Attitude of Health Managers Towards the Annual Health Sector Planning and Budgeting Process in Bungoma County, Kenya

The focus of health planning and budgeting is to identify priorities that, in turn, guide budgetary allocations aimed at improving health outcomes. The shift towards decentralization has necessitated reforms in the planning and budgeting processes. These reforms encompass the enactment of legislation, the formulation of process guidelines, and the utilization of program-based budgeting (PBB). Despite the institutionalization of these reforms, healthcare administrators continue to encounter the challenge of insufficient technical capacity and motivation, which hinders their effective participation in the process. Therefore, this study aimed to examine the knowledge and attitudes of health managers toward the annual health sector planning and budgeting process. A descriptive cross-sectional study design was employed, utilizing both quantitative and qualitative methods. Quantitative data were collected from 170 health managers drawn from all levels of the county health system, while qualitative data were collected from 3 county health executives. Quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS v. 29.0), while qualitative data were thematically analyzed. Fifty-eight percent of the health managers had not received training on the annual planning process, and 81% had not been trained on PBB. Only 41% were oriented on MoH planning guidelines and 40.5% on legal frameworks. Just 42% of health managers were knowledgeable about the planning and budgeting process. Chi-square tests indicated a significant association between training and the knowledge level of health managers, χ2 (1, N = 170) = 94.76, p < 0.001, as well as between the knowledge level and the use of legal frameworks, χ2 (1, N = 170) = 53.67, p < 0.001. Trained health managers displayed higher knowledge and utilization of legal frameworks. Although 93% of health managers acknowledged the process is essential for their units, only 40% affirmed their motivation to participate, and 78% disagreed with having a positive attitude toward the process. Top of Form To enhance the knowledge and attitude of health managers towards planning and budgeting, the county health department should allocate funds for training in the annual planning and budgeting process—including PBB. Additionally, the county health department should implement comprehensive orientation programs for health managers, encompassing the Ministry of Health's planning and budgeting guidelines along with the relevant legal frameworks.