Initial Impact Research Articles

Integrating Information Technology and Reading Teaching to Promote the Development of Students' Reading Ability

A survey was conducted among students from Class VI to VIII at Sarpang Middle Secondary School to understand their perception of the reading culture at the school. The survey also aimed to evaluate the impact of a recent reading program initiative during morning hours on their reading habits and how the development of ICT helped them inculcate reading habits. One hundred students were selected through multi - stage sampling and responded to reading - related questions using a questionnaire. The survey was conducted both before and after the intervention, and data collected were analysed using descriptive statistics and frequency distributions. This systematic review examines how information and communication technology (ICT) is used to teach reading in the classroom and its effect on students' behaviour and motivation. The results showed that most students spent 30 minutes to 1 hour on reading, with books and text provided through technology. Students understood 80% of what they read, and their teachers were reported as their primary source of inspiration for reading. Additionally, all respondents felt that the reading program using ICT was helpful in the post - test survey. Lack of interest and lack of time were the two main constraints students faced in cultivating reading habits, with fiction and non - fiction books, both print and digital, dominating their interests. Overall, the recent intervention of introducing a reading program using both e - readers and library books significantly impacted students' reading habits, with some slight negative differences observed.

Preliminary Results of a Workplace Health Promotion Program in Higher Education

Background: Employees of higher education have an increased risk for stress, burnout, and turnover. Workplace Health Promotion (WHP) programs have been shown to improve quality of life, reduce individual health risks, improve morale, reduce health care costs, and increase employee retention. Aim: The aim of this study was to determine the impact of a WHP initiative on employee intent to stay, life/work balance, and work-related quality of life. Methods: This study employed a cross-sectional design at a Midwestern university. All faculty and staff were invited to participate in an Employee Wellness Hour, which allowed them to take an additional hour per day to participate in wellness-related activities. Those who chose to participate were required to track their wellness activity on a weekly basis in Qualtrics and invited to participate in a survey examining their intent to stay, life/work balance, and work-related quality of life. Analyses were conducted to determine whether participation in the Employee Wellness Hour had an impact on employee intent to stay, their life/work balance, and work-related quality of life. Results: Results indicated that those who participated in the Employee Wellness Hour were more likely to stay with their current employer and rated their working conditions more positively. Conclusions: The cost of employee turnover is immense, making it imperative that employers develop and implement innovative solutions to retain employees and improve working conditions. This study provided preliminary evidence that WHP programs can have a positive impact on retention and working conditions among those employed in institutions of higher education.

An Evaluative Study of a Nurse-Led Surgical Information Initiative for Gender Diverse Individuals Seeking Genital Surgery.

To evaluate the impact of nurse-led one-on-one psychoeducation sessions on gender diverse individuals seeking gender-affirming genital surgery. A quasi-experimental, pre- and post-test research design was employed to examine the impact of a nurse-led initiative on improving patients self-perceived knowledge and confidence pertaining to gender affirming genital surgery. The study followed the SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence) guidelines and the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. The curriculum for the initiative was crafted through literature reviews, expert panel engagements, multidisciplinary team input and was delivered by two specialist gender nurses. The results indicated a statistically significant increase in all participants' self-perceived knowledge and confidence scores. Furthermore, the study increased confidence in the ability to ask questions and plan for the logistical and financial aspects of surgery. Participants reported that the sessions were very useful, and for most, the information did not change their desire to seek surgery but did help them make more informed choices about the procedure, timing and preferred surgeon. The study underscores the imperative role of support networks and recommends interventions to facilitate open communication within families. The study emphasises the importance of customising healthcare approaches to align with the preferences of patients. The study addressed the need for psychoeducation sessions for individuals considering gender-affirming genital surgery. The main findings revealed a significant increase in participants' self-perceived knowledge and confidence, following a nurse-led intervention. The research's impact extends to gender-diverse individuals seeking surgery globally. Four individuals who had undergone gender-affirming surgeries contributed their perspectives to the study design, ensuring that the educational content addressed specific information needs and concerns.

Retraction Note: Impact of corporate sustainable practices, government initiative, technology usage, and organizational culture on automobile industry sustainable performance.

Retraction Note: Impact of corporate sustainable practices, government initiative, technology usage, and organizational culture on automobile industry sustainable performance.

A Quality Improvement Approach to Increasing Access to long-Acting Reversible Contraceptives in a Federally Qualified Health Center.

Long-acting reversible contraceptives (LARCs) are the most effective forms of contraception available and therefore play a critical role in supporting patients to exercise bodily autonomy and achieve reproductive goals. A comprehensive set of quality improvement (QI) interventions were implemented between March and June 2019 to improve LARC access at a federally qualified health center (FQHC) in (US State). An evaluation study was conducted to assess the impact of the QI initiative considering the number of LARCS delivered as a proxy for access. The Wilcoxon-rank test was applied to test for significance, given a non-parametric sample of LARCs delivered by 13 providers (matched to themselves) pre- and post-intervention. Reimbursement for LARC procedures pre- and post-intervention was also examined to determine economic impact and sustainability of incorporating a new device, the Liletta™, in the floor stock. There was a statistically significant increase in LARC delivery between July 2019-March 2020 compared to July 2018-March 2019. Approximately $1,000 per month increased reimbursement for LARC services occurred post-intervention. The evaluation study concluded success of the QI intervention, with need for further study needed to determine equitable delivery of contraceptive services between different subpopulations and by insurance status. The study provides a blueprint for QI initiatives to improve access to LARCs while also increasing revenue for LARC services in an FQHC setting.

Impact of a trainee-led initiative to address PCP prophylaxis barriers.

319 Background: In a prior trainee-led QI initiative, we surveyed clinicians about Pneumocystis pneumonia (PCP) and assessed rates of appropriate prophylaxis. Through retrospective chart review, we found that 47% of eligible patients (n=140/297) received PCP prophylaxis between 5/2022 and 5/2023. Clinician-reported barriers included knowledge gaps, systems-related gaps, and unclear corticosteroid durations. In the current initiative, we built an order set to facilitate PCP prophylaxis prescription and created an automated approach to assess prophylaxis rates. We then re-evaluated perceived barriers to prescribing PCP prophylaxis. Methods: A multidisciplinary team of oncology fellows and QI staff was established at Johns Hopkins. A new PCP prophylaxis order set was implemented on 4/15/2023. An automated data query was developed to identify patients with solid malignancies who were eligible for PCP prophylaxis per ASCO/IDSA guidelines (≥20mg prednisone equivalents daily for ≥1 month). Patient data was collected between 4/15/2022 and 4/15/2024. Surveys were conducted in 5/2023 and 5/2024 to assess prescriber knowledge of, and attitudes toward, PCP prophylaxis. The survey was open to prescribers across oncology specialties. Results: 1,404 patients were eligible for PCP prophylaxis over the 2-year study period, with 19% (n=264) receiving prophylaxis. In the year before the order set, 21% (n=138) of eligible patients were prescribed prophylaxis. In the year after the order set, 17% (n=126) of eligible patients were prescribed prophylaxis. A survey conducted post order set implementation included 52 responses from 42% (n= 22) attending physicians, 35% (n=18) advanced practice providers, and 23% (n=12) residents/fellows. While 92% (n=48) of survey participants had prescribed PCP prophylaxis, 31% (n=16) knew the dose/duration of corticosteroids at which society guidelines recommend prophylaxis. Unclear corticosteroid duration, guideline knowledge, and concern about side-effects were the most commonly reported barriers to prescribing prophylaxis. Conclusions: Compared to the prior chart review approach, the automated query identified more than twice as many patients at risk for PCP. Strikingly, <25% of eligible patients were prescribed PCP prophylaxis. Prescription rates did not improve following implementation of the order set. However, the post order set survey found increased rates of guideline knowledge and identified unclear corticosteroid durations as the primary barrier to prophylaxis. Building on these findings, an additional PDSA cycle is ongoing including development of notification system alerting providers when PCP prophylaxis is recommended for their patients. Barriers to PCP prophylaxis. Barrier Number of Respondents (%) Pre Order Set Number of Respondents (%) Post Order Set Unclear Corticosteroid Duration 8 (11%) 10 (19%) Guideline Knowledge 11 (16%) 7 (13%) Lack of EMR Notification 6 (9%) 2 (4%)

A Qualitative Exploration of Undergraduate Students’ Experiences of Using Virtual Reality for Dementia Inclusive Education

Abstract Background Dementia prevalence is expected to exponentially increase over the coming decades. Across society, an increased awareness of dementia inclusive environments is important, to promote inclusivity and foster empathy. The aim of this study was to explore the experiences of undergraduate students using virtual reality (VR) for dementia inclusive education. Methods Purposive sampling was employed in one University in Ireland to recruit first year undergraduate students who had completed a VR workshop on dementia inclusive environments. Five semi-structured in-person interviews were conducted during February 2024. Interviews were audio-recorded, transcribed, and thematically analysed. Results Three themes were identified. The first theme ‘Food for thought’ represented participants’ greater understanding, as a result of using VR, of the potential for design to impact the dementia experience. Participants felt as though they were able to virtually place themselves in someone else’s shoes, which was described as “eye-opening”. The second theme ‘Impact variation’ revealed that although participants’ showed enhanced levels of awareness, empathy and understanding of this global health issue, the depth of learning depended on the participants’ prior exposure to dementia. The final theme related to ‘The VR experience’ as a whole. Students described the VR experience as positive, engaging, easy to use, and revealed that they were excited to take part in the workshops. Conclusion The student experience of using VR for dementia inclusive education was positive and enlightening. Using VR to introduce universal design concepts could be integrated into a range of undergraduate programmes to foster understanding and has the potential to empower future designers and policymakers to create environments that are accessible and inclusive for everyone. While this is a small-scale study, the difference in impact of this VR initiative on students with prior personal exposure to people with dementia and those without was an interesting finding and requires further research.

Exploring the feasibility of using Participatory Action Research (PAR) as a mechanism for school culture change to improve mental health

ABSTRACT Adolescence is a key time to prevent or reduce poor mental health outcomes. Supportive school environments play an important role in this, and the concept of health-promoting schools have been supported globally. Participatory action research (PAR) combines theory, practice, action, and reflection by developing practical solutions to address concerns and issues within communities. Running four PAR groups across three secondary schools, we explored the feasibility of using the approach as a mechanism for bringing about culture change and improving mental health. We undertook interviews and focus groups with students (n = 24), school staff (n = 11), facilitators (n = 3), and parents/carers (n = 2). Findings are organised under five key headings: 1) Establishing PAR groups, and the PAR cycle; 2) PAR group impact; 3) Facilitators of PAR success; 4) Barriers to PAR success; 5) Future recommendations. This study demonstrated the feasibility of PAR as a tool to improve school culture. Students participating in PAR were engaged, passionate, and motivated to influence and transform school culture to improve mental health. Future research should aim to trial the PAR approach on a larger scale, to determine whether the barriers and facilitators of PAR success identified here are relevant and transferable to schools in other contexts, and to measure the impact of such initiatives on mental health outcomes.

The Impact of China's Belt and Road Initiative on Agricultural Trade Status: A Network Analysis of Countries Along the Route

The Impact of China's Belt and Road Initiative on Agricultural Trade Status: A Network Analysis of Countries Along the Route

Crowdsourcing the digital parliament

ABSTRACT Parliaments will eventually not evade the digital evolution of every institution to become data-driven organisations. This study examines the Hellenic Optical Character Recognition (OCR) Team, a pioneering crowdsourcing initiative aimed at processing and analysing parliamentary data. Under certain conditions, crowdsourcing, in other words, the power of the people, can be appropriately channelled and exploited to support representative institutions and their societal stakeholders in managing their change processes. Based on survey findings, this research highlights the profiles and motivations of participants, identifies best practices for crowdsourcing in parliamentary contexts, and demonstrates the initiative's impact on improving data accessibility and transparency. The results suggest that the Hellenic OCR Team significantly contributes to the digital evolution of parliamentary functions and promotes greater public involvement in the legislative process.

Exploring Perceptions of Students and Faculty on the Integration of Research in the Outcome-based Integrated Curriculum: A Qualitative Focus Group Study at Defence Services Medical Academy Myanmar

This study explores the perceptions of students and faculty members regarding the integration of a research component in the Outcome-Based Integrated Curriculum at the Defence Services Medical Academy (DSMA) in Myanmar. Using qualitative focus group discussions, this research investigates the benefits, challenges, and overall impact of this educational initiative. The findings reveal that both students and faculty perceive the research component as beneficial, enhancing knowledge, critical thinking, and presentation skills. However, challenges related to resources, support, and early engagement need to be addressed. Recommendations for improving the research component are provided to strengthen the curriculum and better prepare graduates.

Impact of a Comprehensive Quality Improvement Initiative for Reducing AUS Rates in Thyroid FNA Cytology: an Institutional Experience

Impact of a Comprehensive Quality Improvement Initiative for Reducing AUS Rates in Thyroid FNA Cytology: an Institutional Experience

446.6: Enhancing knowledge and attitudes towards organ donation: A survey of the impact of educational Initiative among health care professionals in Sri Lankan.

446.6: Enhancing knowledge and attitudes towards organ donation: A survey of the impact of educational Initiative among health care professionals in Sri Lankan.

Adherence to Labor Arrest and Failed Induction of Labor Guidelines: The Impact of a Quality-Improvement Educational Intervention.

Background/Objective: To evaluate adherence to labor arrest and failed induction of labor (IOL) criteria in nulliparous, term, singleton, and vertex (NTSV) cesarean deliveries at an academic medical center and to measure the impact of a quality-improvement educational initiative that focused on obstetric provider education of modern labor arrest and failed IOL criteria. Methods: This is a retrospective cohort study using electronic health record (EHR) data with a pre- (1 September 2018-30 September 2019) and post-intervention (1 October 2019-31 March 2020) study design of all NTSV cesarean deliveries for labor arrest or failed IOL performed at an academic medical center in the northeastern United States. The quality-improvement educational intervention consisted of the distribution of educational pocket cards outlining modern labor arrest and failed IOL criteria to obstetric providers. Outcomes included adherence to labor arrest and failed IOL criteria pre- and post-intervention with secondary outcomes evaluating adherence by provider type (Maternal-Fetal Medicine (MFM) or generalist obstetrician). Descriptive and bivariate statistics were used in the analysis. Results: Pre-intervention, 272 NTSV cesarean deliveries were performed for labor arrest or failed IOL versus 92 post-intervention. Adherence improved post-intervention amongst failed IOL (OR 6.5, CI 1.8-23.8), first-stage arrest (OR 4.5, CI 2.2-10.8) and second-stage arrest (OR 3.7, CI 1.5-9.4). When comparing provider type, MFM physicians were more likely to be adherent to labor arrest and failed IOL criteria compared to generalist obstetricians pre-intervention (OR 3.1, CI 1.7-5.5); however, post-intervention, there was no longer a difference in adherence (OR 3.3, CI 0.9-12.3). Conclusions: Adherence to labor arrest criteria was suboptimal in the pre-intervention period; however, a targeted quality-improvement educational intervention improved adherence rates to labor arrest and failed IOL criteria among obstetric providers.

Impact of a first-year medical student patient navigation initiative on healthcare access and students' skills

Background: Medical schools with complex patient populations, characterized by linguistic diversity and uncertain immigration status, face challenges in imparting essential skills in patient care, particularly in understanding healthcare barriers, building rapport, and fostering empathy. A South Florida medical school with a predominantly non-English-speaking and undocumented patient population piloted a Patient Navigation (PN) program within the first-year curriculum to address these challenges. We present the student feedback from the program’s first two years to guide medical schools in simultaneously caring for this unique patient population, with the aim of enhancing medical education. Methods: This program diverged from traditional Patient Navigation approaches by leveraging specialized hospital-associated translation services and collaborating with the Health System's Financial Assistance program. We performed a crosssectional study on student feedback surveys to identify program features significantly associated with a satisfying PN experience, and to provide insights to optimize and refine the program for future implementations. Results: The program engaged 245 out of 306 first-year medical students in PN for 118 patients. Successful contact was established with 55% of patients and 70% achieved their navigation objectives. Satisfaction metrics revealed that students given patients were nearly five times more satisfied than their counterparts. This positively impacts both student experience and patient outcomes, showcasing the program's effectiveness in bridging healthcare disparities. Discussion: The PN program proved successful in linking low-risk patients to follow-up care, offering medical students first-hand exposure to the challenges of care for primarily non-English-speaking and undocumented populations. The initiative aimed to enhance healthcare access for marginalized patients while providing medical students with an immersive understanding of patient-centric care beyond conventional curricular offerings. Key lessons learned include improving communication channels between students and patients, and optimizing community resources for streamlined patient support. Future iterations will prioritize these lessons, emphasizing cultural competence and patient advocacy to enhance both student education and patient care outcomes.

Impact of a department-sponsored portable breast pump initiative at a single institution

Rationale and objectivesMany barriers to breastfeeding upon return to the workplace are reported by female radiologists, which have implications on maternal/infant health and physician burnout. The Department of Radiology at our institution piloted an initiative to provide a free portable breast pump to address these barriers. Materials and methodsAn anonymous voluntary 32-question survey assessing the impact of the portable pump on postpartum work-life integration was sent to all female radiologists and radiologists-in-training in the department from May 2023 to July 2023. ResultsA total of 59 surveys were completed (65 % response rate). Overall, respondents reported a positive or very positive impact of the pump on transitioning back to work (median 4.5/5 on a 5-point Likert scale), on their decision to continue breastfeeding when returning to work (median 4/5), and duration of breastfeeding (median 4/5). Use of the pump was reported as favorable, with utilization of the pump while simultaneously engaging in clinical work (median 4.5/5) obviating necessity of dedicated lactation rooms, and positive impact on daily productivity (median score of 4/5). Nearly all (94 %, 16/17) users of the portable pump had their lactational needs addressed while returning to work, compared to 54 % (6/13) of those returning from leave prior to the pump initiative (p = 0.003). Compared to those utilizing traditional lactational resources, those who utilized the portable pump were significantly less likely to miss educational opportunities (0 % vs 44 %, p = 0.03), or academic engagements due to lactational practices at work (0 % v 44 %, p = 0.01). ConclusionA department-sponsored portable breast pump initiative proved to be an effective resource to support physician breastfeeding and work-life integration.

Policy impact of national comprehensive pilot initiative for new-type urbanization on carbon emissions from rural energy consumption in China

Policy impact of national comprehensive pilot initiative for new-type urbanization on carbon emissions from rural energy consumption in China

Healthcare workers’ views on decentralized primary health care management in Lesotho: a qualitative study

BackgroundLesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management. Launched in 2014 through collaboration between the Ministry of Health and Partners In Health, Lesotho’s Primary Health Care Reform (LPHCR) aimed to improve service quality and quantity by decentralizing healthcare management to the district level. We conducted a qualitative study to explore health workers’ perceptions regarding the effectiveness of LPHCR in enhancing the primary health care system.MethodsWe conducted 21 semi-structured key informant interviews (KII) with healthcare workers and Ministry of Health officials purposively sampled from various levels of Lesotho’s health system, including the central Ministry of Health, district health management teams, health centers, and community health worker programs in four pilot districts of the LPHCR initiative. The World Health Organization’s health systems building blocks framework was used to guide data collection and analysis. Interviews assessed health care workers’ perspectives on the impact of the LPHCR initiative on the six-health system building blocks: service delivery, health information systems, access to essential medicines, health workforce, financing, and leadership/governance. Data were analyzed using directed content analysis.ResultsParticipants described benefits of decentralization, including improved efficiency in service delivery, enhanced accountability and responsiveness, increased community participation, improved data availability, and better resource allocation. Participants highlighted how the reform resulted in more efficient procurement and distribution processes and increased recognition and status in part due to the empowerment of district health management teams. However, participants also identified limited decentralization of financial decision-making and encountered barriers to successful implementation, such as staff shortages, inadequate management of the village health worker program, and a lack of clear communication regarding autonomy in utilizing and mobilizing donor funds.ConclusionOur study findings indicate that the implementation of decentralized primary health care management in Lesotho was associated a positive impact on health system building blocks related to primary health care. However, it is crucial to address the implementation challenges identified by healthcare workers to optimize the benefits of decentralized healthcare management.

Analyzing the Impact of China's Belt and Road Initiative on South Pacific Countries' Pursuit of Self-Reliance and Sustainable Development

This study is focusing on analyzing China's Belt and Road Initiatives (BRI) within the broader context of geo-political and geo-economic interests in the Indo-Pacific region. The primary goal is to fill a gap in the academic literature by using analytical tools and methods to gather data from various sources. The collected data is then analyzed within historical and contemporary geo-political contexts to draw conclusions and offer recommendations based on the findings. Received: 26 March 2024 / Accepted: xx month 2024 / Published: 8 July 2024

How Does the One Belt One Road Initiative Affect the Chinese International Architecture, Engineering, and Construction Firms? Empirical Analysis Based on Propensity Score Matching and Difference-in-Differences Method

With the proposal of the “One Belt One Road (OBOR) initiative”, the Chinese architecture, engineering, and construction (AEC) industry has increasingly been exploring the overseas markets. This paper adopted the propensity score matching and difference-in-differences (PSM-DID) method to evaluate the impact of the OBOR Initiative on Chinese international contractors and consulting firms, respectively. The results shows that the OBOR Initiative significantly stimulated the overseas market development of contractors, whereas it had no positive impact on consulting firms. The results may provide comprehensive guidance for industry practitioners, policymakers, and scholars to correctly understand the different characteristics of international contractors and consulting firms, thereby formulating a targeted development strategy.