Implemented Programs Research Articles

8-Week Online Fitness Intervention on Muscle Strength, Flexibility, Body Composition and Physical-Self Perception: A Randomized Controlled Trial

This research examines the effect of an online physical fitness intervention plan on health-related components, and self-perception with randomized controlled trial. A total of 43 individuals completed the study, 21 of them were in the experimental group, and 22 were in the control group. Muscle strength was assessed using push-ups and sit-ups, while flexibility was determined through sit-and-reach tests. Fat and muscle mass in the arms, legs, trunk, android, gynoid regions, and total body were measured in grams by using Dual Energy X-Ray Absorptiometry. Health, body fat, strength, flexibility, endurance sub-dimensions of Marsh Physical Self-Description Inventory was used for self-perception. Results showed that group and time interaction had a significant effect on self-perception of body fat and push-ups, flexibility left and right, total fat, body fat mass in the arm, leg, and gynoid regions. Although the muscle mass of the experimental group increased in the 8-week period, this situation was not statistically significant. The implemented physical fitness intervention program has a significant impact, particularly in terms of fat burning. The findings obtained in strength tests can be associated with a decrease in fat mass, especially in the upper body. In conclusion, these findings underscore the potential of online fitness interventions in achieving positive health outcomes, emphasizing the multifaceted benefits of such programs on both perceived and measured physical well-being.

A Cross-Sectional Study of Pediatric Enhanced Recovery After Surgery in 23 Medical Institutions Across 17 Provinces and Cities in China

Objectives: The study aims to assess the current state of enhanced recovery after surgery (ERAS) in children across 23 medical institutions in China, providing data to support the management and policy-making of ERAS. Methods: In April 2023, a survey was conducted using convenience sampling among the pediatric surgical units of the National Medical Center's Pediatric Nursing Alliance. Data were collected using a specifically designed pediatric ERAS questionnaire, which included information on hospital demographics, surgical volumes, nurse-to-bed ratios, ERAS implementation status, and the primary challenges and obstacles in implementing ERAS programs. Results: The survey revealed that 21 out of the 23 hospitals (91.3%) had implemented ERAS programs, but only 6 (26.1%) had dedicated ERAS nurses. The challenges faced in implementing ERAS included the lack of ERAS clinical guidelines for specific diseases, the absence of unified quality control plans in hospitals, insufficient understanding of ERAS among medical staff, and the lack of hospital-level policy support. Conclusions: While the implementation of ERAS is a growing trend in pediatric surgical care, there is a significant shortage of specialized ERAS nurses, and various obstacles still hinder the widespread adoption of pediatric ERAS. Future research should focus on developing disease-specific ERAS clinical guidelines and establishing uniform ERAS quality control standards. Hospital administrators should provide policy support following ERAS implementation in their departments to facilitate the progression of ERAS.

The extent of implementation and perceptions of maternity and social care professionals about two interprofessional programs for care for pregnant women: a mixed methods study

BackgroundIn 2018, the Dutch government initiated the Solid Start program to provide each child with the best start in life. Key program elements are a biopsychosocial perspective on pregnancy and children’s development and stimulating local collaborations between social and health domains, with a specific focus on (future) families in vulnerable situations. Two programs for interprofessional collaboration between maternity and social care professionals to optimize care for pregnant women in vulnerable situations were developed and implemented, in Groningen in 2017 and in South Limburg in 2021. This paper describes the extent of implementation of these programs and the perceptions of involved professionals about determinants that influence program implementation.MethodsWe conducted a mixed-methods study in 2021 and 2022 in two Dutch regions, Groningen and South Limburg. Questionnaires were sent to primary care midwives, hospital-based midwives, obstetricians (i.e. maternity care professionals), (coordinating) youth health care nurses and social workers (i.e. social care professionals), involved in the execution of the programs. Semi-structured interviews were held with involved professionals to enrich the quantitative data. Quantitative and qualitative data were collected and analyzed using Fleuren's implementation model.ResultsThe findings of the questionnaire (n = 60) and interviews (n = 28) indicate that professionals in both regions are generally positive about the implemented programs. However, there was limited knowledge and use of the program in Groningen. Promoting factors for implementation were mentioned on the determinants for the innovation and the user. Maternity care professionals prefer a general, conversational way to identify vulnerabilities that connects to midwives’ daily practice. Low-threshold, personal contact with clear agreements for referral and consultation between professionals contributes to implementation. Professionals agree that properly identifying vulnerabilities and referring women to appropriate care is an important task and contributes to better care. On the determinants of the organization, professionals indicate some preconditions for successful implementation, such as clearly described roles and responsibilities, interprofessional training, time and financial resources.ConclusionsAreas for improvement for the implementation of interprofessional collaboration between maternity care and social care focus mainly on determinants of the organization, which should be addressed both regionally and nationally. In addition, sustainable implementation requires continuous awareness of influencing factors and a process of evaluation, adaptation and support of the target group.

Agency selling or reselling: The role of cause marketing

Cause marketing (CM) is commonly adopted to pursue profit growth or/and achieve corporate social responsibility (CSR). In online retailing, to facilitate CM for the products, e-retailers are increasingly implementing CM programs for the firms that sell products directly to consumers, i.e., suppliers under agency selling mode or themselves under reselling mode. Motivated by this, we examine how CM for the product influences the equilibrium outcomes under the two selling modes and the selling mode preferences of the supply chain members. Our results suggest that CM for the product is beneficial to both the supply chain members but can render the e-retailer to be hurt by a higher agency fee. Significantly, the supplier can prefer agency selling mode only when the agency fee is lower, whereas the e-retailer can prefer it even if the agency fee is lower. As a result of the changes in the selling mode preferences, the CM program can hurt the e-retailer when the selling mode is determined by the supplier. We further consider the cases where either of the supply chain members cares about CSR and fulfills it with CM. The results indicate that the concern for CSR of either of the supply chain members can coordinate their selling mode preferences. Specifically, the concern for CSR of the supplier (e-retailer) can induce them to prefer agency selling mode (reselling mode), thereby eliminating (further exacerbating) the adverse impact of the CM program on the supply chain members.

Enhancing Education Sector Collaboration: the Contributions of Community Colleges

This study investigates the pivotal role of community colleges in enhancing collaboration within the education sector. Despite the recognized importance of collaboration, the specific contributions of community colleges remain underexplored. Employing a mixed-method research approach, the study utilizes a sequential exploratory design to comprehensively examine the roles, benefits, challenges, and strategies related to collaboration facilitated by community colleges. Data were collected through qualitative semi-structured interviews and quantitative surveys in places where community colleges exist. Findings indicate that community colleges serve as intermediaries, offering flexible education programs and contributing to workforce development, thereby fostering partnerships and cooperation among diverse stakeholders. While collaborative initiatives yield benefits such as enhanced student success and increased educational access, challenges such as resource constraints and communication barriers persist. Strategies to enhance collaboration effectiveness include building strong relationships, investing in capacity building, and establishing clear communication channels. These findings underscore the significance of recognizing and leveraging the unique contributions of community colleges to promote collaboration and address systemic issues within the education sector. The study concludes with recommendations to strengthen partnerships, allocate resources, implement capacity-building programs, and further research to explore additional factors influencing collaboration.

Peran Pemerintah Desa dalam Pemberdayaan Masyarakat Lokal di Desa Ujung Serdang Kecamatan Tanjung Morawa

The Ujung Serdang Village Government plays a crucial role in empowering the local community, focusing on economic development and cultural preservation. These initiatives aim to enhance welfare, economic independence, and local wisdom. However, challenges such as lack of community awareness and insufficient support from the central government persist. This study analyzes the village government's role through implemented programs and their impacts, using a descriptive qualitative method. The results are expected to provide insights into effective empowerment mechanisms and identify obstacles for future improvements.

Application of the Concept Planning, Organizing, Actuating, Controlling in Improving the Quality of Education at Madrasah Ibtidaiyah Wathoniyah Cirebon

This study investigates the application of management functions in enhancing the quality of education at Madrasah Ibtidaiyah Wathoniyah Putra Buntet in Kabupaten Cirebon. Despite the potential for good management to improve educational quality, the current management practices at this school are ineffective and inefficient, leading to poorly implemented programs and plans. The research aims to: 1) explore the application of education management functions; 2) understand the management practices at Madrasah Ibtidaiyah Wathoniyah Putra Buntet; 3) identify factors that hinder and support quality improvement in education. The research focuses on the management functions of planning, organizing, implementing, and controlling. Utilizing a qualitative approach, the study seeks to understand the experiences of the research subjects through observation, documentation, and interviews. Data analysis involves reduction, presentation, and conclusion drawing. Findings indicate that while the management functions are recognized, their execution is insufficient, resulting in ineffective programs. Inhibiting factors include inadequate infrastructure, insufficient funding, and low-quality educators. Supporting factors are strong leadership, good coordination and cooperation, and teachers' classroom management skills.

Методика для решения задачи выбора признаков в регрессионной модели Кокса

The technique based on the use of a hybrid optimization method to solve the feature selection problem for the Cox regression model is proposed. The hybrid optimization method includes two metaheuristic methods: the ant colony optimization and the genetic algorithm. The ant colony optimization used as the basic algorithm that solves the main optimization problem. The genetic algorithm solves the problem of finding the optimal set of parameters for the ant algorithm improving its performance. The method is modified and adapted to solve the problem under consideration. The key feature of adaptation is the deposition of pheromones on the vertices rather than on the edges of the graph, as well as the method for calculating the assessment of heuristic information about each vertex. A fitness target function was constructed that determines the quality of solutions to the feature selection problem and is based on an assessment of the performance of the Cox model with a selected set of parameters. The concordance index (c-index) was used to evaluate the Cox model. The efficiency of the methodology is shown using the implemented program using the example of a database of recidivism. For the database used, the most significant sets of features were obtained that have the greatest impact on the quality of training of the survival analysis model.

Implementation of back to living well, a community-based program for the tertiary prevention of low back pain: a study protocol

BackgroundThe current literature supports the effectiveness of exercise, education, and self-management interventions for the long-term management of persistent low back pain. However, there is significant uncertainty about the implementation of interventions related to barriers, facilitators, and patient’s preferences. This study will evaluate the Back to Living Well program implementation from a participant and organizational perspective. More specifically we address the following objectives: 1) identify program barriers and facilitators from participants’ perspectives, 2) identify factors related to program, personal and contextual factors that contribute to negative and positive outcomes, and outcome trajectories, 3) identify factors influencing participants’ selection of an in-person or e-health program, and 4) evaluate program specific barriers and facilitators from the organization and care delivery perspectives.MethodsThis study will utilize a mixed-method convergent design including a longitudinal cohort strand and a longitudinal qualitative interview strand. The RE-AIM framework will be used to assess program implementation. Participants (n = 90, 1:1: in person or virtual) who choose to register in the program as well as staff (n = 10 to 15) involved in the delivery of the program will be invited to participate. Participants will participate in a 12-week physical activity, education, and self-management program. Implementation outcomes will be measured at 3-, 6-, 12-months, and six months after the end of the follow-ups. Interview scripts and directed content analysis will be constructed based on the Theoretical Domains Framework and the Neuromatrix Model of Pain, Theoretical Domains Framework. Staff interviews will be constructed and analyzed using the Consolidated Framework for Implementation Research. Participants will also complete pain, disability, quality of life and psychological questionnaires, wear an activity tracker at all time points, and complete weekly pain and activity limitation questions using a mobile application.DiscussionThe study results will provide evidence to inform potential future implementation of the program. An effective, appropriately targeted, and well implemented exercise program for the long-term management (i.e., tertiary prevention) of LBP could minimize the burden of the condition on patients, the health care system and society.Trial registrationClinicalTrials.gov NCT05929846. This (Registration Date: July 3 2023) study has been approved by the Hamilton Integrated Research Ethics Board Project ID#15,354.

Using the consolidated framework for implementation research to identify church leaders’ perspectives on contextual determinants of community-based colorectal cancer screening for Black Kentuckians

BackgroundBlack Kentuckians experience more deleterious colorectal cancer (CRC) outcomes than their White counterparts, a disparity that could be reduced by increased screening in Black communities. Previous research has shown that Black Kentuckians may not be equitably informed of different CRC screening options by health care providers, making community-based screening a potentially effective option among this disparate population. We used the Consolidated Framework for Implementation Research (CFIR) to identify church leaders’ perspectives of contextual factors that might influence community-based screening and explore the feasibility of using church-based screening outreach.MethodsSix participants were selected, based on leadership roles and interest in CRC screening, from five established Louisville-area church partners that had previously participated in community health initiatives. Data were collected, both virtually and in-person, in Summer 2021 using semi-structured interview guides developed with guidance from the CFIR Guide that focused on domains most relevant to community-based interventions. Data were transcribed verbatim, coded by two independent researchers, and member checked for accuracy.ResultsData were aligned primarily with six CFIR constructs: key stakeholders, champions, opinion leaders, tension for change, compatibility, and culture. Participants noted a strong tension for change in their community due to perceptions of inadequacy with clinical approaches to CRC screening. Additionally, they stressed the importance of identifying individuals both within the church who could champion CRC screening and help implement program activities, as well as those outside the church who could collaborate with other local organizations to increase participant reach. Finally, participants agreed that faith-based CRC screening aligned with church culture and would also likely be compatible with overall community values.ConclusionsOverall, our church partners strongly endorsed the need for, and importance of, community-based CRC screening. Given a history of successful implementation of health promotion programs within our partner churches, it is highly likely that a CRC screening intervention would also be effective. Findings from this study will be used to identify implementation strategies that might positively impact a future faith-based CRC screening intervention, as well as CFIR constructs that are most positively associated with CRC screening completion.

Empowering Students Through Increasing Santriprenuer Knowledge

Islamic boarding schools are required to be agents of development, playing an active role in contributing to and transforming the field of economic empowerment and the quality of their resources. Many Islamic boarding schools have adapted and transformed into institutions that participate in economic empowerment efforts, but the programme only involves motivators and target groups without the involvement of the students, both cognitively and in terms of action. Thus, students must be empowered. Among the skills that students should be prepared with are those that will enable them to support the pesantren's economy and also add value for them when they return to society. The objective of this assistance is to enhance the understanding and awareness of students and pesantren on the significance of the creative industry for the advancement of pesantren and as a precursor for students after graduating from these educational institutions. Therefore, the research team/servant and the pesantren together explore the potential or assets that they have, develop appropriate programmes, and also evaluate the implemented programmes. The ABCD approach is a service methodology employed in this mentoring programme. This service technique is broadly divided into five stages: (1) Identification of community strengths; (2) Asset mapping of the community, (3) Planning the form of the mentoring programme; (4) programme implementation; (5) monitoring and evaluation (M&E) is conducted using the Most Significant Change (MSC) technique.

Local Government Initiatives: A Comprehensive Analysis of Infertility Diagnostic and Treatment Programs in Poland (2009-2020).

BACKGROUND Infertility is an increasingly significant public health problem. However, thanks to the achievements of modern medicine, it is possible to take steps to treat it. The objective of this study was to present data about programs for the diagnosis and treatment of infertility that were developed, implemented, and financed by local governments at all levels in Poland in 2009-2020. MATERIAL AND METHODS The study was conducted based on the analysis of existing data from the Minister of Health. We present data on infertility diagnostics and treatment programs, the number of programs in particular years, the number of programs implemented by individual levels of local governments, the number of people participating in the programs, and the total cost of the programs in EUR. RESULTS Programs aimed at diagnosing/treating infertility began to be implemented in 2012 (most were implemented in 2019 and 2020, 18 each). Twenty-three local governments of various levels, including 5 communes, 13 cities with poviat rights, 1 poviat, and 4 voivodeships, participated in the implementation of these programs. A total of 22 379 people were covered by infertility diagnosis and treatment programs in the years 2012-2020. The cost of all implemented programs was over EUR 10.7 million. CONCLUSIONS The legal situation in Poland caused the vast majority of infertile couples who wanted to have children to have to self-finance in vitro fertilization procedures. A small number of local governments undertook actions aimed at co-financing in vitro fertilization procedures.

Continued Increase in Incidence of Kidney Cancer in Iran and its 31 Provinces

Background: Kidney cancer in adults includes malignant tumors originating from the parenchyma and pelvis and is the most lethal urogenital cancer. Available data in Iran indicate that the incidence and pattern of this cancer are changing. Objectives: Our study aimed to present an updated incidence rate of kidney cancer in Iran and its 31 provinces and their trends, and climate zones distribution of the disease. Methods: In this study, the age standard incidence rate (ASIR) of kidney cancer based on provinces, age groups, and gender has been calculated using the available data in the national cancer registration system of the Ministry of Health from 2003 to 2016. Results: Overall ASIR of kidney cancer was 1.28 per 100,000 from 2003 to 2016. ASIR of this cancer in men has increased from 0.96 in 2003 to 3.66 in 2016 and similarly, reached from 0.61 in 2003 to 2.24 in 2016 in Iran. Fars, Yazd, Tehran and Isfahan provinces had the highest ASIR in Iran. Hot climate zones are associated with a higher incidence of kidney cancer while moderate climate is linked to lower incidence rates in Iran. Conclusions: Although the incidence rate of kidney cancer in Iran and its provinces is low, the increasing trend is concerning particularly among men. Therefore, it is crucial to develop cost-effective screening tests and implement control and prevention programs in the high-incidence provinces.

Strengthening the Competitiveness of Ulu Benteng 2 Public Elementary School through the Development of Quality Human Resources

This study aims to analyze the human resource development at Ulu Benteng 2 Public Elementary School to strengthen the school's competitiveness. The research uses a qualitative approach with a descriptive method. Data were collected through observations, interviews, and documentation. The findings indicate that Ulu Benteng 2 Public Elementary School has successfully implemented human resource development programs, focusing on planning, organizing, execution, and evaluation. These programs have provided various benefits, such as enhancing teachers' competence and professionalism, improving the quality of education, increasing the school's standards, and boosting the school's competitiveness. In conclusion, the human resource development at Ulu Benteng 2 Public Elementary School has been effective and beneficial for the school, teachers and staff, students, and the community. Therefore, it is essential to continue supporting and developing these programs to ensure they keep benefiting all parties.

Is Antimicrobial Stewardship Policy Effectively Implemented in Polish Hospitals? Results from Antibiotic Consumption Surveillance before and during the COVID-19 Pandemic.

The COVID-19 pandemic posed numerous challenges to public health systems, particularly in antimicrobial stewardship. This study aimed to assess antibiotic consumption before and during the COVID-19 pandemic to evaluate the effectiveness of the implemented antimicrobial stewardship program. This retrospective study was carried out at the University Hospital in Krakow, Poland, between 1 January 2019 and 31 December 2020. A total of 80,639 patients were enrolled. Antibiotic usage was measured as the percentage of patients receiving antibiotics and the number of days of therapy (DOTs). The World Health Organization (WHO) methodology and Anatomical Therapeutic Chemical (ATC) codes and AWaRe classification were utilized. The analyzed ATC antibiotic groups included penicillins (J01CA, J01CE, J01CF, J01CR, excluding piperacillin/tazobactam), piperacillin with tazobactam-beta-lactamase inhibitor (J01CR05), third- and fourth-generation cephalosporins (J01DD, J01DE), carbapenems (J01DH), macrolides (J01FA), fluoroquinolones (J01M), colistin (J01XB01), metronidazole (J01XD01) and others (J01DF, J01DI, J01E, J01G, J01XA, J01A). In the AWaRe classification, Access, Watch and Reserve groups of antibiotics were included. In 2020, 79.2% of COVID-19 patients and 40.1% of non-COVID-19 patients were treated with antibiotics, compared to 28.8% in 2019. Also, in 2020, the antibiotic consumption in non-ICU COVID-19 patients was twice as high as in non-COVID-19 patients: 50.9 vs. 38.5 DOTs/100 patient days (pds). Conversely, in the ICU, antibiotic consumption in COVID-19 patients was 112.1 DOTs/100 pds compared to 248.9 DOTs/100 pds in non-COVID-19 patients. Significant increases were observed in the usage of third- and fourth-generation cephalosporins in 2020. The analysis according to the AWaRe system revealed the highest usage of the Watch group-ranging from 61.9% to 78.7%-and very high usage of the Reserve group-from 5.8% to 11.1%-in non COVID-19 and COVID-19 patients, respectively. Our findings highlight substantial issues with antibiotic use both before and during the COVID-19 pandemic. The results underscore the urgent need for improved antimicrobial stewardship policy implementation.

Determinants of data use for programmatic evidence-based decision making at peripheral public health care centres in Haryana, India

BackgroundHealth policies and programs in India are put into practice at the local level, where the frontline managers -Medical Officers in Charges (MOICs) use data for evidence-based decision-making (EBDM) and implementing these programs. However, there are various organizational, technical, and individual determinants that can impact data use. The study aims to recognize the determinants of data-driven decision-making at the grassroots level. MethodsThe cross-sectional study collected primary empirical data from 120 MOICs from six identified districts in Haryana, India. Data utilization was the variable of interest and was measured through Data Utilization Score (DUS). Determinants affecting DUS were extracted through Principal Component Analysis (PCA). Hierarchical multiple regression analysis was used to identify predictors of data utilization from the extracted factors. ResultsMOICs used routine data to plan, implement, manage, and monitor health programs, and administrative activities. Actual skill for data usage (65 %) was less than the anticipated skill (82 %). Twenty-seven reliable organizational, technical, and individual factors were generated from the 154 variables explaining 57.7 %–68 % of the total variance. Regression analysis showed that management meetings with superiors/subordinates, data-conducive and promotive culture, perceived data quality, incentivization, basic software knowledge/skills, and training needs were among the most significant predictors of data usage. ConclusionAlthough a disparity exists between the expected and actual data utilization skills of MOICs, still data-based decisions can be enhanced by effective management meetings, fostering a robust data culture, prioritizing skill development, and incentivizing data use.

Preventing the Trafficking of Youth: A Retrospective Evaluation of kNow MORE! An Educational Program in San Diego, California

ABSTRACT In 2017, California enacted the Human Trafficking (HT) Prevention Education and Training Act, requiring HT prevention curricula in middle and high schools. Prevention efforts to combat trafficking among vulnerable groups are scarce. Additionally, implemented educational programs tend to lack evaluation. In 2016, in San Diego, California, kNOw MORE! 1 1 The kNOw MORE! Human Trafficking Prevention Program is copyrighted—2021 Point Loma Nazarene University. (kM!), a drama-based and student-centered HT prevention curriculum, was developed. It aims to provide education among youth about awareness of HT, traffickers’ strategies of recruitment, identification of victims, and advocacy strategies. This analysis begins to address the current evaluation gap of implemented preventive educational programs. A mixed-method retrospective single-group design was applied. Pre- and post-assessment tools were utilized to collect data throughout a five-year period (2016–2021). Descriptive and inferential statistical analyses of association were performed. Qualitative thematic analysis was conducted to triangulate key findings. The sample comprised predominantly Latinx and Non-Hispanic white students from middle and high schools throughout San Diego, California. The results demonstrated that kM! has proven to increase the knowledge of its participants about HT victimization and how to advocate for themselves and others. The findings of this study provide significant implications for preventive educational efforts locally and nationwide. Future research should include a rigorous evaluation when such preventive educational curriculum is replicated.

Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal.

HIV self-testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community-led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost-effectiveness of community-led HIVST in Côte d'Ivoire, Mali and Senegal. An HIV transmission dynamics model was adapted and calibrated to country-specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP-female sex workers (FSW), and men who have sex with men (MSM)-and their sexual partners and clients. We compared the cost-effectiveness of two scenarios against a counterfactual without HIVST over a 20-year horizon (2019-2039). The ATLAS-only scenario mimicked the 2-year implemented ATLAS programme, whereas the ATLAS-scale-up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability-adjusted life-years (DALY) averted. Scenarios were compared using incremental cost-effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to $USD 2022 and estimated using a cost-function to accommodate economies of scale. The ATLAS-only scenario was highly cost-effective over 20 years, even at low willingness-to-pay thresholds. The median ICERs were $126 ($88-$210) per DALY averted in Côte d'Ivoire, $92 ($88-$210) in Mali and 27$ ($88-$210) in Senegal. Scaling-up the ATLAS programme would also be cost-effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale-up scenario were $199 ($122-$338) per DALY averted in Côte d'Ivoire, $224 ($118-$415) in Mali and $61 ($18-$128) in Senegal. Both the implemented and the potential scale-up of community-led HIVST programmes in West Africa, where KP are important to overall transmission dynamics, have the potential to be highly cost-effective, as compared to a scenario without HIVST. These findings support the scale-up of community-led HIVST to reach populations that otherwise may not access conventional testing services.

Risks of operation of the Russian gas industry in the newest conditions

The article analyzes the risks and limitations faced by the Russian gas industry in recent years. Russian gas sector faced with the negative influence of a number of internal and external factors («the perfect storm»). Currently, there is unprecedented pressure, that include not only falling export revenues, but also technological limitations. The Russian gas sector has been able to partially adapt to new operating conditions – a more flexible method of gas monetization is coming to the fore. Pipeline gas is increasingly losing its role as the basis for the development of the gas sector in the medium term, giving way to liquefied natural gas. The key factors limiting the operation of the industry are technological risks and restrictions in gas production and liquefied gas production, resource base limitations, risks on the side of the gas transportation system, as well as institutional risks and restrictions. In addition to development difficulties, new restrictions make it possible to reconsider the role of the gas sector in the economy: use more flexible approaches to export issues, develop domestic demand for gas, promote the development of independent gas production companies, and implement programs to support domestic manufacturers of a wide range of gas equipment and gas carriers.

Management Strategies of Village-Owned Enterprises in Tanjungharjo Village, Bojonegoro

One of the efforts that the Indonesian government can undertake to boost the local economy is by encouraging Village-Owned Enterprises, known as “Badan Usaha Milik Desa” or BUM Desa, to become more active. In the case of Tanjungharjo Village, there is a BUM Desa named Tanjungkarya. However, during its implementation, various obstacles were encountered, such as a lack of financial resources, human resources, infrastructure, and effective programme management. This research aimed to describe the Management Strategies of the Village-Owned Enterprise (BUM Desa) for developing the community's economy in Tanjungharjo Village, Kapas Sub-District, Bojonegoro Regency. The study employed a qualitative approach with a descriptive method, and informant selection is based on purposive sampling. The informants consist of the Village Head of Tanjungharjo, the Secretary of Tanjungharjo Village, the Chairman of BUM Desa Tanjung Karya, the Secretary of BUM Desa Tanjung Karya, the Treasurer of BUM Desa Tanjung Karya, and members of the Tanjungharjo community. Data was collected through observation, interviews, and documentary analysis. The data was then analysed through data reduction, data presentation, and drawing conclusions. The research focused on six criteria based on Koteen's strategy, which are 1) organisational strategy, 2) resource strategy, and 3) programme strategy. The research findings indicate that the management strategies of the Village-Owned Enterprise (BUM Desa) to enhance the local economy in Tanjungharjo Village encompass three main aspects. First, in the organizational strategy aspect, there was a formulation of a vision and mission involving various stakeholders, and the implemented programmes align with the vision and mission set by BUM Desa Tanjung Karya. Second, regarding the resource-supporting strategy, there were still several hindrances that impede the optimisation of this strategy. Third, regarding the programme strategy, this pertained to the evaluation and implementation of programmes. Based on the programmes conducted by BUM Desa Tanjung Karya, they had contributed to the Village Revenue (PAD) for the Tanjungharjo Village Annual Village Budget (APB Desa). Thus, the management strategies of BUM Desa had not been fully executed optimally due to the presence of these obstacles.