Client Knowledge Research Articles

Economics of prescription of medicines in Pakistan; market failure or executive decision. Points to ponder for improving prescription practices.

Economics of prescription of medicines in Pakistan; market failure or executive decision. Points to ponder for improving prescription practices.

Data-free knowledge distillation via generator-free data generation for Non-IID federated learning

Data heterogeneity (Non-IID) on Federated Learning (FL) is currently a widely publicized problem, which leads to local model drift and performance degradation. Because of the advantage of knowledge distillation, it has been explored in some recent work to refine global models. However, these approaches rely on a proxy dataset or a data generator. First, in many FL scenarios, proxy dataset do not necessarily exist on the server. Second, the quality of data generated by the generator is unstable and the generator depends on the computing resources of the server. In this work, we propose a novel data-Free knowledge distillation approach via generator-Free Data Generation for Non-IID FL, dubbed as FedF2DG. Specifically, FedF2DG requires only local models to generate pseudo datasets for each client, and can generate hard samples by adding an additional regularization term that exploit disagreements between local model and global model. Meanwhile, FedF2DG enables flexible utilization of computational resources by generating pseudo dataset locally or on the server. And to address the label distribution shift in Non-IID FL, we propose a Data Generation Principle that can adaptively control the label distribution and number of pseudo dataset based on client current state, and this allows for the extraction of more client knowledge. Then knowledge distillation is performed to transfer the knowledge in local models to the global model. Extensive experiments demonstrate that our proposed method significantly outperforms the state-of-the-art FL methods and can serve as plugin for existing Federated Learning methds such as FedAvg, FedProx, etc, and improve their performance.

How clients choose procurement strategies and organizational control systems in the Swedish housing sector

Purpose This paper aims to examine how different contextual contingency factors and organizational goals influence construction clients’ decision-making when procuring contractors in the housing sector. More specifically, it investigates how clients’ choice of procurement strategies and organizational control systems is contingent upon various contextual factors and organizational goals. Design/methodology/approach It is based on an explorative interview study of clients and contractors in the Swedish housing sector underpinned by a review of organizational control literature. Findings The client's knowledge and resources, as well as project complexity and uncertainty, are the most important contextual contingency factors, while property management and sustainable development are the most important organizational goals that housing clients consider when designing procurement strategies. Research limitations/implications The paper contributes to the understanding of how construction clients choose procurement strategies, by providing new insights into effects of the mentioned contextual contingency factors and organizational goals on clients’ choice of control systems through their procurement strategies. Practical implications Property owners who continuously procure housing projects with sustainability requirements and high degrees of complexity and uncertainty should develop knowledge and resources related to their client role, to enable the design and implementation of appropriate procurement strategies. Originality/value Novel aspects of the paper are the demonstration of the value of a holistic approach, considering both contextual contingency factors and organizational goals, when selecting control systems and explicit discussion of how the client's knowledge and resources influence possibilities to implement different control systems.

Clients’ expectations and experiences with providers of menstrual regulation: a qualitative study in Bangladesh

BackgroundMenstrual Regulation (MR) has been legal in Bangladesh since 1979 in an effort to reduce maternal mortality from unsafe abortion care. However, access to high-quality and patient-centered MR care remains a challenge. This analysis aimed to explore what clients know before going into care and the experience itself across a variety of service delivery sites where MR care is available.MethodsWe conducted 26 qualitative semi-structured interviews with MR clients who were recruited from three different service delivery sites in Dhaka, Bangladesh from January to March 2019. Interviews explored client expectations and beliefs about MR care, the experience of the care they received, and their perception of the quality of that care. We conducted a thematic content analysis using a priori and emergent codes.ResultsClients overall lacked knowledge about MR care and held fears about the damage to their bodies after receiving care. Despite their fears, roughly half the clients held positive expectations about the care they would receive. Call center clients felt the most prepared by their provider about what to expect during their MR care. During counseling sessions, providers at in-facility locations reinforced the perception of risk of future fertility as a result of MR and commonly questioned clients on their need for MR services. Some even attempted to dissuade nulliparous women from getting the care. Clients received this type of questioning throughout their time at the facilities, not just from their medical providers. The majority of clients perceived their care as good and rationalized these comments from their providers as coming from a caring place. However, a handful of clients did report bad care and negative feelings about their interactions with providers and other clinical staff.ConclusionProviders and clinical staff can play a key role in shaping the experience of clients accessing MR care. Training on accurate knowledge about the safety and effectiveness of MR, and the importance of client communication could help improve client knowledge and person-centered quality of MR care.

Creating a productive relationship with smallscale farmers

The American public has experienced a renewed interest in where their food comes from in recent years. This has led to a resurgence in small-scale farming – especially in the face of the Covid pandemic – which presents several unique challenges to veterinarians, including client knowledge of animal husbandry and financial limitations. There may also be a disconnect be­tween veterinarians, who have high standards for animal hus­bandry and welfare, and producers, who may be unaware of those standards or view them (and the attached bills) as exces­sive or unwarranted. The following are some insights from my time as a solo, mixed animal practitioner in southern Califor­nia’s Inland Empire where 99% of my livestock clientele were farms with less than 20 animals. Not every suggestion will work in every situation and some practitioners may find this com­pletely useless. All I can do is share the knowledge that allowed me 4 very happy and productive years as a veterinarian to the hobby farmers and homesteaders of southern California.

Occupational therapists’ perspectives on knowledge transfer in clinical practice in the Free State, South Africa

Background: The transfer of all types of knowledge in occupational
 therapy practice is complex, and there is little agreement globally on the
 most important types of knowledge that inform clinical practice. This
 study aimed to uncover the perspectives of occupational therapists in the
 Free State, South Africa on knowledge transfer in clinical practice.
 Methodology: Q methodology was used to collect data from 14
 occupational therapists utilising Q Method Software.
 Results: Factor analysis revealed two factors with eigenvalues of greater
 than 1. Factor 1 had an eigenvalue of 2.97, and factor 2 had an eigenvalue
 of 1.48. These two factors were constructed from six and five participants’
 Q Sorts respectively, with the highest factor loads for factor 1 and factor 2.
 Thematic content analysis of these two factors identified two themes,
 namely: client-centred philosophy and practice informed through clinical
 reasoning.
 Conclusion: The strategic use of Q methodology presented empirical
 evidence of the transfer and utilisation of all types of knowledge in
 clinical practice in the Free State, South Africa. The results indicated the
 transfer of propositional, procedural, personal, and client knowledge
 strengthens client-centred practice and manifests in clinical reasoning.
 Furthermore, the results indicate an interdependence between the types
 of knowledge, meaning that it is important that therapists utilise all types
 of knowledge and not rely on only one form of knowledge when they
 work with patients to promote well-being.
 Implications for Practice
 • Q Methodology is an ideal research method to identify the
 subjective perspectives of participants where different opinions on
 a topic might exist.
 • Clinicians hold a wealth of practice experience and personal
 knowledge that should be shared and captured through research.
 • The client’s voice needs to be heard more often to ensure clientcentred
 practice is not only an idea on paper.

Cegah Perudungan dengan Pengembangan Potensi Warga Belajar di PKBM Yabes Medan

Community Learning Activity Center (PKBM) is a non-formal education unit organized to meet various learning needs of the community established and managed by the community in an effort to empower local communitie. The purpose of this writing is to prevent bullying with the development of the potential of residents studying at PKBM Yabes Medan. The location of the practice is on Jl. Jamin Ginting GG. Build Sangka Manuk No. 8, Kel. Mangga, Kec. Medan Tuntungan, Medan City, North Sumatra. With the focus of the research subject on learning citizens. With a period of practice for 4 months. The method used in this practice is the groupwork method proposed by Zastrow with stages consisting of: (1) Engangement, Intake and Contract, (2) assessment, (3) Planning, (4) Intervention, (5) Monitoring, (6) Evaluation, and (7) Termination. The results of this practice show an increase in client knowledge in English language skills, basic computer operating skills and character. However, clients in a condition are vulnerable to bullying actions beyond their control. This is the result of previous habits. So evaluation and supervision are needed as a reminder so that clients can control themselves.

Senam Hipertensi Bagi Lanjut Usia (LANSIA) Di Posyandu Cekke Kabupaten Enrekang

Hypertension exercise is an exercise that aims to increase blood flow and oxygen supply to active muscles and skeleton, especially the heart muscle, so that it can reduce blood pressure. The aim of this community service (PkM) is to increase the understanding of elderly people about hypertension elderly exercise and to determine the effect of elderly hypertension exercise on the blood pressure of elderly people with hypertension in the Posyandu Cekke work area, Enrekang Regency. The method used to achieve the target of this activity is by approaching, lecturing and jointly doing exercises for the elderly with hypertension. The final outcome of this PkM activity is that it can increase the client's knowledge about exercise for the elderly with hypertension and can control complications of hypertension, namely stroke due to hypertension in old age. The method for implementing community service (PkM) is by using counseling which aims to gain knowledge about the importance of exercise for the elderly. It is hoped that after getting the theory about the importance of exercise for the elderly, they will be able to increase their knowledge and be willing to do exercise either at the Posyandu for the Elderly or at home. The result of this community service (PkM) is an increase in the elderly's knowledge about the importance of posyandu, which can be seen from the results of the pre-test and post-test, namely an increase of 32%. Increasing the activeness of elderly people in posyandu and motivation for elderly exercisers to always take part in elderly exercise seriously.

The Impact of Digitalization on Customer Knowledge Management

Abstract The best way for a business to gather pertinent knowledge and apply it for the growth and sustainability of the firm is through communication with its customers. Companies must adapt to today’s data, information, and knowledge-based economy. A company’s ability to evolve depends on how strategically it uses its intangible resources to build its knowledge capital. Digital tools create new channels for client engagement and collaboration. The current study assesses how digital tools affect how businesses interact with their customers and how these tools help customers share knowledge with companies. This study updates knowledge management and customer knowledge management practices in a digital context and serves as an example of these practices. The study aims to address the absence of specific and valuable components in business practices that give them access to client knowledge. The study is conducted on a sample of 10 individuals, managers, and CEOs of Romanian enterprises, using the in-depth interview method. Data from the survey were analyzed and interpreted, and significant results were drawn by comparing them to prior research. The study emphasizes the value of digital tools for customer communication and the potential these platforms provide for gathering knowledge about, for, and from customers. The respondents stressed the significance of knowledge for both the growth of the company and the innovation process. Still, there needs to be more internal structures to manage this knowledge strategically and capitalize on it for the beginning of innovative business approaches. The study identifies the primary challenges to communicating via digital channels and suggests solutions to help companies acquire, share, and use customer data to its fullest potential.

Barriers to Building Information Modelling Adoption in Small and Medium Enterprises: Nigerian Construction Industry Perspectives

The widespread adoption of building information modelling in the construction industry faces significant obstacles, particularly among small and medium-sized construction enterprises. This research accessed barriers to building information modelling adoption among small and medium enterprises in the Nigerian construction industry. The study obtained quantitative data from 182 participants out of the 200 questionnaires that were distributed. A combination of descriptive and exploratory factor analysis was performed using IBM SPSS version 26, and the Kaiser–Meyer–Olkin (KMO) test and Bartlett’s sphericity test were conducted to check data adequacy and reliability. The study findings clustered five factors from the 25 identified barriers to BIM adoption in SMEs in the Nigerian construction industry. They are functionality and compatibility, risk and the unavailability of BIM resources, inadequate awareness of BIM, inadequate clients’ demands and support, and stakeholders’ skills gaps. The study recommends training opportunities for construction professionals, government facilitation through incentives, and safeguarding intellectual property linked to BIM-oriented projects. Collaboration among construction stakeholders would also increase client awareness and knowledge sharing on modern technology, such as BIM adoption in SMEs in the construction industry.

Use of maternity open days initiative to increase access to comprehensive maternal and neonatal health services at the Lwala Community Health Centre

Background: Maternity open day (MOD) is an event in which a health facility opens its doors to the community and provides a specific opportunity for pregnant women and their birth companions to interact freely with health care providers and receive antenatal care services, including obstetric ultrasound, and tour maternity units. Objective: To increase access and utilization of MNH services, improve knowledge, promote transparency, familiarize with the environment, procedures, and maternity staff, and increase the client's knowledge and confidence on what to expect during labor and delivery. Results: It ensured an increase in the number of women seeking comprehensive antenatal care (ANC), including ANC profile care at both first and fourth ANC visits, and skilled birth attendants. The (MODs) provided a platform to expand access to affordable maternity care through client enrollment in Linda Mama services. Over 99% of pregnant women who attended MODs embraced hospital deliveries and 99% skilled births. A total of 1060 women attended MOD, and 3,903 women underwent obstetric ultrasound, with zero maternal deaths and one neonatal death recorded between 2022 and 2023. Conclusion: Maternity open day provides a platform for increasing access to comprehensive antenatal care and affordable maternity care through Linda Mama. It improved the quality of maternal and child health services, reduced defaulters in the ANC clinics, and increased access to MNH services for continuum care and built trust between women and healthcare providers.

Clinic Staff Perceptions of Implementing a Sexual and Reproductive Health Entertainment-Education Program for Young Women of Color.

Entertainment-education interventions remain underutilized in sexual and reproductive health (SRH) despite evidence that they can be effective and place a low burden on staff. This study explores perceived facilitators and barriers for implementing an entertainment-education video intervention for 18- to 19-year-old African American and Latina women in SRH clinics. Cross-sectional online survey (n=100) and telephone interviews (n=19) were completed May through August 2018. SRH clinics were located across 32 US states and 1 Canadian province. SRH clinic staff were diverse in type of clinic, role, and geography and were recruited using purposive sampling. Bivariate analyses were used for quantitative data, and thematic analysis was used for qualitative data. Intervention acceptability, perceived feasibility, and likely uptake were assessed using agreement statements (survey) and open-ended questions (interviews and survey). Interviewed clinic staff described the intervention as engaging, educational, and promising for improving client SRH knowledge and behaviors. Nearly all (95%) survey respondents said showing the video would be feasible. Most (56%) indicated likely uptake, which was significantly associated with perceived feasibility (P=.000), acceptability (P≤.001), and working at a public health clinic (P=.023). Implementation barriers included the video's potential relevance to only certain clients and the need for additional information or staff and/or management buy-in. This is the first study to assess perceived implementation facilitators and barriers of an entertainment-education video intervention among SRH clinic staff. The intervention was well received, with certain barriers potentially alleviated by offering information about entertainment-education and multiple implementation methods. These findings can help improve dissemination efforts for video-based entertainment-education interventions in clinics serving young women of color.

Gap Analysis of Providing Primary Health Care in Comprehensive Rural Health Centers of Iran

Background: The lack of primary health care (PHC) assessment will lead to the lack of knowledge of the final client's needs and to deviation from the mission of the health system. This study was conducted to compare the understanding and experience of PHC providers and recipients regarding the principles of PHC in Iran.
 Methods: This cross-sectional descriptive-analytical study was conducted on Comprehensive Rural Health Centers (CRHCs) in 2022. The research population consisted of health service providers and recipients in rural areas. A Primary Care Assessment Tool (PCAT) was used. 410 child/ adolescent and 402 adult PCAT were completed by stratified cluster sampling method and 413 service providers were randomly selected. This questionnaire had 6 core domains and 3 ancillary domains. After collection and entering the Excel; data were analyzed by inferential statistics tests including Independent T-test and one-way ANOVA, by SPSS26 and STATA16 at the significant level of P>0.05.
 Results: Except for the Cultural Competence and Services Available domains, in the rest of the domains, there was not the same understanding between the service provider and recipient regarding PHC services. Also. child/adolescent PHC recipients had the same understanding as adult PHC recipients in the domains of Cultural Competence, Family Centeredness, Information System, Ongoing Care, and Access. But a significant difference was between the two groups in other domains, Primary Care Score, and Primary Care Expanded scores (P >0.05).
 Conclusions: For the common understanding between all three compared groups, cultural competence was the strongest component, and coordination-referral system, services provided, and community orientation were the weakest components. To fill this gap, increasing the health literacy of service recipients, real needs assessment, and providing services based on the needs of the community, reforming the processes of the referral system, and the commitment of the government to implement the processes seem necessary.

Client Peripheral Knowledge and Outsourcing Project Outcomes

ABSTRACT Client peripheral knowledge is the knowledge residing in the client organization regarding the specific technologies and methodologies needed to successfully complete an IT (information technology) project that has been outsourced by the client. Data is collected from 205 USA managers, who have overseen outsourced IT projects, to see if peripheral knowledge in their own client organization affected outsourced project processes and outcomes. The project processes examined are the degree of stability of requirements during the project, and the level of vendor activities to interface with the client. The project outcome is operationalized as client satisfaction, as well as project cost performance and time performance. We find client peripheral knowledge positively affects requirement stability and vendor activities to interface with the client; requirement stability in turn positively affects client satisfaction and time performance; and vendor activities positively affect client satisfaction, but levy a penalty on the cost performance and time performance.

Does mobile renewal make health insurance more responsive to clients? A case study of the National Health Insurance Scheme in Ghana

BackgroundIn 2018, Ghana’s National Health Insurance Authority (NHIA) introduced a mobile strategy to enhance re-enrolment and improve client knowledge of their entitlements. This study investigated how Ghana’s mobile strategy has...

Implementation determinants and strategies in integration of PrEP into maternal and child health and family planning services: experiences of frontline healthcare workers in Kenya.

Delivery of PrEP to adolescent girls and young women (AGYW) and to pregnant women through maternal and child health (MCH) and family planning (FP) clinics is scaling up in Kenya. Evaluation of implementation challenges and strategies is critical to optimize delivery. We conducted focus group discussions (FGDs) with healthcare workers (HCWs) in MCH and FP clinics offering PrEP in a large implementation project in Kisumu, Kenya. Discussion guides were based on the Consolidated Framework for Implementation Research (CFIR). FGDs were audio recorded and transcribed. Directed content analysis was used to identify implementation challenges and strategies to overcome them. Fifty HCWs from 26 facilities participated in 8 FGDs. HCWs believed PrEP integration was appropriate because it met the needs of AGYW and pregnant women by providing a female-controlled prevention strategy and aligned with policy priorities of elimination of vertical HIV transmission. They were universally accepting of PrEP provision, especially through MCH clinics, noting the relative advantage of this approach because it: (1) enabled high coverage, (2) harmonized PrEP and MCH visits, and (3) minimized stigma compared to PrEP offered through HIV care clinics. However, HCWs noted implementation challenges affecting feasibility and adoption including: (1) increased workload and documentation burden amid workforce shortages, (2) insufficient health care worker knowledge (3) multiple implementing partners with competing priorities (4) drug and documentation form stockouts. HCWs employed various implementation strategies to overcome challenges, including task shifting from nurses to HIV testing providers, patient flow modifications (e.g., fast-tracking PrEP clients to reduce wait times), PrEP demand generation and myth clarification during health talks, provider education, dedicated PrEP delivery rooms, and coordination with adolescent-friendly services. Additional suggested strategies to improve PrEP integration included community education to increase broader PrEP awareness and enable shorter counseling sessions, and task-shifting data entry and client risk assessments. HCWs were enthusiastic about the appropriateness and acceptability of integrating PrEP services into MCH and FP clinics but noted challenges to adoption and feasibility. Strategies to address challenges focused on improving provider time and space constraints, and increasing provider and client knowledge.

Federated Unsupervised Cluster-Contrastive learning for person Re-identification: A coarse-to-fine approach

Person Re-identification (ReID) has attracted considerable interests in recent years, largely driven by the escalating demand for public safety measures. However, the acquisition and handling of sensitive personal data can trigger significant privacy concerns. Federated learning has been introduced as a potential solution to this problem, with the goal of limiting the exposure of sensitive data across different participating entities (clients). Existing methods often depend on labour-intensive data annotations and face difficulties in maintaining cross-domain uniformity. To tackle these challenges, we propose a Federated Unsupervised Cluster-Contrastive (FedUCC) method based on deep learning for Person ReID that follows a generic-to-specific learning strategy. First, FedUCC procures generic knowledge from a conventional federated learning scheme to aggregate and distribute parameters across local clients. Second, specialized knowledge is explored to facilitate client personalization by disentangling client-specific knowledge from generic knowledge through parameter localization. Third, to further enhance effective fine-grained patterns instead of overfitting on specialized client knowledge, we investigate two key aspects: patch-level feature alignment and camera-invariant learning. Comprehensive experiments on eight public benchmark datasets demonstrate the state-of-the-art performance of our proposed method.

Security Awareness Strategy for Phishing Email Scams: A Case Study One of a Company in Singapore

Social Engineering Procedures and phishing are some of the standard procedures and problems today, mainly through sophisticated media such as email, the official means of communication companies use. Phishing emails are usually associated with Social Designing. They can be sent via joins and connections in this email, but they are not secure. Proliferation can be hacked into private/confidential data or total control over the computer/Email without the client's knowledge. The method used in this research is a cycle that will run continuously in a life cycle, starting from problem identification, then generating ideas and evaluating the Implementation of solutions. At each stage, a thorough checking process is needed to obtain results. Follow what you want. Achieved. The results of this study provide recommendations and some suggestions that companies can make; this aims to be one of the doors that provides restrictions for access from parties who are not entitled to access the application. Some thought has shown that this attack is growing and affecting the population. The evaluation stages in this study consist of 5 phases. Each phase is a step used to prevent both the system and the behavior in the company. Awareness is critical at the start considering this is the basis for the organization to determine who will take care of the personnel's knowledge related to information security. It thinks about using survey writing strategies and recommendations that can be made in anticipation of an attack, such as setting up representation or attention as early and often as possible.

Influence of Codesign as a Cocreation Strategy on Constructability (Among Sri Lankan Architectural and Engineering Design Start-Up Practices)

This research looks at the influence that codesign has on the constructability of a project and how the client’s knowledge impacts this relationship. Client knowledge is explored as a mediator. Further The factor that gave the largest contribution to codesign was the form of facilitation with a mean of 1.59, which was closest to the strongly agree point on the scale (number 1 was assigned to Strongly agree). The overall mean value of codesign was 1.82. Knowledge management gave the largest contribution towards constructability with a mean of 1.61. The overall mean of constructability was 1.70. The mediator, client knowledge had an overall mean of 2.10 with experience having the largest contribution with a mean of 2.08. Four hypotheses were tested. Hypothesis 1 was accepted since the correlation was 0.633, and its significance was 0.000, with the regression model fitting by 40.1%, showing that there was an impact on constructability from codesign. Hypothesis 2 was to test whether codesign and client knowledge were related, and it was proven, since correlation is reported to be 0.432 and its significance is 0.000, with the regression model fitting by 18.6%. Hypothesis 3 tested the relationship between client knowledge and constructability. It was also accepted in the correlation is reported to be 0.453 and its significance is 0.000 with the regression model fitting by 20.6%. Further, all factors in the three variables were validated through cross validation via thematic analysis, except for access to information. This could be because the client may not be able to interpret the information on their own. Hypothesis 4 investigated the mediator and an z value of 2.26 with significance of 0.000 indicates that client knowledge significantly mediates the relationship between codesign and constructability.

Using Omaha System data to explore relationships between client outcomes, phenotypes, and targeted home intervention approaches: an exemplar examining practice effectiveness for older women with circulation problems.

Improved health among older women remains elusive and may be linked to limited knowledge of and interventions targeted to population subgroups. Use of structured community nurse home visit data exploring relationships between client outcomes, phenotypes, and targeted intervention approaches may reveal new understandings of practice effectiveness. Omaha System data of 2363 women 65years and older with circulation problems receiving at least 2 community nurse home visits were accessed. Previously identified phenotypes (Poor circulation; Irregular heart rate; and Limited symptoms), 7 intervention approaches (High-Surveillance; High-Teaching/Guidance/Counseling; Balanced-All; Balanced-Surveillance-Teaching/Guidance/Counseling; Low-Teaching/Guidance/Counseling-Balanced Other; Low-Surveillance-Mostly-Teaching/Guidance/Couseling-TreatmentProcedure-CaseManagement; and Mostly-TreatementProcedure+CaseManagement), and client knowledge, behavior, and status outcomes were used. Client-linked intervention approach counts, proportional use per phenotypes, and associations with client outcome scores were descriptively analyzed. Associations between intervention approach proportional use by phenotype and outcome scores were analyzed using parallel coordinate graph methodology for intervention approach effectiveness. Percent use of intervention approach differed significantly by phenotype. The 2 most widely employed intervention approaches were characterized by either a high use of surveillance interventions or a balanced use of all intervention categories (surveillance, teaching/guidance/counseling, treatment-procedure, case-management). Mean outcome discharge and change scores significantly differed by intervention approach. Proportionally deployed intervention approach patterns by phenotype were associated with outcome small effects improvement. The Omaha System taxonomy supported the management and exploration of large multidimensional community nursing data of older women with circulation problems. This study offers a new way to examine intervention effectiveness using phenotype- and targeted intervention approach-informed structured data.