Performance Improvement Program Research Articles

Diabetes Performance Improvement Program With Continuous Glucose Monitoring, Pharmacist Intervention, and Team Management

Diabetes Performance Improvement Program With Continuous Glucose Monitoring, Pharmacist Intervention, and Team Management

Analysis of Maintenance Management at PT.XYZ Power Plant (With MTTR, MTTF, and Availability Factors) and Development of Performance Improvement Program

Analysis of Maintenance Management at PT.XYZ Power Plant (With MTTR, MTTF, and Availability Factors) and Development of Performance Improvement Program

Closing the Trauma Performance Improvement Loop With In-situ Simulation

IntroductionContinuous performance improvement (PI) programs are essential for excellent trauma care. We incorporated PI identified from trauma cases into an in-situ simulation-based medical education curriculum. This is a proof-of-concept study exploring the efficacy of high-fidelity pediatric trauma simulations in improving self-reported provider comfort and knowledge for identified trauma PI issues. MethodsThis study was performed at an American College of Surgeons-verified Level I Pediatric Trauma Center. Several clinical issues were identified during the trauma PI process, including management of elevated intracranial pressure in traumatic brain injury and the use of massive transfusion protocol. These issues were incorporated into a simulation-based medical education curriculum and high-fidelity in-situ trauma mock codes were held. In-depth debriefing sessions were led by a senior faculty member after the simulations. The study participants completed pre- and postsimulation surveys. Univariate statistics are presented. ResultsTwenty three providers completed surveys for the pediatric trauma simulations. Self-reported provider confidence Likert scale improved from pre- to postsimulation (P = 0.02) and trauma experience and knowledge scores improved from 82% presimulation to 93% postsimulation (P = 0.02). ConclusionsHigh-fidelity pediatric trauma simulations enhance provider comfort, knowledge, and experience in trauma scenarios. By integrating high-fidelity trauma simulations to address clinical issues identified in the trauma PI process, provider education can be reinforced and practiced in a controlled environment to improve trauma care. Future studies evaluating the implementation of clinical pathways and patient outcomes are needed to demonstrate the effectiveness of simulations in PI pathways.

An automated OpenMP mutation testing framework for performance optimization

Performance optimization continues to be a challenge in modern HPC software. Existing performance optimization techniques, including profiling-based and auto-tuning techniques, fail to indicate program modifications at the source level thus preventing their portability across compilers. This paper describes Muppet, a new approach that identifies program modifications called mutations aimed at improving program performance. Muppet’s mutations help developers reason about performance defects and missed opportunities to improve performance at the source code level. In contrast to compiler techniques that optimize code at intermediate representations (IR), Muppet uses the idea of source-level mutation testing to relax correctness constraints and automatically discover optimization opportunities that otherwise are not feasible using the IR. We demonstrate the Muppet’s concept in the OpenMP programming model. Muppet generates a list of OpenMP mutations that alter the program parallelism in various ways, and is capable of running a variety of optimization algorithms such as delta debugging, Bayesian Optimization and decision tree optimization to find a subset of mutations which, when applied to the original program, cause the most speedup while maintaining program correctness. When Muppet is evaluated against a diverse set of benchmark programs and proxy applications, it is capable of finding sets of mutations that induce speedup in 75.9% of the evaluated programs.

An evaluation of a multi-partner approach to increase routine immunization coverage in six northern Nigerian States

BackgroundGlobal health partnerships are increasingly being used to improve coordination, strengthen health systems, and incentivize government commitment for public health programs. From 2012 to 2022, the Bill & Melinda Gates Foundation (BMGF) and Aliko Dangote Foundation (ADF) forged Memorandum of Understanding (MoU) partnership agreements with six northern state governments to strengthen routine immunization (RI) systems and sustainably increase immunization coverage. This mixed methods evaluation describes the RI MoUs contribution to improving program performance, strengthening capacity and government financial commitment as well as towards increasing immunization coverage.MethodsDrawing from stakeholder interviews and a desk review, we describe the MoU inputs and processes and adherence to design. We assess the extent to which the program achieved its objectives as well as the benefits and challenges by drawing from a health facility assessment, client exit interview and qualitative interviews with service providers, community leaders and program participants. Finally, we assess the overall impact of the MoU by evaluating trends in immunization coverage rates.ResultsWe found the RI MoUs across the six states to be mostly successful in strengthening health systems, improving accountability and coordination, and increasing the utilization of services and financing for RI. Across all six states, pentavalent 3 vaccine coverage increased from 2011 to 2021 and in some states, the gains were substantial. For example, in Yobe, vaccination coverage increased from 10% in 2011 to nearly 60% in 2021. However, in Sokoto, the change was minimal increasing from only 4% in 2011 to nearly 8% in 2021. However, evaluation findings indicate that issues pertaining to human resources for health, insecurity that inhibits supportive supervision and vaccine logistics as well as harmful socio-cultural norms remain a persistent challenge in the states. There is also a need for a rigorous monitoring and evaluation plan with well-defined measures collected prior to and throughout implementation.ConclusionIntroducing a multi-partner approach grounded in a MoU agreement provides a promising approach to addressing health system challenges that confront RI programs.

Equity-focused Monitoring and Evaluation and Performance of School-based Health Projects

The purpose of the study was to examine the influence of equity-focused monitoring and evaluation on performance of school-based health projects. The study objectives were to determine to what extend does equity-focused monitoring and evaluation influence performance of school-based health projects, to establish the key constructs that drive equitable implementation of health projects, and to determine which methodological designs are used and how they compare across existing studies. A search criteria protocol was developed and adopted for systematic literature review to identify the most current peer-reviewed journal articles published in English between January 2019 and April 2024 using Google scholar and PubMed database search engines. Search terms used were as follows; Equity, Inequity, equity-focused monitoring and evaluation, performance, school-based health program, Equity in health systems. Data extraction was performed using a pre-defined eligibility criterion and a pre-tested data abstraction form. Online database search yielded 25 studies out of which five met the inclusion criteria. Data were analysed using descriptive analysis. Study results suggest that equity-focused adaptation was widely conceptualized in literature but with limited description of how to operationalize monitoring and evaluation as a tool to advance equity and improve program performance. Of the five articles reviewed (n=5), inclusion of a collaborative design, anti-racism consideration, embedding priority population expertise, cultural safety, and values were identified as key constructs that drive equitable implementation of health projects. Methodological convergence was noted across all the articles (n=5) where purposive sampling method, stakeholders as the target population was adopted while four articles (n=4) also converged on mixed method study design. Divergence was reported in sample size and data analysis methods. We conclude that current studies have not exploited the potential influence of equity-focused monitoring and evaluation on performance of school-based health projects. Key constructs for equitable implementation and methodological designs are well grounded though with limited operationalization. The study recommends that there is a need in future for equity-focused monitoring and evaluation empirical studies to test operationalization of the conceptual and theoretical frameworks currently available in literature. This will help advance equity and performance of school-based health projects.

EVALUASI PROGRAM PENINGKATAN KINERJA APARATUR SIPIL NEGARA (ASN) DINAS KESEHATAN KABUPATEN MOJOKERTO

The ASN professionalism index (IP) is a statistical measure that describes the quality of ASN based on the educational qualifications, competence, performance and discipline of ASN employees in carrying out their job duties. The aim of this service activity is to evaluate the Performance Improvement Program for State Civil Apparatus (ASN) within the Mojokerto District Health Service in 2023. This activity was carried out in March 2023. The activity was carried out in the stages of analyzing the situation, identifying problems, determining problem priorities, determining alternative solutions. problems, determining activity plans, implementing activities and evaluating activities. The results of the activities obtained are that the performance of the ASN Health Service has increased in 2023. The performance of the ASN Mojokerto District Health Service has changed for the better with the SUHITA Application. The majority of employees have passed the set target points. The Personnel Section of the Mojokerto District Health Service should publish the results of the performance assessment within the Mojokerto District Health Service at every meeting so that it can be a motivation for ASN.

Pendampingan Optimalisasi Peran Sumberdaya Manusia Perusahaan Kontraktor di Banjarmasin dan Palangkaraya untuk Peningkatan Kinerja Organisasi

More than in the previous era, after the COVID-19 pandemic, companies must build effective human resource management (HRM) to improve employee performance and work culture. This condition requires an organizational form and HRM system relevant to performance needs and demands. PT Gagah Putera Satria needs to transform employees' systems, processes, and work culture to increase their performance as a company engaged in the service sector. Improving and enhancing the performance of the human resource organization is the key to the company's success in achieving the expected performance. That is why the company developed a comprehensive HRM as a major project along with the change in the form of the company, which was initially a heavy equipment rental company, shifted to heavy equipment contractors in the mining industry in Kalimantan. This assistance aims to help the company improve HRM performance. The activities include mapping the actual conditions of the problems experienced related to the company's HRM, restructuring the human resource organization, and disseminating recommendations for HRM performance improvement programs to principals and employees of the head office and project office at the site. The results of the assistance are the formation of an integrated structure of the HRM system, the operation of the human resource management process with a streamlined structure and a more effective process, and the increased managerial skills of the HRM personnel of the company.

An assessment of asymmetric impact of financial stability and agricultural subsidies on agricultural production in Pakistan

PurposeThere will probably be nine billion people on the earth by 2050, meaning food consumption will rise dramatically. Pakistan, the fifth most populous nation in the world, is rapidly expanding its population, making it difficult for the nation to sustain its food supply. Unfortunately, the country's focus on ensuring food security has not kept up with the demographic shifts in its population. However, innovative solutions are sorely needed in the face of several worldwide problems, especially in the crucial agriculture sector. This underscores the need to integrate sustainable financial practices. Considering these circumstances, this research thoroughly examines the intricate relationship inside Pakistan between financial stability (FS), agricultural subsidies, and productivity. Acknowledging the underlying intricacies and asymmetries at work, this study aims to analyze the complex relationships influencing the nation's agricultural production.Design/methodology/approachThe research tries to shed light on the subtle processes at the intersection of financial stability, agricultural subsidies, and agricultural productivity through a comprehensive investigation of these multiple challenges. A non-linear autoregressive distributive lag (NARDL) technique is used, using a dataset from 1980 to 2022.FindingsThe results show that FS has a mixed impact on agricultural productivity, both positive and negative. Increasing FS_POS has a beneficial influence on agricultural output, linked to a notable 1.404% increase in output. On the other hand, increasing FS_NEG causes a significant 11.441% decrease in agricultural output, demonstrating its negative impact on output. Subsidies for agriculture also have asymmetric impacts; SUB_POS and SUB_NEG influence variations in agricultural productivity. A substantial 2.414% rise in agricultural output is shown by SUB_POS, demonstrating its noteworthy beneficial influence. Conversely, SUB_NEG adds a relatively small increase of 1.659% in agricultural output. However, the different amounts of each person's contribution show how subtle their effects are.Research limitations/implicationsThe current study is limited to the relationship between financial stability, agricultural subsidies, and agricultural productivity, considering the inherent complexity and asymmetries at work in Pakistan only. Further studies are required in Asian markets to have a bigger picture of the agricultural sector.Originality/valueConsidering these critical empirical findings, the report recommends strategic strategies to promote long-term agricultural growth in Pakistan. These include providing integrated financial services customized to farmers' needs, such as credit, insurance, and savings alternatives. Transparency and efficiency in procedural frameworks and the formation of efficient public-private partnerships should be prioritized. Furthermore, improving agricultural subsidy schemes emerges as a crucial priority. Targeting marginalized farmers more effectively and optimizing distribution through transparent, digitally driven systems can significantly improve program performance.

ACR-ARS Practice Parameter for the Performance of Proton Beam Therapy

PurposeThis practice parameter for the performance of proton beam radiation therapy was revised collaboratively by the American College of Radiology (ACR) and the American Radium Society (ARS). This practice parameter was developed to serve as a tool in the appropriate application of proton therapy in the care of cancer patients or other patients with conditions in which radiation therapy is indicated. It addresses clinical implementation of proton radiation therapy, including personnel qualifications, quality assurance (QA) standards, indications, and suggested documentation. Materials and MethodsThis practice parameter for the performance of proton beam radiation therapy was developed according to the process described under the heading The Process for Developing ACR Practice Parameters and Technical Standards on the ACR website (https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters – Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS. ResultsThe qualifications and responsibilities of personnel, such as the proton center Chief Medical Officer or Medical Director, Radiation Oncologist, Radiation Physicist, Dosimetrist and Therapist, are outlined, including the necessity for continuing medical education. Proton therapy standard clinical indications and methodologies of treatment management are outlined by disease site and treatment group (e.g. pediatrics) including documentation and the process of proton therapy workflow and equipment specifications. Additionally, this proton therapy practice parameter updates policies and procedures related to a quality assurance and performance improvement program (QAPI), patient education, infection control, and safety. ConclusionAs proton therapy becomes more accessible to cancer patients, policies and procedures as outlined in this practice parameter will help ensure quality and safety programs are effectively implemented to optimize clinical care.

Revisiting the opioid and naloxone education (ONE) program: Program evaluation using the RE-AIM model four years later

ObjectiveThe Opioid and Naloxone Education (ONE) Program focuses on community pharmacy-based patient screening and interventions to improve population health with regard to opioid use. The purpose of this paper is to reevaluate the ONE Program performance using the RE-AIM model, in comparison to the review performed in 2019. MethodsThe program performance of the ONE Program was evaluated from January 1, 2021 to December 31, 2022 was evaluated using the five domains of the RE-AIM model. Reach was defined as the proportion of patients receiving opioid prescriptions who completed the screening. Efficacy was defined as the proportion of individuals identified as at risk who received a pharmacist intervention. Adoption was defined as the proportion of community pharmacies who enrolled in the ONE Program. Implementation was defined as the proportion of pharmacies that enrolled that provided at least five patient screenings. Maintenance was defined as the proportion of pharmacies that completed at least one screening three months. These results were compared against evaluation of the program from October 12, 2018 to June 1, 2019. ResultsApproximately 7.28 % of patients receiving opioid prescriptions were screened for risk of opioid misuse and accidental overdose (Reach). Of the patients screened, 97.4 % of patients at risk for opioid misuse or accidental overdose received a pharmacist-led intervention (Efficacy). Additionally, 49.6 % of the pharmacist that enrolled in the ONE Program completed at least five screenings (79 %) and of those, 86.4 % maintained the program three months later. ConclusionsIn years four and five of implementation, the ONE Program demonstrated improvement in four of the five domains of the RE-AIM model compared to years one and two. However, Reach declined over time. This reevaluation has demonstrated the importance of longitudinal program assessment, and the possibility of improved program performance over time.

A collaborative multidisciplinary trauma program improvement team improves VTE chemoprophylaxis guideline compliance in non-operative stable TBI.

Delays in initiating venous thromboembolism (VTE) prophylaxis in patients suffering from traumatic brain injury (TBI) persist despite guidelines recommending early initiation. We hypothesized that the expansion of a Trauma Program Performance Improvement (PI) team will improve compliance of early (24-48 hours) initiation of VTE prophylaxis and will decrease VTE events in TBI patients. We performed a single-center retrospective review of all TBI patients admitted to a Level I trauma center before (2015-2016,) and after (2019-2020,) the expansion of the Trauma Performance Improvement and Patient Safety (PIPS) team and the creation of trauma process and outcome dashboards. Exclusion criteria included discharge or death within 48 hours of admission, expanding intracranial hemorrhage on CT scan, and a neurosurgical intervention (craniotomy, pressure monitor, or drains) prior to chemoprophylaxis initiation. A total of 1,112 patients met the inclusion criteria, of which 54% (n = 604) were admitted after Trauma PIPS expansion. Following the addition of a dedicated PIPS nurse in the trauma program and creation of process dashboards, the time from stable CT to VTE prophylaxis initiation decreased (52 hours to 35 hours; p < 0.001) and more patients received chemoprophylaxis at 24 hours to 48 hours (59% from 36%, p < 0.001) after stable head CT. There was no significant difference in time from first head CT to stable CT (9 vs. 9 hours; p = 0.15). The Contemporary group had a lower rate of VTE events (1% vs. 4%; p < 0.001) with no increase in bleeding events (2% vs. 2%; p = 0.97). On multivariable analysis, being in the Early cohort was an independent predictor of VTE events (adjusted odds ratio, 3.74; 95% confidence interval, 1.45-6.16). A collaborative multidisciplinary Trauma PIPS team improves guideline compliance. Initiation of VTE chemoprophylaxis within 24 hours to 48 hours of stable head CT is safe and effective. Therapeutic/Care Management; Level IV.

High-Precision Joint TDOA and FDOA Location System

Passive location based on TDOA (time difference of arrival) and FDOA (frequency difference of arrival) is the mainstream method for target localization. This paper proposes a fast time–frequency difference positioning method to address issues such as low accuracy, large computational resource utilization, and limited suitability for real-time signal processing in the conventional CAF (cross-ambiguity function)-based approach, aiming to complete the processing of the target radiation source to obtain the target parameters within a short timeframe. In the mixing product operation step of the CAF, a frequency-domain approach replaces the time-domain convolution operation in PW-ZFFT (pre-weighted Zoom-FFT) to reduce the computational load of the CAF. Additionally, a quadratic surface fitting method is used to enhance the accuracy of TDOA and FDOA. The localization solution is obtained using Newton’s method, which can provide more accurate results compared to analytical methods. Next, a signal processing platform is designed with FPGA (field-programmable gate array) and multi-core DSP (digital signal processor), and works by dividing and mapping the algorithm functional modules according to the hardware’s characteristics. We analyze the architectural advantages of multi-core DSP and design methods to improve program performance, such as EDMA transfer optimization, inline function optimization, and cache optimization. Finally, this paper constructs simulation tests in typical positioning scenarios and compares them to hardware measurement results, thus confirming the correctness and real-time capability of the program.

Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.

Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; however, there are aspects that have changed. This narrative review highlights current and avant-garde methods of handling patients experiencing septic shock based on the experience of its authors and the best available evidence in a context of uncertainty. Following the first recommendation of the Surviving Sepsis Campaign guidelines, it is recommended that specific sepsis care performance improvement programs are implemented in hospitals, i.e., "Sepsis Code" programs, designed ad hoc, to achieve this goal. Regarding hemodynamics, the importance of perfusion and hemodynamic coherence stand out, which allow for the recognition of different phenotypes, determination of the ideal time for commencing vasopressor treatment, and the appropriate fluid therapy dosage. At present, this is not only important for the initial timing, but also for de-resuscitation, which involves the early weaning of support therapies, directed elimination of fluids, and fluid tolerance concept. Finally, regarding blood purification therapies, those aimed at eliminating endotoxins and cytokines are attractive in the early management of patients in septic shock.

Invited Commentary to "Performance Improvement Program Review of Institutional Massive Transfusion Protocol Adherence: An Opportunity for Improvement".

Invited Commentary to "Performance Improvement Program Review of Institutional Massive Transfusion Protocol Adherence: An Opportunity for Improvement".

Performance Improvement Program Review of Institutional Massive Transfusion Protocol Adherence: An Opportunity for Improvement.

Given the acuity of patients who receive MTPs and the resources they require, MTPs are a compelling target for performance improvement. This study evaluated adherence with our MTP's plasma:red blood cell ratio (FFPR) of 1:2 and platelet:red blood cell ratio (PLTR) of 1:12, to test the hypothesis that ratio adherence is associated with lower inpatient mortality. The registry of an urban level I trauma center was queried for adult patients who received at least 6 units of packed red blood cells within 4 hours of presentation. Patients were excluded for interfacility transfer, cardiac arrest during the prehospital phase or within one hour of arrival, or for head AIS ≥5. Univariate analysis and multiple logistic regressions were performed to identify variables associated with early transfusion protocol noncompliance and the effect on inpatient mortality. Three hundred and eighty-three patients were included, with mean ISS of 25.9 ± 13.3 and inpatient mortality of 28.5%. Increasing age, ISS, INR, and total units of blood product transfused were associated with increased odds of mortality, while an increase in revised trauma score was associated with a decreased odds ratio of mortality. Achieving our goal ratios were protective against mortality, with OR of .451 (P = .013) and .402 (P=.003), respectively. Large proportions of critically injured patients were transfused fewer units of plasma and platelets than our MTP dictated; failure to achieve intended ratios at 4 hours was strongly associated with inpatient mortality. MTP processes and outcomes should be critically assessed on a regular basis as part of a mature performance improvement program to ensure protocol adherence and optimal patient outcome.

Adopting a Novel Approach to Prevent and Address Patient Mistreatment of Staff in a Community Mental Health Center.

Verbal mistreatment of staff by patients is common in health care settings. Experiencing or witnessing mistreatment can have harmful psychological impacts, affecting well-being and clinical practice. As part of an effort to become an antiracist organization, an academic community mental health center based in Connecticut developed an initiative to address verbal mistreatment. Training in the Expect, Recognize, Address, Support, Establish (ERASE) framework was provided to 140 staff members. This training and subsequent actions to enhance the culture of safety were perceived as helpful by staff. Further development of the initiative is proceeding as the center's primary performance improvement program.

Health-related quality of life among people living with HIV in the era of universal test and treat: results from a cross-sectional study in KwaZulu-Natal, South Africa

Background The World Health Organisation’s (WHO) key population-based strategy for ending the human immunodeficiency virus (HIV) epidemic is universal HIV test and treat (UTT) along with pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Despite the successful scale-up of the UTT strategy in sub-Saharan Africa (SSA), the quality of life (QoL) of people living with HIV (PLHIV) remains sub-optimal. Poor QoL in PLHIV may threaten the UNAIDS 95-95-95 programme targets. Monitoring QoL of PLHIV has become a key focus of HIV research among other outcomes so as to understand health-related QoL (HRQoL) profiles and identify interventions to improve programme performance. This study aimed to describe HRQoL profiles and identify their predictors in PLHIV in KwaZulu Natal, South Africa. Methods We conducted a secondary data analysis of a cross-sectional survey conducted between May and June 2022 among PLHIV (n = 105) accessing HIV services at an outpatient clinic in KwaZulu-Natal, South Africa. Socio-demographic, HRQoL (EQ-5D-5L index scores), clinical data, depressive symptoms (CES-D-10), and viral load data were collected from all participants. We examined predictors of HRQoL using generalised linear models controlling for age and sex. Results The mean age of the participants was 45 years (SD = 13). The proportion of participants with disabilities and comorbidities were 3% and 18%, respectively. Depressive symptoms were present in 49% of the participants. Participant’s mean EQ-5D-5L index score was 0.87 (SD = 0.21) and ranged from 0.11 to 1.0. The mean general health state (EQ-VAS) was 74.7 (SD = 18.8) and ranged from 6 to 100. Factors that reduced HRQoL were disability (β = −0.607, p ≤ 0.001), comorbidities (β = − 0.23, p ≤ 0.05), presence of depressive symptoms (β = −0.10, p ≤ 0.05), and old age (β = −0.04, p ≤ 0.05). Factors that increased HRQoL were a good perceived health state (β = 0.147, p ≤ 0.001) and availability of social support (β = 0.098, p ≤ 0.05). Conclusion A combination of old age (60 years and above), any disability and comorbidities had a considerable effect on HRQoL among PLHIV. Our findings support the recommendation for an additional fourth UNAIDS target that should focus on ensuring that 95% of PLHIV have the highest possible HRQoL. Psycho-social support interventions are recommended to improve the HRQoL of PLHIV.

Exploiting Partially Context-sensitive Profiles to Improve Performance of Hot Code

Availability of profiling information is a major advantage of just-in-time (JIT) compilation. Profiles guide the compilation order and optimizations, thus substantially improving program performance. Ahead-of-time (AOT) compilation can also utilize profiles, obtained during separate profiling runs of the programs. Profiles can be context-sensitive, i.e., each profile entry is associated with a call-stack. To ease profile collection and reduce overheads, many systems collect partially context-sensitive profiles, which record only a call-stack suffix. Despite prior related work, partially context-sensitive profiles have the potential to further improve compiler optimizations. In this article, we describe a novel technique that exploits partially context-sensitive profiles to determine which portions of code are hot and compile them with additional compilation budget. This technique is applicable to most AOT compilers that can access partially context-sensitive profiles, and its goal is to improve program performance without significantly increasing code size. The technique relies on a new hot-code-detection algorithm to reconstruct hot regions based on the partial profiles. The compilation ordering and the inlining of the compiler are modified to exploit the information about the hot code. We formally describe the proposed algorithm and its heuristics and then describe our implementation inside GraalVM Native Image, a state-of-the-art AOT compiler for Java. Evaluation of the proposed technique on 16 benchmarks from DaCapo, Scalabench, and Renaissance suites shows a performance improvement between 22% and 40% on 4 benchmarks, and between 2.5% and 10% on 5 benchmarks. Code-size increase ranges from 0.8%–9%, where 10 benchmarks exhibit an increase of less than 2.5%.

Structural Reform of Police Organization at Village Level Government in Bandung Regency, West Java Province

The research aimed to enhance the Police's performance in delivering exemplary community service and harmonize the National Police's structure with the Village/District Level Regional Government. The study employed qualitative description with SWOT and ASOCA Analysis. In Bandung Regency, there's a notable security vulnerability. The data indicates: 1) Potential disturbances exceed 70%, 2) Disorder threshold surpasses 60%, and 3) Actual disruptions are above 30%. Addressing this and to achieve structural synchronization between the National Police and the Regional Government, a strategy is devised titled "Structural Reform of the Police Organization at the Village Government Level." This aims to optimize police performance, resonating with the National Police's 2005-2025 Grand Strategy. SWOT analysis reveals 1) Strength in Leadership, 2) Weakness in Organizational Structure, 3) Opportunities within the Legal Framework, and 4) Threats from misalignment with the Village's Regional Government. ASOCA Analysis emphasizes several factors. Internally, it points out the Police Leadership's ability and members' loyalty. It stresses the importance of harnessing police resources and an Organizational Performance Improvement Program. There's a highlight on the intellectual prowess of police members and their potential to act creatively. Externally, the community's aspiration for better police service is noted. The Bandung Regency's distinct culture and traditions play a role. Challenges persist, like the misalignment of the organizational structure with geographical realities and limited flexibility in local Police management. Community participation and educational levels remain concerns. Lastly, the Village Police follows a "Line and Staff Organization" model. This aligns with the higher-level organizational structure, emphasizing task decentralization and role clarity, ensuring a robust hierarchy and efficient task delegation.