Program Evaluations Research Articles

Analysis of the Contribution of HRM to the Process of POAC in Improving the Quality of Teachers at SDIT AZ-Zahra Rantau, Tapin Regency

This study analysed the contribution of human resource management (HRM) to the processes of planning, organizing, actuating, and controlling (POAC) in improving teacher quality at SDIT Az Zahra Islamic elementary school in Tapin Regency, South Kalimantan Province of Indonesia. A qualitative case study approach was employed involving interviews with the school principal, foundation representatives, and teachers, as well as classroom observations and document analysis. The findings revealed SDIT Az Zahra implements the POAC framework effectively in its HRM practices. The planning stage involves needs assessment through surveys and performance data analysis. Organizing prioritizes task delegation and program coordination aligned with identified needs. Actuating centres on delegation, rewards, and a supportive work environment. Controlling includes regular program evaluations and feedback mechanisms. While teachers valued training opportunities, there was a need for more skills-focused and personalized development. Challenges in integrating faith, knowledge and technology into lessons were also identified. Recommendations include pursuing partnerships for shared resources, leveraging technology for teacher development, and benchmarking with other schools. Overall, SDIT Az Zahra's data driven HRM approach utilizing POAC shows promise for maintaining high teacher quality and achieving academic excellence. The study contributes insights into improving HRM alignment with organizational goals in Islamic educational institutions.

Injury mortality in South Africa: a 2009 and 2017 comparison to track progress to meeting sustainable development goal targets

ABSTRACT Background Injuries, often preventable, prompted urgent action within the United Nations’ 2030 Agenda for Sustainable Development Goals (SDGs) to improve global health. South Africa (SA) has high rates of injury mortality, but accurate reporting of official national data is hindered by death misclassification. Objective Two nationally representative surveys for 2009 and 2017 are utilised to assess SA’s progress towards SDG targets for violence and road traffic injuries, alongside changes in suicide and under-5 mortality rates for childhood injuries, and compare these estimates with those of the Global Burden of Disease for SA. Methods The surveys utilised multi-stage, stratified cluster sampling from eight provinces, with mortuaries as primary sampling units. Post-mortem files for non-natural deaths were reviewed, with additional data from the Western Cape. Age-standardised rates, 95% confidence intervals (CIs), and incidence rate ratios (IRRs) were calculated for manner of death rate comparisons and for age groups. Results The all-injury age-standardised mortality rate decreased significantly between 2009 and 2017. Homicide and transport remained the leading causes of injury deaths, with a significant 31% decrease in road traffic mortality (IRR = 0.69), from 36.1 to 25.0 per 100 000 population. Conclusions Despite a reduction in SA’s road traffic mortality rate, challenges to achieve targets related to young and novice drivers and male homicide persist. Achieving SA’s injury mortality SDG targets requires comprehensive evaluations of programmes addressing road safety, violence reduction, and mental well-being. In the absence of reliable routine data, survey data allow to accurately assess the country’s SDG progress through commitment to evidence-based policymaking.

Why do companies adopt workforce well-being programs?*

Economic evaluations of workforce well-being programs (WWPs) typically focus on return on investment (ROI) analyses to demonstrate that WWPs generate financial savings through reduced health care costs or improved labor productivity. Although the outcomes considered by WWP evaluations should be linked to businesses’ strategies to provide policy-relevant evidence, there are not empirical studies linking companies’ stated reasons for adopting WWPs to their choice of specific programming. This study used a large convenience sample of employer survey data to empirically link companies’ stated reasons for adopting WWPs to specific program implementation choices. In so doing, it analyzed the assumption that financial savings drive the adoption of WWPs and provides evidence of the extent to which ROI expectations drive WWP adoption. Our findings provide evidence that ROI is not necessarily the main objective of companies implementing WWPs and the current state of the literature does not align the evaluation metric with true company values, strategic objectives, and characteristics.

Peer support for borderline personality disorder: A critical review of its feasibility, acceptability, and alignment with concepts of recovery.

Many organizations have adopted peer support to increase service alignment with recovery-oriented principles. Yet, few studies have scrutinized borderline personality disorder (BPD)-specific concepts of "recovery" and "recovery-oriented practice," nor evaluated the extent to which existing peer support services (PSS) align with these concepts. We addressed these knowledge gaps in four phases: (a) a literature review to understand BPD-specific concepts of "recovery" and "recovery-oriented practice," (b) a literature review and open web search to describe the implementation, feasibility, or effectiveness of PSS for people with BPD, (c) a landscaping survey of program administrators regarding their BPD-PSS programs, and (d) a critical review of the extent to which current peer support for BPD aligns with "recovery" and "recovery-oriented practice." We identified 40 published sources that defined "recovery" or "recovery-oriented practice" as it pertains to BPD, and narratively summarize these results, nine sources that described PSS for people with BPD, and received survey responses from seven BPD-PSS program administrators. Our critical review highlighted the distinctive but overlapping concepts of "clinical recovery" versus "personal recovery" and underscored the alignment of BPD-PSS with personal recovery goals, including increased self-knowledge and -acceptance, hope, engagement in meaningful social roles and relationships, and self-determination. While peer support is experienced positively by service users, peer supporters, and clinicians, challenges include setting boundaries, minimizing dual roles, and ensuring adequate training, supervision, and personal support to reduce burnout. Peer support appears to be a feasible avenue for meeting the personal recovery goals of people with BPD; however, formal program evaluations are needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reflecting on the quality of a methodologically pluralist evaluation of a large-scale Indigenous health research collaboration in Australia

BackgroundIndigenous communities worldwide lead calls for all evaluations of research, programmes and policies affecting their communities to reflect the values, priorities and perspectives of the Indigenous peoples and communities involved....

Delivery platforms for reaching adolescents with nutrition interventions in low- and middle-income countries.

Adolescents in low- and middle-income countries (LMICs) are a vulnerable population given increased nutritional needs as puberty approaches. School-based nutrition programs exist in some settings, but the comprehensive provision of nutrition services requires knowledge of the mechanisms to reach out-of-school adolescents. A comprehensive scopingreview was performed using formal and informal search strategies to landscape all potential delivery platforms with nutrition services to reach adolescents. Peer-reviewed studies, institutional strategies, program evaluations, and programmatic reports in LMICs were reviewed, including gray literature. A total of 87 out of 270 identified publications and reports describing nutrition programs for adolescents were identified. Although nutrition programs targeted at adolescents were sparse, various innovative and inclusive delivery platforms were included, such as school feeding programs, school-based anemia control, and nutrition-friendly school initiatives; health facility-based, youth-friendly health and nutrition services; social safety nets targeted at adolescents; community-based approaches targeting youth development and peer education within youth centers and faith-based settings; and technology-based platforms, including digital health services and mass media communication sensitization and mobilization efforts. Existing delivery mechanisms and platforms in health and other sectors that target adolescents offer great potential to extend nutrition interventions to this vulnerable yet hard-to-reach population.

Peer Support Interventions for People With CKD: A Scoping Review

Formalized peer support is a promising approach for addressing the emotional and practical needs of people living with chronic kidney disease (CKD). We aimed to systematically identify and summarize peer support interventions studied in individuals with CKD with or without kidney replacement therapy (KRT). We searched electronic databases and grey literature sources in March 2023. Studies of any design were eligible if they reported sufficient detail on peer support interventions and outcomes for adults with CKD with or without KRT and/or their caregivers. We extracted information on study and intervention characteristics and reported outcomes using established frameworks. We summarized quantitative data descriptively and qualitative data thematically. Our approach observed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. We included 77 studies describing 56 unique peer support interventions. Most reports were program evaluations (39%) or randomized controlled trials (27%) published after 2013. Two thirds of interventions focused on in-centre hemodialysis or mixed CKD populations, and three quarters were integrated within a kidney care clinic or program. Whereas most peer interactions centered on informational support, few programs offered focused support in areas such as transplant navigation or dialysis modality selection. Only one third of outcomes were assessed against a comparator group, with results suggesting improvements in psychological health with peer support. Heterogeneity of included studies; lack of rigorous program evaluation. This review suggests recent growth in peer support programming with a variety of formats and delivery methods to address the diverse needs of people living with kidney disease. Notable gaps in peer support availability for transplant and home dialysis recipients and the lack of rigorous evaluations present opportunities to expand the reach and impact of peer support in the kidney care context.

Evaluation of high-fidelity and virtual reality simulation platforms for assessing fourth-year medical students’ encounters with patients in need of urgent or emergent care

Background Medical students in the U.S. must demonstrate urgent and emergent care competence before graduation. Urgent and emergent care competence involves recognizing, evaluating and initiating management of an unstable patient. High-fidelity (HF) simulation can improve urgent and emergent care skills, but because it is resource intense, alternative methods are needed. Study Objective Our primary purpose was to use program evaluations to compare medical student experiences with HF and virtual reality (VR) simulations as assessment platforms for urgent and emergent care skills. Methods During their emergency medicine clerkship, students at The Ohio State University College of Medicine must demonstrate on HF manikins, competence in recognizing and initiating care of a patient requiring urgent or emergent care. Students evaluated these simulations on a five-point quality scale and answered open-ended questions about simulation strengths and weaknesses. Faculty provided feedback on student competence in delivering urgent or emergent care. In 2022, we introduced VR as an alternative assessment platform. We used Wilcoxon Signed Ranks and Boxplots to compare ratings of HF to VR and McNemar Test to compare competence ratings. Comments were analyzed with summative content analysis or thematic coding. Results We received at least one evaluation survey from 160 of 216 (74.1%) emergency medicine clerkship students. We were able to match 125 of 216 (57.9%) evaluation surveys for students who completed both. Average ratings of HF simulations were 4.6 of 5, while ratings of VR simulations were slightly lower at 4.4. Comments suggested that feedback from both simulation platforms was valued. Students described VR as novel, immersive, and good preparation for clinical practice. Constructive criticism identified the need for additional practice in the VR environment. Student performance between platforms was significantly different with 91.7% of students achieving competence in HF, but only 65.5% in VR (p≤.001, odds-ratio = 5.75). Conclusion VR simulation functions similarly to HF for formative assessment of urgent and emergent care competence. However, using VR simulation for summative assessment of urgent and emergent care competence must be considered with caution because students require considerable practice and acclimation to the virtual environment.

Community Sports Program in a Vocational College in Jiangxi Province, China

This study aimed to assess Jiangxi Science and Technology Vocational College students' perceptions of community sports programs with a view to developing improved community sports programs. The study found that students generally rated the program as excellent in terms of accessibility, sustainability, effectiveness and satisfaction, demonstrating its success in addressing barriers to participation, using environmentally friendly, inclusive and flexible strategies, and responding to student feedback responded positively. Although there were differences in terms of gender, age, course, and grade level, these factors had no significant impact on students' evaluations of community sports programs. Through the evaluation of existing programs and suggestions for improvement, this study hopes to provide a valuable reference for the development of sports programs in vocational colleges.

Summarising Quantitative Outcomes in Parental Mental Illness Research.

A quarter of all children grow up in a family where a parent experiences a mental illness (FaPMI). Research activity in this area is growing rapidly and it is now critical to better understand the extant knowledge in the field. This scoping review of quantitative FaPMI literature parallels a qualitative literature review and a series of Delphi studies with key stakeholders (e.g. lived experience and clinicians), that is part of a larger program of research to achieve consensus regarding the direction of FaPMI research; including making recommendations about outcomes and measures. The programme of research aims to promote and facilitate greater comparison and learning across studies and settings. Initially this scoping review summarises the quality and focus (e.g. country and sampling) of 50 quantitative studies from 2000 to 2023 and then classifies studies according to outcomes for parents, children and families. Six to eleven years were the most common child sample group and girls were slightly underrepresented (49/51) and parents were 88% mothers. Analogous parent and child outcomes were; mental illness/psychopathology, wellbeing, mental health literacy, trauma and stressful experiences, coping, help seeking/service need, within family relationships and supports, outside family relationships and supports. Additional outcomes for parents were; parenting skills, parent competence and parenting stress and for children in relation to their; cognitive functioning and caregiving. The family related outcomes were the within and outside family relationships and supports. Since 2000 there have been 136 different survey instruments employed with approximately 80% used in only one study. This suggests that the broader goals of the program of research are warranted as there is a need for less heterogeneity in measures used. Suggested areas for future research include a sampling focus on fathers, economic evaluations of programs, parent mental health literacy, trauma, genetics and integrating well-being concepts into research designs. Child research should focus on mental health literacy, the level and impact of caring responsibilities, assessing past trauma and the roles of close family and external supports.

Diverting 911 calls: Lessons from early adopting urban jurisdictions

AbstractResearch SummaryTwo perceptions drive interest in finding ways of diverting more 911 calls from police to civilian first responders: (1) police responses can result in inadvertent harm to citizens and (2) many calls to which police respond require services that police often cannot provide. Thus, using other personnel may improve police–citizen relations and strengthen crime fighting by reducing extraneous police burden. Using a case study design, we conducted formative evaluations of programs that have developed beyond pilots in three large U.S. cities: Albuquerque, Atlanta, and Houston. In each city, we interviewed officials, program operators, and other stakeholders and reviewed program documents and statistics. We detail the events and forces that led to the establishment of each program, the way in which the programs have been institutionalized, and the way they interact with the Police Department. We then discuss key lessons learned for these jurisdictions.Policy ImplicationsMany U.S. cities are considering diverting some emergency calls for service from police to civilian first responders. This analysis provides evidence to aid policy makers, researchers, and other stakeholders in the development and evaluation of community responder programs. In all respects, we find that cities’ unique experiences inform program design. For example, in Albuquerque, a City Hall‐driven initiative established a new city agency parallel to the Police Department. In Atlanta, decarceration activists drove the initiative; the program is a city/county‐funded nonprofit, more fragile in its funding. Risk aversion among call takers and dispatchers has led to low call diversion rates across all sites, but training and collaboration have shown promise to resolve this problem. Public safety officials external to the diversion programs commonly expressed concerns about first responder safety and perceptions that police are expected when 911 is called. This risk aversion has led to slower‐than‐expected expansion of the program within each city.

Leadership development programmes in healthcare research: a systematic review, meta-analysis and meta-aggregation

BackgroundAcademic institutions benefit from researchers adopting leadership positions and, subsequently, leadership development programmes are of increasing importance. Despite this, no evaluation of the evidence basis for leadership development programmes for...

Insights into Digital MedicRehApp Maintenance Model for Pulmonary Telerehabilitation: Observational Study.

Maintenance strategies after center-based pulmonary rehabilitation (CBPR) are currently needed. This study aimed to evaluate the feasibility and effect on the quality of life of a home-based pulmonary rehabilitation (HBPR) program delivered by a digital app. As secondary objectives, the patients' adherence, symptoms, effort tolerance changes, and safety were evaluated. This was a single-arm prospective observational monocentric study on 30 patients referred for chronic respiratory diseases. The prescription and evaluations of the HBPR programs performed at the pulmonary facility and delivery of structured exercise and counselling by the digital health tool were achieved under the supervision of a respiratory therapist. Digital capabilities included aerobic, strength, and respiratory exercises, which were monitored with a fitness tracker. The engagement rate of the HBPR after the CBPR was 1:10. The EuroQoL VAS score increased from 66.2 ± 16.28 to 75.60 ± 16.07 (p < 0.001), mainly in younger subjects. No patient was lost during the HBPR program. The global adherence session rate was 94%. The Medical Research Council dyspnea scale (MRC), COPD Assessment Test (CAT) score, and six-minute walking test (6MWT) improved from admission into the pulmonary unit to the end of the HBPR program. Between the beginning and end of the CBPR, the CAT score decreased from 14.4 ± 6.39 to 8.50 ± 5.39 (p < 0.001), the MRC decreased from 1.87 ± 0.9 to 1.17 ± 0.83 (p < 0.001), and the 6MWT increased from 451 ± 93 to 473 ± 115 m (p < 0.05). The average Technology Acceptance Model score for usability was high (145 ± 12.1) and no adverse events occurred during the HBPR program. This HBPR model seemed to be feasible and well-accepted by patients, leading to improvements in quality of life, symptoms, and functional capacity.

Service navigation and concrete supports from a family Perspective: A preventative and community-based approach to child welfare

The child welfare system in the United States has historically focused funding on intervening after child maltreatment has occurred, with fewer resources allocated to prevention. However, research has found that families benefit from concrete supports, like financial payments, and when families are provided with these supports, child welfare involvement significantly declines. Less is known about the impact of preventative approaches, such as service navigation, which could act as a bridge between families and essential concrete supports and resources. Additionally, it is vital to incorporate family voice into decisions being made regarding the development and evaluation of prevention programming. This qualitative study explores family experiences and outcomes with community-based service navigation. The sample included 12 family members working with a community navigator at the time of data collection. Data were obtained through focus groups and interviews held in English, Spanish, and Arabic. A thematic analysis guided the researchers in better understanding participants’ perspectives on service navigation. Results indicate that participants found preventative service navigation to be a supportive and collaborative experience through which they were connected with concrete supports and other essential resources. Five themes were identified: (1) normalizing the need for support; (2) time as a limited resource for families; (3) service navigation as empowering and humanizing for families; (4) service navigation poses new challenges for families; and (5) service navigation creates new opportunities for families. Results from this study suggest that service navigation may represent a more socially just intervention to ensure child safety, permanency, and well-being.

Perinatal intervention strategies providing food with micronutrients to pregnant and breastfeeding women in low‐ and middle‐income countries: A scoping review

AbstractIn resource‐constrained settings, pregnant and breastfeeding women and girls (PBW/G) are particularly vulnerable to undernutrition. Micronutrient‐fortified balanced energy protein (BEP) supplementation may be provided to boost maternal nutritional status and improve birth and infant outcomes. We conducted a scoping review of the published literature to determine the impact of BEP and other related nutrition interventions that provided fortified food or cash along with a minimum of 3 micronutrients on maternal, birth, and infant/child outcomes in low‐ and middle‐income countries. We conducted a PubMed search using pre‐defined keywords and controlled vocabulary search terms. All titles and abstracts were reviewed for eligibility by two independent reviewers, and data were extracted according to outcome type. We identified 149 eligible research articles that reported on a total of 21 trials and/or programme evaluations which assessed the health impact of one or more products (fortified lipid‐based nutrient supplement [LNS, n = 12], fortified blended flours [n = 5], milk‐based beverages [n = 2], and local food/snacks [n = 3]) that provided 118–750 kcal/day and varying levels of protein and micronutrients. Only one of these programme evaluations assessed the impact of the provision of cash and fortified food. Effects on maternal outcomes such as gestational weight gain and duration of gestation were promising but inconsistent. Birth outcomes were reported in 15 studies, and the effects on birthweight and birth length were generally positive. Seven studies demonstrated sustained benefits on infant and child growth out of the 15 studies that reported at least one of these outcomes, although data were sparse. Additional research is needed to investigate issues of dose, cost‐effectiveness, and incorporation into multi‐component interventions.

Selection And CBT Treatment Pilot Program Final Evaluation Using IORNS in Macedonian Male Prison Population

The treatment or the resocialization is the most important part of the prison sentence which methods can be individual and group. Motivated inmates and less resistance for the treatment are the main precondition for effective treatment. Appropriate behavior of personnel is the main factor for that result. Cognitive-behavioral therapy (CBT) as the most effective evidence based psychotherapy approach for offender population is a type for inmate treatment. CBT is a result of Aaron Beck pioneering work in the 1960s. CBT model is based on the triangle relationships between cognition, emotions and behavior. The cognition is defined as a product of the three levels: cognitive schemas, negative automatic thoughts and dysfunctional thinking or thinking errors. The inventory of risk, need and strengths (IORNS), an risk assessment instrument, based on Risk, need and responsivity (RNR) model, was used for selection of (N=27) inmates and CBT treatment pilot program final evaluation, in Macedonian prison Bitola. The evaluation was done by comparing pre and post test measures in (N=12) male inmates, as optimal number for group psychotherapy treatment. According to the RNR model the treatment program needs to be oriented to the inmates needs. Implementing CBT treatment program for group psychotherapy and IORNS as short screening tool in Macedonian prisons was the aim of the project supported by the Council of Europe in this work. The results showed significant lower Procriminal attitudes but higher Aggression because of higher Aggressive behavior in the post measures. Results and instrument can be used in next CBT programs evaluations for better rehabilitation of prison inmates and reducing recidivism.

Meningkatkan Akses dan Kemampuan Literasi Digital di Era Informasi

In today's digital era, digital literacy is a fundamental skill that every individual must possess. The community service program to enhance Access and Capabilities in Digital Literacy in the Information Era aims to reduce the digital divide by improving digital literacy access and skills among the community, especially in underdeveloped areas. Through a series of training and workshops that include basic introductions to information technology, digital security, and assessing the credibility of online information, the program has successfully enhanced the digital literacy skills of its participants. Program evaluations indicate significant improvements in technology use and understanding of information security. Despite challenges such as infrastructure limitations and varied initial abilities among participants, flexible curriculum adaptations and teaching methods have helped overcome these barriers. This program not only provides direct benefits to participants but also has the potential to expand economic and educational opportunities and prepare the community for more active participation in social and cultural life in the digital age.

Beyond Victim Identification: A Practitioner’s Guide to Designing a Youth Anti-Sex Trafficking Advocacy Program

ABSTRACT Thousands of youth are sexually trafficked each year in the United States. In order to address this concern, anti-trafficking advocates often emphasize the importance of uniform screening protocols to assist with the identification of survivors. Unfortunately, an oft-overlooked component of sex trafficking identification is what to do once a victim has been identified, and how to best meet survivors’ complex needs. In this article, the authors provide social work practitioners and other advocates with best practice guidelines for how to design and evaluate anti-sex trafficking advocacy programs for children and youth. These guidelines include considerations related to direct services with clients, community partnerships, and organizational capacity, as well as recommendations for how to begin and then evaluate programming. Regardless of the form selected for the program, all anti-sex trafficking programs should be designed to provide effective, client-centered follow-up and advocacy once a positive identification is made in the community. The recommendations included in this paper are based upon extant literature, the authors’ practice experience with survivors, and insights from anti-sex trafficking program evaluations.

Evaluation of Programming in C using WSM Method

Programming in C. The machine-oriented programming language C is mostly used to create many applications and operating systems, like Windows, as well as other complicated programmers, such the Oracle database, Kit, the Python interpreter, and games. Computer programmers and low-level programming applications are often written in the procedural or structured programming language C. Concatenation, data hiding, data compression, inheritance, and polymorphism are some extra aspects of C++ despite the fact that it is an object-oriented programming language. Multiple entities of the same type can be grouped together into a larger group using the C concept of an array. These entities or components may be user-defined data types or structures, such as integer, float, double, or float data types. C-written programmers compile and execute far more quickly than those written in other languages. This is because there are no additional processing overheads like garbage collection. As a result, when compared to other programming languages, the language is quick. An algorithm is a series of actions carried out in a preset order to address a challenge or finish a task. A function is a section of code that is called and carried out by other software elements. An operating system is made using it. The "C" programming language is used to create operating systems like Apple's OS X, Microsoft's Windows, and Symbian. It is utilized to create platforms for desktop and mobile devices. It is used to create compilers. One C feature that contains symbols for doing mathematical, relational, bitwise, conditional, or logical manipulations is the C operator. There are many built-in operators in the C programming language that can be used to carry out different tasks as needed by the application. C has an advantage over other dynamic languages since it is a statically typed programming language. Also, C is a compiler-based programming language, in contrast to Python and Java, which are interpreter-based. It expedites the compilation and execution of code. Weighted Sum works by multiplying the designated field values Indian Technical Institution or appraising the alternatives Analysis in Simply types, Enum types, Struct types, Nullable types. Evaluation parameters in Class types, Interface types, Array types, and Delegate types. Simply types, Enum types, Struct types, Nullable types. Class types, Interface types, Array types, and Delegate types. Nullable types got the first rank whereas Simply types have the lowest rank.

THE IMPORTANCE OF A PARTICIPATORY APPROACH IN VILLAGE DEVELOPMENT IN THE VILLAGE OF TANJUNG MEDAN LABUHAN BATU SELATAN

The participatory approach in village development prioritizes the active role of the community as the main actors, with full involvement in every stage of development, from planning to evaluation. This concept is based on the capabilities and self-reliance of the community, as well as continuous learning built from their experiences, ensuring that village development aligns more closely with the community's capabilities and progress. This study employs a descriptive method with a qualitative approach to understand community participation in Tanjung Medan Village, South Labuhan Batu Regency. Data were collected through direct observation, surveys, and interviews with the village head and the community. The results show that although the community participates in gotong royong activities and program evaluations, there is dissatisfaction with the village government's transparency, particularly regarding budget reporting. Improvements in the evaluation and monitoring phases are needed to enhance the effectiveness of the participatory approach