Planning Program Research Articles

The importance of anatomical knowledge and execution technique for optimizing strength training results: opinion article

Strength training is essential for maintaining and optimizing health and is an effective non-pharmacological resource in the treatment of various comorbidities. The repercussions revolve around the promotion of motivated adaptations due to the planning and structuring of the training program through the manipulation of variables such as intensity, volume, selection and order of exercises, weekly frequency, cadence, and amplitude. These include the manipulation of variables such as intensity, volume, exercise selection and order, recovery interval, weekly frequency, cadence, and amplitude. This study aims to discuss the importance of anatomical knowledge and the use of an appropriate execution technique, which must be applied in strength exercises. However, what can be observed in practice is a lack of methodology, as well as an undefined movement standard of exercises, which is based on the premise of improving body composition. In this context, the study points to the need for a more robust discussion on the movement standard and the application of an adequate execution technique in three exercises commonly prescribed in physical training programs. Implementing a proper execution technique based on origin, muscle and joint insertion and actions could optimize strength, hypertrophy, and weight loss results. And, since improving these components is related to a reduction in comorbidities, there is a need for studies that discuss the role of movement execution in greater depth. Thus, further research could evoke a debate on the feasibility of incorporating execution technique as the eighth variable in muscle strength training. Keywords: Physical exercise; physical training; body composition.

Principal’s Managerial Competence in Improving Teacher’s Professional Competence

Improving the quality of education needs to be supported by improving the professionalism of teachers which will also affect the quality of graduates. In this case, the role of the principal is very necessary to support the success of the teacher professional improvement program. The purpose of this study is to discuss the managerial competence of school principals to improve the professional competence of teachers at SD Muhammadiyah 1 Krian Sidoarjo. This study uses a qualitative approach with a case study type of research. Data collection techniques through interviews, observations, and documentation. The results of this study reveal that with the managerial competence possessed by the principal of SD Muhammadiyah 1 Krian in improving the professional competence of teachers, teachers have tried to carry out their roles to the maximum. By looking at the planning of programs to improve teachers' professional competence, school organization management, cooperation with vice principals, educators and education staff, control, find solutions to the challenges faced in improving teachers' professional competence and evaluation at SD Muhammadiyah 1 Krian. Establishing a KKG program for teachers also provides opportunities for teachers to continue their S2, PPG and PMM studies as an effort to improve teacher professionalism. This research is expected to be a reference for academics to continue to strive to improve the quality of education in Indonesia. Not only for teachers and school principals, but all levels of society to show their concern for education.

Analysis of the Role of Agile Governance in the Development of the Smart City Concept: A Qualitative Study of the Banyumas Regency Government, Indonesia

The smart city concept has become a new paradigm in urban development, offering innovative solutions to improve people's quality of life. Agile governance, with its flexibility and adaptability, is a promising approach in managing the complexity of smart city development. This research aims to analyze the role of agile governance in developing the smart city concept in the Banyumas Regency Government, Indonesia. This research uses a qualitative approach with a case study of the Banyumas Regency Government. Data was collected through in-depth interviews with relevant government officials, document analysis, and field observations. Data analysis was carried out using thematic coding and triangulation techniques to ensure the validity and reliability of the research results. The research results show that agile governance plays an important role in developing the smart city concept in Banyumas. Agile principles such as collaboration, iteration, and focus on customer value have been adopted in the planning, implementation, and evaluation processes of smart city programs. Agile governance allows governments to respond quickly to change, actively involve the public, and optimize the use of resources. Agile governance has proven effective in overcoming the challenges of complexity and uncertainty in smart city development. Implementing agile governance can increase the efficiency, effectiveness and sustainability of smart city programs. This research contributes to the development of agile governance theory and practice in the context of smart cities, as well as providing recommendations for other local governments who wish to adopt this approach.

Pemodelan Faktor-Faktor yang Memengaruhi Kejadian HIV/AIDS di Provinsi Jawa Barat

Indonesia is focusing on preparing for Indonesia’s Golden 2045 through the Golden Generation. The Golden Generation is expected to be the country's quality and superior human resource. The province of West Java, with the largest population in Indonesia, plays an important role in realizing Indonesia's Golden 2045 ambition. However, the high HIV/AIDS incidence in West Java is a major challenge that could potentially hinder Indonesia’s achievement of the 2045 Gold Plan. The Ministry of Health has launched the Three Zero HIV/AIDS concept to meet one of Indonesia's Golden 2045 pillars. Based on this, the study aims to identify factors that influence the number of HIV/AIDS cases in West Java. The HIV/AIDS case is a data count, so the approach used in this study is Poisson Regression. The results of the study showed that the number of cases of violence (X1), the percentage of use of condom contraceptives among members of the Family Planning (KB) program (X2), population density (X3), the proportion of poor population (X4), and number of health facilities per 100,000 inhabitants (X5) were related to cases of HIV/AIDS in the West Java Province. It is seen from the p-value of each variable X is 0.0 except the population density is worth 0.003. Having identified significant factors influencing cases of HIV/AIDS in West Java, the government is expected to enhance cooperation with relevant agencies in reducing the risk of the number of cases in Western Java. Thus, Three Zero in West Java can be achieved by 2030.

Eco-Friendly information literacy in green and sustainable business programs

Background of the study: Eco-friendly information literacy plays an important role in helping to change public behavior towards a more environmentally friendly lifestyle. Purpose: The aim of this research is to examine various aspects of information literacy within the green and sustainable business programs conducted by The Local Enablers (TLE) in an eco-friendly context. Method: The research method employed is qualitative descriptive study. The research subject is based on the involvement of specific parties with the research object to be studied in-depth. The subjects involved in this study consist of several individuals who play roles in the TLE project team during the planning and implementation of green and sustainable business programs. Findings: This research outlines the information literacy process in the green and sustainable business program at TLE according to the Big6 Model theory, from problem formulation to information evaluation. The Big6 Model assists TLE as a problem-solving framework for the information needs of the green and sustainable business program. Each member of the TLE team is able to explain the process of searching for and using information during program development. Conclusion: Eco-friendly information literacy is well-established within TLE, where they actively seek out and implement new environmental information within the TLE ecosystem. In designing and implementing green and sustainable business programs, TLE recognizes the urgency of environmental issues and understands that the process of information literacy is an effective problem-solving tool.

The Right Prescription for Family Bliss: A Cross-Sectional Study on Community Satisfaction in Indonesian Family Planning Programs

Although significant progress has been achieved over many decades, sustaining the success of family planning programs in Indonesia requires a deep understanding of the factors that influence community satisfaction among those involved. This study surveyed 503 Family Planning Field Workers (PKBs) across Indonesia’s regions to identify the main factors encouraging satisfaction among communities participating in these programs. A structured online questionnaire was distributed to collect data on the sociodemographic factors influencing satisfaction, which were then analyzed using multiple linear regression. The results showed that effective follow-up on community feedback (β = 0.233, p < 0.001), implementing a rights-based approach (β = 0.207, p < 0.001), enabling community participation (β = 0.147, p < 0.001), collaborating with healthcare providers and facilities (β = 0.159, p < 0.001), and monitoring and evaluating programs (β = 0.155, p < 0.001) were significant positive predictors. More notable, the regression model accounted for a considerable 74.7% of the variation in community satisfaction, pointing to how significant the explanatory power of the identified factors was in predicting the level of satisfaction among communities participating in family planning programs. Actions must be developed to enhance reproductive health and manage population growth by focusing on key factors such as responsive communication, rights, integrated services, community involvement, and evaluations, which are what matters most for family planning programs.

ASPIRE for excellence in student engagement: Examples of how institutions operationalize a complex construct

Student engagement is a key contributor to educational programme quality. It is a complex construct often defined with the focus on student behaviors. However, a broader, more organizational approach takes into account the institutional context and how this can be structured to encourage and support students’ willingness and ability to become engaged. This paper includes suggestions for a student engagement system using key elements recognized in the literature and concrete examples from medical schools that achieved recognition in the ASPIRE-to-Excellence student engagement initiative. The examples from the ASPIRE participants demonstrate that the presence of certain key features creates a mutually beneficial collaborative approach between students and their institutions. This includes opportunities for students to formally engage in four domains touching on the breadth of student life, including institutional governance and policy-making, educational programme development and evaluation, participation in activities in the academic community, and participation in local community and international outreach. Based on an in-depth review of the information from three medical schools that recently received an ASPIRE-to-Excellence award in student engagement, it was possible to identify certain specific practices that individually and taken together allow an institution to demonstrate excellence in this complex construct. As an overarching concept, it was clear that student participation in each of these domain areas benefitted from a supportive institutional culture characterized by specific formal attributes and activities. Examples included codifying student involvement in governance through institutional policies; maximizing communication routes among students and between students and school administrators and faculty; and formalizing a participatory environment through missions statements or strategic plans. For programme planning, a helpful conceptualization is that a successful student engagement programme occurs when change is championed by all stakeholders within an institution and the organization supports a collaborative culture that includes students as active participants and partners.

Stage at diagnosis and survival among adult patients with cancer in Rwanda: A population-based study.

There are marked disparities in cancer survival in low-income countries compared to high-income countries, yet population-based data in the first is largely lacking. In this study, data from the national cancer registry of Rwanda were examined for 542 patients diagnosed with eight of the most common cancers of adults stomach (C16), colorectum (C18-20), liver (C22), breast (female) (C50), cervix (C53), ovary (C56), prostate (C61), and non-Hodgkin lymphomas (C82-85) between 2014 and 2017. Subjects were randomly selected for active followed-up to calculate 1-, 3-, and 5-year observed and relative survival (RS) by cancer type and stage. Overall, 53.7% of cases had died within 5 years of diagnosis. Five-year RS varied by malignancy and ranged from 17.6% (95% confidence interval [CI]: 6.7%-32.6%) for liver cancer to 68% (CI: 51.6%-79.8%) for cancers of the prostate. Stage was assigned for 71.6% of patients (n = 388 of 542), with over half (58%) having advanced stage (III/IV) at diagnosis. For all except liver and ovary, stage was a strong predictor of survival; for example, three-year observed survival was 90.9% and 44.8% (p-value: .002) for early and advanced breast cancer, respectively. This study demonstrates that stage specific survival can be obtained from population based cancer registries in sub Saharan Africa, data that are invaluable for international benchmarking, and for local planning and evaluation of cancer control programs.

Organised and non-organised activities contribute to overall physical activity levels in adolescents and young adults with Down syndrome: a cross-sectional study.

Participation in organised and non-organised physical activities among adolescents and young adults with Down syndrome is underexplored. This study aimed to examine differences between organised and non-organised physical activities among adolescents and young adults with Down syndrome. Forty participants with Down syndrome (27 woman; mean age 21.4±4.9years) were recruited. Data on physical activity participation were collected by self- or proxy-reported questionnaires about attendance, involvement and type of physical activity. Adolescents and young adults with Down syndrome participated in more organised than non-organised activities (P<0.05), more often (P<0.05), but there was no difference in the total time spent participating in these activities overall. Participants spent more time in vigorous physical activity during organised activities (P<0.05) and spent more time in light physical activity during non-organised physical activities (P<0.05). Dancing (organised activity) and walking (non-organised activity) were the most reported activities. Participation in both organised and non-organised physical activities is important to increase overall physical activity levels of adolescents and young adults with Down syndrome. Future research exploring physical activity preferences may help guide the planning and adaption of community programmes for this group.

NURS-04. MUSIC THERAPY WITH CAREGIVERS FOR THOSE WITH PEDIATRIC BRAIN CANCER AND BRAIN TUMORS: A CRITICAL REVIEW OF THE LITERATURE AND RECOMMENDATIONS FOR FUTURE PROGRAMS

Abstract BACKGROUND Caregivers for those with pediatric brain cancer and brain tumors face significant challenges. During the course of treatment, pediatric brain cancer and brain tumor patients face not just the physical consequences of treatments, but the neurological effects as well. METHODS This critical review of the literature examines the effects of Music Therapy on Caregivers, Caregivers for cancer patients, and Caregivers for pediatric cancer patients. A literature review was specifically chosen with the intention of making recommendations for future program planning. Subjects explored include the psychological, physical, and financial impacts of caregiving. Additional concepts include personality traits of Caregivers and multicultural considerations in caregiving. The topics of brain cancer and the use of Music Therapy with patients are also explored. Special attention is given to Music Therapy for Caregivers for those with pediatric brain cancer and brain tumors. Main points under this headline also include Caregiver stressors, similarities and differences in multicultural caregiving, and the limited research available to Caregivers. RESULTS At the time the literature review, no research had been conducted in the area of Music Therapy and Caregivers for pediatric brain cancer and primary brain tumors. Music Therapy was proven, however, to be a significant non-pharmaceutical intervention for several areas, including anxiety and pain management. CONCLUSION The conclusion drawn was that more research is needed with Music Therapy and this particular population. Additionally, a basic framework for a Music Therapy program for Caregivers for those with pediatric brain cancer and brain tumors has been provided with recommendations on the expansion of the program.

Placement of ilio-sacral screws in fusionless technique for pediatric neuromuscular scoliosis utilizing planning software, in conjunction with intraoperative navigation, results in a safer optimal screw: a CT-based study.

The insertion of ilio-sacral (IS) screws for distal anchoring in the instrumentation of pediatric neuromuscular scoliosis (NS) presents a significant challenge, often leading to elevated rates of complications. Utilizing computed tomography (CT) navigation and preoperative planning technology is proposed as a potential solution to mitigate these challenges. This study aims to assess the precision of IS screw placement through CT-graphic measurements, both with and without preoperative planning, followed by navigated IS screw insertion, in pediatric neuromuscular scoliosis. Thirty-two treated patients were grouped based on surgical procedure: planned (P): 19 patients (n=38 screws) and non-planned (NP): 13 patients (n=26 screws). All screw placements (P and NP) took place under CT navigation. IS screw trajectories of P-group were drawn preoperatively on CT images with the cranial trajectory planning program and fused with the intraoperative CT images. There are several important anatomical structures that should be avoided when placing the IS screw (L5 root, spinal canal, L5S1 facet, SI joint, neurovascular structures anteriorly to the sacrum, S1 root in the S1 foramen and the intestines). Each trajectory was evaluated based on seven radiographical parameters whom we have enlisted partially based on the essentials of a good trajectory described by Miladi et al. (1: Ilium; 2: SI joint; 3: Promontorium; 4: Sacral plate; 5: Anterior sacral cortex; 6: S1 foramen; 7: Spinal canal). An independent sample T test was executed to compare both groups. The trajectories in the P group showed a significantly (P<0.05) higher overall similarity and optimality (12.1±2.1 vs 9.1±2.2 points) compared to the non-planned trajectory. Preoperative planning and navigated placement of IS screws on fusion images with intraoperative CT, results in a better trajectory of the ilio-sacral screws.

Manajemen Kurikulum Program Pembelajaran Kewirausahaan di Sekolah Menengah Kejuruan

This research examines the planning, implementation and supervision of the entrepreneurship learning program at the Cukir Diwek Jombang Muallimat College Vocational School. The aim of this research is to evaluate how curriculum planning is carried out, how learning programs are implemented, and how supervision of these programs is carried out. This research uses a qualitative approach with a case study method. Data collection was carried out through interviews, observation and documentation of school principals, curriculum cadets and field teachers. The research results show that entrepreneurship curriculum planning is carried out comprehensively by involving various stakeholders, ensuring the curriculum is relevant and in line with the needs of the job market. Implementation of the program uses experiential learning methods, combining theory and direct practice, as well as collaboration with local industry, although it still requires improvements in the use of technology and ongoing training for teachers. Supervision is carried out through academic and non-academic approaches, ensuring the achievement of educational goals and the development of students' practical skills. In conclusion, the entrepreneurship learning program at the Jombang Muallimat Vocational School is effective in equipping students with the necessary entrepreneurial skills, but requires several improvements to achieve more optimal results

THE EXAMINATION OF URINALYSIS PROFILES OF PREGNANT WOMEN AND TODDLER AS AN EFFORTS OF SCREENING THE POTENTIAL OCCURRENCE OF STUNTING INCIDENTS AND LOW BIRTH WEIGHT BABIES IN PENJARINGAN FLATS, RUNGKUT DISTRICT, SURABAYA

Penjaringan Sari Flats is a solution implemented by the Surabaya City Government to overcome the limited housing in Surabaya. Due to the high number of residents , Penjaringan Sari Flats have a rapid and spread infectious rate. One of the impacts of infectious diseases that may be experienced by pregnant women and also children under five aged is low birth weight (LBW) babies and stunting. One solution to reduce the number of stunting and LBW that can be done is screening at early conditions of infection in pregnant women and toddler using the urine examination method (urinalysis). In examining a urine sample which is examined using the dipstick method (urinalysis using strips), 11 parameters can be read. Three of the eleven dipstick parameters (nitrite, leukocytes, and protein) were stated to be sufficient to screen a patient's initial infection profile. Participants in this community service activity are residents of Penjaringan Sari flats who are female, pregnant, and/or small children aged up to 5 years. The first stage carried out was the introduction of this program and activity plan to the Head of Penjaringan Sari Subdistrict. Data collection on the number of pregnant women and toddlers in Penjaringan Sari Village using observational methods. Data collection was carried out personally by the Head of Community Service accompanied by local women community. The number of pregnant women is 40 and toddlers are 60 as of August 2023. The results of urine sample examinations from 74 patients from residents of Penjaringan Sari Subdistrict are divided into two different categories: pregnant women and toddlers. In the category of pregnant women, around 90% of patients had positive leukocyte results, 60% had proteinuria, and 10% showed positive urine nitrite. In the second group, namely toddlers, the results showed that around 58.13% showed positive leukocytes, around 16.27% experienced proteinuria, and 4.65% of toddler patients had positive nitrite values.

Germline Predisposition to Hematopoietic Malignancies: An Overview

Deleterious germline variants are now recognized as common drivers of hematopoietic malignancies (HMs) and bone marrow failure syndromes. With the increasing use of personalized medicine and the application of tumor-based profiling via next-generation sequencing, diagnosis of HM predisposition occurs with increasing frequency. Although deleterious germline variants can be readily identified by comprehensive clinical testing, numerous barriers exist for many clinicians. Observations regarding particular germline predisposition disorders challenge widely held assumptions about these conditions. Here, we review approaches to germline genetic testing, highlighting key points in a typical patient's course that present challenges for testing and interpreting results. Increasing awareness by health care providers of these conditions and improvements in testing platforms are crucial for enabling a proactive approach to tailoring a suitable treatment plan and surveillance program for the patient and their family members.

Pediatric Respiratory Syncytial Virus Hospitalizations, 2017-2023

Respiratory syncytial virus (RSV) transmission was disrupted worldwide following the COVID-19 pandemic, and further study is required to better understand these changes. To compare observed and expected RSV hospital and intensive care unit (ICU) admission rates and characteristics of admitted children during the 2021-2022 and 2022-2023 seasons. A population-based cohort study of all children aged younger than 5 years in Ontario, Canada, July 1, 2017, through March 31, 2023, was conducted. Individual and neighborhood-level sociodemographic and clinical characteristics were identified from administrative data, including age, palivizumab eligibility, complex medical conditions, rurality, and living in a marginalized neighborhood. The main outcome was RSV-associated hospitalization. Secondary outcomes included ICU admissions, mechanical ventilation, extracorporeal membrane oxygenation, and in-hospital death. Poisson generalized estimating equations were used to model weekly age- and sex-specific hospitalization rates and estimate expected rates in the postpandemic era; adjusted rate ratios (RRs) and 95% CIs are reported. This cohort study included approximately 700 000 children per study year. Compared with prepandemic years (2017-2018, 2018-2019, and 2019-2020), the 2021-2022 RSV season peaked slightly earlier, but overall admission rates were comparable (289.1 vs 281.4-334.6 per 100 000, or approximately 2000 admissions). The 2022-2023 season peaked a month earlier and resulted in more than twice as many hospitalizations (770.0 per 100 000; n = 4977 admissions). The proportion of children admitted to an ICU in 2022-2023 (13.9%) was slightly higher than prepandemic (9.6%-11.4%); however, the population-based rate was triple the prepandemic levels (106.9 vs 27.6-36.6 per 100 000 children in Ontario). With the exception of palivizumab-eligible children, all sociodemographic and health status characteristics were associated with lower-than-expected RSV hospitalization rates in 2021-2022. In contrast, older age of patients was associated with higher-than-expected rates in 2022-2023 (ie, 24-59 months: RR, 1.90; 95% CI, 1.35-2.66). There were notable differences in RSV epidemiologic characteristics in Ontario following the COVID-19 pandemic. It is not yet clear whether and how long atypical RSV epidemics may persist. Clinicians and program planners should consider the potential for ongoing impacts to health care capacity and RSV immunization programs.

Functional Patterns and Postural Balance in Young Women With Chronic Non-Specific Low Back Pain and Healthy Individuals

Introduction In the case of chronic low back pain, changes occur at the central nervous system level. It leads to functional limitations, muscle activity, and motor control impairments.Objectives The aim of the study was to analyze the impact of chronic low back pain on the quality of performance functional patterns and postural balance in young women.Material and methods The study involved 60 women with an average of 21.571.07. In Group 1 (n=30), participants reported chronic low back pain, Group 2 (n=30) was the control group. To assess functional efficiency, the Functional Movement Screen was used. Postural stability was evaluated using the FreeMED Posture Base pedobarographic platform. Pain level was determined using the VAS scale, and pelvic anterior tilt was measured using the BROM II.Results In the group of women with chronic low back pain, significantly lower levels of functional efficiency were observed. The length distance covered by the CoP, the area of an ellipse containing the trajectory of the CoP, and the average velocity of the CoP were greater compared to the group of women without pain. In Group 1, significantly greater asymmetry in foot pressure distribution was noted.Conclusions Individuals reported chronic low back pain demonstrate poorer quality of performance functional patterns and postural stability compared to healthy ones. Detecting movement disorders may contribute to a physiotherapist's planning of a therapeutic program that includes the specific movement deficits of patients. It can directly impact the reduction or delay of pain occurrence.

Postpartum family planning among women attending maternal and child health centers in Assiut Governorate, Upper Egypt

BackgroundPostpartum family planning (PPFP) is important in helping couples to achieve their reproductive intentions. National surveys have consistently reported higher fertility, lower use of family planning (FP), and higher unmet needs for FP in Upper Egypt. This study aims to identify the factors associated with the use of PPFP in Assiut Governorate, Upper Egypt, and to assess the current status of integration of PPFP counseling in the existing maternal and child health services (MCH).MethodsThe study employed a cross-sectional study design, collecting data from 455 postpartum women aged 15 to 49 years in 4 primary health care (PHC) centers in Assiut Governorate, Upper Egypt. The women were interviewed using a structured questionnaire. The questionnaire consisted of 4 sections: the first section included the participants’ demographic characteristics; the second section included women’s obstetric history; the third section included questions about PPFP knowledge, attitude, past and current use of contraception; and the fourth section assessed the current status of integrating PPFP counseling within antenatal, natal, and postnatal services.ResultsIn total, 54.5% of postpartum women were using a modern contraceptive method. The significant predictors of using PPFP methods were as follows: receiving information about PPFP from health care providers (AOR = 11.46, p < 0.001), better attitude towards PPFP (AOR = 10.54, p < 0.001), using modern FP methods (AOR = 6.98, p < 0.001), resumption of menstruation (AOR = 4.11, p < 0.001), older age (AOR = 2.15, p < 0.05), and better PPFP knowledge (AOR = 1.72, p < 0.001). Only 5.3%, 1.3%, and 3.5% received PPFP counseling during antenatal care (ANC), delivery, and the postpartum period, respectively.ConclusionsPostpartum contraception use was associated with receiving PPFP counseling by health care providers and women’s knowledge and attitude regarding PPFP. However, FP counseling was not integrated with other MCH services. Updating the components of MCH services to include PPFP counseling during ANC, at delivery, and during the postpartum period should be prioritized by program planners and policymakers.

The Role of The Internal Audit Unit in the Indonesia Civil Pilot Academy Public Service Agency

The Indonesia Civil Pilot Academy Public Service Agency is an educational institution under the Ministry of Transportation. A Public Service Agency is responsible for managing finances and budgets effectively and efficiently. A unit that supports the effectiveness of the Public Service Agency’s financial management is the Internal Audit Unit. This research examines the role of the Internal Audit Unit in improving financial efficiency at the Public Service Agency of the Indonesia Civil Pilot Academy. The method used is qualitative research with a field study approach. Data were collected through interviews, observation, and document study. The research included interviews with three participants who are directly involved with the Indonesia Civil Pilot Academy’s finances: the Head of The Internal Audit Unit, The Expenditure Treasurer, and The Program and Activity Plan Analyst. The research results show that internal unit audit plays an important role in the Public Service Agency of the Indonesia Civil Pilot Academy. The internal audit unit can ensure that the use of Public Service Agency funds is carried out effectively and efficiently, as well as maintaining accountability and compliance with laws and regulations. Results suggest that a competent and well-communicating Internal Audit Unit is vital for optimal financial management.

An analytical framework for breast cancer public policies in Sub-Saharan Africa: results from a comprehensive literature review and an adapted policy Delphi

BackgroundBreast cancer is the leading cause of death from cancer in women and is a major public health problem worldwide. Despite the lower incidence rates of breast cancer in resource-limited settings, especially sub-Saharan Africa, there is a higher mortality rate compared to high-resource countries where the disease has a higher incidence. This makes breast cancer the second deadliest cancer in African women. These poor results reflect the weakness in public health policies. The aim of this paper is to contribute to the effective control of breast cancer by designing a framework for a comprehensive and systemic analysis of these policies in Sub-Saharan Africa.MethodsThis research is based on a literature review that adopted a systematic approach followed by a modified policy Delphi involving breast cancer experts in Sub-Saharan Africa. We included narrative reviews and systematic reviews/meta-analyses published between 2015 and 2022 as well as official documents in the analysis. We integrated the World Health Organization’s health system building blocks with Walt and Gilson’s policy analysis triangle to analyse the information collected and develop our analytical framework.ResultsA total of 22 reviews and documents were included in the study. Sixteen breast cancer experts from Sub-Saharan Africa participated in the first Delphi round, and nine participated in the second round. The different components identified for a comprehensive and systemic analysis of effective breast cancer policies can be classified into policy content divided according to the health system building blocks and related policy processes; individual, organized national and international policy stakeholders; and policy contexts.ConclusionThis study enabled the design of a framework suitable for the comprehensive and systemic analysis of breast cancer control policies in Sub-Saharan Africa. This framework can be used as a checklist for stakeholders to guide the planning, implementation and evaluation of policies and specific breast cancer control programmes at the national and facility levels.

Consensus in uncertainty. A group Delphi study on the impact of digitalisation on the continuing education of low-qualified adults in Germany

ABSTRACT This paper conducts Group Delphi-study and foresight approach within a five-year horizon in the field of digital education, with a specific focus on Continuing Education (CE) in a post-pandemic society. The study examines the impact of increasing digitalisation on the significant population of low-qualified individuals (approximately five million in Germany). The project identifies both opportunities and risks associated with digitalisation in CE for the low-qualified. The study focuses on 1) the impact of digitalisation on the participation of low-qualified people in CE, 2) the impact of accelerated digitalisation on the planning of programmes and services for this target group, 3) the transformation of programmes and services for low-qualified people due to digitalisation, and 4) methodological innovations for predicting the impact of digitalisation in the CE sector.