Suboptimal Implementation Research Articles

Evaluating the implementation of the National Primary Health Care Development Agency (NPHCDA) gateway for the Basic Healthcare Provision Fund (BHCPF) across six Northern states in Nigeria.

This evaluation research utilized both qualitative and quantitative methods to assess the implementation of the National Primary Health Care Development Agency (NPHCDA) gateway of the Basic Health Care Provision Fund (BHCPF) across six states in Northern Nigeria: Bauchi, Borno, Kaduna, Kano, Sokoto, and Yobe. This was a mixed-method research that utilized longitudinal surveys and Key informant interviews to gather information about the implementation status of the BHCPF-NPHCDA gateway. Checklists were developed based on the BHCPF's national guidelines to gather quantitative data, while simple open-ended questionnaires were used to collect qualitative data from the state BHCPF Program Implementation Unit (PIU) focal persons as key informants. The result revealed that the NPHCDA had accredited these six states to use one Primary Health Care (PHC) facility in each political ward to implement the BHCPF. Factors that contributed to the success achieved in some states included the early completion of contingent start-up activities, well-established coordination structures, strong support from partners, and the availability of established financial management systems. However, the delays in the submission of quarterly business plans by the BHCPF facilities affected timely approval and fund disbursement. Other challenges included staff capacity gaps, inadequate human resources, and poor management and supervision from the state health agency teams. There was suboptimal implementation of the BHCPF in at least one thematic area across all states. Therefore, actions such as government commitment for improved coordination, continuous capacity building, effective monitoring and evaluation, and targeted supportive supervision using innovative approaches should be undertaken to improve the program's implementation. In a broader setting, the insights from BHCPF implementation are valuable for LMICs, offering guidance on overcoming implementation challenges associated with PHC financing. This research provides a resource for enhancing healthcare financing strategies in similar contexts.

Automating TODO-missed Methods Detection and Patching

TODO comments are widely used by developers to remind themselves or others about incomplete tasks. In other words, TODO comments are usually associated with temporary or suboptimal solutions. In practice, all the equivalent suboptimal implementations should be updated (e.g., adding TODOs) simultaneously. However, due to various reasons (e.g., time constraints or carelessness), developers may forget or even are unaware of adding TODO comments to all necessary places, which results in the TODO-missed methods . These “hidden” suboptimal implementations in TODO-missed methods may hurt the software quality and maintainability in the long-term. Therefore, in this paper, we propose the novel task of TODO-missed methods detection and patching, and develop a novel model, namely TDPatcher ( T O D O-comment Patcher ), to automatically patch TODO comments to the TODO-missed methods in software projects. Our model has two main stages: offline learning and online inference. During the offline learning stage, TDPatcher employs the GraphCodeBERT and contrastive learning for encoding the TODO comment (natural language) and its suboptimal implementation (code fragment) into vector representations. For the online inference stage, we can identify the TODO-missed methods and further determine their patching position by leveraging the offline trained model. We built our dataset by collecting TODO-introduced methods from the top-10,000 Python GitHub repositories and evaluated TDPatcher on them. Extensive experimental results show the promising performance of our model over a set of benchmarks. We further conduct an in-the-wild evaluation which successfully detects 26 TODO-missed methods from 50 GitHub repositories.

Optimalisasi Penyelenggaraan Statistik Sektoral sebagai Upaya Pemenuhan Data Statistik Berkualitas di Indonesia

The development of data needs in Indonesia has increased awareness of the importance of quality data in supporting development planning and implementation. The government responded by issuing Presidential Regulation Number 39 of 2019 concerning One Data Indonesia (SDI), which aims to produce accurate, up-to-date, and accountable data. However, the implementation of sectoral statistics still faces challenges, including the low national Statistical Development Index (IPS) in 2023 which is in the less than ideal category with a value of 1.78 on a scale of 5.00. This study aims to identify the root causes of the suboptimal implementation of sectoral statistics by Ministries/Institutions/Regions/Agencies (K/L/D/I) and to prepare policy recommendations for improvement in order to realize quality sectoral statistics. The methodology used includes literature studies, secondary data analysis from the results of the Evaluation of Sectoral Statistics Implementation (EPSS), interviews with related teams, and review of laws and regulations. The results of the analysis show several main causal factors: the failure to implement comprehensive sectoral statistics guidance by the Central Statistics Agency (BPS); not all K/L/D/I submit independent assessments so that the progress of sectoral statistics implementation cannot be measured; and budget limitations to support sectoral statistics activities in the regions. To overcome these problems, it is recommended that BPS formulate clear regulations on sectoral statistics development guidelines and increase active development to K/L/D/I. In addition, the Ministry of Home Affairs is expected to encourage regional governments to provide adequate budgets through official circulars. In conclusion, improving the quality of sectoral statistical data requires collaborative efforts between BPS, K/L/D/I, and regional governments. Intensive development, comprehensive evaluation, and adequate budget support are the keys to realizing quality statistical data in accordance with the One Data Indonesia principle.

Utilizing Static Pricing to Boost Room Revenue in Archipelago International Indonesia Hotels Group

Purpose: This research examines the implementation of static rates to increase room revenue at Archipelago International Indonesia Hotels Group. While the majority of Archipelago International management considers that dynamic rates are more effective at increasing room revenue, the impact of global economic events such as the Covid-19 pandemic, wars, and earthquakes (force majeure) has been underestimated. Static rates can be used to respond to economic downturns induced by these occurrences, which reduce demand. Research methods: This research uses qualitative research methodologies to assess current practices and offer ideal static rate models. It is supported by three concepts and theories: static rates, room revenue, and hotel management. This research also uses tourism economy and revenue management as theoretical foundations. Results and discussion: The findings highlight suboptimal implementation challenges and propose two models at Archipelago International Indonesia Hotels Group: (1) Static Rates Stand Alone: managed by the channel manager for a minimum two-night stay, beneficial for remote or pre-opening hotels, during low occupancy or economic downturns; and (2) Bundle Packages: combining room rates with other services to increase revenue and promote additional facilities. Implication: These models provide consistent pricing, improved forecasting, and increased brand awareness. Implementing these models can help Archipelago International optimize its revenue plans and financial performance.

The Contestation of Legal Foundations in the Resolution of Islamic Economic Disputes in Religious Courts

Prior to the issuance of Supreme Court Regulation No. 2 of 2008, judges in Sharia economic dispute cases primarily relied on legal sources from kutub al-turāṡ (classical fiqh texts), including those pertaining to fiqh al-qadā’ (jurisprudence on adjudication). However, following the implementation of this regulation, some judges have continued to incorporate the Civil Code in their legal reasoning. This article seeks to examine the legal framework for resolving Sharia economic disputes in Indonesia. The theoretical foundation applied by the author is Lawrence Meir Friedman’s legal system theory. This study employs a normative legal approach to explore the legal system governing Sharia economic justice in Indonesia’s Religious Courts. It examines decisions from the Religious Courts in Purbalingga, Banyumas, and Purwokerto, focusing on rulings made both before and after the issuance of the Supreme Court Regulation on the Compilation of Sharia Economic Law (KHES), as well as five decisions from 2018-2019. The study’s findings reveal that the legal framework for Sharia economic dispute resolution in Indonesia has adequately addressed community needs, with the Religious Courts holding exclusive jurisdiction over these matters. However, there is an ongoing contestation between Islamic legal sources and civil law, which is rooted in Dutch law, in the decisions analyzed. Moreover, the absence of a Compilation of Islamic Economic Procedure Law based on Islamic Law has contributed to the suboptimal implementation of legal substance and culture. As a result, according to Friedman’s legal system theory, the legal framework for resolving Islamic economic disputes has not yet functioned effectively from the perspective of Islamic law.

The Current State of the Clinical Utility of Evidence-Based Practice for Ulcer Prevention in Long-Term Care Facilities

Background: Pressure ulcers (PUs) are localized skin injuries that mostly occur over bony prominences. PU prevalence in long-term care (LTC) facilities is currently extremely high despite the availability of evidence-based practice (EBP) guidelines at national and international levels. This narrative review aimed to investigate the current state of the clinical utility of EBP in the prevention of PUs in LTC facilities. Methods: A narrative review approach was used to synthesize studies that offer insights into the current state of clinical utility of EBP guidelines in LTC facilities. Studies were searched on PubMed, Web of Science, ScienceDirect, and Google Scholar. Findings: The findings revealed suboptimal implementation of EBP guidelines in LTC facilities in various countries. Nurses use clinically validated risk assessment tools less often to decide patients who are at risk of developing PUs for tailored interventions. Although scheduled positioning and the use of pressure relieving devices are commonly implemented, they are less documented in care plans. Nutritional assessments and interventions are the least often used. Nurses and other healthcare professionals often involve patients, family, and carers in planning and decision-making processes, but further improvements are still needed. Conclusion: There is a need to integrate into routine care clinically validated instruments for risk assessment for PU prevention in LTC facilities. Also, prioritizing nutritional assessments and interventions should be encouraged in LTC facilities, but there is a need to first understand barriers and facilitators.

Implementasi Program Petani Mandiri dalam Meningkatkan Kesejahteraan Petani di Kecamatan Sumberrejo Kabupaten Bojonegoro

This study aims to examine the implementation of the Independent Farmer Program in Sumberrejo Sub-district, Bojonegoro Regency, a flagship priority program of the local government. This program is governed by Regent Regulation Number 43 of 2020 concerning the Second Amendment to Regent Regulation Number 20 of 2019, which amends Regent Regulation Number 48 of 2018 on the Independent Farmer Program. The program seeks to improve farmers' welfare through empowerment and access to agricultural resources. The study's findings indicate that the program faces challenges, such as low farmer awareness and the suboptimal implementation of several initiatives. The research employs a qualitative approach with a case study method, involving in-depth interviews, field observations, and document analysis. Recommendations include enhancing farmer outreach and training, as well as strengthening program monitoring and evaluation to ensure effectiveness and sustainability.

Qualitative system dynamics modelling to support the design and implementation of tuberculosis infection prevention and control measures in South African primary healthcare facilities.

Tuberculosis infection prevention and control (TB IPC) measures are a cornerstone of policy, but measures are diverse and variably implemented. Limited attention has been paid to the health system environment, which influences successful implementation of these measures. We used qualitative system dynamics and group-model-building methods to (1) develop a qualitative causal map of the interlinked drivers of Mycobacterium tuberculosis (Mtb) transmission in South African primary healthcare facilities, which in turn helped us to (2) identify plausible IPC interventions to reduce risk of transmission. Two 1-day participatory workshops were held in 2019 with policymakers and decision makers at national and provincial levels and patient advocates and health professionals at clinic and district levels. Causal loop diagrams were generated by participants and combined by investigators. The research team reviewed diagrams to identify the drivers of nosocomial transmission of Mtb in primary healthcare facilities. Interventions proposed by participants were mapped onto diagrams to identify anticipated mechanisms of action and effect. Three systemic drivers were identified: (1) Mtb nosocomial transmission is driven by bottlenecks in patient flow at given times; (2) IPC implementation and clinic processes are anchored within a staff 'culture of nominal compliance'; and (3) limited systems learning at the policy level inhibits effective clinic management and IPC implementation. Interventions prioritized by workshop participants included infrastructural, organizational and behavioural strategies that target three areas: (1) improve air quality, (2) improve use of personal protective equipment and (3) reduce the number of individuals in the clinic. In addition to core mechanisms, participants elaborated specific additional enablers who would help sustain implementation. Qualitative system dynamics modelling methods allowed us to capture stakeholder views and potential solutions to address the problem of sub-optimal TB IPC implementation. The participatory elements of system dynamics modelling facilitated problem-solving and inclusion of multiple factors frequently neglected when considering implementation.

Indoor Air Quality Assessments in 10 Long-Term Care Facilities during the COVID-19 Pandemic, California, 2021–2023

ObjectivesThis study aimed to assess indoor air quality (IAQ) in long-term care facilities (LTCFs) in California during the COVID-19 pandemic and evaluate their implementation of IAQ best practices described by public health authorities to control respiratory pathogen transmission via inhalation. DesignThis observational study conducted IAQ assessments in a convenience sample of LTCFs to gather qualitative data on the implementation of IAQ best practices. The design included 5 pilot visits to develop a standardized method of data collection and then systematic data collection at 10 facilities. Setting and ParticipantsThe study focused on 10 LTCFs across California, chosen from facilities that responded to flyers advertising free IAQ assessments. Some of the facilities had previously experienced COVID-19 outbreaks affecting residents and staff. MethodsState health department industrial hygienists performed site visits to collect data on each facility's heating, ventilation, and air-conditioning (HVAC) system operation, outdoor air introduction, recirculated air filtration, use of portable air cleaners, and directional airflow in isolation areas to evaluate implementation of IAQ best practices in each of these areas. Qualitative data were obtained through visual inspections and interviews with maintenance personnel. ResultsFindings indicated suboptimal implementation of IAQ best practices across the assessed facilities: no facility operated HVAC systems continuously, 40% had all outdoor air dampers open, 20% used MERV-13 or higher rated filters, 20% used portable air cleaners, and 20% performed directional airflow assessment and management for isolating COVID-19 cases. Conclusions and ImplicationsMost LTCFs assessed were not adhering to IAQ best practices, highlighting a significant opportunity for improvement. IAQ best practices described in this study are achievable with existing systems and are critical for reducing virus transmission through the air in LTCFs. The findings underscore the need for more systematic assessments and improvements in IAQ within LTCFs to protect staff and residents.

Exploring the economic role of cybersecurity in SMEs: A case study of the UK

This study explores the economic role of cybersecurity in Small and Medium Enterprises (SMEs), situating cybersecurity within the framework of merit-goods within the economic theory of market failures and public goods. By examining 240 SMEs across the UK, the empirical findings of this investigation underscore its classification as a merit-good due to its extensive social benefits and the critical gap in its optimal provision. The results confirm the existence of market failure, such as the lack and asymmetry of information regarding cybersecurity, acknowledging the myopia and lack of information within SMEs, leading to suboptimal implementation of cybersecurity. Moreover, the lack of optimal implementation is evidenced by the findings indicating that neither cybersecurity incidents nor cybersecurity impacts in SMEs drive the implementation of cybersecurity. Additionally, we observe that implementation is more focused on control systems than on management systems, which is a significant differentiating factor from large enterprises. The study contributes theoretically by framing cybersecurity as a merit-good, provides managerial insights into SME cybersecurity practices, and emphasizes the importance of nuanced policies to bridge the implementation gap.

Estimating the potential value of MSM-focused evidence-based implementation interventions in three Ending the HIV Epidemic jurisdictions in the United States: a model-based analysis.

Improving the delivery of existing evidence-based interventions to prevent and diagnose HIV is key to Ending the HIV Epidemic in the United States. Structural barriers in the access and delivery of related health services require municipal or state-level policy changes; however, suboptimal implementation can be addressed directly through interventions designed to improve the reach, effectiveness, adoption or maintenance of available interventions. Our objective was to estimate the cost-effectiveness and potential epidemiological impact of six real-world implementation interventions designed to address these barriers and increase the scale of delivery of interventions for HIV testing and pre-exposure prophylaxis (PrEP) in three US metropolitan areas. We used a dynamic HIV transmission model calibrated to replicate HIV microepidemics in Atlanta, Los Angeles (LA) and Miami. We identified six implementation interventions designed to improve HIV testing uptake ("Academic detailing for HIV testing," "CyBER/testing," "All About Me") and PrEP uptake/persistence ("Project SLIP," "PrEPmate," "PrEP patient navigation"). Our comparator scenario reflected a scale-up of interventions with no additional efforts to mitigate implementation and structural barriers. We accounted for potential heterogeneity in population-level effectiveness across jurisdictions. We sustained implementation interventions over a 10-year period and evaluated HIV acquisitions averted, costs, quality-adjusted life years and incremental cost-effectiveness ratios over a 20-year time horizon (2023-2042). Across jurisdictions, implementation interventions to improve the scale of HIV testing were most cost-effective in Atlanta and LA (CyBER/testing cost-saving and All About Me cost-effective), while interventions for PrEP were most cost-effective in Miami (two of three were cost-saving). We estimated that the most impactful HIV testing intervention, CyBER/testing, was projected to avert 111 (95% credible interval: 110-111), 230 (228-233) and 101 (101-103) acquisitions over 20 years in Atlanta, LA and Miami, respectively. The most impactful implementation intervention to improve PrEP engagement, PrEPmate, averted an estimated 936 (929-943), 860 (853-867) and 2152 (2127-2178) acquisitions over 20 years, in Atlanta, LA and Miami, respectively. Our results highlight the potential impact of interventions to enhance the implementation of existing evidence-based interventions for the prevention and diagnosis of HIV.

The Implementation of Aceh Qanun on Halal Labeling for MSMEs in West Aceh Regency

The purpose of this study is to determine the implementation of Aceh Qanun Number 8 of 2016 on the Halal Product Assurance System (The Aceh Qanun on Halal Label) on Micro, Small, and Medium Enterprises (MSMEs) and to understand the supervision of the implementation of the Aceh Qanun on Halal Label in West Aceh Regency. The study method used is empirical juridical, producing descriptive data regarding implementing the Aceh Qanun on Halal Label towards MSMEs in the West Aceh Regency. This study is important because data from the Health Office of West Aceh Regency shows that 30 MSMEs have obtained halal certificates. In comparison, 64 MSMEs do not have halal certificates for their marketed food products. Based on the data, this fact does not comply with the provisions of Article 4 of Law Number 33 of 2014 on Halal Product Assurance (hereinafter referred to as the Halal Product Guarantee Law 2014), which obliges all products traded in Indonesia to have halal certification. This provision is in line with Article 4 of the Aceh Qanun on Halal Label, which states that the Halal Product Assurance System aims to provide protection, peace of mind, and legal certainty to the community in consuming and using Halal and hygienic products for physical and spiritual health. The assurance of halal products refers to legal certainty regarding the halal status of products, proven by halal certificates, halal registration numbers, and halal labels. Many MSMEs in West Aceh do not have halal product certificates, so the objectives of the Aceh Qanun on Halal Label have yet to be well implemented. The suboptimal supervision also influences the suboptimal implementation of the Aceh Qanun on Halal Label. This supervision involves various West Aceh Regency Local Government institutions, such as the Ministry of Religious Affairs and the Health Office. The main constraint is the limited funds allocated for such supervision, resulting in suboptimal halal product supervision for MSMEs in West Aceh.

PPE Education to Reduce the Risk of Workplace Accidents in The Furniture Industry

Occupational safety and health is an important aspect in the industrial world, including the furniture industry. If a company implements the Occupational Health and Safety well, it can reduce the risk of work accidents, thereby increasing work productivity. Work accidents can occur due to workers’ negligence or suboptimal implementation of the Occupational Health and Safety System. To reduce the risk of work accidents, a risk analysis is carried out, which is one part of risk management. One of the risk analyses that can be done is by using the Failure Mode and Effect Analysis (FMEA) method. Risk identification in the furniture industry is based on field reviews, which then assess the severity (S), occurrence rate (O), and detection level (D). Then the assessment results are sorted to determine the highest Risk Priority Number (RPN) value variable. In the furniture production process, there are various potential hazards, with the highest RPN found in the cutting process, where a machine incident occurred with an RPN value of 120. The severity factor is given a value of 6 because the error leads to torn injuries and equipment damage, so it must be handled immediately, and there is the repair of the damage. One effort to reduce the risk of work accidents is to provide PPE at work.

Obstacles to the Implementation of clinical practice guidelines at Mandau District General Hospital.

Highlights:1. Given the suboptimal implementation of clinical practice guidelines at Mandau District General Hospital, it is important to conduct research on potential obstacles to this problem.2. The findings of this study can encourage hospitals to develop and apply effective clinical practice guidelines while also addressing the obstacles to their implementation. Abstract Clinical practice guidelines are procedures followed by physicians to optimize healthcare services and achieve more effective outcomes. Conducted in October 2022, this study aimed to analyze the factors that hinder the implementation of clinical practice guidelines among physicians at Mandau District General Hospital, Bengkalis, Indonesia. This study used an analytical survey design and a cross-sectional approach. This study included all 85 individuals who were employed as general practitioners at the Mandau District General Hospital. The data were subjected to univariate, bivariate, and multivariate analyses. The independent t-test was used in the data analysis, with a value of p<0.05 considered significant. The results showed that there was an association between the implementation of clinical practice guidelines and several variables, including the levels of ability in recognizing and explaining clinical pictures of diseases (p=0.008), diagnosing diseases (p=0.004), carrying out initial management (p=0.000), and carrying out independent and directed management (p=0.001). Upon conducting the follow-up analysis on logistic regression, it was found that the variables that were associated with the implementation of clinical practice guidelines were the ability to carry out initial management (p=0.000, OR=65.512, 95% CI=22.048–98.835). In conclusion, physicians' insufficient ability to perform initial management hinders the implementation of clinical practice guidelines. This study suggests incorporating the findings as input in the evaluation and development of training for physicians on the implementation of clinical practice guidelines.

Modern Approaches to Sustainable Agriculture

The global population is increasing at an alarming rate, presenting a formidable challenge in meeting the escalating demand for food. This concern has garnered the attention of agrarian scientists and policymakers worldwide. The present population's rapid utilization of natural resources raises apprehensions about compromising the entitlement of future generations to access nutritious food and clean air. The multifaceted causes of this challenge can be delineated, with a prominent factor identified as the deficient or suboptimal implementation of innovative approaches and practices for sustainable agriculture. These contemporary strategies encompass climate-smart agriculture (CSA), precision farming, sustainable intensification, biodynamic agriculture, regenerative agriculture, organic farming, agroecology, integrated nutrient management (INM), integrated pest management, conservation agriculture, aquaponics, biotechnology, artificial intelligence, and big data analytics. It discusses the potential of these approaches to enhance resource efficiency, optimize yield, minimize environmental impact, and address challenges related to food security and climate change resilience. Empirical evidence supports the assertion that the adoption of these approaches and practices serves as a safeguard for agricultural sustainability.

Truthfulness as the basis for ethical safeguards in deceptive research: An interview study with researchers

ABSTRACT Ethical safeguards such as debriefing are often recommended or required for research studies in which participants are deceived. However, existing guidance on these safeguards seems insufficiently coherent and precise, which may be associated with their suboptimal implementation in practice. This study aimed to contribute to a more coherent and precise framework of ethical safeguards in deceptive studies through semi-structured interviews with a diverse sample of 24 researchers who had significant experience with deception. Interviewees discussed which ethical safeguards they implemented and how, as well as their relation to the notion of truthfulness (i.e., the intentional communication of true information). Moreover, interviewees provided a variety of reasons for and against implementing these safeguards, as well as how these reasons varied with the particular context of a study. Overall, the current study contributes to a more coherent and precise understanding of ethical safeguards in deceptive research that could be useful for guiding researchers and ethics reviewers in their ethical decision-making, although certain imprecisions and incoherent aspects remain in need of further investigation and normative reflection.

The impacts of undetected nonadherence in phase II, III and post-marketing clinical trials: An overview.

This research aims to provide an overview of the consequences of undiagnosed nonadherence (noninitiation, suboptimal implementation, nonpersistence) in randomized clinical trials (RCTs). This research was conducted by combining a literature review and qualitative semistructured interviews with key opinion leaders. Based on this groundwork, the consequences of undiagnosed nonadherence in RCTs were summarized and reported in a figure. This study focused on phases II, III and post-marketing in ambulatory settings across a variety of therapeutic areas and indications. Various consequences of nonadherence in RCTs were investigated. In phase II, drug efficacy may be underestimated, variability in the outcomes may be high and a distorted picture of side effects could be reported, resulting in an uncertain impression of the investigational product's profile and complicating decision-making. The sponsor may need to increase the sample size of the upcoming phase III study to improve its power, representing additional costs, or even terminate the study. In phase III, similar phenomena may be observed, making demonstration of efficacy to the regulatory bodies more difficult. Lastly, after commercialization, a distortion in pharmacometrics may occur: the drug may underperform, prescriptions may be refilled less often than expected or extra expenses may be incurred by the payers. This can result in post-marketing dose reduction, new competitors coming into the market and, eventually, product withdrawal. This research highlighted the many potential adverse consequences of undiagnosed nonadherence in RCTs, including additional costs. Collecting accurate data appeared to be crucial for decision-making throughout the drug development process.

Assessment of Clinical Pharmacy Service Standards Implementation at Bhayangkara Hospital Level III in Kendari

One crucial component influencing the successful implementation of healthcare efforts in hospitals is the pharmaceutical system. Pharmaceutical services play a pivotal role in supporting quality healthcare, as outlined in Permenkes Number 72 of 2016, which delineates Pharmaceutical Service Standards in Hospitals. However, preliminary survey results conducted by the author indicate suboptimal implementation of these standards in 2021. Consequently, the researchers embarked on a study aimed at analyzing the implementation of pharmaceutical service standards at the Pharmacy Installation of Bhayangkara TK III Kendari Hospital. This research is scheduled to be conducted in January - February 2024. This study employed an exploratory qualitative method involving 9 informants at the pharmaceutical installation of Bhayangkara Hospital TK III Kendari. Data collection was conducted using interview guidelines, followed by transcription, introduction to interviews, coding, analysis, interpretation, and data mapping into a matrix. The implementation of health minister regulation Number 72 of 2016 regarding clinical pharmaceutical service standards at the Pharmacy Installation of Bhayangkara TK III Kendari Hospital can be summarized as follows: assessment and prescription services were carried out effectively, tracing the history of drug use was partially implemented well, drug reconciliation was partially implemented, drug information services (PIO) were partially implemented well, but some items such as counseling, visitation, monitoring drug therapy (PTO), monitoring drug side effects (MESO), evaluating drug use (EPO), dispensing sterile preparations, and monitoring drug levels in the blood (PKOD) were not implemented optimally. Overall, the implementation of pharmaceutical service standards according to health minister regulation Number 72 of 2016 at the pharmaceutical installation of Bhayangkara Hospital TK III Kendari has not been optimal. Keywords: Pharmaceutical service standards, Health minister regulation, Pharmacist, Hospital

Eco-centric Theory: Environmental Conscious Constitution

Many national constitutions incorporate elements of environmental constitutionalism, yet the absence of these provisions in some countries indicates suboptimal implementation. This normative juridical research investigated the key factors that influence a country's decision to embrace environmental constitutionalism based on historical case studies of countries that have amended their constitutions in this area, underscoring the contextual background as a pivotal influence on the constitutional amendment process. This environment inevitably shaped the amendment process, exposing it to a variety of influential factors. The research concluded by emphasizing critical strategies necessary for successful constitutional amendments, including aligning environmental protection with national values, leveraging crises, addressing economic factors thoroughly, and garnering the requisite political support from both the public and politicians.

Using social exchange theory to predict residents’ perspective on factors influencing tourism development in Pokhara

<p>Tourism development involves sustainably creating and managing destinations, products, and services that balance economic, social, and environmental factors while meeting visitor and local community expectations. The purpose of this study is to understand the local people’s perception of tourism development in Pokhara, Nepal. An explanatory research design is used to show the cause-and-effect relationship between variables. The research was conducted using Social Exchange Theory (SET). The data was examined using both descriptive and inferential statistics. The sample size was determined to be 403 using non-probability sampling. A structured questionnaire was designed to collect the data using the KOBO toolbox. Furthermore, the Structure Equation Model (SEM) was the analytical approach used to process the data. Results reveal a noteworthy relationship between independent variables (such as cultural impact, social impact, environmental impact, and economic impact) and dependent variables (support for tourism development). The major challenges in tourism development have been identified, including deficient infrastructure, suboptimal tourism strategies and implementation, and inadequate government oversight. Effective mitigation of these challenges necessitates the implementation of appropriate infrastructure and development initiatives, proficient governmental management, and a concerted effort to augment the quantity and quality of hotels and accommodations. The significance of cultural, social, environmental, and economic impact cannot be understated or overstated in the context of tourism development. Addressing major challenges, the study suggests focused efforts in enhancing infrastructure and development, adopting effective management practices, and augmenting the quantity and quality of hotels and accommodations.</p>