bluuebunny/crossref_metadata_2025_split huggingface dataset:
KAITAN BANTUAN LANGSUNG MASYARAKAT (BLM) PENGEMBANGAN USAHA AGRIBISNIS PERDESAAN (PUAP) DENGAN TINGKAT KEBERHASILAN KEGIATAN USAHATANI DI GAPOKTAN KOTA JAMBI
Authors: Trioni Nuri , Hamid Ernawati , Fitri Yanuar 
Published: May 2018

Penelitian ini dilakukan untuk mengetahui gambaran umum dan kegiatan gabungan kelompok tani pada pengelolaan dana pengembangan usaha agribisnis perdesaan, serta tingkat keberhasilan kegiatan usahatani anggota gabungan kelompok tani pada pengembangan usaha agribisnis perdesaan. Metode penarikan sampel yang digunakan adalah metode cluster sampling. Analisis data menggunakan analisis deskriptif yang di ukur untuk menganalisis pendapatan masing-masing komoditi pada kegiatan pengembangan usaha agribisnis perdesaan. Hasil pembahasan diketahui bahwa modal usaha yang disalurkan melalui gabungan kelompok tani yaitu sebesar Rp. 100 juta rupiah untuk dimanfaatkan anggota gabungan kelompok tani pada sarana produksi pertanian, kegiatan gabungan kelompok tani pada pengelolaan dana pengembangan usaha agribisnis perdesaan yaitu melalui penyusunan rencana usaha anggota, rencana usaha kelompok, rencana usaha bersama yang bertujuan untuk memperoleh bantuan langsung masyarakat dengan memenuhi syarat dokumen administrasi yang akan di periksa oleh tim teknis pengembangan usaha agribisnis perdesaan, dan tingkat keberhasilan kegiatan usahatani anggota gabungan kelompok tani pada pengembangan usaha agribisnis perdesaan dinilai dari tercapainya keperluan sarana produksi pertanian yang dilihat dari keadaan kelompok tani, luas lahan petani, biaya produksi yang dikeluarkan, produksi usahatani, penerimaan usahatani, serta meningkatnya pendapatan petani. Rata-rata pendapatan anggota gabungan kelompok tani di Kelurahan Lingkar Selatan yaitu sebesar Rp. 1.939.322,53 setiap musimnya dan di Kelurahan Mudung Laut rata-rata pendapatan anggota gapoktan yaitu sebesar Rp. 3.948.505,22 tiap musimnya.
Kata Kunci : Pengembangan Usaha Agribisnis Perdesaan (PUAP), Anggota Gapoktan, Kegiatan usahatani, Pendapatan
Hubungan Kepercayaan Petani Terhadap Penjualan Bahan Olah Karet Kepada Pedagang Pengumpul di Kabupaten Muaro Jambi Provinsi Jambi
Authors: Amar Abu , Murdy Saad , Sardi Idris 
Published: May 2018

Kepercayaan merupakan hubungan antara dua belah pihak atau lebih yang mengandung harapan yang saling menguntungkan satu pihak atau kedua belah pihak melalui interaksi sosial. Kepercayaan pada dasarnya terikat, bukan kepada resiko namun kepada berbagai kemungkinan. Kepercayaan pada penelitian ini terjalin antara petani kepada pedagang pengumpul. Beberapa faktor yang mempengaruhi petani menjual bahan olah karet kepada pedagang pengumpul yaitu pengetahuan petani tentang harga, hutang petani, modal pedagang pengumpul dan hubungan kekeluargaan. Penelitian ini bertujuan untuk mengetahui hubungan kepercayaan petani terhadap penjualan bahan olah karet kepada pedagang pengumpul di Kabupaten Muaro Jambi. Pemilihan lokasi dilakukan secara purposive dengan mempertimbangkan bahwa Kabupaten Muaro Jambi merupakan salah satu sentral produksikaret di Provinsi Jambi namun hanya memilki satu pasar lelang dan sebagian besar petani menjual bahan olah karet kepada pedagang pengumpul. Jenis data dalam penelitian ini meliputi data primer dan data skunder. Data di analisis secara deskriptif melalui Tabel distribusi frekuensi. Uji analisis yang digunakan adalah uji dengan motode Chi- Square (X2). Hasil penelitian menunjukkan : 1) Kepercayaan petani yang terdiri dari beberapa faktoryang mempengaruhi seperti pengetahuan petani tentang harga, hutang petani kepada pedagang pengumpul, modal pedagang pengumpul dan hubungan kekerabatan petani kepada pedagang pengumpul dengan kategori kuat sebesar 52,53 persen. 2) Penjualan bahan olah karet kepada pedagang pengumpul kategori tinggi sebesar 54,54 persen. 3) Terdapat hubungan antara kepercayaan petani terhadap penjualan bahan olah karet kepada pedagang pengumpul secara nyata.
Kata kunci : Kepercayaan Petani, Penjualan Bahan Olah Karet, Pedagang Pengumpul
ANALISIS KINERJA KEUANGAN KOPERASI UNIT DESA DI KECAMATAN TEBING TINGGI KABUPATEN TANJUNG JABUNG BARAT
Authors: Gavinanda Ayu Primadiptha , Alamsyah Zulkifli , Nainggolan Saidin 
Published: May 2018

Penelitian ini bertujuan untuk mengetahui keadaan keuangan, kinerja keuangan dan manfaat yang dirasakan anggota Koperasi Unit Desa di Kecamatan Tebing Tinggi. Penelitian ini dilakukan pada KUD Suka Makmur, KUD Sawit Mandiri, KUD Karya Mandiri, KUD Karya Tani dan KUD Harapan Makmur dengan pendekatan rasio keuangan dan mendeskriptifkan manfaat yang dirasakan anggota. Kondisi keuangan menunjukkan bahwa KUD Suka Makmur, KUD Sawit Mandiri, KUD Karya Mandiri, dan KUD Harapan Makmur memiliki modal lebih besar dibandingkan dengan hutang yang ditanggung. Sedangkan KUD Karya Tani memiliki hutang yang lebih besar dibandingkan dengan modal yang dimiliki. Dari hasil perhitungan likuditas KUD di Kecamatan Tebing Tinggi mampu menjamin hutang yang dimiliki dengan aktiva lancar dan persediaan, namun KUD tidak mampu menjamin hutang dengan kas dan bank, karena KUD memiliki saldo kas yang kecil. Dari hasil perhitungan rasio solvabilitas menyatakan KUD mampu memenuhi kewajiban jangka panjangnya.Dari hasil perhitungan profitabilitas KUD mampu menghasilkan laba dari usaha yang dijalankan. Dari perhitungan rasio aktivitas KUD memiliki nilai perputaran dana pada persediaan, aktiva tetap dan dana pada piutang yang baik. Peran koperasi bertujuan untuk mensejahterakan anggota dengan memberikan manfaat sosial dan ekonomi. Berdasakan hasil penelitian KUD telah memberikan manfaat yang dapat dirasakan oleh anggota dengan baik, namun manfaat yang diberikan KUD Harapan Makmur masih kurang dirasakan oleh anggota, karena kurangnya terjalinnya komunikasi dengan anggota, kurangnya pelayanan, barang-barang yang dijual masih terbatas dan pembagian SHU yang dibagikan belum meringankan beban kebutuhan anggota.
Kata Kunci : Koperasi Unit Desa, Kinerja Keuangan, Manfaat Sosial dan Ekonomi.
Positional and dimensional temporomandibular joint changes after correction of posterior crossbite in growing patients:A systematic review
Authors: Ellabban Mohamed T. , Abdul-Aziz Ahmed I. , Fayed Mona M. Salah , AboulFotouh Mai H. , Elkattan Ehab S. , Dahaba Mushira M. 
Published: May 2018

ABSTRACT

Objective:
To elucidate the positional and dimensional temporomandibular joint (TMJ) changes after correction of posterior crossbite in growing patients.

Materials and Methods:
A systematic unrestricted search was done in six databases until June 27, 2017. A manual search in the reference lists of the included studies and gray literature was also performed. The eligibility criteria included randomized controlled trials and prospective nonrandomized controlled clinical trials and a sample of growing subjects with posterior crossbite that required maxillary expansion. Risk of bias assessment was performed using Cochrane's Risk of Bias Tool. The literature search, study inclusion, risk of bias assessment, evaluation of quality of evidence (GRADE), and data extraction were performed by two reviewers independently.

Results:
Only two articles were finally eligible to be included in the qualitative analysis. Both studies were RCTs and were assessed as having unclear risk of bias. Meta-analysis was not possible since one study used cone-beam computed tomography as an assessment tool while the other used ultrasonography. One study reported significant reduction in the condylar positional difference between centric and habitual occlusion in the treatment group, while no spontaneous correction of condylar asymmetric position occurred in the control group. The other study reported minor changes of condylar position in both treatment and control groups.

Conclusions:
The current available data provide insufficient and weak evidence to form a solid and firm conclusion. There is poor, very low-quality evidence regarding the positional and dimensional effects of posterior crossbite correction on the TMJs.
Aspects of Multicomponent Integrated Care Promote Sustained Improvement in Surrogate Clinical Outcomes: A Systematic Review and Meta-analysis
Authors: Lim Lee Ling , Lau Eric S.H. , Kong Alice P.S. , Davies Melanie J. , Levitt Naomi S. , Eliasson Björn , Aguilar-Salinas Carlos A. , Ning Guang , Seino Yutaka , So Wing Yee , McGill Margaret , Ogle Graham D. , Orchard Trevor J. , Clarke Philip , Holman Rury R. , Gregg Edward W. , Gagliardino Juan José , Chan Juliana C.N. 
Published: May 2018

OBJECTIVE
The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes.

RESEARCH DESIGN AND METHODS
We searched PubMed and Ovid MEDLINE (January 2000–August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes. Two reviewers extracted data and appraised the reporting quality.

RESULTS
In a meta-analysis of 181 trials (N = 135,112), random-effects modeling revealed pooled mean differences in HbA1c of −0.28% (95% CI −0.35 to −0.21) (−3.1 mmol/mol [−3.9 to −2.3]), in systolic blood pressure (SBP) of −2.3 mmHg (−3.1 to −1.4), in diastolic blood pressure (DBP) of −1.1 mmHg (−1.5 to −0.6), and in LDL cholesterol (LDL-C) of −0.14 mmol/L (−0.21 to −0.07), with greater effects in patients with LDL-C ≥3.4 mmol/L (−0.31 vs. −0.10 mmol/L for &lt;3.4 mmol/L; Pdifference = 0.013), studies from Asia (HbA1c −0.51% vs. −0.23% for North America [−5.5 vs. −2.5 mmol/mol]; Pdifference = 0.046), and studies lasting &gt;12 months (SBP −3.4 vs. −1.4 mmHg, Pdifference = 0.034; DBP −1.7 vs. −0.7 mmHg, Pdifference = 0.047; LDL-C −0.21 vs. −0.07 mmol/L for 12-month studies, Pdifference = 0.049). Patients with median age &lt;60 years had greater HbA1c reduction (−0.35% vs. −0.18% for ≥60 years [−3.8 vs. −2.0 mmol/mol]; Pdifference = 0.029). Team change, patient education/self-management, and improved patient-provider communication had the largest effect sizes (0.28–0.36% [3.0–3.9 mmol/mol]).

CONCLUSIONS
Despite the small effect size of multicomponent integrated care (in part attenuated by good background care), team-based care with better information flow may improve patient-provider communication and self-management in patients who are young, with suboptimal control, and in low-resource settings.
Higher Plasma Methylglyoxal Levels Are Associated With Incident Cardiovascular Disease and Mortality in Individuals With Type 2 Diabetes
Authors: Hanssen Nordin M.J. , Westerink Jan , Scheijen Jean L.J.M. , van der Graaf Yolanda , Stehouwer Coen D.A. , Schalkwijk Casper G. ,   SMART Study Group, Algra Ale , van der Graaf Yolanda , Grobbee Rick D.E. , Rutten Guy E.H.M. , Visseren Frank L.J. , de Borst Gert Jan , Kappelle Jaap L.J. , Leiner Tim , Nathoe Hendrik M. 
Published: May 2018

OBJECTIVE
Methylglyoxal (MGO) is a reactive dicarbonyl compound and a potential key player in diabetic cardiovascular disease (CVD). Whether plasma MGO levels are associated with CVD in type 2 diabetes is unknown.

RESEARCH DESIGN AND METHODS
We included 1,003 individuals (mean ± SD age 59.1 ± 10.5 years, 69.3% male, and 61.6% with prior CVD) with type 2 diabetes from the Second Manifestations of ARTerial disease cohort (SMART). We measured plasma MGO levels and two other dicarbonyls (glyoxal [GO] and 3-deoxyglucosone [3-DG]) at baseline with mass spectrometry. Median follow-up of CVD events was 8.6 years. Data were analyzed with Cox regression with adjustment for sex, age, smoking, systolic blood pressure, total cholesterol, HbA1c, BMI, prior CVD, and medication use. Hazard ratios are expressed per SD Ln-transformed dicarbonyl.

RESULTS
A total of 287 individuals suffered from at least one CVD event (n = 194 fatal events, n = 146 myocardial infarctions, and n = 72 strokes); 346 individuals died, and 60 individuals underwent an amputation. Higher MGO levels were associated with total (hazard ratio 1.26 [95% CI 1.11–1.42]) and fatal (1.49 [1.30–1.71]) CVD and with all-cause mortality (1.25 [1.11–1.40]), myocardial infarction (1.22 [1.02–1.45]), and amputations (1.36 [1.05–1.76]). MGO levels were not apparently associated with stroke (1.03 [0.79–1.35]). Higher GO levels were significantly associated with fatal CVD (1.17 [1.00–1.37]) but not with other outcomes. 3-DG was not significantly associated with any of the outcomes.

CONCLUSIONS
Plasma MGO and GO levels are associated with cardiovascular mortality in individuals with type 2 diabetes. Influencing dicaronyl levels may therefore be a target to reduce CVD in type 2 diabetes.
Clinical Effectiveness of a Resin-modified Glass Ionomer Cement and a Mild One-step Self-etch Adhesive Applied Actively and Passively in Noncarious Cervical Lesions: An 18-Month Clinical Trial
Authors: Jassal M , Mittal S , Tewari S 
Published: May 2018

SUMMARY

Objectives:
To evaluate the clinical effectiveness of two methods of application of a mild one-step self-etch adhesive and composite resin as compared with a resin-modified glass ionomer cement (RMGIC) control restoration in noncarious cervical lesions (NCCLs).

Methods:
A total of 294 restorations were placed in 56 patients, 98 in each one of the following groups: 1) G-Bond active application combined with Solare-X composite resin (A-1SEA), 2) G-Bond passive application combined with Solare-X composite resin (P-1SEA), and 3) GC II LC RMGIC. The restorations were evaluated at baseline and after six, 12, and 18 months according to the FDI criteria for fractures/retention, marginal adaptation, marginal staining, postoperative sensitivity, and secondary caries. Cumulative failure rates were calculated for each criterion at each recall period. The effect of adhesive, method of application, and recall period were assessed. The Kruskal-Wallis test for intergroup comparison and Friedman and Wilcoxon signed ranks tests for intragroup comparison were used for each criterion (α=0.05).

Results:
The retention rates at 18 months were 93.26% for the A-1SEA group, 86.21% for the P-1SEA group, and 90.91% for the RMGIC group. The active application improved the retention rates compared with the passive application of mild one-step self-etch adhesive; however, no statistically significant difference was observed between the groups. Marginal staining was observed in 13 restorations (1 in A-1SEA, 4 in P-1SEA, and 8 in RMGIC) with no significant difference between the groups. The RMGIC group showed a significant increase in marginal staining at 12 and 18 months from the baseline. There was no significant difference between the groups for marginal adaptation, secondary caries, or postoperative sensitivity.

Conclusion:
Within the limitations of the study, we can conclude that mild one-step self-etch adhesive followed by a resin composite restoration can be an alternative to RMGIC with similar retention and improved esthetics in restoration of NCCLs. Agitation could possibly benefit the clinical performance of mild one-step self-etch adhesives, but this study did not confirm that the observed benefit was statistically significant.
PARTISIPASI PETANI PADI DALAM PELAKSANAAN PROGRAM PENINGKATAN PRODUKSI BERAS NASIONAL (P2BN) DI KECAMATAN SEPUTIH MATARAM LAMPUNG TENGAH
Authors: Yama I Made Thresna , Gitosaputra Sumaryo , Hasanuddin Tubagus 
Published: May 2018

This study aims to find out the performance of the P2BN Program, to find out the level of rice farmers’ participation in the P2BN Program and to study the factors that influence the rice farmer participation in the P2BN Program. The research method used is a survey. The location is determined intentionally in subdistricts Seputih Mataram Central Lampung regency in November - December 2016. Sample units are 95 rice farmers. The analyses of data used descriptive method and used Rank-Spearman correlation to test the hypothesis. The results of the research showed that: the performance of P2BN Program in planning, implementation, profit utilization, and evaluation in Seputih Mataram Subdistrict of Central Lampung Regency is in high classification, The level of rice farmer participation in P2BN Program is in middle classification. Factors significantly related to farmers’ participation in implementation of P2BN Program are knowledge on P2BN Program and social support. Meanwhile, the large of arable land, income level, and facility received by farmers do not have relationship with their participation in the P2BN Program.Key words: P2BN Program, participation, Seputih Mataram
PARTISIPASI PETANI DALAM PROGRAM UPSUS PAJALE DI KECAMATAN RAWA JITU SELATAN KABUPATEN TULANG BAWANG
Authors: Maulidiawati Destika , Nikmatullah Dewangga , Prayitno Rio Tedi 
Published: May 2018

This study aims to examine the implementation, the level of farmers’ participation, and factors related to the level of participation in the Upsus Pajale program in South Rawa Jitu Sub-District of Tulang Bawang Regency. This study data was collected in January-February 2017 by envolving 54 farmers’ respondents. This study was conducted by survey method and its data was analyzed descriptively and statistically by Rank Spearman Correlation. The results showed that factors related to farmers’ participation in Upsus Pajale Program were production, group communication behavior and intensity of program socialization. Farmers' participation in planning activity was mostly (59,26%) in moderate category, participation in implementation activity was mostly (83,3%) in high category, participation in monitoring and evaluation activities was low (46,3%) and participation in the utilization of development outcomes was high (100%). In overall, most of farmers' participation in Upsus Pajale program in Rawa Jitu Selatan sub District wass moderate (48,15%) .Key words: farmer, participation, Upsus Pajale
ANALISIS PERBEDAAN KINERJA PETANI KAKAO MITRA DAN NON MITRA DENGAN PT OLAM INDONESIA DI KABUPATEN PESAWARAN
Authors: Putri Rahmi Eka , Abidin Zainal , Kasymir Eka 
Published: May 2018

This research intended to differentiate the productivity and cocoa farming revenue of partner farmers and non-partner farmers in in Sungai Langka and Wiyono villages of Pesawaran district. The research was conducted by survey method in which data was collected in January 2017 and analyzed by descriptive quantitative method. The locations of this research were chosen by gradual sampling. This research envolving all 54 cocoa farmers as respondents in that villages. The data was analyzed by analysis tools of difference and farming revenue. The results showed that based on the analysis of difference there was no difference in cocoa productivity between partner farmers and non-partner farmers; whereas, there was difference in cocoa farming revenue between partner farmers and non-partner farmers Key words: cocoa, farmers, non-partner, partner
ANALISIS KINERJA PELAYAN KOPERASI KEPADA ANGGOTA DAN STRATEGI PENGEMBANGANNYA (STUDI KASUS KUD USAHA BERSAMA DI KABUPATEN LAMPUNG UTARA)
Authors: Sijabat Winda Verawati , Widjaya Sudarma , Adawiyah Rabiatul 
Published: May 2018

This research aimed to analyze the economic benefit the members received from KUD Usaha Bersama (Usaha Bersama Village Unit Cooperatives) and the cooperatives’ economic benefit contribution to its members’ household income, the household income of the cooperatives’ members, and to develop an alternative strategy of developing KUD Usaha Bersama further. This research was taken place in KUD Usaha Bersama in Trimodadi Village of Abung Selatan Sub District of Lampung Utara Regency selected purposively. This research employed case study method. Data of this research was collected in March 2016. The data related to cooperatives was obtained from cooperatives’ administrators, while that related to operation performance was obtained from 72 cooperatives’ members as the respondents selected by simple random sampling technique. The results showed that the economic benefit the members received from cooperatives were still relatively low, in which the contribution of such the economic benefit on the members’ household income was small in percentage. The household income of KUD Usaha Bersama members belonged to low category based on Indonesian National Revenue Standar. the strategy that could be taken for developing KUD Usaha Bersama was growth strategy including optimizing the capital circulation by means of utilizing the community feeling helped with the presence of cooperatives, using many business units corresponding to the community’s need in order to help the community by the presence of cooperatives, and optimizing the capital circulation by utilizing more modern technology. Key words: development strategy, KUD, service performance
MODIFIKASI DAN UJI KINERJA MESIN PEMARUT SAGU TIPE SILINDER
Authors: Thoriq Ahmad , Sutejo Agus 
Published: May 2018

Pada penelitian sebelumnya terungkap bahwa pengguna mesin pemarut sagu tipe TPB 01 di Papua mengeluhkan kesulitan mengencangkan sabuk v-belt, adanya kontak mata parut dengan landasan pada bagian pemasukan batang sagu dan banyaknya bagian batang sagu yang tidak terparut sempurna. Penelitian ini bertujuan untuk memperbaiki kinerja mesin pemarut sagu tipe TPB 01 melalui modifikasi beberapa bagian mesin. Metode yang digunakan pada penelitian ini yaitu melalui pendekatan rancangan teknik yang terdiri atas indentifikasi masalah, perumusan konsep modofikasi, gambar teknik, uji fungsional dan uji kinerja. Berdasarkan identifikasi masalah, bagian mesin yang dimodifikasi adalah memindahkan tenaga penggerak ke dudukan yang terletak di bagian samping mesin dan menambahkan lempengan nilon 5 mm pada landasan bagian pemasukan. Mata parut akan kontak dengan nilon namun karena karakteristik teknik dari nilon yang lebih lunak dibandingkan dengan mata parut menyebabkan nilon terkikis dan membentuk alur mata parut. Hasil pengujian mesin hasil modifikasi menunjukkan kapasitas pemarutan sebesar 571,15 kg/jam dengan efesiensi pemarutan sebesar 95,32%, tingkat kehilangan empulur sagu berupa parutan yang tertinggal pada mesin sebesar 4,68% dan tidak terdapat batang sagu yang tidak terparut.
Lääkärit ja hoitajat parempien tietojärjestelmien kehittämistyössä: kyvykkäät ja innokkaat käyttäjät alihyödynnettyinä
Authors: Martikainen Susanna , Kotila Jaana , Kaipio Johanna , Lääveri Tinja 
Published: May 2018

Loppukäyttäjien osallistuminen potilastietojärjestelmien kehittämiseen on keskeistä, jotta järjestelmiä voidaan kehittää heidän tarpeitaan vastaaviksi ja työtehtäviin sopiviksi. Sairaanhoitajien ja lääkärien osallistumista käyttämiensä tietojärjestelmien kehittämistyöhön selvitettiin valtakunnallisten kyselytutkimusten avulla. Sairaanhoitajien aineisto kerättiin keväällä 2017. Lääkärien kyselytutkimus toteutettiin samoin keväällä 2017 ja lisäksi vuosina 2014 ja 2010, tosin vuonna 2017 lääkäreiltä ei kysytty kehittämiseen osallistumisen tavoista.
Kyselyyn vastanneista sairaanhoitajista 46 % ja lääkäreistä 49 % kertoi osallistuneensa tietojärjestelmien kehittämistyöhön. Sairaanhoitajista 21 % oli valmiita osallistumaan kehittämisryhmiin ja vain 20 % ei ollut lainkaan kiinnostuneita osallistumaan; vuoden 2014 kyselyssä lääkäreillä vastaavat osuudet olivat 18 % ja 16 %. Ohjelmistotoimittajien ei koettu olevan kiinnostuneita loppukäyttäjien näkemyksistä eikä kehittämisehdotuksia toteutettu toivotulla tavalla eikä ripeydellä. Verrattuna vuosiin 2010 ja 2014 lääkärien arviot eivät olleet muuttuneet positiivisemmiksi.
Loppukäyttäjistä suuri osa olisi halukkaita osallistumaan kehittämistyöhön jollakin tavalla, mutta ohjelmistokehitys ei ole toistaiseksi löytänyt parhaita tapoja heidän osallistumisensa mahdollistamiseen. On ilmeistä, että loppukäyttäjät eivät koe pystyvänsä vaikuttamaan ohjelmistokehitykseen toivotulla tavalla. Osallistamisen on myös oltava mahdollista osana jokapäiväistä työtä. Terveydenhuollon organisaatioiden on tunnistettava kehittämistyöhön osallistumisen merkitys ja mahdollistettava esimerkiksi tietojärjestelmälääkärien ja -hoitajien urapolut. Tärkeää on, että tietojärjestelmiä kehittävien lääkäreiden ja sairaanhoitajien kliininen työ jatkuu tietojärjestelmien kehittämisen rinnalla, jotta näkemys työhön, missä järjestelmiä käytetään, säilyy.