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Umi Nur Khamidah; Putri Nur Fadhila; Dian Eka Puspitasari; Mualimin Mualimin

Dinamika Pembelajaran : Jurnal Pendidikan dan bahasa 2026 Lembaga Pengembangan Kinerja Dosen

This study examines the strategic role of management psychology in enhancing educational institution quality through optimizing teacher performance. Employing a qualitative descriptive approach via library research—analyzing recent journals, books, and sources from 2021–2026—data were processed using content analysis techniques, encompassing systematic identification, categorization, and interpretation of prior findings to reveal patterns, relationships, and research gaps. Results indicate that psychological factors such as work motivation, mental well-being, supportive leadership, and conducive work climate significantly shape teachers' behaviors and performance, fostering effective and sustainable learning environments. Integrating management psychology principles proves essential for holistic human resource management in education, offering practical implications for school leaders' policies to build high-quality educational systems. In addition, the study emphasizes that consistent professional development and emotional support systems for teachers further strengthen institutional effectiveness and improve instructional outcomes. Therefore, management psychology serves as a fundamental framework in aligning organizational goals with teacher well-being and performance enhancement in educational settings.

Kristina Maharani

Publikasi Hasil Pengabdian dan Kegiatan Masyarakat 2026 Asosiasi Periset Bahasa Sastra Indonesia

The postpartum period is a critical phase in which mothers experience physiological and psychological recovery. Bengkung, a traditional abdominal binding cloth, is commonly used by Indonesian postpartum mothers, but inappropriate application may cause discomfort and may not support recovery optimally. This community service program aimed to improve postpartum mothers' knowledge and skills regarding safe and appropriate bengkung use. The activity was conducted through counseling, demonstration, guided practice, and evaluation using a one-group pre-test and post-test approach involving 30 postpartum mothers at a community-based maternal health service setting. The educational content covered postpartum physiological changes, indications and contraindications, safe binding principles, hygiene, duration of use, warning signs, and when to seek professional care. The evaluation showed an increase in good knowledge from 26.7% before education to 86.7% after education, and correct practice skills increased from 20.0% to 83.3%. Participants also reported better understanding of avoiding overly tight binding, maintaining breathing comfort, and discontinuing use when pain, shortness of breath, excessive bleeding, or wound problems occur. This activity indicates that structured education and demonstration can strengthen postpartum self-care and support safer integration of traditional practices into maternal health services.

Mohd Fauzan Azmi

SABER : Jurnal Teknik Informatika, Sains dan Ilmu Komunikasi 2026 STIKes Ibnu Sina Ajibarang

Mental health issues among university students have become a growing concern, driven by academic pressures, career uncertainties, and complex social transitions. However, a large proportion of students remains reluctant to seek professional psychological support due to social stigma and limited access to institutional counseling services. This study proposes the design and implementation of an Android-based chatbot application that integrates mood tracking and sentiment analysis to continuously monitor the emotional states of university students. The system employs a fine-tuned RoBERTa (Robustly Optimized BERT Pretraining Approach) model trained on the EmoContext conversational dataset (SemEval-2019 Task 3), comprising 30,160 labeled three-turn dialogue instances across four emotion classes: angry, happy, sad, and others. The model was fine-tuned for four epochs using the AdamW optimizer with a learning rate of 2e-5 and a maximum sequence length of 128 tokens. Evaluation on a held-out validation set of 6,032 samples yielded an overall accuracy of 88.28%, a macro-average F1-score of 0.87, and a weighted-average F1-score of 0.88. Per-class F1-scores were 0.89 (angry), 0.83 (happy), 0.91 (others), and 0.86 (sad). The classified emotion is transmitted in real time to the chatbot response logic, which generates empathetic replies and personalized relaxation recommendations based on the detected mood. Primary data collection through questionnaires and interviews with 62 and 19 university students respectively confirmed the need for accessible digital mental health support. The results demonstrate that RoBERTa-based fine-tuning on conversational data provides a reliable foundation for real-time emotion-aware mental health chatbot systems.

Wilda Shilviyah Andiyanti; Fairuz Meita Aurelia

Jurnal Penelitian Manajemen dan Inovasi Riset 2026 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

Employee engagement is critical to organizational performance, employee well-being, and long-term sustainability. In hybrid work contexts, generational differences have become increasingly evident, particularly between Generation Y and Generation Z employees. Generation Y tends to emphasize work–life balance, career development, and meaningful collaboration, while Generation Z prioritizes flexibility, job security, digital integration, and the use of technology in the workplace. This study adopts a systematic literature review (SLR) approach by synthesizing findings from various peer-reviewed studies related to employee engagement and hybrid work practices across generations. The review focuses on identifying key factors that influence employee engagement in modern work environments. The results indicate that hybrid work can significantly enhance employee engagement when organizations provide flexibility, autonomy, adequate technological support, professional development opportunities, and fair reward systems. In addition, supportive organizational culture and effective leadership are important in maintaining employee motivation and commitment. However, differences in generational expectations require organizations to implement adaptive managerial strategies, including flexible work policies, personalized communication approaches, and inclusive leadership practices to strengthen employee engagement across different generations in hybrid work settings.

Andari, Andari; Nafiudin Nafiudin; Fatya Nisyah; Niken Widillahi

International Journal of Economics, Commerce, and Management 2026 Asosiasi Riset Ekonomi dan Akuntansi Indonesia

This study aims to analyze the influence of work discipline, professionalism, and organizational culture on organizational commitment among employees in the Public Service Sector. Organizational commitment is an important factor that reflects employee loyalty and attachment to the institution, while the three independent variables are considered as internal factors that can strengthen this commitment. The method used in this study is associative quantitative with a multiple linear regression approach. Data were collected through distributing questionnaires to 46 respondents based on probability sampling techniques. Data processing and analysis in this study used SPSS software version 27. Based on the results of the study, it was found that there is a significant influence of work discipline on organizational commitment. In addition, professionalism has a significant effect on organizational commitment, organizational culture has a significant effect on organizational commitment. Based on simultaneous hypothesis testing, it is proven that work discipline, organizational culture, and professionalism jointly influence organizational commitment. While the amount of contribution is 54% to organizational commitment, while the remaining 46% of organizational commitment is influenced by other factors such as leadership style, motivation, competence, rewards, job satisfaction, and employee performance. Thus, this study confirms that to increase organizational commitment, government agencies need to strengthen a healthy work culture, enforce discipline, and encourage a professional attitude in the work environment.

Dwight Nusawakan; Abdul Malik Mufty; Nurul Chaerani Nur; Harianti Fajar; Yosef Marsianus Karno

Publikasi Hasil Pengabdian dan Kegiatan Masyarakat 2026 Asosiasi Periset Bahasa Sastra Indonesia

Malpractice in the health professions is one of the issues that can cause harm to patients, health professionals, and healthcare institutions. A lack of understanding among students as prospective health professionals regarding ethical aspects, legal principles, professional standards, and proper service procedures may increase the risk of malpractice. This Community Service activity aims to provide students of STIKES Pasapua Ambon with an understanding of the concept of malpractice, the factors causing malpractice, and preventive efforts through the implementation of professional ethics, compliance with standard operating procedures, effective communication, and the improvement of professional competence. The activity was carried out through counseling, educational sessions, interactive discussions, and guidance on health law for participants. The results of the activity indicate an increase in students’ knowledge and awareness of the importance of understanding the limits of professional authority, legal responsibility, and preventive measures to avoid malpractice in healthcare practice. This activity is expected to help develop future health professionals who are professional, ethical, and responsible in providing safe and high-quality healthcare services.

Hakin Najili; Supiana Supiana; Mohamad Erihadiana; Suyatman, Ujang

International Journal of Islamic Educational Research 2026 Asosiasi Riset Ilmu Pendidkan Agama dan Filsafat Indonesia

This study aims to analyze the strategies employed by madrasah principals to enhance teacher professionalism through the implementation of managerial functions, academic supervision, entrepreneurship, and socio-spiritual leadership at MAN 1 Bandung and MAN 2 Bandung. The study employs a qualitative approach using a descriptive case study method. Data collection techniques included in-depth interviews, participatory observation, and document analysis, while data analysis was conducted using the Miles and Huberman model through the stages of data reduction, data presentation, and drawing conclusions. The research findings indicate that strategies for enhancing teacher professionalism begin with needs-based planning, followed by strengthening clinical academic supervision, fostering a collaborative and innovative work culture, and implementing continuous evaluation. The implementation of these strategies has a positive impact on improving teachers’ pedagogical and professional competencies, work discipline, and the quality of learning. The novelty of this research lies in the discovery of the “Resilient Professionalism” model a model of teacher professionalism that emphasizes resilience and adaptability to changes in curriculum, technology, and educational dynamics. This model is built through the synergy of the spiritual-managerial leadership of the madrasah principal and the collective efficacy of teachers to achieve sustainable quality in Islamic education.

Hafib Adifaizal; Arief Budiman; Mohamad Yusup Nurjaman; Ike Junita Triwardhani

JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL 2026 CV. ALIM'SPUBLISHING

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Hafib Adifaizal; Arief Budiman; Mohamad Yusup Nurjaman; Ike Junita Triwardhani

JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL 2026 CV. ALIM'SPUBLISHING

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Magda Siringo-ringo; Rusmauli Lumban Gaol; Gryttha Tondang; Ruri Meilyana Tarigan

JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL 2026 CV. ALIM'SPUBLISHING

Chronic kidney disease is one of the global health problems that requires long-term therapy, one of which is through hemodialysis. According to the World Health Organization (WHO), adherence to treatment and diet is a key factor in improving the quality of life for patients with chronic diseases. An appropriate diet plays an important role in controlling electrolyte levels, fluids, and toxic substances in the body. This study aims to describe the knowledge and dietary compliance of patients undergoing hemodialysis at Santa Elisabeth Hospital Medan in 2025.This research used a descriptive quantitative design with a cross-sectional approach. The sample consisted of 36 patients selected using purposive sampling techniques. The research instrument was a questionnaire developed based on dietary guidelines for hemodialysis patients according to WHO and the Indonesian Ministry of Health standards. The results showed that among the 36 hemodialysis patients, 15 respondents (41.7%) had a good level of knowledge, 14 respondents (38.9%) had a moderate level, and 7 respondents (19.4%) had a low level of knowledge. Regarding dietary compliance, 13 respondents (36.1%) were compliant, 18 respondents (50.0%) were moderately compliant, and 3 respondents (13.9%) were non-compliant. There was a tendency showing that higher knowledge levels were positively correlated with better dietary compliance, in line with WHO’s principle that health education is an essential intervention in managing chronic diseases. This study recommends strengthening ongoing educational programs by healthcare professionals, particularly in delivering accurate and easy-to-understand information about diet management for hemodialysis patients.

Magda Siringo-ringo; Rusmauli Lumban Gaol; Gryttha Tondang; Ruri Meilyana Tarigan

JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL 2026 CV. ALIM'SPUBLISHING

Chronic kidney disease is one of the global health problems that requires long-term therapy, one of which is through hemodialysis. According to the World Health Organization (WHO), adherence to treatment and diet is a key factor in improving the quality of life for patients with chronic diseases. An appropriate diet plays an important role in controlling electrolyte levels, fluids, and toxic substances in the body. This study aims to describe the knowledge and dietary compliance of patients undergoing hemodialysis at Santa Elisabeth Hospital Medan in 2025.This research used a descriptive quantitative design with a cross-sectional approach. The sample consisted of 36 patients selected using purposive sampling techniques. The research instrument was a questionnaire developed based on dietary guidelines for hemodialysis patients according to WHO and the Indonesian Ministry of Health standards. The results showed that among the 36 hemodialysis patients, 15 respondents (41.7%) had a good level of knowledge, 14 respondents (38.9%) had a moderate level, and 7 respondents (19.4%) had a low level of knowledge. Regarding dietary compliance, 13 respondents (36.1%) were compliant, 18 respondents (50.0%) were moderately compliant, and 3 respondents (13.9%) were non-compliant. There was a tendency showing that higher knowledge levels were positively correlated with better dietary compliance, in line with WHO’s principle that health education is an essential intervention in managing chronic diseases. This study recommends strengthening ongoing educational programs by healthcare professionals, particularly in delivering accurate and easy-to-understand information about diet management for hemodialysis patients.

Muhammad Zulkarnaen; Mazwar; Teuku Muttaqin Mansur

International Journal of Sociology and Law 2026 Asosiasi Penelitian dan Pengajar Ilmu Hukum Indonesia

This study aims to analyze the effectiveness of legal capacity-building for Temporary Land Deed Officials (PPATS) in the preparation of land deeds in Aceh Besar Regency, Aceh Province. The research employs an empirical juridical method with a qualitative approach, utilizing data collection techniques including interviews, observation, and document analysis. This approach enables a comprehensive examination of both the normative framework and its practical implementation in the field. The findings indicate that the effectiveness of capacity-building for PPATS remains suboptimal, as the existing programs are largely administrative, incidental, and insufficient in addressing substantive legal aspects. Several factors influence this condition, including the non-legal educational background of PPATS, prevailing community legal culture, limitations in training programs, weak institutional coordination, and social pressures encountered in the practice of land deed preparation. These challenges contribute to a low level of material competence and legal prudence among PPATS in carrying out their duties. Accordingly, there is a need for a more sustainable, contextual, and competency-based capacity-building model to enhance the professionalism of PPATS. Such an approach is essential to strengthen their substantive legal understanding, improve the quality of land deeds, and ultimately support the realization of legal certainty in land administration services.

Kezia Verena; Joshua Christian

jurnal Riset Rumpun Agama dan Filsafat 2026 Pusat Riset dan Inovasi Nasional

This study analyzes the integration of pedagogical leadership and professional competence in the Christian Religious Education (CRE) learning strategy course among undergraduate students. Employing a quantitative approach with a descriptive-correlational survey design, the research involved 26 respondents. Data were collected using a Likert-scale questionnaire, with the results analyzed using descriptive statistics and Pearson correlation. The findings show that both pedagogical leadership (85%) and professional competence (86%) are categorized as high. The Pearson correlation test reveals a strong and significant relationship between the two variables (r = 0.78). These results suggest that pedagogical leadership and professional competence are effectively integrated in the learning process. The course plays a strategic role in shaping students into professional and reflective learning leaders, providing them with the necessary skills to apply their leadership in educational settings. This integration enhances students' readiness to excel in their future roles, emphasizing the importance of these competencies for becoming well-rounded and effective educators.

Aufi Hidayatul Azmi; Anisa Septi Artanti; Adifa Zahra; Ratna Juwita; Zulian Fikry

Jurnal Ilmu Pendidikan 2026 Lembaga Pengembangan Kinerja Dosen

Autism Spectrum Disorder (ASD) is a developmental disorder that requires ongoing support and intervention from family and related parties. The role of families, especially parents, is crucial in the admissions process, the provision of emotional support, as well as active involvement in the therapy and social interventions of children with autism. Various studies show that social support and family education contribute significantly to the success of children's growth and development. However, families also face challenges such as limited access to services, social stigma, and lack of knowledge. Effective approaches that can be used such as knowledge enhancement through education, social support networks, and collaboration with professionals. In addition, government policy support and the availability of inclusive services are also important factors in supporting the success of interventions. This study uses a literature review methodology and focuses on the role of families in supporting children with autism holistically to develop a sustainable and effective intervention program based on family needs. These findings are expected to be the basis for the development of a more comprehensive and adaptive family assistance strategy for various socio-cultural conditions.

Fitria Husna

Jurnal Ilmu Sosial, Bahasa dan Pendidikan 2026 Pusat Riset dan Inovasi Nasional

Self-development is a crucial competence for navigating the professional world; however, many individuals face significant barriers in optimizing this potential. This study aims to formulate an integrative model of Quranic Tadabur and bibliotherapy as a professional therapeutic intervention in counseling, addressing gaps in existing literature. Using a library research method with content analysis, the findings indicate that Quranic Tadabur effectively enhances essential self-development skills, including self-awareness, work motivation, problem-solving, time management, emotional regulation, critical and creative thinking, and social collaboration. Within the bibliotherapy framework, the self-development process is structured through stages of motivation, incubation, follow-up, and evaluation. Furthermore, several counseling techniques are proposed, such as self-management, minimal contact, counselor-led management, and directed counseling, to support individual growth. This integrative approach highlights the role of spirituality in fostering holistic personal and professional development. The study contributes theoretically to the advancement of spirituality-based counseling models, particularly in the context of modern career development, and offers a conceptual foundation for future empirical research.

Yohanes Sri Guntur; Maria Goretti Kentris Indarti; Pancawati Hardiningsih; Jacobus Widiatmoko

International Journal of Economics, Management and Accounting 2026 Asosiasi Riset Ekonomi dan Akuntansi Indonesia

Financial reporting integrity is heavily reliant on audit quality. This research explores the effect of auditor attributes, specifically integrity and professional background, on audit standards in Timor-Leste. Quantitative data was collected from a survey of 60 auditors and analyzed using descriptive statistics, correlation analysis, and multiple linear regression techniques. The findings suggest that auditor ethics has a substantial positive impact on audit quality, indicating that conformity to professional ethical guidelines is vital for enhancing audit results. In contrast, experience in auditing does not demonstrate a statistically significant impact on the quality of audits. Visualization through scatter plots further supports the notion that the relationship between ethics and audit quality is more robust than that of other auditor characteristics. Strengthening ethical standards in the auditing profession is crucial to enhancing audit quality, as these findings demonstrate. This study contributes to the body of research on auditing behavior by presenting empirical findings from a developing institutional setting. The findings also have practical implications for policymakers and auditing bodies in Timor-Leste.

Fahira Intan Ukhrowi; Ikrimatul Uyun; Ilman Derajat; Mu’allimin Mu’allimin

Jurnal Manajemen dan Pendidikan Agama Islam 2026 Asosiasi Riset Pendidikan Agama dan Filsafat Indonesia

This research is based on the reality that classroom management often tests teachers' emotional stability, especially when dealing with highly active students. This study focuses on how teachers use emotional intelligence to control themselves when facing challenging learning situations. The purpose of this study is to describe the forms of emotional regulation carried out by teachers and their influence on the effectiveness of classroom management. The research was conducted using a qualitative descriptive approach through observations and interviews with teachers. The results show that effective emotional management is carried out through several methods, such as increasing self-awareness to recognize stress triggers, pausing before responding to student behavior, and trying to understand the background of student activity through empathy. Teachers with good emotional intelligence tend to be able to direct student activity into more positive learning participation, rather than responding to it with reactive or authoritarian responses. This study emphasizes the importance of strengthening psychological aspects and emotional management skills in teacher professional development programs. Emotional maturity not only helps create a more harmonious classroom atmosphere but also forms the basis for inclusive learning interactions and supports the continuous development of student character.

Nandita Filaria Haridji; Sri Yulianty Mozin; Rahmatia Pakaya

WISSEN : Jurnal Ilmu Sosial dan Humaniora 2026 Asosiasi Peneliti Dan Pengajar Ilmu Sosial Indonesia

This study aims to examine the service performance of the Women’s Empowerment and Child Protection Agency (DPPPA) of Gorontalo Regency in handling cases of violence against children. The study focuses on addressing the service performance from several aspects; (a) productivity, (b) service quality, (c) responsiveness, (d) responsibility, and € accountability. This study was conducted based on the persistently high number of cases of violence against children, which require effective, responsive, and accountable public service handling from the local government. This study employed a qualitative method with a descriptive approach. Data collection techniques included observation, interviews, and documentation, while data analysis used the Miles and Huberman model, consisting of data reduction, data display, and conclusion drawing. The findings indicate that service productivity is fairly good, as reflected in a clear case-handling flow, though it remains constrained by limited human resources and cross-sector coordination. Service quality is considered positive in terms of empathetic attitudes and the availability of private service spaces; however, the quality of physical facilities and the availability of professional personnel still need improvement. Officers’ responsiveness is relatively quick at the initial stage, but follow-up information on cases is not consistently provided. Responsibility for implementing procedures is in accordance with standard operating procedures, although completion times are often lengthy. Meanwhile, administrative accountability functions well, but the transparency of information to victims still needs to be strengthened.

Elita, Carlene Amalia; Salsabilla, Islama A’la Syifa; Ramadhani, Novalina Rizka Brillian; Ismawati, Rusida; Ramadhani, Zulfa Rozin

DINAMIKA HUKUM 2026 Universitas Stikubank

The case of medical malpractice involving a toddler in Bima has attracted public attention and raised the urgency of evaluating legal accountability mechanisms in healthcare. This study aims to analyze the law enforcement process and the forms of legal responsibility that can be imposed on medical personnel and healthcare institutions suspected of involvement. Using a normative juridical approach, this study examines relevant laws, doctrines, and legal literature, including provisions in the Medical Practice Law, the Health Law, the Hospital Law, and the Criminal Code. The results indicate that law enforcement in malpractice cases can be pursued through administrative, civil, and criminal channels, depending on the level of negligence and the resulting consequences. Medical personnel can be held personally liable for violations of professional standards, while healthcare institutions can be held accountable based on the principle of vicarious liability. This study concludes that the case in Bima underscores the importance of strengthening regulations, improving medical service standards, and ensuring transparency in law enforcement to protect patient rights, particularly children.

Michelle Angelika S; Wijaya, Hanna; Gosal, Darren; Afladhanti, Putri Mahirah; Kartika, Ronald Winardi +2 more

Jurnal Riset Rumpun Ilmu Sosial, Politik dan Humaniora 2026 Pusat Riset dan Inovasi Nasional

Emergency medical care constitutes a fundamental patient right and an institutional obligation of hospitals that must be provided without temporal discrimination. However, in practice and public discourse, the meaning of “physician presence” is often narrowly reduced to physical presence alone, giving rise to allegations of medical negligence, particularly during weekends or outside regular working hours. This distorted understanding risks generating legal injustice, undermining the dignity of the medical profession, and encouraging defensive medical practice. This article aims to analyze the meaning of physician presence from a health law perspective through theoretical, normative, and systemic approaches, by distinguishing models of physician presence as on-site, on-call, and home-call/teleconsultation in emergency care services. This study employs a normative legal research method using statutory, conceptual, and limited comparative approaches. The analysis examines Law Number 17 of 2023 on Health, Government Regulation Number 28 of 2024, as well as health law literature and emergency care practices. The analysis demonstrates that, in legal terms, physician presence is not synonymous with physical presence, but rather should be understood as process-based professional responsibility, provided that care is delivered in accordance with professional standards, service standards, and an adequate triage system. Physician presence must be reconstructed as the presence of professional responsibility within an integrated emergency care system. Legal assessment in health law should be grounded in process and system integrity, rather than solely on clinical outcomes or public perception.