Dimensions Of Access Research Articles

Assessment of the Effect of Implementing an Obesity Center of Integrated Responsibility on Hospital Performance in Portugal

The continuous increase in the prevalence of obesity has generated growing concern, having become an important challenge at a global level in economic and public health terms. In Portugal, the treatment of obesity presents significant problems in access to health services. In this context, there is a need to implement new management models that offer more effective responses. Centers of integrated responsibility, already implemented in this area, are a cutting-edge approach, and it is important to evaluate their performance and identify recommendations for improving the model. The main objective of this study is to assess the impact of implementing an obesity center of integrated responsibility on hospital performance. This study was conducted using a comprehensive multiple-case study approach, which was predominantly descriptive but also included explanatory elements. The methodological approach is a well-balanced mix of quantitative and qualitative analyses. The study evaluates various hospital performance indicators, encompassing the dimensions of access, production, efficiency, quality, and economic-financial, both before and after the implementation of the new model. The overall results indicate that the implementation of an obesity center of integrated responsibility led to improvements in hospital performance, particularly in the dimensions of access, production, and efficiency. While these findings are promising, the study also identifies areas for potential improvement in the model, such as organizational, functional, and legal aspects, including the method of granting incentives and the funding process. In the analyzed cases, this new organizational model proved to be a solution for improving hospital performance, particularly around obesity. These units can play a fundamental strategic role in the National Health System, contributing to access to specialized treatments, retention of professionals and financial sustainability.

ANALYSIS OF TOURIST ATTRACTION ON TOURIST VISITING INTEREST IN PERLANG TOURISM VILLAGE CENTRAL BANGKA

This research is motivated by the growing development of Indonesian tourism, one of which is a tourist village. Tourism villages are cultural diversity to tourist destinations owned by each region. The existence of interesting things contained in the tourist village makes tourists interested in visiting Perlang Tourism Village. In this study, it was found that Perlang Tourism Village was included in the top 50 best tourism villages nominated by ADWI and third place in the digital and creative categories. Therefore, the purpose of this study is to provide input to managers on what attractiveness can be developed to become an advantage for Perlang Tourism Village. This research is entitled "Analysis of Tourism Attractiveness of Tourist Visiting Interest in Perlang Village, Central Bangka". This study used a causal analysis method with a quantitative approach. Data collection techniques through observation, interviews, and questionnaires, with 100 research samples selected using non-probability methods and purposive sampling techniques. Data analysis was performed using simple linear regression test, descriptive (mean) test, t test, F test, and R2 analysis. The results of the t test showed that partially the Attraction & Ancillary dimension had a significant influence on visiting interest, while the Amenities &; Accessibility dimension did not have a significant influence. Test F shows that simultaneously, all four dimensions of tourist attraction affect visiting interest. In conclusion, attractiveness has a positive and significant influence on partial interest in visiting. Therefore, this destination must maintain the attractiveness it already has.

Classifying and Validating Metahuman Service Quality Dimensions: A Mixed-Method Study

With the development and integration of artificial intelligence (AI) and virtual reality technology, metahuman powered by AI is gradually becoming an important force in service marketing. Considering the novel characteristics of metahuman services, this study aims to identify and validate the core dimensions of the metahuman service quality. Online review analysis, multiple regression analysis, and fuzzy-set Qualitative Comparative Analysis (fsQCA) were employed to analyze data in this study. The results show that nine dimensions of metahuman service quality, including stability, complementary, efficiency, continuous improvement, empathy, accessibility, personalization, cultural sociability, and fault tolerance, significantly contribute to customer satisfaction. Moreover, the results suggest that there are five multiple and equally effective combinations of metahuman service quality dimensions that can achieve high consumers’ satisfaction. This study contributes to the avatar literature by unveiling the complexity behind the adoption of AI-powered avatar. It also offers meaningful practical implications for marketing managers to optimize the combination of metahuman service quality.

Use of telehealth to improve healthcare access and outcomes in surgical oncology.

The dimensions of healthcare access includes availability, accessibility, accommodation, affordability, and accessibility. Many patients face significant barriers to accessing oncologic care and subsequently, health outcomes are suboptimal. Telehealth offers an opportunity to mitigate many of these barriers to improve health access and outcomes. This review discusses how telehealth can be leveraged to improve healthcare access in surgical oncology while also highlighting important challenges to realizing the full potential of this mode of healthcare delivery.

Access to Decentralised Public Healthcare Service Delivery in Rural Areas of Lesotho

Despite being a basic right for all citizens of every country, access to healthcare has been a challenge for many people globally. However, the emergence of the COVID-19 pandemic has heightened the need for improvedhealthcare service delivery and access to healthcare globally. The need for improved access to healthcare is especially critical for developing countries as theywere the worst affected in terms of healthcare service delivery by the pandemic. This study, which sought to assess healthcare accessibility in rural areas of Lesotho, is relevant because Lesotho is a country with high poverty levels, and most of the poor people in Lesotho live in the rural areas. The study employed a quantitative design and sampled 200 healthcare users from the rural areas of Lesotho to measure the dimensions of access to healthcare (which refer to the affordability, availability, acceptability and accessibility / accommodation of healthcare) on a 5-point Likert-type scale. The study’s findings showed that healthcare affordability remains a barrier to access in rural Lesotho. This was followed by accessibility and accommodation, then acceptability and availability of healthcare in rural Lesotho. The study then made recommendations to guide health policy makers in Lesotho.

Access to medications in pediatric patient with hereditary angioedema: the role of the pharmacist

A request for icatibant 30 mg/3ml, a high-cost drug, was made to the pharmacy at the Hospital in San Francisco (Córdoba, Argentina). This medication was not available at the institution (off-formulary), and its active ingredient is only marketed by two laboratories in the country. The cost ranges between 3,500 and 4,500 USD per ampoule, depending on the brand. The medication was requested for a 9-year-old female pediatric patient diagnosed with hereditary angioedema, confirmed by laboratory tests, and prescribed a dose of 15 mg via the subcutaneous route. It was indicated for treating acute episodes, such as facial and/or laryngeal edema, and for administration prior to surgery, such as a dental extraction. The cost of the medication was unaffordable for a family without private health insurance. Additionally, the family lived far from the health center, so it was requested that at least two doses be made available for her. This case highlights the significant challenges in accessing high-cost, life-saving medications for a young patient with hereditary angioedema in a low-resource setting. The situation emphasizes the critical role of pharmacists in navigating these challenges to ensure that patients receive the necessary treatment despite financial and logistical barriers. The pharmacist plays a pivotal role in overcoming these difficulties by addressing the five dimensions of access to medication: availability, affordability, accessibility, acceptability, and quality. In this case, the pharmacist's role extends far beyond dispensing medications. It involves active participation in the management of rare and complex conditions, advocating for patient access to necessary treatments, and ensuring that the care provided is both effective and sustainable.

Governance of family food security and sustainable planning. The case of the municipality of Santiago de Cuba

Governance is a process that enables communication and cooperation between the government, other public institutions, social organizations, and families. In Cuba, the recent approval in 2020 of the Food Sovereignty and Nutrition Education Plan implies strengthening governance as a catalyst for family food security (SAF). However, incorporating sustainable planning to promote food security from dimensions that describe eating practices in Cuban homes still needs to be improved. This research aims to assess the links between governance and sustainable planning, to strengthen the dimensions of access, use, social capital, and cultural food capital, among others (SAF) in the Santiago de Cuba municipality. For this, the interview and survey methods are used. The first, to 20 families in a situation of social food vulnerability, and the second, to a sample of 300 households whose coexistence is not marked exclusively by the exposure mentioned earlier. The results point to poor communication among the social actors, generating food-destructuring practices. It is also visible the scarce insertion of these dimensions in planning to achieve greater family food sustainability. It is concluded that to achieve SAF, it is necessary to strengthen the interconnection of governance and sustainable planning from a relational perspective of the food field.

Navigating Social Services from the Perspective of Finnish Older Adults with Complex Needs: An Examination of Different Dimensions of Access

This study aims to increase understanding of accessing social services for older adults with complex needs. Individual interviews (18) with older clients of gerontological social work and diaconal social work in Finland were analyzed using abductive content analysis. The conceptual framework of access to services, consisting of five interrelated dimensions by Penchansky and Thomas (1981) and the sixth dimension, awareness, by Saurman (2016), was used as a basis for analysis and reporting of results. The findings showed that accessing services was affected by all six dimensions and factors related to both the service system and the clients. The main results showed that available services did not always meet the needs of older adults (Availability), or they did not have enough information about the services (Awareness). Attitudes toward both the service system and older adults affected their experiences (Acceptability), as well as the perceived approachability of the services (Accommodation). In addition, mobility of services and physical abilities of clients (Accessibility), together with the perceived worth of services in relation to their cost (Affordability), influenced older adults’ access to services. Overall, this study emphasizes the significance of considering different aspects of access in service design and policies for services for older adults.

Research on the application of high-speed EMU driver’s cab console based on new composite materials

Abstract This paper mainly introduces the design and verification of the driver’s cab console for high-speed EMU based on new composite materials and molding technology. The structure of the driver’s cab console is divided into 5 functional modules, and the main body of the structure is made of carbon fiber. The electrical layout follows the relevant standards such as UIC 651 and UIC 612, and is arranged according to the dimensions of importance, frequency, and accessibility. Through ergonomics simulation analysis, finite element simulation analysis, and prototype trial verification, the design scheme proposed in this paper has been significantly improved in many aspects such as function realization, lightweight, and ergonomics comfort.

Heterogeneity analysis of food supply-demand patterns and land carbon loss under different dietary structures in China

China’s diets are undergoing a profound transformation, and carbon storage loss generated by dietary structure change is increasingly serious, accompanied by concerns about sustainable diets and food supply–demand conflicts. This paper designed a dual ‘material–environmental’ framework based on the dietary structure classification, around which we conducted the heterogeneity analysis of food supply–demand patterns and land carbon loss, and then tracked hotspot diets of trade-generated carbon loss through the multi-regional input–output (MRIO) model. The research found that 31 provinces could be classified into five clusters with obvious spatial agglomeration patterns, most of which still had a high proportion of staches, but also showed an evolutionary trend towards diversified compositions. Driven by dietary structure, the national food supply–demand match under the material accessibility dimension showed barely balanced overall, while in terms of environmental effects, ecosystems lost significant amounts of carbon stocks, with losses of 331 and 950 Tg11Tg refers to teragram, a weight unit, 1 Tg = 106 t = 1012 g of vegetation carbon and soil organic carbon, respectively, which together accounted for 14 percent of the total carbon stocks in the vegetation and topsoil carbon pools. The clusters to which Henan, Jiangsu, Zhejiang and Guangdong belong were tracked as hot dietary clusters exhibiting hotspots in inter-regional trade, contributing to carbon loss in external provinces through trade linkages. Heilongjiang and Inner Mongolia were at a low level of supply–demand balance but played the role of a carbon storage loser, while Guangdong, Zhejiang, and Jiangsu not only possessed higher balance levels but also pulled more external carbon loss. China's food system should optimise internal cropping structures and monitor external land use conversion. It is equally important to track food consumption side rights and responsibilities.

Rural veteran perception of healthcare access in South Carolina and Florida: a qualitative study

BackgroundAccess to mental and physical healthcare in rural areas is challenging for Veterans and their families but essential for good health. Even though recent research has revealed some of the challenges rural Veterans face accessing healthcare, a complete understanding of the gap in access is still unclear.MethodsThis qualitative study aimed to explore participants’ perceptions of healthcare access. Structured interviews were conducted with 124 Veterans and spouses of Veterans from rural qualifying counties in South Carolina and Florida.ResultsThe study’s results revealed five main dimensions of access: geographic proximity, transportation, communication, cultural competence, and resources. Distance to service needed can negatively impact access for Veterans and their families in general, especially for those whose health is declining or who cannot drive because of their age. Lack of transportation, problems with transportation services, and lack of public transportation can lead to delays in care. Additionally, the lack of communication with the Veterans Affairs (VA) Health System and with the healthcare team, as well as inefficient communication among the healthcare team, lack of coordination of care between the VA health system and community providers, and the lack of cultural competence of healthcare providers and contracted personnel made access to services even more challenging.ConclusionsImproving communication can help to develop a sense of trust between Veterans and the VA, and between Veterans and spouses with the healthcare team. It can also lead to increased patient satisfaction. Ensuring healthcare providers and contracted personnel are culturally competent to talk and treat Veterans can improve patient trust and adherence to treatment. Lastly, resource-related challenges included financial problems, lack of prompt access to appointments, lack of providers, limited access to local clinics and hospitals, limited local programs available, and reimbursement issues.

Health literacy as a predictor of cardiovascular disease risk factor knowledge level among women in Turkey: A community-based cross-sectional study.

While more common in men globally, heart diseases also rank as the leading cause of death among women. This study aimed to examine the relationship between Turkish women's level of knowledge about cardiovascular disease (CVD) risk factors and their health literacy. Data for this descriptive and cross-sectional study were collected online by using Health Literacy Scale and CVD risk factor knowledge level scale from October 2022, to May 2023. The study sample consisted of 409 women. It was found that the total score average of the women on the CVD risk factor knowledge level was 20.65 ± 4.72 and the Health Literacy Scale was 107.06 ± 16.01. There was a moderate, significantly positive correlation between CVD knowledge levels and health literacy (r = .548, P = .000). It was found that women with high health literacy also had increased knowledge levels. Furthermore, all health literacy dimensions of access to information (P < .001), understanding information (P < .001), appraisal/evaluation (P < .001), and implementation (P < .001) were detected as the predictors of CVD risk factor knowledge levels. Factors such as educational level and economic status significantly influenced scores on both scales (P < .05). The study's findings highlight the challenges encountered by women with low socioeconomic status in accessing accurate information. It may be recommended that nurses provide health education and consultancy services to these women on the prevention and management of cardiovascular diseases. Also, public education programs should consider socioeconomic and educational levels, focusing on women who encounter difficulties accessing information.

Understanding the factors related to how East and Southeast Asian immigrant youth and families access mental health and substance use services: A scoping review.

The objective of the review is to identify factors related to how East and Southeast Asian immigrant youth aged 12-24 and their families access mental health and substance use (MHSU) services. To address how East and Southeast Asian youth and their families access mental health and substance use services, a scoping review was conducted to identify studies in these databases: PubMed, MEDLINE (Ovid), EMBASE (Ovid), PsychINFO, CINAHL, and Sociology Collection. Qualitative content analysis was used to deductively identify themes and was guided by Bronfenbrenner's Ecological Systems Theory, the process-person-context-time (PPCT) model, and the five dimensions of care accessibility (approachability, acceptability, availability and accommodation, appropriateness, affordability). Seventy-three studies met the inclusion criteria. The dimensions of healthcare accessibility shaped the following themes: 1) Acceptability; 2) Appropriateness; 3) Approachability; 4) Availability and Accommodation. Bronfenbrenner's Ecological Systems Theory and the PPCT model informed the development of the following themes: 1) Immediate Environment/Proximal Processes (Familial Factors, Relationships with Peers; 2) Context (School-Based Services/Community Resources, Discrimination, Prevention, Virtual Care); 3) Person (Engagement in Services/Treatment/Research, Self-management); 4) Time (Immigration Status). The study suggests that there is a growing body of research (21 studies) focused on identifying acceptability factors, including Asian cultural values and the model minority stereotype impacting how East and Southeast Asian immigrant youth access MHSU services. This review also highlighted familial factors (16 studies), including family conflict, lack of MHSU literacy, reliance on family as support, and family-based interventions, as factors affecting how East and Southeast Asian immigrant youth access MHSU care. However, the study also highlighted a dearth of research examining how East and Southeast Asian youth with diverse identities access MHSU services. This review emphasizes the factors related to the access to MHSU services by East and Southeast Asian immigrant youth and families while providing insights that will improve cultural safety.

Accesibilidad a medicamentos usados para el tratamiento de enfermedades crónicas no transmisibles durante la pandemia por COVID-19, Chiclayo- Perú, 2021

Objective: To describe the accessibility of medicines used to treat chronic non-communicable diseases during the COVID-19 pandemic in Chiclayo city. Materials and Methods: The present study was observational, descriptive, cross-sectional and prospective, with a sample of 386 participants, conducted with a questionnaire validated by expert judgment and established reliability through a pilot test. It was structured in two sections, covering sociodemographic, economic and health characteristics of patients with chronic diseases during the COVID-19 pandemic and the four dimensions of accessibility (physical availability, affordability, geographic accessibility and acceptability). Results: 92.5% didn’t had full accessibility to medicines. 45.9%, 53.4%, 83.9% and 23.3% had physical availability, affordability, geographic accessibility and acceptability of medicines, respectively. When accessibility was related to associated factors, it was found that there was a statistically significant relationship (p&lt;0.05) with age, number of people living in thehousehold, monthly income, number of medications and evolution of the disease. Conclusion: The majority of patients treated in health centers and hospitals in Chiclayo did not have full accessibility to their medications during the COVID-19 pandemic, and this was related to the number of people, monthly income, evolution of the disease, age and number of medications.

Leisure reimagined: mapping the enablers of restorative servicescapes

ABSTRACT Servicescapes play a crucial role in the marketing strategies of contact-based service businesses, significantly influencing consumer experiences and well-being. Researchers have explored their potential impact on stress levels and attention restoration from various perspectives, including environmental psychology, perceived sensory dimensions and evidence-based design. This study builds upon existing knowledge by employing Interpretive Structural Modelling and MICMAC Analysis to identify the enablers that contribute to the restorative quality of a leisure servicescape. The current research reveals that enhancing servicescape restorativeness involves integrating elements such as refuge, culture, complexity, typicality, accessibility, familiarity, hygiene, space, calmness, legibility, biophilic designs and social dimension. Additionally, the investigation into the interrelationships among these factors highlights the pivotal roles of refuge and culture, influencing the efficacy of most other enablers. Servicescape typicality, however, relies heavily on the operationalization of other enablers. Notably, none of these enablers operates independently in promoting a restorative servicescape. Their interconnected associations underscore the importance for marketers in the leisure service industry to comprehend and leverage the interplay of these factors to achieve optimal results in enhancing the restorative property of their servicescapes. The study concludes by offering recommendations for marketers and policymakers to improve consumer and citizen well-being in a sustainable manner.

Women’s Local Knowledge and Engagement in Groundwater Irrigation: Impacts on Household Food Security in the Upper East Region of Ghana

Groundwater irrigation in Ghana is a major livelihood activity that secures food through the cultivation of vegetables for households, particularly in the dry season. This activity is largely driven by the application of local knowledge. However, the existing studies that examined local knowledge of groundwater irrigation focused mostly on male irrigation farmers. Women’s local knowledge is often ignored or remains undocumented. In instances where it is studied, women’s local knowledge is lumped with males’ local knowledge thus ignoring its uniqueness. Furthermore, the studies about women’s local knowledge in this activity present this knowledge as one that permits women to perform only supplementary roles. Also, irrigation generally has an impact on food security. Yet, few studies have examined how women’s engagement in this activity secures food for their households. Therefore, the study discusses the following: the source of women’s local knowledge of groundwater irrigation, the value and application of women’s local knowledge of groundwater irrigation and the contributions of groundwater irrigation undertaken by women to household food security. Local knowledge is special knowledge; thus, a qualitative study approach was employed to explore it. Five rural communities in the Upper East Region of Ghana were studied. Interviews were used to generate the primary data while ATLAS.ti and GraphPad software were used in organising, analysing and presenting the data. The results showed that women farmers possessed local knowledge which was traced to different sources. The knowledge extended to include their negotiation power for access to land/wells, resources of which they have been marginalised. The application of this knowledge in groundwater irrigation promoted household food security, in the dimensions of access, utilisation, affordability, and agency. However, climate change may threaten groundwater irrigation’s contribution to food security unless artificial groundwater recharge is promoted.

Availability, accessibility, and intake of vegetables native to Mexico

Objective: to analyze the intake of vegetables native to Mexico from 1980 to 2020, based on the food security approach. Methodology: the availability and accessibility dimensions of food security were taken into consideration for this study; in addition, descriptive statistics and regression models were used. Results: the apparent national intake of native vegetables increased during the study period, reaching 6.821 million tons in the year 2020, while the per capita intake was 148 grams in the same year. The actual income and the quarterly family expenses on vegetables, pulses, and seeds decreased from $1,890 Mexican pesos in 1980 to $1,082 Mexican pesos in 2020. Study Limitations/Implications: the food utilization and stability dimensions that encompass food safety were not included in the study. Conclusions: public food security policies must promote the production and intake of vegetables native to Mexico and increase the actual income of the most vulnerable Mexican families, facilitating accessibility to these products.

Expressions of inequalities in access to health services in Latin America: a scoping review.

Latin America is one of the most unequal regions in the world. Due to colonization and occupation of the territory, structural inequalities mark people's living and health conditions. In health, we can observe how different dimensions of inequalities condition access and user experience in the service. This scoping review aimed to map and analyze the expressions of inequalities in access to health services in Latin American countries from the scientific production of the last ten years, from which 272 articles were selected. The categorical analysis classified articles into five dimensions, which characterize the expressions of inequalities in access to health services: socioeconomic, geospatial, ethnic/racial, gender, and people with disabilities. The most frequent access barriers were socioeconomic or ability to pay, geographic or transportation difficulty, availability of services, cultural/ethnic, communication, and architecture. The main conditioning factors of health inequalities were income, schooling, transportation, and living conditions. Combating health inequalities requires proposing structuring and sectorial policies.

Assessing the impact of women’s underrepresentation on public service delivery in Afghanistan

ABSTRACT In the wake of the political upheaval witnessed in Afghanistan in August 2021, there has been a noticeable curtailment of women’s involvement in the public sector. This quantitative cross-sectional study, grounded in representative bureaucracy theory, examines the perceived effects of this underrepresentation through a diverse and representative sample of 349 employees from various government departments. Employing a 21-item questionnaire with 5-point Likert scales, the survey assessed service accessibility, quality, responsiveness, accountability, and innovation dimensions. Snowball sampling was utilized due to access limitations post-August 2021, with a minimum one-year work experience as the inclusion criterion. Data analysis involved descriptive statistics, index creation for service dimensions, correlation analysis, and ANOVA to examine differences based on participant characteristics like grade, education, and age. The findings indicate that the lack of female representation significantly impairs service delivery across dimensions like accessibility, quality, innovation, and accountability, particularly concerning women. The study underscores the detrimental consequences of gender homogeneity on formulating gender-sensitive policies and maintaining inclusive, high-quality public services. These results emphasize the necessity of promoting gender diversity within the Afghan public sector to ensure responsive and equitable service delivery aligning with the needs of all societal segments.

User satisfaction regarding regional health polyclinics services in Bahia, Brazil

The Regional Health Polyclinics (RHPs) are a recent initiative, and there are still no evaluative research on them. This study aims to assess the satisfaction of RHP users in Bahia. A quantitative and qualitative survey was conducted, employing three strategies: questionnaires, semi-structured interviews with users and managers, and observation by researchers. The data were analyzed using descriptive analysis and content analysis. The majority of respondents (89.7%) were very satisfied with the services. The performance of professionals generated high satisfaction (98.3%). In interviews, the dimension of access was identified as the primary core of meaning, with mentions of difficulties in access, associated with the high demand from municipal users for specialists. The results can help managers improve the quality of services offered.