Additional Services Research Articles

Spatially explicit ecosystem accounts for coastal wetland restoration

Coastal wetlands (i.e., mangroves, saltmarshes, and seagrasses) have been recognised as an efficient natural climate solution to help mitigate and adapt to climate change. These ecosystems are also known to provide additional ecosystem services to coastal communities (e.g., fisheries and biodiversity enhancement, nutrient removal). Despite their importance to coasts and coastal communities, we lack spatially explicit information on the values of these ecosystems and the estimated return on investment from coastal management activities to rehabilitate them. Here, we aligned an environmental economic accounting framework combined with a scenario analysis to develop a set of accounts for mangroves, saltmarshes, and seagrasses across the state of Victoria (Australia) as a case study, including the following ecosystem services: commercial and recreational fisheries, carbon and nitrogen sequestration, and coastal hazard mitigation. Importantly, we assessed the current extent, condition, and ecosystem services (physical and monetary) from these coastal ecosystems and examined how they could be improved through management actions. Overall, we found that the combined benefit (i.e., nitrogen and carbon sequestration, fisheries, and coastal hazard mitigation) provided by existing mangroves, saltmarshes, and seagrasses in Victoria is approximately AUD120.9 billion per year. Considering the management scenarios included in this study, our analysis showed that levee removal plus managed retreat had the highest cost at AUD7.6 billion; however, it also provided the highest net benefit of AUD134.8 trillion after 50 years, with a 5 % discount rate. In contrast, fencing was the cheapest management action to restore mangroves and saltmarshes, delivering more than AUD140 billion after 50 years. While our results demonstrate a large return on investment if coastal wetlands are restored at large scale, the implementation of small-scale projects is still a major challenge. However, this study demonstrates that an environmental economic accounting framework combined with a scenario analysis is a powerful approach to guide the decision-making process, providing critical information on the estimated return-on-investment from restoration of mangroves and saltmarshes, with encouraging implications of the impacts of actions at local scales.

Enabling coordination in energy communities: A Digital Twin model

Starting from the EU vision for Energy Communities (EC), our purpose is to support them by proposing a Digital Twin (DT) that includes a bi-level optimization model to deliver coordination, economic, social, and environmental benefits to its members that can be quantified as Key Performance Indicators (KPI). The diversity of EC members from the size and interest perspectives leads us to consider a bi-level optimization model. It offers support to individual consumers/prosumers (first level) and coordination for EC (second level). This model is embedded into a DT that replicates the EC and the operation of individual entities such as consumers/prosumers and public assets. The DT is created as an automatic assistant with two components: iEMS – as a member's assistant and eEMS – as an EC assistant. These components optimize the schedule, generate bids for the Local Electricity Market (LEM) and control the flexible appliances of the participants to deal with deficits and surpluses. The DT receives input from EC members, LEM, metering system and improves the operation of the EC in a two-way continuous exchange data flow. Furthermore, it is a reliable framework to test and improve models, regulations and policies in emergent EC as DT provides alternatives regarding its functionalities: optimization, market operation, setting the clearing price, settlement, value sharing for distributing benefits, etc. It can be extended to support grid operators to design tariffs, testing regulation and offer additional energy services. The proposed DT model is tested within an EC case study, both on a seasonal and an annual basis. The average trading index on LEM is 0.6 during the summer and 0.3 during the winter months, while the Degree of Local Sufficiency (DLS) for the EC is 0.45 in summer and 0.28 in winter. Moreover, the proposed LFM model reduces the exchanges with the main grid by an average of 45 kW in summer, that represents almost 15% of the average exchange at peak hours.

Analysis of a novel virtual pediatric concussion clinic in a rural setting.

Children and adolescents who sustain concussion in rural communities are lost to follow-up after initial evaluation more often than their urban counterparts. Thus, this study aims to determine the feasibility and accessibility of a novel virtual pediatric concussion clinic at a rural academic hospital. Data regarding patients referred to a virtual concussion clinic at a rural Pediatric Level 2 Trauma Center over a 16-month period was prospectively collected. Patients experiencing concussive symptoms were referred to the pediatric neurosurgery clinical registered nurse and received a phone call following an injury. Referrals to therapy were made based on symptoms reported. Data from 44 patients was collected: 9 did not follow-up in concussion clinic despite leaving a voicemail. Forty-three were referred from the emergency department. The median time from referral placed to completing a virtual follow-up was 4.5days. Among the referrals, 3 (8.6%) were to pediatric neurology, 10 (28.6%) to occupational therapy (OT), 6 (17.1%) to physical therapy (PT), 4 (11.4%) to speech-language pathology(SLP), and 25 (71.4%) did not receive referrals as their symptoms had abated. Patients followed with pediatric neurology post-injury for an average of 75.9days, OT for an average of 52.7days, and PT for an average of 2.3days. This is a feasible model to follow patients and place referrals for additional therapeutic services in a rural community. With 79.5% of patients completing a follow-up, the clinic demonstrates easy accessibility and reliable adherence.

Perceived Competence of Ground Staff in Dealing with Unruly Passenger Behavior at Manila International Airport Authority Airports

Abstract: Unruly passenger behavior poses a significant challenge to the airline industry, affecting safety, security, and customer satisfaction. Ground staff play a crucial role in managing these behaviors, and their perceived competence is pivotal in shaping passengers' overall experiences. Passengers' perception of ground staff competence depends on factors such as staff knowledge of airline policies, de-escalation techniques, and their projection of confidence in handling unruly passengers. Airlines have an opportunity to enhance ground staff competence through comprehensive training, clear policies, and a culture of support and teamwork. The study aims to assess and describe the perceived competence of ground staff in dealing with unruly passenger behavior at Manila International Airport Authority airports. A quantitative research design used a survey as the primary data collection method. Stratified and convenience sampling methods were combined to select 1,475 respondents, representing a diverse sample. Data was analyzed using mean scores, standard deviation, and variance to assess the perceived competence of ground staff. The data suggests that ground staff generally exhibit competence in dealing with unruly passenger behavior. However, competence may vary in specific situations, such as when passengers exploit minor anomalies or use their social status for additional services. Overall, ground staff are perceived as competent, particularly in handling passengers displaying potentially violent tendencies. The findings of this study reveal that ground staff at Manila International Airport Authority airports are generally perceived as competent in handling unruly passenger behavior. While competence may vary in specific situations, such as when passengers exploit minor anomalies, overall, ground staff are well-equipped to ensure passenger safety and a smooth travel experience. The study highlights the importance of ongoing investment in staff training and resources to improve the competence of ground staff in addressing unruly passenger behavior, ultimately contributing to passenger satisfaction and safety.

Advanced Triple-Negative Breast Cancer

ObjectivesOur focus within this review is to summarize key advances and new therapeutic approaches within advanced triple-negative breast cancer. In addition, we highlight the importance of multidisciplinary management, discussing key issues for patients and importance of the supportive role that specialist nurses provide. Data SourcesPeer-reviewed literature, clinical practice guidelines, clinical trial, and government websites. ConclusionTriple-negative breast cancer is a highly heterogeneous subtype of breast cancer, often associated with a less favorable prognosis compared to other types. Significant advances in our understanding of specific mutations and signaling pathways within this subtype, coupled with expanding therapeutic options, has broadened the treatment landscape considerably. While chemotherapy traditionally formed the mainstay of treatment, new therapeutics such as immunotherapy, targeted agents, and antibody-drug conjugates in first-line and subsequent-line settings are now available. It is essential for all those who care for this patient group to be up-to-date on current practice and emerging treatments, so patients receive the support they need and deserve. Implications for Nursing PracticeNurses need to become familiar with new systemic anticancer therapies within advanced triple-negative breast cancer to provide patients with adequate information about new treatment options and support with potential treatment-associated toxicities. It is important for nurses to be able to recognise key issues facing patients with a diagnosis of advanced triple-negative breast cancer, to gain a deeper understanding of both the physical and psychosocial support required, signposting or referring patients to additional support services if needed.

Flexural improvement of reinforced concrete beams strengthened with self-prestressing shape memory alloys

The study reported here aims to investigate the application of shape memory alloys (SMAs) in the form of strips for strengthening cracked reinforced concrete (RC) beams. The study proposes an innovative technique for prestressing RC beams by utilizing the shape recovery property of the alloy. Nine full-scale RC beams with a length of 3.75 m and a cross-section of 200 mm × 300 mm were categorized into three groups based on the steel reinforcement ratio, and tested under static loading. Three RC beams were used as control specimens and the other six were retrofitted with either one layer or two layers of SMA strips. The beams to be strengthened were exposed to an initial applied load before the installation of the SMA strip to simulate the deterioration scenario. SMA strips were retrofitted on the soffits of the deteriorated beams and activated by applying temperature from an external heat source while the temperature-deflection-strain measurements were monitored. Specimens were tested again up to failure to evaluate the strength improvement of the retrofitted specimens. Beams retrofitted with one layer of SMA experienced a deflection recovery up to 2.3 mm upon activation and an additional service load of up to 62%, whereas beams retrofitted with two layers experienced a deflection recovery up to 2.8 mm and an additional service load of up to 95%. In general, the deflection recovery was proportional to the ratio of the total reinforcement ratio after strengthening to the initial reinforcement ratio before strengthening. Therefore, tested specimens with two SMA layers experienced less improvement than specimens with one SMA layer. Finally, the experimental results were evaluated with two analytical methods: ACI method and the non-linear sectional analysis proposed by Oukaili.

LEVEL OF CUSTOMER SATISFACTION OF SOCIAL SECURITY MEMBERS ON THE SERVICES OF SOCIAL SECURITY SYSTEM SAN PABLO BRANCH

The objective of this research endeavor is to assess the level of satisfaction that Social Security Services in San Pablo has among its members. This study employed both quantitative and qualitative research designs. To determine the level of satisfaction of SSS members, quantitative inferential research was utilized, which not only permitted responses to pre-formulated queries but also encouraged respondents to candidly recount their personal experiences. The proposed methodology will be executed by administering a questionnaire survey to members of the SSS, utilizing a convenience sampling approach. The first section comprises the demographic profile of the participants. The subsequent section employs a Likert scale to evaluate the respondents’ comprehensive experience with SSS services, including promptness, convenience, reliability, meaningful service, and related aspects. The data result presents the frequency and percentage of SSS members belonging to each age category. In addition, the majority of study participants fall within the age range of 31 to 40 years. Regarding gender, the majority of respondents are female SSS members. Regarding coverage status, the majority of participants are SSS members by employment. The majority of members express contentment with regards to the significance and dependability of the service. However, the least content with regard to convenience and timeliness. Limited research has been conducted on the manner in which SSS members perceive and satisfy their customers. This study acknowledges certain implications that may extend to encompass additional branches and services of SSS. Due to the paucity of research examining the degree of consumer satisfaction among SSS members

PENENTUAN OBJEK WISATA FAVORIT DI PULAU NUSA PENIDA MENGGUNAKAN SIMPLE ADDITIVE WEIGHTING METHODE (SAW)

The level of development of tourism in Klungkung especially in Nusa Penida has experienced a significant increase. This is inseparable from the smooth sea transportation in the form of speedboats with additional service schedules. The increase has also been influenced by the discovery of a number of new tourist attractions and maritime tours that are especially enjoyed by foreign tourists (diving and snorkeling). The location of the tourist attractions are not in one place but spread in several places with a considerable distance. If the vacation is only for one day, then the tourists must be able to choose attractions that line between the departing lane and the return lane so that it is more efficient. The data to be used in this study are internal and external data, alternatives that will be compared are a number of tourist sites with several criteria to be used. The method for processing data to be used is one of the methods in the Multi-Attribute Decision Making (MADM), the Simple Additive Weighting (SAW) Method. This method is used to find weighted sums and performance ratings on each alternative on all attributes. Research methods carried out starting from literature studies, interviews, data analysis to be used, data processing with the method of Simple Additive Weighting (SAW) method. The research is done in order to enable the tourists to determine the choice of tourist attractions that will be visited during their vacation on the island of Nusa Penida more easily. Based on the criteria and alternatives used, the study has resulted in having Cystal Bay as the most visited tourist attraction with a total preference value of 2.9200.

Implementation of Jackson Queueing Network in General Polyclinic and Dental Polyclinic Patient Services at Jelekong Health Center

The buildup in the service system is generally caused because service facilities cannot meet service needs, so service users need time to use the facilities. Health Center is one of the facilities that provide services in the health sector. However, the number of doctors needed in health centers in Indonesia has yet to be met, and the number of patients who are never empty every day causes a buildup in the service system. The application of the service network system using the open Jackson queueing network can model the optimal service system and analyze its performance. The observation method was used to observe patients' arrival and departure times at the Jelekong Health Center, especially in the registration section, general polyclinic, dental polyclinic, and pharmacy, for three days. There was an increase in patient waiting time before being served and time in the system at the general polyclinic after implementation, so one additional service facility was added. Meanwhile, the dental polyclinic experienced decreased patient waiting time before being served and time in the system, so there was no need to add service facilities.

Developing Coastal Tourism Attractions in Padangbai Village, Karangasem, Bali

The variety of potential beach tourism attractions in Padangbai village requires the stakeholders to determine the beach attraction which needed as the priority that can be done in advance and that can be done effectively and efficiently. The objectives of this research first was to know the existing condition of a beach tourist attraction in Padangbai village which is a Bias Tugel Beach and Blue Lagoon Beach. To be able to determine the development priority of a beach tourism attraction which can be seen from 6A components of tourism development, includes attraction, accessibility, amenities, ancillary, activities, and available packages. Researchers used data collection techniques in the form of observations and interviews with informants. The informant determination technique uses using purposive sampling technique with 10 informants which consist of academics, business, community, government, and media, as the stakeholders in accordance pentahelix concept. The data analysis technique used in this research was qualitative descriptive which was analyzed by AHP (Analytic Hierarchy Process) method. The result of this research indicates that Bias Tugel Beach is a priority to develop. The determination of Bias Tugel Beach as a priority tourist attraction has an average value of each criterion from the highest to the lowest value, such as a tourist attraction of 26.5%, tourist activity criteria of 22.9%, additional service criteria of 18.5%, accessibility criteria by 14.7%, the criteria for amenities by 9.9% and the criteria for the availability of tour packages by 7.6%. Nevertheless, there are accessibilities and amenities criteria that need to be improved by the management based on tourism development 6A components..

Competitive Strategies and Organizational Performance of Corporate Enterprises in Nigeria

This study examined the relationship between competitive strategies and organizational performance in corporate enterprises in Nigeria. The survey was based on five selected entrepreneurial companies with a sample size of 15 staff. Questionnaires were administered to the staff of the selected companies. Two hypotheses were formulated and tested, and the statistical tool Pearson Product Moment Correlation Coefficient was used to test the strength and direction of the relationship between the variables. Findings revealed that there is a relationship between competitive strategies and organizational performance. Therefore, it was concluded that to thrive in today’s business environment, corporate enterprises must adopt suitable competitive strategies, as these make up the life wire of an organization to create value, outwit competitors, and increase market share. Thus, we recommended that corporate enterprises should focus on strategies that improve their profit margins, quality of service and customer satisfaction; they should invest in customer relationship management to retain existing customers and upsell additional products or services; and they should leverage technology to enhance operational efficiency, reduce costs and improve product/service quality.

Outcomes of elevated blood alcohol concentrations in elderly patients following a ground level fall: A matched analysis from the national trauma quality program

BackgroundThe rising elderly population and the concomitant increase in alcohol consumption can result in a ground level fall (GLF). The purpose of this study is to evaluate the in-hospital mortality, hospital length of stay, and discharge disposition of elderly patients who sustained a ground level fall (GLF) and tested positive for an elevated blood alcohol concentration (BAC). MethodsThe data of patients who were 65 years and older, had an injury after a GLF, and tested for BAC were accessed from the American College of Surgeon – Trauma Quality Improvement Program (ACS-TQIP) from the calendar years of 2011–2016. Patients’ demography, injury, comorbidities, and outcomes were compared between the groups who tested positive (>0.08 g/dL) and negative (0 mg/dL) for BAC. Univariate, followed by matched analyses were performed. All p values are two-sided, and a p value < 0.05 is considered statistically significant. ResultsOut of 20,163 patients who satisfied the inclusion criteria, 2398 patients (∼12%) tested positive for an elevated BAC. There were significant differences found between the two groups, BAC-positive vs. BAC-negative, in univariate analysis for age and sex with p values < 0.001. Propensity score matching balanced demographic characteristics; however, differences remained in certain comorbidities. Exact matching balanced patient demography, injury, and comorbidities. The paired-matched analysis showed no significant differences between the two groups for in-hospital mortality (2.1% vs. 2.1%, p = 1) and median hospital length of stay (5[4–5] vs. 5[5–5], p = 0.307). A higher proportion of patients in the BAC group suffered from alcohol withdrawal syndrome (AWS) and deep vein thrombosis (DVT) complications (9.5% vs. 1.4%, p < 0.001 and 1.5% vs. 0.5%, p = 0.018) compared to BAC-negative patients. A slightly higher percentage of patients in the BAC-positive group were discharged home without any additional services (39.6% vs. 36.9%, p = 0.009). ConclusionOf the elderly patients who sustained a GLF and tested for BAC, approximately 12% tested positive for BAC. The overall in-hospital mortality was 2.1%. The BAC-positive group suffered from higher complications of AWS and DVT, and more than 60% of patients required additional services at the time of discharge.

Healthcare service use in paediatric inflammatory bowel disease: a questionnaire on patient and parent care experiences in Germany

BackgroundPaediatric inflammatory bowel disease (PIBD) patients require chronic care over the lifespan. Care for these patients is complex, as it is adapted for childrens’ life stages and changing disease activity. Guideline based care for this patient group recommends a multidisciplinary approach, which includes in addition to paediatric gastroenterologists, nutritional and psychological care services. For PIBD patients, a discrepancy between available guideline-based multidisciplinary care and actual care has been found from the provider side, but to what extent patients experience this is unclear.ObjectivesTo identify which healthcare services were used and whether socio-demographic, geographic or disease related factors have an influence on health service utilisation.MethodsA standardised questionnaire (CEDNA) was distributed amongst parents of children aged 0–17 diagnosed with PIBD and adolescents (aged 12–17) with a PIBD. Items related to health service use were analysed, these included specialist care, additional care services, reachability of services and satisfaction with care. Logistic regression models on additional service use were calculated. Service availability and reachability maps were made.ResultsData was analysed for 583 parent and 359 adolescent questionnaires. Over half of the respondents had Crohn’s Disease (CD, patients n = 186 parents n = 297). Most patients and parents reported their paediatric gastroenterologist as their main care contact (patients 90.5%; parents 93%). Frequently reported additional services were nutritional counselling (patients 48.6%; parents 42.2%) and psychological support (patients 28.1%; parents 25.1%). Nutritional counselling was more frequently reported by CD patients in both the patient (OR 2.86; 95%CI 1.73–4.70) and parent (OR 3.1; 95%CI 1.42–6.71) sample. Of the patients, 32% reported not using any additional services, which was more likely for patients with an illness duration of less than one year (OR 3.42; 95%CI 1.26–9.24). This was also observed for the parent population (OR 2.23; 95%CI 1.13–4.4). The population-based density of specialised paediatric gastroenterologists was not proportionate to the spatial distribution of patients in Germany, which may have an influence on access.ConclusionsParents and children reported highly specialised medical care. Multidisciplinary care offers do not reach the entire patient population. Access to multidisciplinary services needs to be ensured for all affected children.

„Es ist eine unserer Hauptaufgaben, die Sicherheit der Patienten zu gewährleisten.“ – Ergebnisse einer qualitativen Studie zur Gewährleistung von Sicherheit in der beatmungsspezifischen Hilfsmittelversorgung

BackgroundMaintaining safety is critical in home mechanical ventilation (HMV). It is co-determined by the availability of reliable technical aids and their correct application. Ensuring safe aid supply is part of the aid providers'́ legal mandate. However, whether and how this is achieved is largely unknown. Therefore, the tasks of technical aid providers, associated requirements and challenges with special regards to educational and safety aspects were investigated. MethodsFor this purpose, episodic interviews were conducted between July and December 2020 with a purposive sample of field representatives of eleven technical aid providers. Between one and six persons participated in each of the interviews, resulting in a total sample of 25 persons (14 field representatives without management function, ten with management function, one director). Given the conditions during the COVID-19 pandemic, six interviews took place face-to-face and five as web meetings. Interviews were analysed using qualitative content analysis. ResultsFrom the interviewees'́ perspective, the most important safety-related measure is the legally required and individually tailored initial instruction in a safe aid application. Additional safety-related tasks comprise counselling, e. g. for prescribing physicians and users (patients, relatives, nursing service employees), regular home visits, and the provision of a technical emergency service. Interviewees indicate that safety risks emerge primarily from a lack of skills and a high staff turnover among professional caregivers. This, they state, challenges building up and maintaining competencies among nursing staff. Other safety risks arise from healthcare fragmentation, lacking coordination, cooperation, and accountability of the professionals involved. Respondents address these challenges pragmatically by providing additional services, like ongoing caregiver training, care coordination and support roles. DiscussionMaintaining safety in ventilation-associated technical aid supply must be considered a crucial component of the overall HMV care processes, in which safety currently cannot be taken for granted. Field representatives of technical aid providers address the existing challenges with selective and intuitive strategies, some of which exceed their legal mandate. ConclusionImproving safety in home care can be supported by establishing Advanced Nursing Practice roles in nursing services. The systematic further development of roles and tasks of staff of technical aid providers should be clarified within an overarching discourse on viable approaches to cross-sectoral and interprofessional HMV care.

Assessment of Haemophilia Patients' and Other Bleeding Disorders Needs of Psychosocial Support and Health Care Needs and Their Utilization in Haemophilia Treatment Centres (ILLUSTRATE Study)

Background: Psychological support for chronically ill patients as an integral component of medical care could improve health-related quality of life (HRQoL) of patients and contribute to a reduction in treatment costs. A meta-analysis including almost 3,000 patients revealed that persons with hemophilia (PWH) are at increased risk for depression, anxiety, and ADHD compared to the general population (Al-Huniti et al., 2020). Studies have shown that the self-efficacy, coping mechanisms, and HRQoL of parents of hemophilic children were improved by self-help programs, and depression, anxiety, and parenting stress were reduced. Although different psychological interventions have been used to help PWH to cope with their psychological problems, there is a gap between patients' need for psychosocial support from the perspective of health care professionals (HCPs) and their utilization by PWH. The aim of the ILLUSTRATE study was to assess the need for psychosocial support and medical care in patients with inherited bleeding disorders (IBD) and in HCPs and their use in hemophilia centers. Methods: Patients with IBD (PIBD) were invited by different German patient organizations (Deutsche Bluthilfe, DHG, IGH, Hämophilie 2000) to participate in an on-line surevey (from December 2022-June 2023). In addition, HCPs were asked to complete a similar on-line survey via the mailing list of the German Society for Thrombosis and Hemostaseology. A positive ethical approval for the study was obtained by the Local Psychological Ethics Committee at the University Medical Centre in Hamburg, Germany (LPEK-0578). The questionnaire for patients consisted of the following aspects: socio-demographic data, medical background, care services and psycho-social support, dealing with stress and difficult situations, dealing with special situations that may arise or be exacerbated by the bleeding disorder, offer of psycho-social counseling/support, and need for expansion. The questionnaire for HCPs contained the following themes: personal background, need of patients for psycho-social counseling/support (PSCS), supply of PSCS and need for expansion, utilization, and benefits of PSCS. Results: In total, 154 patients and parents of children with an IBD participated (72 PIBD,80 parents, 2 others) with a mean age of 41.06±13.3 years, 60.4% were female. In addition, 65 HCPs completed the respective survey (34 physicians, 27 nurses and 4 others) with a mean age of 48.11 ± 12.7 years, in average they worked since 13.1±10.8 years in haemostaseology, 78.5% worked in a hemophilia comprehensive care center (HCCC), 20% in a hemophilia treatment center (HTC) and 1.5% in a homecare service. In the IBD group (patients, parents) most were married (59.1%), lived with a partner (83.8%) and worked full- or part-time (66%). Most PIBD had hemophilia (74%) with a severe form (81.8%). 28.6% of the IBD group felt little to not at all supported to overcome psycho-social challenges. It was demonstrated that they had an intermediate stress resilience (14.76±3.1), with 1/3 showing a low resilience. When asking what coping strategies they used in stress situations, 26% mentioned that they ignore difficult situations and 16% compensated their stress with drugs and alcohol. 20% often to always felt helpless and overwhelmed due to their IBD and 31% rarely to never received support in these situations. 71% reported to have a need for PSCS, 57% wished more support services (69% mainly at the HTC), 71% felt not to have enough information about these services and 64% would use them more often if they were more accessible. 52% of HCPs found that the IBD group has a need of PSCS, they assumed that parents and adolescent patients would benefit most of these services and expected the highest advantage from psychological counseling. 60% thought that there is a need for information and education. The IBD group and HCPs preferred PSCS in presence, the IBD group would use services as well via phone or digital. Conclusions: Although offered psycho-social support programs are rarely used by patients, a large proportion of the IBD group and HCPs confirmed a need for it. Increased accessibility to PSCS and more information were identified as a factor for increased use of this support programs. Additional digital psycho-social support services were desired and represent a helpful alternative if services are not available on site.

Services of Regional Universal Scientific Libraries: Problems and Approaches to Their Presentation on Websites

Scientific libraries are active social institutions that promptly respond to the challenges of the external environment, changing preferences of readers and users, their needs for different library, information, socio-cultural demands in online and offline spaces, for self-realization of creative and educational potential. Among scientific libraries a special place is occupied by regional universal scientific libraries (RUSL), which take an active part in the formation of educational, cultural, scientific and economic potential of their territories; ensure the creation of a unified regional information and library space; provide services to the population taking into account regional needs and specifics of the region’s development. The projects reflected in the “IFLA Bank of Ideas”, “Library Creativity Bank”, on the Library Map of the World, in the final materials of the All-Russian contests of library innovations, international contests of marketing projects of IFLA libraries, and in the professional press testify to the innovative practice of the RUSL. The results of the analysis of the websites of 50 regional universal scientific libraries of Russia (the main innovators in library services in the regions) are presented, the purpose of which was to identify the problems of reflection of library and information and other services in the web space. The study analyzed free and paid services offered in online and offline modes and ranked their most common types. The results showed gaps in the presentation of library and information and other services on websites (lack of a unified approach to the presentation of services by type and a complete list of all library and information and other services, difficult search for paid services, lack of a section “Services” and visual support for the provision of additional services, etc.), as well as showed a panorama of opportunities to better reflect them for different categories and segments of users. It is concluded that the solution of the above problems will allow public libraries to raise the level of awareness of users and demonstrate the fullest range of stationary, non-stationary and remote services provided on a paid and free basis.

Revisiting brand performance metrics and its impact on customer loyalty in Indian banking sector: role of relational quality and duration

PurposeThe purpose of this study is to revisit brand performance metrics (BPMs) (brand affinity, brand content and knowledge, brand image, brand ethics and brand value) and evaluate the moderated mediation effect of relationship quality (mediator) and relationship duration (moderator) in brand performance and customer loyalty relationship in an Indian banking context.Design/methodology/approachThe research model was tested in the Indian banking sector. The primary data was collected from the 1,000 account holders of five Indian public and private banks. The data was analysed and validated using exploratory factor analysis and confirmatory factor analysis. Structural equation modelling and the Hayes process were used for testing the hypotheses.FindingsThe study results established BPMs as a four-dimensional structure comprising brand affinity, brand content and knowledge, brand image, brand ethics and brand value. The BPMs significantly positively impact relational quality (RQ) and customer loyalty. Further results also prove the existence of moderated mediation effect on BPMs and customer loyalty link and portray that the impact of BPMs on customer loyalty is mediated by the RQ and influenced by relationship duration.Research limitations/implicationsThe study is confined to the Indian banking sector. It did not examine the dimension-wise impact of brand performance indicators on RQ and customer loyalty. Future research is required to explore their influence in banking and other sectors.Practical implicationsThe study findings suggest that to enhance brand performance, banks need to follow excellence in every conduct, take immediate actions against inappropriate behaviour, consistently update their relevant and valuable contents (news, videos, white papers, e-books, case studies, FAQ’s, photos, etc.) on their websites and also introduce loyalty schemes to reimburse customers’ interests with some substantial benefits such as rebates, discounts, annual gifts and extraordinary or additional services. These strategies can pave the way for enhancing long-term quality relationships between customers and their service providers and increasing customer loyalty.Originality/valueTo the best of the authors’ knowledge, the study is a maiden attempt to assess the effect of BPMs on customer loyalty in the presence of RQ and at the value of relationship duration/length. Besides, the study results also prove the existence of moderated mediation effect and portray that the impact of customer equity and relational benefits on customer loyalty is influenced by relationship duration and mediated by RQ.

The cancer caregiver lived experience: Supporting and advocating for patients with cancer throughout the care continuum.

222 Background: Data from the National Cancer Institute’s Surveillance, Epidemiology &amp; End Results Program (SEER 2022) estimates there are currently over 18.1 million cancer survivors in the United States who rely on family and friends to provide caregiver support. Family and volunteer caregivers fulfill a vital and essential role for cancer patients throughout the care continuum and are at the forefront of advocating and navigating the health care system for the patients under their care. Recognizing the caregiver’s lived experience and the demands and obstacles caregivers endure has a direct impact on understanding the challenges cancer patients face daily. Methods: November 2022 – April 2023 the Raymond Foundation hosted nationwide cancer caregiver focus groups, personal interviews, advisory boards, and online surveys. Primary goals included reaching a diverse range of caregivers in medically underserved communities, rural, urban and community oncology settings. In addition, researchers were interested to learn how the cancer caregiver experience and burden had evolved since our nationwide cancer caregiver published studies in 2018 and 2020. Results: 1214 caregivers (48% identified as male; 52% identified as female) participated during the six-month research period. 96% stated they provide direct patient care, such as: overseeing and ensuring adherence of oral chemotherapy or immunotherapy; communicating with clinicians to coordinate medications for adverse effects; surgical and treatment-related wound and drain care; colostomy, ileostomy, urostomy, and percutaneous endoscopic gastrostomy (PEG or G) support; 94% of caregivers reported they are included in all medical and treatment decisions; 91% reported they felt ill-equipped to navigate complex medical terminology including precision medicine information, biomarker, genetic and hereditary testing and navigating clinical trial options; 87% reported respite care, additional support and educational services would enable them to become a more empowered caregiver and patient advocate; 78% reported their overall quality of life had diminished since becoming a caregiver with feelings of depression, anxiety, financial insecurity, burn-out, loneliness and fear. Conclusions: Cancer caregivers experience significant challenges as they care for their loved one facing a cancer diagnosis. Caregivers are trusted partners in treatment decision making, but too often caregivers do not receive the tools they need to help make informed decisions. Additional caregiver education and support services are essential, so caregivers can provide the best possible support for patients throughout the care continuum.

Evaluating the impact of therapy dogs on patients with cancer.

278 Background: Chemotherapy/Immunotherapy infusion visits are unique experiences for cancer patients that can often increase stress and anxiety. Multiple papers have shown that therapy dogs can decrease anxiety, improve mental health, and increase relaxation. It has not been established that therapy dog visits during infusions can improve stress and anxiety similar to other clinical experiences. Our purpose was to explore if during this stressful experience therapy dogs would have the same impact as previously researched situations. Methods: At Virginia G. Paper Cancer Care Network North Scottsdale (HonorHealth) we drafted a survey. This anonymous and voluntary survey abstracted patient data that included: age, gender, dog ownership, and pet affinity. Patients were asked prior to a therapy dog visit to grade their anxiety and relaxation level and answered identical questions post-visit. Questions were drafted with Yes/No and scale of 1-10. Surveys were collected over an eight-week period from January 1, 2023 through February 28, 2023. Patients were surveyed in an outpatient infusion center. Results: 61 surveys were collected and analyzed. Statistical analysis was performed with a t-test for numeric and a binomial regression was fit to the data. 100% of patients surveyed liked animals &amp; felt that therapy dogs helped with anxiety and relaxation. Anxiety levels significantly decreased by 31.1% (p &lt;0.00001) after a therapy dog visit and relaxation levels increased by 25.8% (p = 0.0001). Age surveyed ranged from 40-85 with an average age of 63, with more females than males being surveyed. Conclusions: Patients at a small community hematology/oncology center can benefit from additional supportive services. In our prospective survey project, having a visiting therapy dog significantly decreased patient anxiety and improved relaxation during chemotherapy/immunotherapy infusion visits.

Crowd-Driven Deep Learning Tracks Amazon Deforestation

The Amazon forests act as a global reserve for carbon, have very high biodiversity, and provide a variety of additional ecosystem services. These forests are, however, under increasing pressure, coming mainly from deforestation, despite the fact that accurate satellite monitoring is in place that produces annual deforestation maps and timely alerts. Here, we present a proof of concept for rapid deforestation monitoring that engages the global community directly in the monitoring process via crowdsourcing while subsequently leveraging the power of deep learning. Offering no tangible incentives, we were able to sustain participation from more than 5500 active contributors from 96 different nations over a 6-month period, resulting in the crowd classification of 43,108 satellite images (representing around 390,000 km2). Training a suite of AI models with results from the crowd, we achieved an accuracy greater than 90% in detecting new and existing deforestation. These findings demonstrate the potential of a crowd–AI approach to rapidly detect and validate deforestation events. Our method directly engages a large, enthusiastic, and increasingly digital global community who wish to participate in the stewardship of the global environment. Coupled with existing monitoring systems, this approach could offer an additional means of verification, increasing confidence in global deforestation monitoring.