Additional Services Research Articles

Possible Approaches to the Reconstruction of the Vyšehrad Bridge in Prague

Prague has two iconic views. The first is Charles Bridge with the silhouette of Prague Castle in the background, the second is the Vyšehrad Railway Bridge framed by the imposing structure of Vyšehrad. It has been a listed cultural monument since 2004. The Vyšehrad Railway Bridge was opened in its first form on 15 August 1872, its current appearance dates back to 1901. It is a riveted structure with three parabolic arches spanning about 70 m with verticals and diagonals in the shape of segmented cross-sections. The structure is an important technical cultural monument, which is also located in an exposed part of the Prague Monument Reserve. However, due to long neglected basic maintenance, the structure deteriorated to such an extent that the Railway Administration decided to demolish it. Having carried out an inspection and structural assessment of the bridge we are confident that it can be repaired, refurbished, and modified to provide a long and satisfactory additional service life for future operation of the railway and footways. In particular, localized corrosion defects resulting from inadequate maintenance over many years can be repaired and the structural components which fail to meet the assessment criteria in their current condition can be repaired or replaced. Expressed in weight, only 15 % of the structure by mass needs structural repair or improvement; the rest is satisfactory without further intervention, other than renewing the corrosion protection system. The paper is based on a study by Petr Tej, Andreas Galmarini and Ian Firth and will focus on a detailed survey of the bridge’s condition and the possibilities of its reconstruction for rail traffic. It describes the reconstruction system, replacement of individual elements and contact points. Part of the paper is also a proposal for the reconstruction and use of the stone viaduct for trade and services, including static and visual rehabilitation.

ГРАНТИ ПРОГРАМИ USAID ДЛЯ БІЗНЕСУ ЗЕРНОВОГО НАПРЯМКУ В ЗБІЛЬШЕННІ ПОТУЖНОСТЕЙ ЗБЕРІГАННЯ ТА СУШІННЯ ЗЕРНА В УМОВАХ ВІЙНИ

The article examines in detail the USAID Program for Agrarian and Rural Development (AGRO) in the direction of "Supporting MSMEs in the grain sector in increasing grain storage and drying capacities" in wartime conditions. The study demonstrates the goals and priorities of the Program, namely: to expand opportunities for grain processing enterprises to increase the number of small and medium-sized producers who benefit from improved services. Emphasis was placed on the fact that the goal of the AGRO Program initiative is to increase the capacity and power of economic entities that provide MSMEs with drying, storage and processing of grain and technical crops. It was established that a distinctive feature of the program is its budget of 270 million UAH, which is planned to be distributed between 10-15 projects, and the amount of grant funding for one project can be from 18,000,000 to 36,000,000. These funds can be directed to cover such costs: purchase of grain processing, drying and storage equipment; purchase of laboratory equipment for determining quality indicators of grain. The expected results of the activities of the grantees have been demonstrated, namely: approximately 70 small and medium-sized enterprises (MSMEs) should receive additional services related to finishing, drying or storage of grain, these services should be expanded by at least 20 thousand tons annually, and/or provided services of grain drying for at least 50,000 tons annually, at least 50% of the total volume of grain processing, drying or storage services will be provided to MSMEs that cultivate (rent) land plots with an area of less than 500 hectares. The research revealed the specifics, as well as features of participation in the grant competition. A number of recommendations have been developed for applicant organizations, the consideration of which will contribute to obtaining grant funding, namely: it is necessary to provide specific data and arguments to strengthen your conclusion, you should ensure a high degree of specificity and confirmation of your statements to strengthen your position in the competition, budget planning should demonstrate a high level transparency and financial responsibility, activities should actively contribute to the creation of equal opportunities and social integration for all categories of the population.

ДИНАМІКА ПОКАЗНИКІВ ДОСТУПНОСТІ ЗАГАЛЬНОЇ СЕРЕДНЬОЇ ОСВІТИ ДЛЯ ОСІБ З ОСОБЛИВИМИ ОСВІТНІМИ ПОТРЕБАМИ

The education of children with special educational needs (SEN) is one of the priority areas for the development of modern education in Ukraine. The article analyses the indicators of accessibility of general secondary education for persons with SEN in accordance with the National Strategy for Creating a Barrier-Free Environment in Ukraine. The article presents data on the status of special and inclusive education for the period of 2014/2015-2023/2024 on the basis of official statistical reporting, identifies trends, key achievements and possible challenges to the implementation of the goals of the Strategy. The legal framework in the field of inclusive and special education was examined. Proposals for improving the statistical forms for the formation of indicators of access to general secondary education for persons with SEN were substantiated, which requires further analysis of the compatibility of these indicators with the Sustainable Development Goals (SDGs), performance indicators of the National Strategy for the Development of Inclusive Education for 2023-2030 and reporting indicators of the Statistical Office of the European Union (Eurostat), etc. The article also deals with the issue of allocation of subventions from the State budget to local budgets for providing state support to persons with SEN in 2024. It is proposed that in order to calculate the performance indicator in reports on the use of these funds, the number of pupils with SEN, including persons with disabilities who received additional services at the expense of this subvention, should be allocated. The relevance of the article's topic is due to the increased attention and demand of society on the need to include persons with SEN in the educational process and to provide them with quality educational services.

SUSTAINABLE DESIGN OF SUPPORTS FOR CULTURAL SERVICES IN OPEN-AIR EXHIBITIONS

This research is focused on the design of sustainable cultural services. Particularly, on the services associated with outdoor exhibitions, which represent an interesting alternative to traditional cultural services, being accessible to all populations, at any time and without ticketing. Open-air exhibitions are usually organized using different supports but the ones with counterweights are the most popular and versatile types. Sustainability aspects of three different design alternatives are studied. In the first alternative cultural content is exposed using printed and replaceable vinyl; in the second alternative, the exhibition is illuminated and content is printed on stretched canvas. The third alternative offers an additional service because when the display panels are replaced exhibitors are transformed into street furniture. The entire life cycle of the services has been reviewed. Moreover, environmental, economic, and social sustainability dimensions have been quantitatively evaluated using, respectively, the global warming potential, the execution costs, and the working time indicators. Thus, the study contributes to integrating sustainability in the design of service systems. The presented cases illustrate the sustainability assessment methods that could be used in the evaluation of different cultural services proposals and results obtained show that different alternatives can be selected according to the criteria applied to reflect the importance of each sustainability dimension. Keywords: Sustainability, design; Service life cycle; Cultural exhibitions; LCSA.

УПРАВЛІННЯ ГОСПОДАРСЬКОЮ ДІЯЛЬНІСТЮ ПІДПРИЄМСТВ ГОТЕЛЬНО-РЕСТОРАННОГО БІЗНЕСУ ПРИ ВПРОВАДЖЕННІ ІННОВАЦІЙ

The article investigates the advantages of implementing innovations. It identifies the potential for incorporating open innovations, which can have both positive and negative impacts on the business operations of enterprises. It is proven that not all improvements result from open innovations. Approaches to implementing innovations in the hotel and restaurant industry are outlined; the benefits of implementing open innovations in hotel and restaurant complexes equipped with special facilities for people with disabilities, which can contribute to rapid recovery, are highlighted. The business activities of hotel and restaurant enterprises in the Odesa region were analyzed, and leaders in the quality of additional services were identified. The need for providing health and rehabilitation services, which can be realized based on hotel and restaurant complexes, is researched and substantiated; the importance of establishing an appropriate center is proven. Based on the analysis of the business operations of hotel and restaurant enterprises, a reserve for health and rehabilitation activities is identified, and the possibility of involving hotel and restaurant complexes in the innovation process is analyzed. The need for developing and implementing an individual rehabilitation program for clients is emphasized. The importance of introducing health and rehabilitation services is evaluated, determining the main areas of activity and financial capabilities. The main problems in managing the business operations of hotel and restaurant enterprises and the need for specialist involvement are identified. The need for implementing health and rehabilitation services in hotel and restaurant enterprises, driven by various types of health improvement and rehabilitation, is substantiated. The components of business operations in providing health and rehabilitation services are determined. The advantages of providing health and rehabilitation services in hotel and restaurant enterprises are proven. The minimum cost of one rehabilitation course with different health improvement structures is calculated. Innovative health and rehabilitation activities are proposed, including the involvement of health tourism, which will allow for the formation of a system of health improvement and rehabilitation.

Mathematical model analysis of mandatory state health insurance : Revisiting risks and opportunities for private health

This article aims to determine a feasible entrance brink constant for secluded healthiness indemnification corporations to access the newest purchaser excess for Kosovo’s planned compulsory wellbeing indemnification fund, as well as to evaluate the reasoning behind it and measure the surplus. We begin with a succinct overview of the current status of the private insurance sector. Despite experiencing a substantial growth spurt in recent years, its share in the overall financial sector has, in fact, decreased. Following this, we delve into an intuitive approach for calculating the threshold coefficient. Due to the unavailability of similar contingent valuation survey data, we adopt a method based on adjusting prices using the consumer price index. These adjusted prices are then used to estimate the most recent data. Our findings reveal the presence of a consumer surplus, signifying an opportunity for original sequestered guarantors to enter the marketplace or for prevailing companies to offer additional services at an additional cost. However, it’s important to note that the 2021 surplus is notably lower compared to the estimate for the year 2015.

Pengembangan Desa Wisata dalam Menjamin Tourism Sustainable di Desa Kubu Gadang Kota Padang Panjang

This research aims to determine the development of Tourism Villages in Guaranteeing Sustainable Tourism in Kubu Gadang Village, Padang Panjang City. This research was conducted using a qualitative approach with a descriptive method, in determining informants the researcher used a purposive sampling method. Data collection techniques are carried out using interviews, observation and documentation. In testing the validity of the data, researchers used source triangulation and method triangulation. Meanwhile, data analysis techniques use data reduction techniques, data presentation, and drawing conclusions/verification. From the research results, it can be seen that the Kubu Gadang tourist village has carried out tourism development through several components such as tourist attractions, accessibility, amenities and additional services. Sustainable tourism in the Kubu Gadang tourist village, seen from an economic aspect, plays a very good role in improving the economy of the local community; the environmental aspect has the potential for rice fields with mountain views to create opportunities for tourism activities; and the social aspect makes social relations strong, maintains culture through tour packages related to the customs found in the Kubu Gadang tourist village. However, in the process of developing the Kubu Gadang tourist village in ensuring sustainable tourism, there are obstacles, namely internal obstacles, namely (a) not all of the human resources or tourist village managers have passion in their respective fields; (b) the Kubu Gadang tourist village facilities are inadequate and the maintenance of the facilities has not been maintained; (c) the budget for developing the Kubu Gadang tourist village is inadequate. Meanwhile, external constraints are (a) environmental conditions around the Kubu Gadang tourist village, Padang Panjang City; (b) there is no regulation. Efforts that can be made to overcome obstacles to the development of the Kubu Gadang Tourism Village, Padang Panjang City in ensuring sustainable tourism are (a) involving managers of the Kubu Gadang tourist village who do not have passion in their field and have not mastered their work and main duties and functions through training; (b) the management of the Kubu Gadang tourist village openly accepts anyone who wants to join as a tourist village activist; (c) establishing a sharia tourism cooperative and selling tour packages to meet the budget for developing the Kubu Gadang tourist village; (d) conducting outreach regarding the importance of maintaining cleanliness to the people of Kubu Gadang and tourists; (e) carry out tree planting programs and reduce the use of plastic.

MODELLING THE BANK CUSTOMER ACTIVITY DURATION BASED ON THE COX ECONOMETRIC SURVIVAL MODEL

The banking sector is constantly evolving, seeking effective ways to attract and retain clients, especially those with high financial potential. One of the ways to achieve this goal is to provide car loans at low interest rates, such as 0.01%. However, the untimely outflow of clients after repayment of the car loan becomes a significant problem for banks leading to the loss of potential income from other banking services. The research aims to evaluate the impact of selling additional banking services on increasing clients' activity duration. The research used statistics on opening new bank clients, whose first product was a car loan at an interest rate of 0.01%, from 2018 to 2022. The dataset included 9,224 records. The Cox proportional hazards model is used to determine the impact of a credit card on the duration of car loan client activity. The analysis of the model coefficients showed that with a credit card, clients closed at a rate of 0.86 of the rate of closing clients without a credit card. However, during the verification of the proportional hazard assumption, it was determined that the credit card's influence level changes significantly over time, indicating the model's inadequacy. The next phase of the study was the search for an influencing parameter that meets all the quality conditions of the Cox model. Having a credit card with at least one transaction was selected. For this model variation, all indicators of model adequacy were met. The coefficient estimation results showed that clients with an active credit card closed at a rate of 0.36 of the rate of closing clients without it. The evaluation of the active credit card impact confirms that selling a credit card allows for an increase in the bank clients' activity duration. However, a critical success factor is the sale of a credit card and its activation. The obtained research results can be used to optimize the bank's marketing and sales strategies, ensure more effective customer retention and increase the bank's profits.

FINTECHS AS A GAME CHANGER IN BANKS-LITERATURE REVIEW AND RESEARCH AGENDA

Purpose:As technology and innovation advance, the world economy is always changing. Due to the recent upheaval in the banking sector brought about by digital technology, banks are now refocusing their business strategies in favor of e-banking. Fintech is the application of technological advances to create novel business models built on a wide range of creative concepts. It has developed additional services to more effectively address client demands at the most affordable pricing.Initially displacing banks due to their reduced operating costs, fintech startups are now collaborating with them to grow their revenue and clientele. Methodology/Approach:The literature reviews objective is to analyze the concept of fintech and how it works in the sector of banking. Findings:Fintech startups are now seen by banks as enablers rather than competitors. By collaborating with fintech firms, banks may instantly increase the services they offer. Banks should adopt Fintechs more proactively to continuously boost their profitability. It is essential to examine the profitability of banks utilizingfintech as it enables financial institutions to make data-driven choices, improve operational efficiency, manage risks, and develop a more customer-centric approach. Originality/Value: In the continuously changing financial landscape of today, assessing how fintech affects bank financial performance cannot be overlooked and it is crucialas it continues to gain popularity. Paper Type:Conceptual Research.

프레이트 포워더의 항공사 선정요인과 대안선정에 관한 연구

Purpose: As the competition between airlines overheats, the need to provide differentiated and high-quality air services that meet the needs of customers is emerging as a very important factor.
 Research design, data, and methodology: T his s tudy d erives t he i mportance a nd priority of freight forwarders' airline selection factors, and compares competitiveness between national airlines and foreign national airlines by employing AHP based on questionnaires collected from freight forwarders. For this study, the variables selected included four factors as higher-level criteria (transport, cost, customer service, and reputation/professional factors) and 16 factors as lower-level criteria from previous studies in the literature.
 Results: T his s tudy s hows t hat t he i mportance o f f actors s uch a s c orporate i mage a nd support functions is greater than other factors, whereas freight rates and transportation services ranked high in most of the existing studies. Analyzing the selection alternatives between national airlines and foreign national airlines found that the remaining three factors (excluding the cost factor) showed an average advantage of about 70%, while foreign national airlines had a competitive advantage of only 70% with regard to costs.
 Conclusions: This study showed that reputation, expertise, and additional service factors, which are non-essential and additional, are more important in selecting a transportation company than transportation and cost, which are the essential factors in air transportation. The results imply that other factors are given more importance, because the difference in cost factors is not high, or that factors other than cost are given more importance in airline selection, considering the high fares due to COVID-19.

INVESTIGATION of CLASSROOM TEACHERS' TECHNOLOGICAL PEDAGOGICAL CONTENT KNOWLEDGE in THE CONTEXT of MATHEMATICS TEACHING for INCLUSIVE STUDENTS

Mathematics teaching has a special place in the process of implementing successful inclusion practices (SIP) for students with special needs (SWD). However, during the process of teaching mathematics skills to SWD, various learning problems are experienced for different reasons, and inclusion cannot be fully achieved. In order to eliminate or minimize this problem situation, effective mathematics teaching should be carried out. In order to achieve this goal, it is very important to make adaptations to SWD by using technological pedagogical content knowledge (TPACK) in mathematics teaching. Based on this importance, the aim of the study is to examine the TPACK of classroom teachers regarding their implementation of SIP in the process of teaching mathematics to SWD. The research has a qualitative research paradigm. In this context, the research model was determined as a multiple-case study. The participants of the study consisted of eight classroom teachers determined by criterion sampling method. The "Semi-structured Interview Form" developed by the researchers was used as a data collection tool. In this context, the answers given by the participants to the interview questions were subjected to descriptive analysis within the framework of themes, sub-themes, and common codes created by the researchers. As a result of the analysis, it was concluded that the classroom teachers' competencies in technology and content knowledge (mathematics and special education) varied. There are some positive aspects (advantages) and negative aspects (disadvantages) of using technology in both general education and mathematics education, they include the use of technology in different aspects of the presentation and evaluation processes of mathematics teaching within the scope of SIP, and they also need additional services such as developing TPACK competencies in the mathematics teaching process, providing devices, infrastructure facilities and training for this purpose. The findings obtained from the study were discussed within the framework of the literature, and limitations and suggestions for further research were stated.

High Seroprevalence of Hepatitis C Virus Among Cisgender Women Who Exchange Sex in the Seattle, Washington Area.

Injection drug use (IDU) is a risk factor for hepatitis C virus (HCV) acquisition and occurs disproportionately among women who exchange sex (WES). However, little is known about HCV epidemiology in this population. We estimated HCV seroprevalence, identified correlates of HCV seropositivity, and characterized social networks by HCV serostatus and IDU history among WES in the Seattle, Washington, area. This was a secondary analysis of data from the 2016 National HIV Behavioral Surveillance survey in the Seattle, Washington area, a cross-sectional survey that used respondent-driven sampling (RDS) to enroll WES for money or drugs (N = 291). All participants were offered rapid HCV-antibody testing. We estimated HCV seropositivity and used log regression methods to estimate crude and adjusted prevalence ratios (PRs) for correlates of HCV seropositivity among WES. Using RDS recruitment chain data, we computed homophily indices to estimate the extent to which participants were likely to recruit another participant with the same HCV serostatus and IDU history. In the study sample of WES in the Seattle, Washington area, 79% reported lifetime IDU and 60% were HCV seropositive. HCV seropositivity was strongly associated with ever injecting drugs (PRadj: 7.7 [3.3, 18.0]). The RDS homophily scores for HCV seropositivity (0.07) and ever injecting drugs (0.02) suggested that participants did not tend to recruit others with the same characteristics beyond what would be expected by chance. Among this sample of WES in Seattle, Washington area, HCV seroprevalence was high and strongly associated with a history of IDU. The high burden of HCV among WES suggests this marginalized group would benefit from additional harm reduction services and targeted HCV treatment campaigns to reduce forward transmission. We saw little evidence of preferential recruitment among WES who were HCV seropositive or reported a history of IDU, suggesting the potential futility of peer-based referrals for HCV treatment.

Supportive care and healthcare service utilisation in older adults with a new cancer diagnosis: a population-based review

ObjectivesOlder adults have unique needs and may benefit from additional supportive services through their cancer journey. It can be challenging for older adults to navigate the siloed systems within cancer...

Effectiveness of pharmaceutical care introduced in coordination with PHC – study design.

Pharmacist services have the potential to lower medical costs and improve patients' clinical outcomes. However, when compared to usual care, depending on the service kind, pharmacist’s services have a varying impact on patient outcomes. Some services appear to have little impact, while others have the potential to improve outcomes on a scale that is clinically relevant. Pharmacists in Poland have received rights to provide additional services to patients in 2021, but new services have not yet been implemented. Although there has been research on impact on patient outcomes of various pharmaceutical interventions, those interventions have been observed in a silos, with little to no care coordination with primary health care.
 Objective of the planned research project is to analyse cost-effectiveness of non-dispensing pharmaceutical services realized as part of coordinated care with primary care providers.
 The research project will be carried out at Medical and Diagnostic Center (MDC) in Siedlce, Poland, where a number of pharmaceutical services have been already introduced. Those have been developed in collaboration between pharmacists, physicians and nurses working in MDC and include:
 
 medication reviews – assessment of patient’s pharmacotherapy and patient’s general health, usually after primary care doctor’s referral,
 medication consultation – educating patient on the use of medicines for a given illness,
 pharmaceutical assistance – preparing medicine sets for patient,
 health prophylaxis and diagnosis – patient education on health prophylaxis, combating vaccine-hesitancy in patients, assistance in combating addictions,
 intervention/urgent visit – health assessment in connection with a minor ailment,
 patient digitalization – assessment of main technical issues related to care coordination, including setting up patient’s account in Polish electronic health record system and MDC account,
 internal pharmaceutical consultation – consultation on patient’s pharmacotherapy between pharmacists and primary care doctor, specialist or nurse via phone, online system or on-site appointment..
 
 To deliver those services, pharmacists will have access to information collected at time of the patient encounter as well as additional set of clinical data from internal MDC IT system. IT system would also allow for communication between different healthcare professionals, allowing for recommendations and referrals.
 A method used in the project will be a controlled intervention study with pre-post comparison between patients receiving pharmaceutical care services and care as usual. Study would look to include at least 200 patients. Outcome measurements will be pharmacotherapy-related problems (drug interactions, drug contraindications, incorrect and not recommended dosing, non-adherence), 12-month clinical outcomes of patients (percentage outside blood pressure range, percentage outside glycated haemoglobin range, SF-36 physical functioning, drug burden index, medication-related hospital admissions), number of pharmaceutical consultations delivered to physicians, and costs. Study will also collect patient experiences with the interventions and their opinions will be used to improve services in the future.
 The research is looking to bridge the science gap in cost and effectiveness assessment of pharmaceutical care services, improve patients’ health outcomes and help bring organizational and financial improvements to healthcare sector.
 

UPAYA PENINGKATAN KINERJA PELAYANAN SURAT KETERANGAN CATATAN KEPOLISISAN (SKCK) DI POLRES SLEMAN

This study aims to improve the service of SKCK (Police Records Certificate) at the Sleman Police. Data collection techniques by interview, observation and literature study. The problem discussed is the performance of the Sleman Police in the service of the Police Record Certificate (SKCK) which is not yet optimal. The purpose of this study was to find out the obstacles that resulted in the SKCK service not being optimal at the Sleman Police, to find out the efforts made to overcome the problem of the non-optimal SKCK service at the Sleman Police. This research is oriented to qualitative descriptive, namely research that describes or describes the results of data collection and processing along with information from sources. The results showed that: 1) Obstacles in SKCK services at Polres Sleman were: a) Lack of technology updates and their mastery by officers. b) Insufficient number of officers. c) Facilities and infrastructure are limited in number. d) The service area is less spacious. 2) Efforts made so that SKCK services can be optimal are: a) Creating an online application for online SKCK applications. b) The need for additional service personnel. c) Training or capacity building for officers. d) Addition of facilities and infrastructure to support services such as generators, computers and laptops. e) Expansion of SKCK service places and facilities for persons with disabilities.

О реализации нечеткой модели оценки лояльности потребителей для организаций электроэнергетики на основе метода аддитивной свертки

The relevance of developing models and tools that take into account the growing role of electricity consumers in order to increase the competitiveness of electric power industry organizations based on the creation of artifi-cial intelligence systems that provide ample opportunities for structuring demand, taking into account the main and additional types of activities, contributing to the formation of development programs for organizations, is emphasized. The developed models for assessing consumer loyalty are characterized, the approach most of-ten used for their formation is determined, and their peculiarity is their application to multi-product sales. It is emphasized that the choice of tools for implementing a model for assessing consumer loyalty for electric pow-er industry organizations is associated with the influence of technical, social and economic factors that deter-mine the use of “soft” modeling. It is shown that the most appropriate method for implementing the model is the additive convolution method. An algorithm for implementing a fuzzy model is presented based on the selected method and the proposed criterion for determining loyal consumers. An example of assessing the loyalty of electricity consumers of an energy sales organization is shown, consumers with a high level of loyalty, includ-ing behavioral and cognitive, are identified in order to formulate proposals for participation in programs for the development of the digital environment and the use of additional services.

ANALYSIS OF THE APPLICATION OF ONLINE TICKET BOOKING APPLICATION ACCESS BY KAI

This study aims to analyze the impact of the implementation of online ticket booking applications on the number of train passengers based on ticket sales data. The development of technology has brought significant changes in the transportation industry, including trains, with the introduction of online ticket booking applications. The analysis method used is a non-parametric statistical test to measure the relationship between the application and the number of passengers. Train ticket sales data for several years before and after the implementation of the application were used in the analysis. The results of the analysis showed a positive relationship between the implementation of online ticket booking applications and an increase in the number of train passengers. The findings support the view that the ease of access and convenience in booking tickets through the app has encouraged more people to use rail services. Although the results of this study indicate the positive impact of implementing online ticket booking applications, there are several other factors that can affect the number of passengers, such as economic factors, promotions, and additional services offered by train operators. Therefore, this study has limitations in considering all these factors. Based on these findings, it is recommended that train operators continue to develop and improve online ticket booking applications as part of their marketing and customer service strategies. This research contributes to understanding how technology can shape consumer behavior in the transportation industry and the extent of its impact on train passenger numbers.

Integrating Social Care Into a Specialized Medical Home for Sex-Trafficked Youth.

After a series of meetings between medical personnel and community stakeholders, the Children’s Hospital of Philadelphia successfully launched the Adolescent Protection Collaborative in July 2021. This novel clinic created a specialized medical home for sex-trafficked youth. The clinic was staffed by a core team of child abuse pediatrics and adolescent medicine physicians and a social worker who provided coordinated evaluations and same-day services, followed by ongoing long-term care. The Adolescent Protection Collaborative model was built on interdisciplinary collaboration with the goal of consolidating medical services and reducing fragmentation of care. A Community Advisory Committee was formed and aided in linking interested youth with additional services. Healthcare navigation was facilitated through support of a clinic-specific social worker, and transportation barriers were largely eliminated through a grant-funded program. Pilot data from the initial 21 months of clinical operations revealed that 88% of 43 referred patients (ages ranging from 13–22 years with a mean of 16 years) attended a scheduled appointment with 55% returning for follow up. Most patients (68%) identified as Black. All (100%) had past or present involvement with child protective services. Fifty percent of referrals tested positive for a sexually transmitted infection with a total of 33 sexually transmitted infections diagnosed and treated. Patient-desired contraception was facilitated for approximately 67% of referrals. Social care needs, such as referrals for educational support, case management, housing and employment resources, and mental health linkages, were offered alongside standard medical services. The described clinic model demonstrates promise in meeting the unique healthcare needs of sex-trafficked youth.

COVID-19 IMPACT ON HEALTH JOURNEYS FOR VETERANS WITH CHRONIC CONDITIONS

Abstract The majority of Veterans receiving care in the Veterans Administration (VA) are over 65 years, and many have multiple chronic conditions and functional limitations. In this mixed methods pilot study, we sought to understand how these Veterans experienced the pandemic and associated VA health system changes across two contrasting (rural/urban) VA New York medical settings. From December 2021-January 2023, we conducted semi-structured interviews including co-created journey maps and extracted participants’ demographic and clinical characteristics and outpatient encounters. Journey maps visualized health and related episodes and associated pain and bright spots calibrated by intensity. 40 Veterans participated. An intense COVID-19 reaction emerged in 25% (10/39) of participant journeys. A majority (80%; 8/10) had a mental health (MH) diagnosis, compared to 55% (21/39) overall. A journey typically began with feeling shocked, afraid, or in extreme distress; subsequently there was divergence with some expressing feeling better and others describing lingering negative effects on daily routines, views of a changed world, and persistent VA service impacts. Some reported new perceptions of vulnerability due to age and decreased well-being. Participants in this group used on average more outpatient care before and during the pandemic than other participants and transitioned to greater consumption of virtual care, reflecting utilization trends across participants with mental health diagnoses. The group had mixed feelings about the benefits of virtual care. Ongoing challenges with COVID-19 may indicate the potential need for additional well-designed supportive services and environments particularly sensitive to the long-term impact of COVID-19.

SUPPORT FOR FAMILY CAREGIVERS: WORK STRAIN AND THE IMPACTS OF FORMAL AND INFORMAL SUPPORT

Abstract In the US, caregiver burnout has significant mental and physical ramifications for an estimated 40 million unpaid caregivers. In addition to higher risks of depression, fatigue, and anxiety, caregivers are often squeezed in the already tenuous balance between work and life. This study seeks to assess whether and to what extent the mental health consequences of caregiver work strain is ameliorated by the presence of additional (informal) family caregivers and formal service use. This study utilizes data provided by the National Study of Caregiving (NSOC) data which is linked with care-recipient information from Health and Aging Trends Study (NHATS) data. We analyze mental health outcomes for caregivers who were present in years 2015 and 2017 (N = 281) using lagged linear regression techniques. We estimate associations of work-strain with mental health issues as well as the moderating effects of informal support (the number of additional caregivers) and utilization of formal support (such as paid service support, formal training, and Medicare funding). Preliminary analyses indicate that the additional informal support mitigates the effect of work strain on mental health. However, formal support corresponds with positive mental health outcomes in the absence of work strain and poorer mental health outcomes when the caregiver experiences work strain. One possible explanation is that formal support is more likely to be used when caregiver burden and isolation is higher, highlighting the importance of timing in service utilization as well as the importance of social and informal resources for employed caregivers.