Benefits Of Services Research Articles

Digital services as alternative for in-person visits among clients with long-term illnesses

Abstract Background For individuals managing long-term illnesses and often requiring complex care across health and social care sectors, the transition to digital platforms holds considerable potential to facilitate management of one’s health. This study examined factors among people with long-term illnesses associated with their perception that digital services had replaced in-person visits in health and social care. Methods A total of 11,012 Finnish residents with long-term illnesses necessitating regular care (56% female, mean age 56.9, SE .23) responded to a nationwide population survey between September 2022 and March 2023. The Inverse Probability Weighting method was used to correct for bias. Complex samples binary logistic regression was used to examine whether factors related to self-rated health, distress, digital skills and perceived benefits of digital services were associated with the replacement of in-person visits by digital services. The model was adjusted for age, gender, education, and urbanicity. Results Approximately one third (35.8%) of the respondents indicated that the use of digital services had replaced in-person visits within the past 12 months. Respondents in poor or moderate health (OR 1.17, 95% CI 1.02-1.34) had greater odds of reporting the replacement compared to those in good health. Those with proficient digital skills (OR 1.84, 1.57-2.14) and those perceiving more benefits in digital services (OR 1.56, 1.47-1.74) had greater odds of reporting of the replacement compared to their counterparts. Conclusions Transition to digital services could facilitate access to care for individuals with long-term illnesses perceiving their health poorer. Promoting digital skills and perceptions of benefits of digital services can significantly increase the use of digital services as substitutes of in-person visits and contribute to more efficient allocation of health and social care resources. Key messages • Especially those reporting poorer health seem to use digital services as replacements of in-person visits, offering the potential to optimize resource utilization in health and social services. • Promotion of digital skills and perceptions of the benefits of digital services could increase the use of digital services as replacements for traditional visits with health and social professionals.

Evaluation of specific offers for mothers with mental stress

Abstract Background As part of the Austrian early intervention programme ‘Frühe Hilfen’, specific interventions (a psychotherapeutic short-term intervention and a therapeutic group) were implemented in some regions. An evaluation was carried out to gain general insights into the need for and benefits of psychosocial services as well as in-depth information on the benefits of the two selected services. The results of the project should also enable further conclusions/recommendations for appropriate services. Methods Mixed-methods approach: qualitative (focus groups, individual interviews, online surveys, participant observation) and quantitative (screening questionnaires) instruments involving a large number of relevant stakeholders and actors. Data analysis: content-structuring qualitative content analysis according to Kuckartz; descriptive analysis of the screening questionnaires. Results The analysis revealed a great need for specific psychosocial services for this target group as well as a high level of satisfaction with the psychosocial services utilised. However, all respondents pointed out barriers to the utilisation of psychosocial services. The evaluation results show that the two specific services make an important contribution to improving the well-being of mothers with mental health problems. Both services largely reach their target group well and, thanks to their focus, contribute to the well-being of mothers with mental health problems. The effectiveness of the service is underpinned by the fact that all participants perceive a reduction in mental stress and notice a reduction in stress during the screenings. Conclusions Based on the evaluation results, it is generally recommended that low-threshold, free and needs-based services be established or expanded. In addition, there is a need for more educational and public relations work on psychosocial stress/diseases and more information on support services. Key messages • There is a great need for psychosocial support among mothers. • The high level of satisfaction with the services evaluated indicates that more such services are needed to support families.

Using a natural capital risk register to support the funding of seagrass habitat enhancement in Plymouth Sound

Seagrass is an important marine habitat that provides benefits to society in the form of ecosystem services. Services include the provision of food via fisheries, the regulation of water quality and the ability to sequester and store carbon. In the UK, seagrass beds are in decline, increasing the risk of ecosystem service loss. Current efforts to protect, restore and create seagrass habitat, beyond spatial management measures, rely on grant funding and donations. Emerging carbon, biodiversity and wider ecosystem service markets offering potential revenue sources could facilitate the enhancement of seagrass habitat at scale. Participation in ecosystem service markets, requires that projects deliver on the ecosystem service benefits defined. As the benefits will have been paid for, there are risks associated with not delivering on ecosystem service benefits. It is important that the risk is clearly defined. In this study we further the marine natural capital and risk register approach and apply the method to a case study area to support the development of sustainable funding options for seagrass habitat enhancement in Plymouth Sound, UK. Habitat Suitability modelling is also used to map potential areas for seagrass habitat enhancement. We find that, in the Plymouth Sound area, the risk of loss of ecosystem services for subtidal seagrass habitats is, at present, high. This is primarily linked to the declining extent and condition of subtidal seagrass assets. Under current governance, all of Plymouth Sound’s subtidal seagrass are within a Marine Protected Area, though this conservation designation does not guarantee that the seagrass bed is protected from damaging activity. Under current environmental conditions there is opportunity for widespread seagrass restoration and creation. Risk to seagrass beds and any future private funding could be reduced by governance actions that enable effective direct protection of the seagrass assets and mitigate harmful pressures (e.g., reduction of water pollution). Emerging financial ‘products’ from seagrass ecosystem services that can support restoration and creation, require a high degree of integrity. The natural capital asset and risk register framework can provide information to underpin product development. With the development of revenue streams from ecosystem services there is a need for more intentional governance and site-based monitoring of these habitats as natural capital assets. Further research is needed to define any social or economic outcomes. Synthesis and Application By assessing the risk to the status of seagrass assets through this approach, it is possible to determine the complementary governance actions needed to underpin investment in seagrass habitat enhancement. The methods are transferable to other locations where data exists to define the asset status. These specific findings are relevant nationally where similar vectors of risk (pressures) are identified.

Exploring the impact of population agglomeration on ecosystem services: an empirical study based on Fenhe River Basin

Abstract Since the 21st century, cities have experienced rapid expansion, posing serious threats to the health of non-urban ecosystems. It is generally believed that continued urbanization will put increasing pressure on ecosystems. However, in recent decades, the degree of population agglomeration and ecological environment have simultaneously increased in China. This paper takes Fenhe River Basin as the study area, measures the spatial Gini coefficient of population distribution (Gini) and ecosystem services in 165 sub-basins from 2000 to 2020, and adopts two-way fixed effects model to study the impacts of population agglomeration on ecosystem services and its mechanism. The results show that population agglomeration is positively correlated with the overall benefit (OB) of ecosystem services, and the effect is moderated by vegetation coverage, slope and distance from market centre, only when the values are greater than 0.198, less than 6.62° and 17.90 km, respectively, will the positive effects become apparent. The phenomenon of ‘people withdrawing and vegetation entering’ makes population agglomeration have significant impacts on individual ecosystem services and trade-offs and synergies. In order to give better play to the positive effect, the population needs to migrate from areas with worse geographical conditions and farther away from market centres to better places, and the return of farmland to forests should be accelerated in areas with population concentration. Following the laws of nature to promote population agglomeration and vegetation restoration, so as to achieve a ‘win–win’ situation between economic development and ecological civilization construction through the optimization of resource allocation.

Understanding the Factors Influencing Adoption of mHealth in Rural Patients: A Case of Embu, Kenya

Background and Purpose: Kenya and other low-income countries face healthcare challenges such as affordability, access, and health worker shortages. Digital technologies have disrupted traditional service delivery in industries such as banking and retail. Significant changes have not yet affected healthcare. Technological advancements in healthcare may help to leapfrog barriers such as the cost of physical infrastructure. The study examined the influence of technical, social, and individual factors in adopting mHealth products in Embu, Kenya. Methods: A cross-sectional quantitative study using a structured close-ended questionnaire was conducted in Embu, Kenya, between August and December 2019. Correlation and regression analysis were used to determine the effect of the influential factors on adopting mHealth products. Results: 207 (75%) randomly selected respondents over 18 years completed the survey, with the largest group (39.4%) aged between 35-44 years and 43% holding a post-secondary school diploma. Correlation analysis showed that social factors positively and significantly correlate to mHealth products' adoption (r (207) = .793, P < .05), reflecting a generally favourable view towards using mobile phones for seeking healthcare. Similarly, technical factors showed a significant correlation with mHealth adoption (r (207) = .931, P < .05), supported by widespread smartphone ownership and access to high-speed internet. Individual factors, including perceptions of the time-saving benefits of seeking healthcare services using a mobile phone, also demonstrated a positive correlation with the adoption of mHealth (r (207) = .708, P < .05). Conclusions: Our study underscores the significant relationship of social, technical, and individual factors in adopting mHealth products. Digital health implementers should leverage increasing access to technical factors such as the Internet, smartphones, good mobile network coverage, and high utilization of social media to facilitate the positive adoption of mHealth. Our research provided insights from Embu; however, expansive studies encompassing rural and urban demographics are required to enhance generalizability

Current constraints to reconcile tropical forest restoration and bioeconomy

AbstractLarge-scale forest restoration is vital for delivering a broad array of ecosystem services benefits to society. However, it is often perceived as an economically noncompetitive land use choice. Integrating economic opportunities into restoration aligns socioeconomic and environmental goals, reducing conflicts between forest production and conservation-oriented management decisions. Supply chains focusing on high-value goods can enhance the reach of forest restoration efforts and unite ecological and economic benefits in a multifunctional manner. The bioeconomy has emerged as a potential but critical driver for attracting investments in restoration. We outline the challenges and solutions to reconcile forest restoration and bioeconomy, specifically about (i) native timber production, (ii) non-timber forest products, (iii) biotechnological products, and (iv) intangible ecosystem services. This requires collaborative and multidisciplinary efforts to improve investment in large-scale projects. The intricacies of these issues intersect with research development, market dynamics, legal frameworks, and regulatory paradigms, underscoring the necessity for nuanced and tailored public policy interventions. These integrated approaches should enable tropical countries to lead the global forest-based economy and usher in a new era of forest restoration. Graphical abstract

Understanding the interplay among urban public transport modes: Spatial variation and built environment effects

Research on public transport systems is continually driven by the societal benefits of transport services. However, the nuanced effects of the built environment on public transport mode shares across different modes have received little attention. Using multi-source travel data from Shenzhen, this study presents an analytical framework, which integrates the light gradient boosting machine and Shapley additive explanations, to delve into the complex interplay among public transport modes. The results reveal that most origin-destination pairs with available metro services exhibit a metro share exceeding 50%, underscoring the high attractiveness of the metro. Travel distance emerges as the primary determinant of mode share, with transport-related characteristics proving more influential than land use modifications. This study identifies nonlinear effects of the built environment on mode share, with specific thresholds for built environment characteristics suggesting fine-tuned planning strategies. Metro station densities of 2 counts/km2 correlates with increased metro share, while bus stop densities of 15 counts/km2 are associated with higher bus share. Areas within 2 km of a metro station or with bus stop densities below 15 counts/km2 tend to have higher bike shares. Specific land use ratios and high levels of land use mix are linked to increased shares of certain modes. The findings suggest optimizing bus services in relation to metro availability and offer guidance for balanced planning in promoting metro and shared mobility to achieve a sustainable transport system.

Carbon Emission Reduction Associated With Utilisation Of Telehealth In Outpatient Clinics In An Australian Quaternary Health Service

Objective: To assess the impact of implementing telehealth in outpatient clinics on the carbon emissions associated with the delivery of health care. Design & Setting: Retrospective cohort study in large metropolitan quaternary referral health service from January 2021- December 2022. Participants: All patients who attended an outpatient clinic appointment during the study period, either in-person, via telehealth or via telephone. Main outcome measures: The estimation of carbon emissions in tonnes (t) of CO2-equivalent (CO2-e) associated with in-person and telehealth appointments based on emissions associated with travel, telehealth platform usage and N95 mask usage. Results: There were 571,121 outpatient clinic appointments during the study period. Of the appointments, 251,458 (44%) were conducted remotely, resulting in an estimated reduction in 3,629t of CO2-e emissions in the two-year period. Telehealth consultations in this time contributed 4.5t of CO2-equivalent emissions. The total emission usage of telehealth clinic was only 0.12% of emissions generated from face-to-face clinic appointments. Conclusion: Telehealth offers the opportunity of substantial carbon emissions reduction within the healthcare sector, while also providing cost and time-saving benefits for healthcare services and patients. Limitations include generalisation of transportation modes and the retrospective nature of the data collection.

Ecommerce and Public Health: Managing the Digital Transformation of Healthcare Services

The study investigates the impact of demographic factors, usage frequency, and professional roles on user satisfaction with digital health platforms. A sample of 300 participants, including healthcare professionals, platform operators, and patients, was analyzed to assess the role of age, gender, professional role, and frequency of platform use on satisfaction levels. The results show that the gender did not significantly influence satisfaction, suggesting that platforms may cater equally to both male and female users. Multivariate Analysis of Variance (MANOVA) revealed that professional role also significantly influenced perceptions of digital healthcare transformation and willingness to adopt new services, with platform operators displaying the most positive views. Patients, however, showed more reluctance to adopt new services, suggesting that additional trust-building measures are needed for wider adoption. The study concludes that digital health platforms must prioritize user experience across demographics, particularly focusing on older users and patients, to increase satisfaction and engagement. Collaborating with healthcare professionals in platform development and enhancing communication about the benefits of digital health services can drive greater adoption and satisfaction.

Exploring public attitudes toward implementing green infrastructure for sponge city stormwater management

Sponge city stormwater management (SCSM) strategy in China aims for sustainable stormwater handling. While many studies have examined the technical aspects of sponge city green infrastructure (SCGI), few have explored public perspectives. This study sought to understand public perceptions, the perceived value of SCGI’s ecosystem service benefits, and the potential for diverse financial compensation methods in sponge city construction. A survey conducted in five Northeastern Chinese cities, involving 1,534 participants, was analyzed using descriptive statistics and logistic regression. The findings reveal no significant correlation between socio-demographic factors and understanding of stormwater management, indicating the concept’s broad accessibility. Public valuation of ecosystem services showed clear priorities, and factors like homeownership and flood experiences significantly impacted the valuation of specific services. Moreover, the study identified a generally positive public attitude towards investing in SCSM, particularly through stormwater fees, underscoring the viability of diverse funding mechanisms. These insights are pivotal for policymakers and urban planners in formulating sustainable and resilient urban water management strategies.

Economic Assessment of Meteorological Information Services for Capture Fisheries in Taiwan

This study evaluates the economic benefits of meteorological information services (MISs) provided by the Central Weather Administration (CWA) in Taiwan, specifically for Taiwan’s capture fishery industry. Using the contingent valuation method (CVM) and conducting in-person interviews, we collected questionnaires from capture fishery practitioners nationwide to gather their subjective evaluations of the meteorological information services provided by the CWA. Based on these evaluations, we further investigated the respondents’ willingness to pay (WTP) for the CWA’s meteorological information services. An empirical analysis of the bid function was conducted to identify the key factors influencing the respondents’ bidding behavior. The empirical findings indicate that the primary factors affecting bids include subjective perceptions (such as forecast accuracy ratings and the ratings of the impacts on fishing production), working location, fishing vessel tonnage, and fishing methods. The median WTP for Taiwanese capture fishery practitioners is Taiwan dollar (TWD) 2111.12 per person per year. Based on the number of capture fishery practitioners in Taiwan in 2019, the total annual economic value of applying MIS in coastal and offshore fisheries is estimated to be between TWD 376 million and TWD 496 million per year.

Assessing Trade-Offs and Synergies in Ecosystem Services within the Tianshan Mountainous Region

In managing ecosystem services (ESs), it is vital to understand and effectively regulate the trade-offs and synergies (ToSs) involved. This study investigates the Tianshan Mountains (TSMs), utilizing the InVEST (Integrated Valuation of ESs and Tradeoffs) model to evaluate ecosystem service changes from 2000 to 2020, while employing univariate linear regression to examine their spatiotemporal dynamics. Pearson correlation analysis was also conducted to assess how climatic variables (temperature and precipitation) and vegetation indicators (NDVI, normalized difference vegetation index) influence the overall ecosystem service benefits. The findings reveal notable spatial heterogeneity and dynamic shifts in ESs across the TSMs, with strong synergies observed between carbon storage (CS) and other services (such as habitat quality, HQ; soil conservation, SC; and water yield, WY), especially in areas experiencing increased vegetation. However, the connection between HQ and WY was comparatively weaker and occasionally exhibited negative correlations during specific periods, highlighting the intricate trade-offs among various services. The correlation analysis further showed that climate and vegetation changes significantly impact ecosystem service benefits, with declining precipitation and rising temperatures reducing these benefits, whereas higher NDVI was associated with improved service functions. Ultimately, this study emphasizes the necessity of recognizing and managing ToSs in ESs to promote sustainable regional ecosystem development.

Benefit-Cost Analyses of Hearing Aids, Over-the-Counter Hearing Devices, and Hearing Care Services.

Limited accessibility to hearing health care threatens healthy aging in place for older adults with hearing loss. A willingness-to-pay (WTP) approach was used to determine benefits and value of prescription advanced digital technology (ADT) hearing aids, over-the-counter (OTC) hearing devices, and rehabilitative services using benefit-cost analyses. This study was a cross-sectional survey with chart review of hearing aid users at two independent audiology practices. Seventy hearing aid users (response rate: 15.6%) provided their WTP for ADT prescription hearing aids, OTC hearing devices, and hearing rehabilitative services. Benefit-cost ratios and net social benefit were calculated using deterministic and exploratory approaches. Point estimates for benefit-cost ratios and net social benefit were derived using bootstrap sampling with replacement (N = 5,000). Median WTP for ADT prescription hearing aids and rehabilitative services were $2,000 and $250, respectively. WTP was lowest for OTC devices (Mdn = $0; maximum = $500). Benefit-cost ratios and net social benefit for ADT prescription hearing aids, OTC devices, and hearing rehabilitative services favored these interventions when out-of-pocket costs remained low. Benefit-cost analyses also produced results favoring prescription ADT hearing aid intervention with costs as high as $1,530 per device. WTP results indicated that all interventions under study have a measurable consumer-perceived benefit. Results of benefit-cost analyses favored the interventions but only when costs were lower than market prices. The benefit-cost analysis results for hearing care services underscore their value when provided as part of a comprehensive rehabilitative plan that may inform future health policy changes.

Re-envisioning par for the course: an assessment of desert golf sustainability from a landscape perspective

ABSTRACT Despite providing valuable ecosystem services (benefits people derive from nature), desert golf courses consume enormous amounts of water and can exacerbate water scarcity in drylands. Yet, few studies have assessed the sustainability of desert golf from a landscape sustainability perspective, which centers on the linkages among landscape pattern, ecosystem services, and human well-being. Focusing on the Phoenix Metropolitan Area (PMA) of USA, a global golf epicenter, this study investigated the relationships among golf course spatial pattern, water use, ecosystem services, and environmental justice. Our analysis revealed that there are 210 golf courses in the PMA, together making up roughly 3.5% of total regional water demand. Furthermore, we found that people from high-income brackets have greater access to the benefits provided by golf courses than those in low-income brackets. To improve desert golf sustainability, we need to design courses that use less water and provide a wider range of ecosystem services beyond the game of golf, including climate regulating services and cultural services. Golf courses should be considered explicitly in sustainable landscape design, with particular emphasis on the diversity and accessibility of ecosystem services they provide in a regional context.

The benefits and barriers of accessing cancer support services

IntroductionCancer is a substantial cause of morbidity and mortality worldwide. In Ireland, rising cancer incidence means that the burden on society will continue to increase. Recent recognition of the large impact of psychological distress on patients with cancer has led to suggestions to use support centres to mitigate this distress. Thus, the benefits of participation and barriers to attendance must be explored. Aims & ObjectivesTo systematically review scientific literature and determine the: (i) Sociodemographic composition of cancer support centres. (ii) Benefits of support services to patients with cancer. (iii) Barriers/facilitators to support centre attendance. MethodsElectronic searches were carried out PubMed and the Cumulative Indexto Nursing and Allied Health Literature (CINHAL) databases using key words addressing the research question. Ten articles were selected and critically appraised. ResultsA summary of article results showed that while various groups remain underrepresented in support centres, new evidence suggests this may be changing. Increased support service attendance was linked to greater benefits. No change in anxiety or depression with attendance were seen. Barriers to attendance were identified. ConclusionsThe literature showed benefits to support services, but long term benefits must be further investigated. Future research quantitatively assessing benefits of support services, using validated assessment instruments are necessary. Psychological benefits of participation are still unclear. Validated questionnaires to assess the barriers to attendance must be developed. Lastly, there is a lack of studies on the benefits of and barriers to support services participation in the Irish population.

Meeting Men Where they are: Motivators and Barriers to Accessing Health Services through a Men's Mobile Wellness Clinic, October 2019 to March 2020, Blantyre, Malawi.

In Malawi approximately, 88.3% people living with HIV are aware of their HIV status. Significant gaps are among men aged 15-34 years; only 72% know their HIV status. To reach men, Jhpiego, in collaboration with the Ministry of Health (MOH), implemented the Men's Mobile Wellness Clinic (MMWC) at workplace settings in Blantyre, Malawi between October 2019 and March 2020. We conducted a descriptive qualitative study to understand motivators and barriers to MMWC service uptake by employees and employers. Primary data was drawn from in-depth telephone interviews from four study populations: employers who accepted or declined to host the MMWC at their worksite, and employees who accessed or did not access the services. We performed a thematic analysis using Nvivo 12 software to identify patterns and themes across the dataset. Main reasons given for using the service among male employees were a desire to know their health status, availability of free health services at the workplace, and good quality services offered by MMWC staff, and support from their supervisor. Men who did not access services stated reasons such as work-clinic scheduling conflicts, lack of adequate promotion of the service, and miscommunication on the criteria about who should attend the MMWC. Employers who accepted to host the MMWC stated convenience and employee's rights to know their health status. Those who declined either stated that employees did not want the services or COVID-19 preventive measures by the MOH between October 2019 and March 2020 restricted participation. This study underscores the potential utility of MMWC services including HIV testing among men. The desire to know their health status, availability of free MMWC services at the workplace, good quality services offered by MMWC staff, and the endorsement of MMWC by supervisors were main motivators to access the MMWC services. Sensitizing supervisors and employees about the benefits of the MMWC services, strengthening demand creation, and clarifying eligibility are important to facilitate MMWC uptake among men in Malawi.

The Gains and Losses of Cultivated Land Requisition–Compensation Balance: Analysis of the Spatiotemporal Trade-Offs and Synergies in Ecosystem Services Using Hubei Province as a Case Study

The cultivated land requisition–compensation balance (CLRCB) policy is an important policy implemented by China to address the reduction in cultivated land and ensure food security. Although this policy has alleviated the loss of cultivated land quantity, it has had complex and diverse impacts on ecosystem services. Taking Hubei Province as the study area, this research explores the impact of the implementation of the CLRCB on ecosystem services and simulates the changes in ecosystem services in the study area in 2030 and the impact of CLRCB on the interactions among various services. The results show the following: (1) from 2000 to 2020, Hubei Province achieved a balance in the quantity of cultivated land through excessive compensation but failed to reach the goals of balancing cultivated land yield and productivity. (2) During the requisition–compensation process, habitat quality decreased by 501,862, and carbon storage lost 1.3 × 107 t, indicating negative ecological impacts; soil conservation services increased by 184.2 × 106 t, and water production increased by 21.29.3 × 108 m3. Within the cultivated land requisition–compensation area, habitat quality and carbon storage, as well as soil conservation and water production, exhibited synergistic relationships, while the remaining pairs of ecosystem services showed trade-off relationships. (3) The simulation of ecosystem services in 2030 indicates that soil conservation and water production are highest under the natural development scenario, while habitat quality and carbon storage are highest under the ecological protection scenario, both of which are superior to the urban development scenario. Under the natural development scenario, the trade-off and synergistic relationships among various ecosystem services in the cultivated land requisition–compensation area remain unchanged, while these relationships change significantly under the other two scenarios. This study emphasizes that future CLRCB should not only focus on maintaining the quantity of cultivated land but also consider the comprehensive benefits of ecosystem services, in order to achieve sustainable land-use management and ecological conservation.

Developing a foundation information and academic skills programme for potential Student Nursing Associates.

This article outlines the development of 'Prepare to Progress', a preapplication programme for potential Student Nursing Associate (SNA) applicants at Gloucestershire Hospitals NHS Foundation Trust. Created collaboratively by the Trust's Library and Knowledge Services and Professional Education teams, the programme aims to provide realistic course expectations, teach study skills and boost confidence in using library services. Evaluation results indicate increased understanding of the SNA course, improved application decision-making, and enhanced academic confidence among participants. The programme demonstrates the valuable role of library services in preparing healthcare support workers for further education and addressing library anxiety. The study suggests benefits for both participants and library services.

Breastfeeding During COVID-19 Stay-at-Home Orders: Implications for Future Maternal Work Policies and Health Equity.

This study aimed to explore the impact of the COVID-19 pandemic and associated stay-at-home orders on the breastfeeding experiences of U.S. people a identify facilitators and barriers to breastfeeding during this period, and to assess the effects of maternal stress and misinformation on breastfeeding practices. U.S. women with infants were selected through purposive and convenience sampling. An online survey, distributed during summer 2020, measured changes in infant feeding practices, maternal stress levels, use of lactation support resources, and the influence of misinformation on feeding decisions. Quantitative data were analyzed using descriptive statistics, and qualitative responses underwent thematic analysis. Our sample (n = 1,861) revealed that 34% of U.S. women realized the pandemic affected their feeding practices, 544 women provided qualitative data. Major themes from qualitative analysis included ease of breastfeeding at home, bonding, increased breastfeeding duration, and challenges like limited access to lactation support. Logistic regressions highlighted demographic influences on breastfeeding practices, with no significant effects found related to the child's age or women's income on changes in feeding practices. The COVID-19 pandemic substantially impacted breastfeeding experiences of U.S. women, yielding insights for future policy and healthcare practices. The findings underscore the potential benefits of telehealth lactation support services and flexible remote work environments for breastfeeding people. Clear and scientifically-grounded communication regarding breastfeeding, mental health support, and policy development, are essential to promote equitable and flexible work and maternity leave options for breastfeeding people especially during global health crises.

Strengths and Weaknesses of HIV Partner Notification Implementation in Iran.

HIV partner notification is a key intervention to facilitate access to HIV testing and treatment. This qualitative study investigated the strengths and weaknesses of the HIV partner notification program in Iran. Additionally, it provides comprehensive recommendations to mitigate potential harms and maximize the benefits of partner notification services. Using purposive sampling, 15 participants, including policymakers, service providers, and researchers in the field of HIV, were recruited from nine provinces between September and December 2023. The qualitative content analysis was conducted using the Graneheim and Lundman approach. Several strengths were reported for the HIV partner notification program, including alignment with international guidelines, use of trained counselors, integration with current HIV testing guidelines being used by HIV testing centers funded by the Ministry of Health, and a well-developed monitoring and evaluation plan at the facility, provincial, and national levels. Notable weaknesses of the program included a lack of a detailed implementation plan overall and for some key populations at high risk for HIV, such as female sex workers, lack of integration of the program with HIV testing services provided in hospitals and HIV centers funded by the Welfare Organization in Iran, lack of a simple quality checklist for monitoring and evaluation of the program. To increase the coverage and quality of the HIV partner notification program in Iran, a more detailed implementation plan, a simple quality checklist, and more targeted advocacy and training programs are needed.