Client satisfaction and associated factors with the health care services in Central Ethiopia, 2025: facility-based comparative cross-sectional study.

ObjectiveWe adapted and evaluated a transdiagnostic psychosocial intervention, the Optimal Health Program (OHP), to meet the unique mental health needs of youth at clinical high risk for psychosis (CHR). This study aimed to establish the acceptability of OHP for CHR (OHP-CHR), the feasibility of conducting a confirmatory clinical trial, and the preliminary efficacy of the intervention in improving clinical and functional outcomes.MethodsIn this single-arm clinical trial, youth aged 16-29 years meeting CHR criteria were recruited between September 2023 and August 2024. Nine OHP-CHR sessions were delivered over 12 weeks. Acceptability of the intervention was assessed through session attendance rates and the Client Satisfaction Questionnaire (CSQ-8). Feasibility of conducting a confirmatory clinical trial was informed by recruitment, retention, adherence, intervention fidelity, and completion of the outcome schedule. Psychiatric symptoms, resilience, and functioning were assessed at baseline and after 12 weeks.ResultsAcceptability of OHP-CHR was demonstrated by high session attendance (n = 26; 86.7% attended all nine sessions) and participant satisfaction scores (CSQ-8: mean = 28.35, SD = 3.68). Feasibility of conducting a confirmatory clinical trial was supported by strong recruitment over 12 months (n = 30; rate of 2-3/month) high retention (n = 26; 86.7% at 12 weeks), intervention fidelity, and ease of completing the clinical assessment schedule. Preliminary indicators of clinical efficacy were demonstrated by a decrease in psychiatric symptoms, improvement in resilience, and enhanced functioning.ConclusionsOHP-CHR is a promising psychosocial intervention co-designed by CHR youth. Our data support the acceptability of the intervention, the feasibility of conducting a confirmatory clinical trial, and preliminary evidence of efficacy in improving clinical and functional outcomes.Trial is registered at ClinicalTrials.gov NCT05757128.

Loyal clients often make repeated purchases; they are less sensitive to the price and more willing to recommend a brand to others.Moreover, retaining loyal clients is much less expensive than acquiring new ones, which makes establishing long-term relationships with clients one of the key elements of a company's marketing strategy.Clients' loyalty and satisfaction are linked to a client's positive perception of a service, i.e. their satisfaction.Satisfaction may lead to loyalty, but it does not guarantee it.Literature review shows that client loyalty, unlike satisfaction, is not only a temporary condition but also an attitude requiring additional factors: trust, relationships, brand identification and long-term benefits.The Client may be satisfied with the service, but only permanent, positive experiences build proper attachment to the brand.The article describes the client's satisfaction and loyalty and analyses the correlation between them.The article aims to use the EPSI (European performance satisfaction index), NPS (net promoter score) and CLI (customer loyalty ratio) indicators to verify the strength and direction of the relationship between satisfaction and loyalty of clients of the selected service type.

Helping people to adjust well to retirement is important, as some retirees struggle. Most recent retirees are in a couple relationship, and the adjustment of spouses is interdependent. The current study is the first evaluation of the effects of couple-based retirement education on couples' relationships and retirement adjustment. Twenty-seven couples attended one of a series of 1-day workshops plus a telephone-based couple session. Content included couple communication and support, healthy aging, financial planning for retirement, and social engagement. Client satisfaction with the program was high, retirement self-efficacy and couple dyadic coping increased, but there was no increase in the already high couple relationship satisfaction. A couple-based approach to retirement education is promising and a randomized controlled trial with larger numbers and follow-up is needed.

Two-Dimensional Sonographic-Guided Versus Non-Guided Copper T IUD Insertion.

In higher education, evaluating client satisfaction is essential for ensuring service quality, sustaining ISO 9001:2015 standards, and guiding continuous institutional improvement. This study assessed the level of client satisfaction with the services provided by Apayao State College – Conner Campus towards ISO 9001:2015 sustainability. Employing a descriptive research design, the study involved 234 respondents selected through stratified random sampling, comprising students, faculty and staff, alumni, and external stakeholders. An adapted client satisfaction survey was used as the primary data gathering instrument. Data were analyzed using frequency, percentage, weighted mean, t-test, and one-way ANOVA. Results revealed that the respondents were predominantly young female students aged 18–25. In terms of service dimensions, respondents were satisfied with the timeliness of services (M = 4.14) and accessibility of records (M = 4.16), while they were strongly satisfied with staff responsiveness (M = 4.32) and overall service quality (M = 4.30). These findings indicate that the institution generally meets and, in several areas, exceeds the service expectations of its clientele. Significant differences in satisfaction levels were found across age groups and customer types in most service dimensions, while sex did not yield any significant difference across all dimensions. Notably, students consistently reported lower satisfaction compared to other customer types, suggesting that student-specific concerns warrant targeted institutional attention. Qualitative feedback further identified concerns regarding staff attitudes, limited awareness of roles and responsibilities, and restricted access to online services. The study concludes that Apayao State College–Conner Campus demonstrates a commendable level of service quality aligned with ISO 9001:2015 standards, while recommending continuous improvement initiatives particularly directed at frontline staff development and digital service accessibility.

Objective: To evaluate the client satisfaction concerning the services given in outpatient department.Material and Methods: Study Design was descriptive cross sectional and was conducted in the departmentPediatric Oncology children hospital and institute of child health Multan. Duration of this study was fromJune 2022 to July 2022. Two hundred patients and their attendants visiting Pediatric Oncology out-patientdepartment were included in the study using non probability consecutive sampling technique. Patients andtheir attendants not willing to participate were excluded from the study. The data were collected on predesignedand pretested questionnaire.Results: Overall satisfaction was reported by 73% of participants. Highest satisfaction was observed withstaff behavior (77%) (p=0.000).Whereas Waiting time showed the lowest satisfaction, with only 48%(p=0.012) of participants expressing satisfaction.Conclusion: Health care services in any medical facility can be enhanced by development of patientfeedback system.Keywords: Health Care Services, oncology department, Patient Satisfaction,How to cite: Arshad U, Adil MK, Saddique A, Qadir S. Client Satisfaction Concerning Health Care Services: A Studyin the Outpatient Department of Paediatric Oncology at Tertiar Care Hospital.Esculapio - JSIMS 2025;22(01):DOI:10.51273/esculap.v22i01.1351

Objectives Behavioral management is recommended for cancer pain, yet not well integrated into clinical practice. PainPac is an asynchronous mobile application that delivers behavioral pain coping strategies. We evaluated PainPac’s feasibility, acceptability, and impact on pain compared to a videoconference-delivered protocol (PCST-Video). Methods Participants (N = 62) were adults with a stage I-IV diagnosis of colorectal cancer within the past two years and pain ≥4 on 0-10 scale from an academic cancer center. Participants were randomized 1:1 to PainPac or PCST-Video. Feasibility (accrual [N = 60/15 months]; attrition at the post-treatment assessment [primary endpoint; <25%]; adherence to all assessments and intervention modules/sessions [>75%]), burden (number of modules/sessions completed; time from baseline to completion of first module/session; time to complete all sessions/modules), engagement (skills practice and PainPac log in >3 times/week), and acceptability (≥80% of participants reporting ≥75% satisfaction on Client Satisfaction Questionnaire) were assessed. Changes in pain and pain-related outcomes were explored at baseline (A1), post-treatment (A2), and 1-month post-treatment (A3). Results Feasibility exceeded prespecified benchmarks (N = 62/10 months; 92% A2 retention). Ninety percent of PainPac participants completed all modules (Msessions=3.77, SD=.82); 80% of PCST-Video participants completed all sessions (Msessions=3.37, SD = 1.33). Participants moved from A1 to completion of first module/session in 1 day for PainPac and 12 days for PCST-Video. Number of days to complete all modules/sessions was M = 23.57 (SD = 5.31) for PainPac and M = 27.63 (SD = 6.70) for PCST-Video. PainPac engagement exceeded prespecified benchmarks (M = 9.22 app logins per week). Satisfaction was high with PainPac (89.3% ≥24; M = 28.11, SD = 3.74) and PCST-Video (92.6% ≥24; M = 28.93, SD = 3.57). Pain outcomes changed in the expected direction for both conditions, improving from A1 to A3. Discussion PainPac is a promising approach for improving cancer pain management. Technology-based behavioral interventions can decrease barriers and improve intervention reach, scalability, and sustainability in clinical practice. Larger, well-powered randomized trials are needed to test PainPac’s efficacy. Clinical Trial Registration Number ClinicalTrials.gov, NCT05686122

This study examined the service quality and client satisfaction of public hospitals in Beijing using the Donabedian Structure–Process–Outcome (SPO) Model as the guiding framework and the SERVQUAL dimensions as operational indicators. A quantitative descriptive–correlational design was employed, with patients from selected public hospitals serving as respondents. Results revealed that structural aspects of service quality were rated high, reflecting the success of hospital modernization and technological investments. However, process dimensions such as responsiveness and empathy scored only moderate, indicating challenges in interpersonal communication, waiting time management, and patient-centered care. Outcome measures showed moderate to high satisfaction, especially in communication and trust, but highlighted weaknesses in coordination and shared decision-making. Overall, findings confirm that while Beijing’s public hospitals have achieved strong structural modernization, process optimization remains incomplete. The study concludes that aligning structure, process, and outcome dimensions is essential to achieve sustainable service excellence and improve patient-centered outcomes.

Abstract Background Thyroid eye disease (TED) causes functional and psychosocial morbidity, but little is known about the patient-experienced burden in Japan. Objective To assess health-related quality of life (HRQOL) and psychological wellbeing among TED patients using standardized quantitative instruments and discuss Patient Reported Outcome (PRO) of Japanese patients compared to US, European, and Asians. Methods This is the first Japanese nationwide cross-sectional survey which shows natural history of QOL prior to the launch of teprotumumab outside of US. Fifty-six TED patients were recruited and answered questionnaires including Short-Form 12-Item Survey-version 2 scores (SF-12v2), Graves’ ophthalmopathy quality of life questionnaire (GO-QOL), Hospital Anxiety Depression Scale (HADS), and Client Satisfaction Questionnaire-8 (CSQ-8). Disease activity and severity were classified based on European Group on Graves’ Orbitopathy (EUGOGO) criteria. Results While SF-12v2 physical component summary (PCS) and mental component summary (MCS) scores were similar to population norms, SF-12v2 role component summary (RCS) scores (mean = 39.5) were notably below national normal. GO-QOL appearance-related/psychosocial scores were impaired as well as SF-12v2, and particularly lower in active disease (52.5 vs. 73.3; P = 0.004). Presence of symptoms such as pain with eye movement, eyelid swelling, strabismus, upper eyelid retraction, and proptosis was significantly associated with lower role/social functioning, and satisfaction with care. Conclusions TED imposes significant psychosocial burden, particularly in active disease and among those with symptoms with structure changes. Psychosocial support and targeted symptom control may improve patient-centered outcomes in TED.

Teledermatology has become an essential part of dermatological care, although challenges in its implementation remain. We conducted a real-life survey on video consultations over a one-year period to assess satisfaction and identify barriers. A monocentric, questionnaire-based study was conducted, using a self-developed questionnaire and the German adaptation of the validated Client Satisfaction Questionnaire. Of 250 scheduled consultations, 89.6% were completed. A total of 128 patients and 13 physicians participated in the survey. The majority of patients (94.5%) and physicians (94.7%) would recommend video consultations. Patients reported high levels of satisfaction, with 93% rating ease of use positively and 80.4% reporting a positive overall experience. Physicians reported high satisfaction, with 98% providing positive feedback regarding scheduling, 94.7% regarding ease of use, and 90.8% regarding overall experience. Feedback on connection stability and skin assessment varied, with connectivity issues correlating with poorer skin findings (p<0.001). Feedback regarding connection stability and adequacy of skin assessment showed variability. Connectivity issues were significantly associated with poorer dermatologic assessment (p<0.001). Physicians who were dissatisfied with the quality of skin assessment were less likely to recommend video consultations (p<0.001) and reported a less favorable overall experience (p<0.001). Video consultations can improve access to dermatologic care, patient and physician satisfaction, and efficient use of healthcare resources. Our real-world data show high acceptance among patients and physicians while highlighting areas for optimization, particularly video quality and adequacy of dermatologic assessment.

The partnership between Ontario Shores Centre for Mental Health Sciences and the Catholic Family Services of Durham (CFSD) exemplifies an innovative approach to integrated care through the development of a stepped care model for trauma services. This initiative aligns with Pillar 2 of the Nine Pillars of Integrated Care, focusing on creating partnerships and alliances to enhance health service delivery. Furthermore, it emphasizes leveraging partnerships for health and development. The stepped care model addresses significant barriers to accessing trauma-focused services by employing a tiered approach that matches intervention intensity to client needs utilizing a measurement-based care approach. The initiative introduced key innovations, including virtual therapy options that transcend geographic limitations and expand service accessibility. This model ensures the equitable distribution of resources by optimizing care pathways, from low-intensity interventions for early-stage trauma to high-intensity treatments for complex cases. A pivotal aspect of this collaboration is the integration of child trauma services, which broadens the scope of care to address intergenerational impacts of trauma. Outcomes from the first two years of implementation demonstrate statistically significant improvements across multiple clinical measures, including the PCL-5 (Posttraumatic Stress Disorder Checklist), PHQ-9 (Patient Health Questionnaire), and WSAS (Work and Social Adjustment Scale). On average, clients reported a 52% reduction in trauma symptoms, with 77% expressing high satisfaction with the services. Furthermore, attrition rates were maintained below the targeted threshold of 10%, reflecting strong engagement and adherence. Notably, the virtual therapy component eliminated access disparities, achieving a 100% satisfaction rate for accessibility metrics among underserved populations. The project exemplifies the power of collaboration in overcoming systemic barriers. A co-designed evaluation framework engaged patients, caregivers, and stakeholders at every stage, ensuring that the services remained person-centered and adaptable. The project also demonstrates fiscal prudence by optimizing human resources, with an additional 1.6 full-time equivalent positions allocated for supervision and service delivery, ensuring sustainability. Future directions include scaling the model to other regions, guided by lessons learned in virtual delivery and partnership dynamics. An evaluation plan set for completion in 2025 aims to refine the model further and explore opportunities for long-term funding. The integration of patient feedback through client satisfaction surveys and focus groups will continue to shape service evolution. This initiative underscores the critical role of partnerships in fostering innovation, equity, and sustainability in integrated care. By leveraging shared expertise and resources, Ontario Shores and CFSD have developed a replicable model that advances the global agenda for trauma-informed care and sustainable development. The outcomes highlight the importance of aligning clinical goals with collaborative frameworks to achieve impactful and scalable solutions in mental health care. This work not only contributes to the knowledge base for integrated care but also provides a practical roadmap for addressing complex health needs through multi-stakeholder engagement and evidence-based practices. It serves as a compelling case study for the transformative potential of collaborative care models in achieving universal health coverage and reducing health disparities.

This study investigates the determinants of client satisfaction in frontline public service delivery at the Registry of Deeds in Patin-ay, Prosperidad, Agusan del Sur. Given the critical role of frontline services in shaping public trust, the research examines how client expectations, service consistency, communication effectiveness, efficiency, transparency, and technology integration influence overall satisfaction. A quantitative, descriptive-correlational research design was employed, and the data were collected in April using a researcher-developed and expert-validated questionnaire measured on a five-point Likert scale. Respondents were selected through convenience sampling from clients actively availing registry services. Instrument reliability was confirmed through pilot testing using Cronbach’s alpha. Data analysis involved descriptive statistics to summarize client perceptions and inferential techniques—specifically, Pearson correlation and multiple regression—to identify significant predictors of satisfaction. Ethical standards, including informed consent, voluntary participation, and confidentiality, were strictly observed. Results indicate a consistently high level of client satisfaction, with overall ratings falling within the “Strongly Agree” category. Client expectations (M = 4.657) and perceived service quality (M = 4.590) emerged as the strongest contributors to satisfaction. Service consistency (M = 4.414), efficiency (M = 4.473), communication effectiveness (M = 4.518), and transparency (M = 4.533) were also found to be statistically significant predictors. Technology integration (M = 4.419) showed strong positive relationships with both service quality and operational efficiency. However, feedback mechanisms recorded relatively lower ratings (M = 3.920–3.947), indicating gaps in institutional responsiveness to client input. While frontline service delivery is highly effective, strengthening feedback systems and institutionalizing sustained client engagement are essential to maintaining service excellence and deepening public trust in government institutions.

Despite the number of empirically supported treatments for posttraumatic stress disorder (PTSD) available in U.S. Department of Veterans Affairs (VA) specialty mental health settings, many veterans decline referrals to this setting or do not follow through with recommended care. Thus, the expansion of PTSD services into primary care settings is crucial for increasing access to evidence-based treatments among veterans. To this end, the current pilot project examined the acceptability, feasibility, and preliminary effectiveness of written exposure therapy (WET) delivered to veterans with clinically significant trauma-related symptoms presenting to VA primary care. Veterans (N = 36) were assessed pretreatment, posttreatment, and 1-month follow-up. Mean satisfaction ratings assessed via the Client Satisfaction Questionnaire-8 suggest that the treatment was acceptable (M = 28.00, SD = 3.91). Recruitment and retention rates suggest that the treatment was feasible to deliver, with 88.0% of respondents who expressed interest initiating treatment and 66.0% of those who initiated treatment completing treatment. Further, the results revealed large reductions in PTSD symptom severity from pre- to posttreatment, d = 0.94, and pretreatment to 1-month follow-up, d = 0.89, as assessed using the PTSD Checklist for DSM-5. These findings provide initial support for WET when delivered to veterans presenting with trauma-related symptoms in a primary care setting.

BackgroundThe prevalence of various mental health conditions is higher among physicians and medical learners. One common barrier to receiving adequate care includes a lack of time to see a provider and follow treatment plans. As such, virtual forms of cognitive behaviour therapy with mindfulness (CBTm) were introduced to mitigate these barriers and provide care in an efficient and effective manner.ObjectiveThe objective of this study was to determine the acceptability and feasibility of a 5-session CBTm program, delivered in 2 virtual formats within a population of medical learners and physicians.MethodsParticipants signed up to the program using an online link and were able to choose a preferred format to participate in the CBTm program. One option was a virtual, facilitator-led class that was held once a week for 5 weeks, in a group setting (CBTm facilitator-led). Another option included a self-directed course that had identical content to the live classes but was independently completed by the participant using an online platform (CBTm self-directed). Feedback forms were collected from participants after every class and analyzed using quantitative and qualitative methods. Thematic analysis was used to qualitatively analyze open-ended questions from participant feedback forms. In addition, the mean values of questionnaire items were used to determine participant satisfaction with the program.ResultsThe results indicated a good level of interest in both CBTm facilitator-led (n=15) and CBTm self-directed (n=94) groups. Of those who registered for the program, 13.8% (15/109) registered for CBTm facilitator-led and 86.2% (94/109) chose the self-directed version. The percentage of participants who participated in the majority of classes was 80% (12/15) for the CBTm facilitator-led group and 45.7% (43/94) for the CBTm self-directed group. The mean age of participants was 44.86 (SD 12.15 years), and the highest rate of uptake was among female physicians. Quantitative mean scores of participant feedback forms also showed a high level of satisfaction. For example, the Client Satisfaction Questionnaire 8 (CSQ-8) was analyzed, and the results indicated mean total scores of 28.00 (SD 3.24) and 26.46 (SD 3.55) for CBTm facilitator-led and CBTm self-directed, respectively. In addition, many themes emerged from thematic analysis and were subsequently categorized into 3 major categories. This included perceived strengths, perceived weaknesses, and suggested revisions to improve the program. Perceived strengths included improved mental health, helpful course content, and improved patient care. Perceived weaknesses included individual barriers to participation, content downfalls, and format-specific barriers. Suggested revisions included improving adherence to homework and virtual delivery of the program.ConclusionsIn conclusion, the results indicate that the self-directed and facilitator-led versions of CBTm were acceptable and feasible in this population of physicians and medical learners.

The hotel sector has significant problems due to elevated personnel turnover, adversely affecting operational efficiency and client satisfaction. This project aims to explore novel techniques for reducing staff turnover and improving retention in the hospitality industry. The research does a systematic literature review (SLR) to assess effective approaches that reduce turnover and enhance employee engagement. The findings highlight the essential importance of excellent Human Resource Management (HRM) practices, which include thorough recruitment, ongoing training, and employee empowerment through inclusive decision-making. These measures have been recognized as essential factors in reducing turnover by fostering a positive work environment and enhancing job satisfaction. Moreover, transformational leadership, which advocates for employee empowerment and well-being, dramatically enhances retention. (1) The research underscores the significance of technology, particularly Decision Intelligence (DI), in streamlining operations and elevating work quality, thereby promoting staff retention. Moreover, Corporate Social Responsibility (CSR) efforts that emphasize employee welfare and environmental sustainability are crucial in strengthening employee loyalty and commitment. (2) This article provides essential insights for hotel managers and HR professionals aiming to use new techniques to reduce turnover, promote retention, and improve organizational performance in a competitive market.

Understanding the determinants of access to sexual and reproductive health (SRH) services in humanitarian settings, and their links to client satisfaction, is essential for effective programming. The primary objective of this study was to describe the levels of utilization of services providing modern contraceptives, STI services, cancer screening, and GBV management among women and men facing humanitarian crises. The secondary objective was to determine the associations between clients' perceived ease of access and their satisfaction with the services received. This was a secondary analysis of the data of a cross-sectional study conducted in five Nigerian states (Borno, Taraba, Yobe, Cross River, Benue) in December 2024. The study participants were refugees, internally displaced persons (IDPs), and migrants. Data were collected via interviews using a structured questionnaire. Utilization of five SRH services (modern contraceptive counseling, STI screening/treatment, cervical and prostate cancer screening, and GBV management) was assessed. Multivariable logistic regression was used to identify factors associated with service utilization, and cross-tabulations examined the link between perceived ease of access and satisfaction. The study included 1,194 sexually active adults (842 women, 352 men). Service utilization was highly gendered. Compared to refugee women, IDP women had significantly lower odds of utilizing contraceptive (AOR: 0.50; 95% CI: 0.34-0.72) and STI services (AOR: 0.66; 95% CI: 0.44-1.00), while migrant women had higher odds of utilizing cervical cancer screening (AOR: 3.04; 95% CI: 1.70-5.44) and GBV management (AOR: 2.12; 95% CI: 1.09-4.09). For men, migrants had higher odds of utilizing STI services (AOR: 2.75; 95% CI: 1.37-5.54) and prostate cancer screening (AOR: 11.63; 95% CI: 3.47-38.98) compared to refugees. A strong, consistent association was found between ease of access and satisfaction. Over 93% of clients reporting 'easy' access were satisfied, while satisfaction plummeted to 20.8-33.3% among those reporting 'uneasy' access. Utilization of SRH services is shaped by gender, displacement status, and service type. The link between perceived ease of access and client satisfaction underscores that the process of obtaining care is as critical as the clinical service itself. SRH programs must adopt tailored, client-centered approaches that address unique sub-population barriers and systematically reduce logistical friction to improve both service utilization and quality of care.

Created to advance cystic fibrosis (CF) mental health care delivery, CF-cognitive behavioral therapy (CBT) is being implemented across North America. An adolescent version (CF-CBT-A) was developed with stakeholder input. To assess the feasibility/acceptability of CF-CBT-A delivered via telehealth by CF care-team providers, we designed a one-arm feasibility trial at 3 CF Centers examining attrition, engagement, homework completion, and treatment satisfaction. Adolescents with CF identified by routine screening with at least mild depression and/or anxiety symptoms received CF-CBT-A. Retention rate (proportion enrolled completing all 9 sessions) and treatment satisfaction (proportion of Client Satisfaction Questionnaire-8 ratings above scale midpoint) were considered good at ≥70% and excellent at ≥80%. Pre-post change in measures of depression, anxiety, psychological stress, and coping (CF Coping Self-Efficacy; CF-CSE) were summarized with Cohen's d metric of effect sizes. Twelve participants (12-17 years; M = 13) enrolled, with 92% retention. Engagement was rated at the highest level, and homework was partially/fully completed for 94% and 74% of sessions, respectively. All adolescent and caregiver acceptability ratings were >Client Satisfaction Questionnaire-8 mid-point. Large effect sizes showed promising improvements in anxiety (-1.01) and coping: CF-CSE Relaxation Skills (2.00), Active Stress Management (1.09), and Acceptance/Communication (1.70). Effect sizes were moderate for depression (-0.64), CF-CSE Daily Self Care (0.68), and adolescent-reported psychological stress (-0.51). Effect sizes were small for caregiver-reported adolescent stress (-0.26). Results support the feasibility and acceptability of CF-CBT-A integrated into CF care, with preliminary evidence of positive impacts. Further research is needed to establish effectiveness and optimal implementation by CF teams to improve access to CF-specific evidence-based mental health care for adolescents.

Facilitators and barriers to mainstreaming climate change adaptation and mitigation into sub-national health systems: Perspectives from primary health care managers in low-resourced settings of Ghana.

Early intervention versus treatment as usual for adolescents with first-episode psychosis: Protocol for the randomized OPUS YOUNG trial.