Convenient Hours Research Articles

Caution Signages and Their Relevance in Commuter Safety in High-Density Construction and Traffic Areas of Two Smart Cities in Odisha: A Cross-Sectional Study to Ensure Eco-Mobility

INTRODUCTION: India has regulations to control RTA and is thus skewed towards regulating traffic and imposing fines if appropriate protective gear is not worn while driving. However, considering the population and perhaps also the socioeconomic standards of a major section of society, it is imperative to be equally vigilant towards the protection of commuters. Commuters can fall into all age ranges and, given the compounded problems of multiple constructions, bad roads, lack of proper walking space, stray animals, and mostly even rash driving, are at the highest risk of accidents. The most cost-effective and basic initial effort to offer them some protection would be to have signages and instructions posted at appropriate points of busy junctions or requisite points. OBJECTIVES: Primary: 1. To assess the awareness among commuters regarding danger signages and pedestrian norms in age groups and among genders. Secondary: 1. To identify the enabling factors that contribute to injuries/accidents among this section of the population on busy roads in sampled areas. 2. To make recommendations to ensure commuter safety and compliance with safety rules. METHODS: Select four sites each as per police station jurisdiction in the twin cities of Bhubaneswar and Cuttack. Two team members are deputed to stand at a convenient hour and seek permission as well as consent from commuters and assess their knowledge from a standardized pictorial flow chart by the Disaster Management Board. Responses were noted in a Google form by the survey team comprising interns and postgraduate students and interviewed at least ten each day. Five consecutive consenting commuters, each from age groups 11-21, 21-50, and >50 years from each gender, for five working days of two weeks, were completed. In the last six months, data from the police station was taken regarding reports of accidents by commuters in those areas and correlations were developed between relevant factors. Results were shared with the commuters and police in random groups to educate and generate a felt need for reinforcement of regulations that would prevent accidents to some extent. The study was conceived in the two busiest cities of Odisha state- Cuttack and Bhubaneswar, where active development activities occur throughout the year. RESULTS: From both cities, 64 commuters were selected for the study. Awareness of signages improved with increasing age, from 56% to 65% to 88%. Signages for construction sites and malls were poor in Cuttack, as it did not have many malls. Accidents were common among those aged 11 to 21 years, especially among females, and no correlation was seen between the reported injuries, gender-wise or socioeconomic status. Although increasing age was protective for injuries (21%; SD ±4.5, OR 0.21, p<0.03), the ones reported were primarily due to the use of alcohol, oversight, and lack of knowledge of signages. The police administration also admitted to under-reporting such injuries. The presence of stray animals was also a highly significant enabling factor for such injuries (OR 5.6, P<0.0001).

Total Hip Arthroplasty or Hemiarthroplasty for Displaced Femoral Neck Fractures?: Commentary on an article by Mina Tohidi, MD, FRCS(C), PhD, et al.: "Comparative Effectiveness of Total Hip Arthroplasty and Hemiarthroplasty for Femoral Neck Fracture. A Propensity-Score-Matched Cohort Study".

Commentary This Canadian study involves a subject of continued controversy1,2. It describes the outcomes of a large matched group of patients ≥60 years old with a displaced femoral neck fracture treated with total hip arthroplasty (THA) or hemiarthroplasty (HA). The 2 groups had similar revision and readmission rates, but those treated with THA had higher dislocation rates. Patients treated with HA had higher mortality rates, but they tended to be older and had higher rates of dementia and institutionalization. These findings are not new or unexpected, so what are surgeons to take away from this study? The major strength of this study is the use of a well-matched cohort with a large sample size (9,224). Most previous studies involved far fewer patients or performed meta-analyses of such studies3. Its major weakness is that surgeon and technical factors could not be taken into account. Who performs the surgery and how it is done are very important but were not captured in the data. In clinical practice, a femoral neck fracture is a devastating but common injury. Treatment should be based on shared decision-making involving the surgeon and the patient, family, or individual who has the power of attorney. These other individuals will ultimately rely heavily on the surgeon’s recommendations. The surgeon should clearly explain why a particular treatment is being recommended, along with the specific risks and benefits involved with each treatment. There are also many confounding factors that can influence the surgeon’s recommendation. These can include surgeon experience and comfort with the procedure, as well as institutional support for performing it at less than convenient hours (holidays, weekends). Age, comorbidities, anticipated life expectancy, approach, femoral component head size, use of a dual-mobility construct, bone quality, and use of cement all need to be taken into account. An institutionalized patient with Parkinson disease will be treated very differently from an active 70-year-old who lives at home. Some studies have not found significant differences between these 2 treatments, or have questioned the clinical importance of better quality-of-life scores after THA than after HA4. However, the pendulum is clearly swinging toward the use of THA for this injury5,6. This study provides further evidence that THA is a reasonable treatment for many displaced femoral neck fractures, but reinforces the need to consider factors that will reduce dislocation rates.

Work Values of Working Women in Israel: A Comparison of Haredi Women with Those from the Secular and Traditional Segments.

The Haredi (or Ultra-Orthodox) sector is the fastest growing population in Israel, but the ability to study their working world is limited, and as far as we know, the work values of Haredi women (who are usually the main breadwinners) have not been studied to date. This unique study compares their work values with those of secular and traditional Jewish-Israeli women. The Meaning of Work (MOW) questionnaire was administered to 467 employed Jewish-Israeli women (309 Secular, 138 Traditional, and 120 Haredi), addressing values, attitudes, and aspirations at the workplace. The findings indicate that, while secular women ascribe more importance to individualistic values related to interesting work and variety than do traditionalist and Haredi women, no significant differences exist among the three groups concerning the interest in good pay, autonomy, interpersonal relations, or job security. In addition, a higher level of religiosity was associated with the importance of convenient hours and inversely associated with the importance of learning new things. Further, Haredi women attribute more importance to promotion and congruence between their personal abilities and experience and the job requirements than did women from the other two groups. Overall, the background demographic variables had little impact on work values. The findings can be explained by the different cultural values (collectivism versus individualism) and the obstacles Haredi women experience in the labor market.

HIV service delivery in the time of COVID-19: focus group discussions with key populations in India.

IntroductionThere are limited data on the impact of COVID‐19‐associated disruptions and novel HIV service delivery strategies among key populations (KPs) in low‐ and middle‐income countries. In March 2020, in response to COVID‐19, the Government of India revised HIV service delivery policies to include community antiretroviral therapy (ART) distribution and multi‐month dispensing (MMD) of ART for all people living with HIV (PLHIV).MethodsTo assess the acceptability of these adaptations and impact of the pandemic among KPs, we conducted focus groups in November–December 2020 with purposively sampled men who have sex with men (MSM), female sex workers (FSWs) and transgender women (TGW) in Telangana and Maharashtra. Seven discussions were conducted. Topics included HIV service access, risk behaviours, economic security and feedback to ensure service continuity. Inductive coding identified themes across topics.ResultsForty‐four individuals aged 20–49 years participated in discussions (13 MSM; 16 FSW; and 15 TGW). Twenty‐four participants self‐identified as living with HIV. People not living with HIV reported challenges in accessing HIV antibody testing at hospitals due to travel restrictions and fear of contracting COVID‐19. Participants accessed HIV antibody testing using transportation arranged by community‐based organizations after lockdowns eased. PLHIV reported uninterrupted ART refills and generally consistent adherence; however, there were experiences of delayed CD4 and HIV RNA testing. Participants shared appreciation for MMD as it saved time, money, and reduced exposure to COVID‐19. Participants expressed gratitude for home deliveries which enabled ART access, yet shared concerns about home‐based services causing confidentiality breaches with family/neighbours. Participants voiced preferences for community‐based service provision due to proximity, convenient hours, and welcoming environments compared to public hospitals. Other requests included support for income, employment, nutrient‐rich food and more accessible mental health, HIV, and other health services.ConclusionsCOVID‐19 restrictions had a greater impact on access to HIV antibody, CD4, and RNA testing services compared to ART access. High acceptance of MMD and community‐based services support the continued role of differentiated service delivery models to improve KP access to HIV antibody, CD4, RNA testing services, convenient ART retrieval, and integrated services beyond HIV, which may be critical for survival and wellbeing.

Community and healthcare providers\u2019 perceptions of quality of private sector outpatient malaria care in North-western Ethiopia: a qualitative study

BackgroundMalaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate adult malaria patients and healthcare providers’ perception of the quality of malaria management at private sector outpatient facilities.MethodsAn exploratory, descriptive, contextual and qualitative research methodology was conducted with 101 participants (33 in-depth interviews (INIs) and ten focus group discussions (FGDs) with 68 participants). All interview and focus group discussions were audio recorded, transcribed verbatim and analysed, using eight steps of Tesch.ResultsDuring data analysis a single theme, two categories and six sub-categories emerged, namely (1) perceived quality of malaria management at outpatient facilities; (a) essential resources; (a1) safe outpatient services; (a2) anti-malarial drugs and supplies; (a3) health workers; (b) factors influencing service utilization; (b1) physical accessibility; (b2) “art of care’’; and (b3) efficient malaria diagnosis and treatment services. Both FGDs and INIs participants had a positive perception of the quality of malaria outpatient services at private health facilities. The positive perceptions include safe and clean facility; availability of supplies and comprehensive services; convenient working hours; short waiting hours and motivated, competent and compassionate health workers. However, some participants raised their safety concerns due to perceived poor infection control practices, small working areas, interruption of anti-malarial supplies and inefficient malaria diagnosis and treatment services.ConclusionBoth community members and healthcare providers had more positive perceptions towards outpatient malaria services offered at private health facilities. However, positive behaviour must be maintained and concerns must be dealt with by enhancing functional public private partnership for malaria care services to improve private sector malaria case management; build the service providers’ capacity; ensure uninterrupted anti-malarial supplies and empower the community with early health-seeking behaviour.

Who are Millennials? And what they want from libraries, bookstores, and librarians

Understanding a generation’s “peer personality” provides librarians a unique opportunity to develop services and programs tailored to the needs and unique attributes of a group of individuals. Master of Library Science students enrolled in a graduate research class at East Carolina University in Greenville, North Carolina, surveyed 245 18-to 24-year old members of the Millennial generation at various locations throughout the state to ascertain their use and perception of libraries and bookstores. Most important to Millennials are helpful library staff, good collections, and convenient hours. Least important are bargain items for sale, coffee, and the library or bookstore as a place to be with others.

Youth’s Perspectives on a Sustainable Model for the Provision of Youth Friendly Sexual and Reproductive Health Services in Kenya: A Quantitative Approach

Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is; youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.

Access to primary care for persons with spinal cord injuries in the greater Gaborone area, Botswana.

BackgroundPeople with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.ObjectiveThis study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.MethodsA quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.ResultsThe male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated satisfaction with services. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height-adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs.ConclusionPrimary care services were mostly affordable and adequate. Availability, acceptability and accessibility aspects created barriers.

Comparing Retail Clinics With Other Sites of Care: A Systematic Review of Cost, Quality, and Patient Satisfaction.

Retail clinics, also referred to as walk-in or convenient care clinics, share common features such as a limited menu of primary care services, on-demand patient appointments, greater use of nonphysician providers such as nurse practitioners, and more convenient hours and access points for patients. Given their rising popularity as an alternative primary care delivery site, it is important to examine retail clinics' impact on patient outcomes. This study's aim was to systematically review the extant literature on retail clinics in the United States with respect to 3 outcomes of interest: quality, cost, and patient satisfaction. A systematic search of 4 databases was done using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies needed to be empirical, measure care in retail, walk-in, or convenient care clinic, and present quality, cost, and/or satisfaction findings. The majority of studies used commercial, administrative claims databases to procure patient outcome data (n=9). Nine of the 15 studies examined costs, 6 examined quality, and only 1 examined patient satisfaction. Overall, retail clinic care compares favorably with similar care in other settings in terms of lower costs, although the evidence on quality and patient satisfaction is minimal and less conclusive. Future research on retail clinic care requires more rigorous study designs, richer quality measures, inclusion of the patient experience in outcomes, less reliance on administrative claims data, and greater independence from industry stakeholders with interest in seeing the retail clinic model grow.

Service value and retention: Does gender matter?

Using the comprehensive service evaluation model and the three-component model of commitment as backdrop, this study investigates the moderating role of gender on the service value-service retention relationship and examines the impact of the initial purchase experience on the value-retention relationship within the automotive service repair (ASR) industry. Employing a survey of 128 automobile dealer customers, logistic regression analyses show that service value (i.e., convenient hours, quality, friendliness), as well as length of ownership influence service retention. Also, gender moderates the service value dimensions and service retention relationship such that various components of service value (convenient hours, friendliness and quality) were significant predictors of service retention whereas service value (friendliness, quality) were significant predictors of service retention for females. In addition, length of ownership and initial purchase experience are significant predictors of service retention for females, but not for males.

Assessment of women\u2019s satisfaction with family planning service at public health facilities in Northwest Region of Ethiopia: a cross sectional study

BackgroundEthiopia is a Sub Saharan African country with an estimated contraceptive prevalence rate of 36% and 22% unmet need for family planning service among married women. Client satisfaction influences the use of Family Planning and other reproductive health services. There is limited information on satisfaction with family planning service among Family planning users particularly in the northern part of Ethiopia. Hence, this study aimed to provide information on client satisfaction and its determinant among women in Public Health facilities of Northwestern Ethiopia.MethodsA Facility based cross-sectional study was conducted from March 1, 2017, to March 30, 2017. An exit interview using structured pretested questionnaire was conducted on randomly selected 490 women attending family planning service in Bahir Dar city, Public Health facilities of Northwest, Ethiopia. The data was cleaned, coded and entered into Epi info™ 7 statistical software and then exported and analyzed using SPSS Version 20 statistical software. A multivariable binary logistic regression model was fitted to identify factors associated with Client satisfaction. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association.ResultsA total of 490 family planning service users were approached for an interview and making a response rate of 99.8%. The overall client satisfaction with the family planning services was found to be 66.1%. Clients who were merchants were more likely to be satisfied with the family planning service than government employees [AOR = 2.5, P-value = 0.007). In addition, house wife’s more likely to be satisfied with the family planning service than government employees AOR = 2.4, P-value = 0.007). Daily laborers were also found to be more likely to be satisfied with the FP service as compared with governmental employees AOR = 3.9, P-value = 0.007). New Family Planning user clients were more likely to be satisfied with the family planning service than repeat users [AOR = 2.3, P-value = 0.004).Family planning service waiting time also affects client satisfaction, in which those having awaiting time of less than half an hour’s (AOR = 9.7, (P-value =001), One to half an hour (AOR = 6.4, (P-value =001), One hour to two hours (AOR = 4.6, (P-value =001) were more likely to be satisfied with the family planning service delivered at the facility than those who had waited for more than two hours. In addition, those whose privacy was maintained during counseling were more likely to be satisfied with the family planning service delivered than whose privacy was not maintained (AOR = 3.2, P-Value = < 0.001). Those having convenient service hour were more likely to be satisfied with the family planning service delivered than those who don’t have convenient service hour (AOR = 2.4, p-value = 0.002).ConclusionThe finding of this study concludes that nearly two -third of the clients were satisfied with the family planning service delivered at Public Health facilities of Northwest of Ethiopia. New family planning service users, waiting time for the service, Maintaining privacy during counseling, having convenient service hour and occupational status of the clients were the predictors for client satisfaction with family planning service delivered at Public Health facilities in Bahir Dar city.

Pharmacies versus doctors’ offices for adolescent vaccination

PurposeWe sought to understand the relative advantage of pharmacies compared to doctors’ offices for delivering HPV vaccination to adolescents. MethodsParticipants were a national sample of 1500 U.S. parents of adolescents ages 11–17 recruited in 2014–15. In an online survey, items informed by Diffusion of Innovation Theory assessed parents’ perceptions of the relative advantages of HPV vaccine delivery in pharmacies and doctors’ offices. Principle findingsMany parents believed doctor’s offices offered a better health care environment than pharmacies, with more privacy (77%) and a safer place for vaccination (70%). However, many parents also believed pharmacies were more accessible than doctors’ offices, requiring less time for vaccinations (71%) and offering more convenient hours (59%). Parents were more willing to get their children HPV vaccine from pharmacists if they indicated more relative advantages in vaccine delivery in pharmacies (β = .29; p < .001) and believed patient accessibility more important than health care environment (β = .20; p < .001). ConclusionsTo be more appealing to parents as HPV vaccine providers, pharmacy providers within community and hospital settings should build on their relative advantage with respect to accessibility and enhance their appeal of their healthcare environment.

Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh.

BackgroundPharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome.MethodsA cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients’ relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome.ResultsWe interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment.ConclusionPeople with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.

Caretakers' Perspectives on Return Pediatric Emergency Department Visits: A Qualitative Analysis of Focus Groups.

Approximately 5% of pediatric patients return to the emergency department (ED) within 72 hours of initial evaluation. The goal of this study was to identify reasons for return visits from the caretaker perspective. Two parent focus groups were conducted in November 2012. Parents were excluded from participation if the return visit was unrelated to the initial visit or the child was asked to return (e.g., wound check). The focus groups were audiotaped, transcribed, and analyzed using a thematic content analysis approach. A total of 13 parents participated. Children were 10 months to 11 years of age (median, 3.1 years). Primary symptoms and diagnoses were related to respiratory (n = 6); gastrointestinal (n = 2); dermatologic (n = 2); musculoskeletal (n = 2); and ear, nose, throat and mouth diseases (n = 1). Return visits occurred 12 to 50 hours (median, 24 hours) after the initial visit. Reasons for return visits were divided into 4 domains: (1) the caretaker's response to the initial visit (e.g., dissatisfaction with medical staff, medical care, or information provided), (2) the child's illness (e.g., continued, worsening, or concerning symptoms), (3) the nature of the ED itself (e.g., subspecialist availability, convenient hours), and (4) follow-up care (e.g., lack of appointments with primary physicians or subspecialists). Several of the reasons parents identify for return visits are within the locus of control of the ED, and several could be addressed by improving regional health care coordination. Surveys based on these themes will quantitate the reasons for return visits and prioritize future strategies to address the perceived need for return visits.

Associations between frequency of food shopping at different store types and diet and weight outcomes: findings from the NEWPATH study.

The present study aimed to: (i) examine associations between food store patronage and diet and weight-related outcomes; and (ii) explore consumer motivations for visiting different types of food store. A stratified probability sample of residents completed household and individual-level surveys in 2009/2010 on food purchasing patterns and motivations, dietary intake, waist circumference (WC), weight and height. Diet quality was calculated using the Healthy Eating Index for Canada from a subset of participants (n 1362). Generalized estimating equations were created in 2015 to examine how frequency of patronizing different types of food store was associated with diet quality, intake of fruits and vegetable, mean intake of energy (kcal) sodium and saturated fat, WC and BMI. Three mid-sized urban municipalities in Ontario, Canada. A representative sample of residents (n 4574). Participants who shopped frequently at food co-ops had significantly better diet quality (β=5·3; 99 % CI 0·3, 10·2) than those who did not. BMI and WC were significantly lower among those who frequently shopped at specialty shops (BMI, β=-2·1; 99 % CI -3·0, -1·1; WC, β=-4·8; 99 % CI -7·0, -2·5) and farmers' markets (BMI, β=-1·4; 99 % CI -2·3, -0·5; WC, β=-3·8; 99 % CI -6·0, -1·6) compared with those who did not. Relative importance of reasons for food outlet selection differed by large (price, food quality) v. small (proximity, convenient hours) shopping trip and by outlet type. Findings contribute to our understanding of food store selection and have implications for potentially relevant retail food intervention settings.

Youth friendly health services in a rural community of Lagos, Nigeria: are the youths receptive?

Globally, the youths constitute a major segment of most societies particularly in developing countries. This study was undertaken to assess the perception and practices related to youth friendly health services (YFHS) by in-school adolescents in a rural community of Lagos, Nigeria. A descriptive cross-sectional survey was conducted on 400 proportionately selected consenting respondents from the senior classes of the three secondary schools in Agbowa community. A pre-tested interviewer-administered questionnaire was used for data collection and analysis was done with the aid of statistical software. Most of the respondents were in the age range of 12-15 years with mean age being 15.33±1.54 years. About half (46.8%) of the respondents correctly described adolescents as persons between the ages of 10 and 19 years. The majority (83.2%) of the respondents first heard about the Youth Friendly Health facilities from parents, guardians and friends. However, only few of the respondents had ever visited a Youth Friendly Center. A good location, convenient hours and comfortable surroundings were the most appealing aspects of YFHS. The provision of a seminar room and educational materials (60.8% and 70.8%, respectively) are important to the respondents. Reproductive health (56.8%) was the most preferred health education topic chosen by the respondents. Sensitization of the youths in the Agbowa community about youth friendly health services and provision of such services would be useful in reducing risky practices and improving their health.

What Are You Selling?

What Are You Selling?

Prevalence and pricing of chain gyms in New York City

Objective: Rates of obesity in New York City (NYC) are extremely high. Research confirms that engagement in physical activity is a critical obesity prevention factor, yet many NYC adults do not meet current physical activity recommendations. Lack of access to indoor gym facilities remains a barrier to regular physical activity engagement. This study examined the prevalence and pricing of chain gyms across the two most and two least obese NYC boroughs. Setting: Ten chain gyms with 142 locations across four NYC boroughs were identified. Design: This descriptive study had a cross-sectional study design. Method: Data regarding monthly membership, enrollment fees, and annual/additional fees were collected online. Socioeconomic data were obtained via the most recent Census. Results: Significantly more chain gyms were observed in Manhattan, the borough with the lowest rates of obesity [X2 = 98.2, p < .001]. Manhattan has significantly higher membership prices (F = 21.9, p < .001). While the difference in gym membership costs between the most obese (Bronx) and least obese (Manhattan) boroughs appears to be consistent with the difference in median income level, costs do not account for NYC's large income disparity. Data also demonstrate that gyms have convenient hours and extra benefits, which may facilitate the ability of residents to meet their daily physical activity requirements. Conclusions: The pricing of chain gyms may preclude low-income NYC residents from having consistent access to safe indoor gym facilities. Local health promotion efforts should focus on increasing the prevalence of affordable fitness options in communities with higher rates of obesity.

Evaluation of a pharmacist-performed tuberculosis testing initiative in New Mexico

ObjectiveTo report experiences of the New Mexico pharmacist tuberculosis (TB) testing program. SettingCommunity pharmacies in New Mexico interested in participating in the TB testing initiative from March 2011 to August 2013. Practice innovationTo expand accessibility of TB testing, New Mexico pharmacists were granted the authority to prescribe, administer, and read tuberculin skin tests (TSTs) in March 2011. To receive this special prescriptive authority, pharmacists had to complete a New Mexico Department of Health training program in accordance with the Centers for Disease Control and Prevention guidelines. EvaluationData were collected on the number of TSTs performed and the TST reading follow-up rate. Patient data collected were demographic information, reason for obtaining a TST (e.g., immigration, school, or work), TB risk factors, and TST results. ResultsIn New Mexico, 43 pharmacists were certified for TB testing during the evaluation period, 25 of whom were actively prescribing and performing TB testing at eight community pharmacies. There were 606 tests administered to 578 patients; 70.9% women, median age 31 years (4–93 years). Employment and school were the main reasons for obtaining a TB test. A total of 578 of 623 (92.8%) patients followed up to have their TSTs read. A total of 18 positive tests (3.1% positivity rate) were identified and appropriate referrals were made. ConclusionNew Mexico expanded the scope of practice for pharmacists. Pharmacist-performed TB testing had a valuable public health benefit. TB testing follow-up rates at community pharmacies in New Mexico were high, most likely due to convenient hours, accessible locations, and no required appointments.

Demand side integration in LV smart grids with multi-agent control system

The low-carbon society requires significant changes in the operation and planning of distribution systems. In order to exploit existing low voltage systems, Demand Side Integration is essential for offering services that increase security and quality of supply, improve energy efficiency and reduce the energy cost. In this paper, a decentralised multi-agent system (MAS) for the coordination of active demand and plug-in electric vehicles is proposed. The load Aggregator aggregates the demand to sellenergy and services by operating a Master Agent and independent Agents. The Master Agent coordinates independent Agents for moving demand to the most convenient hours without degrading power quality. All Agents use a combination of local and global data to perform the optimisation following the Nash's theory on games. The MAS does not require huge bidirectional information flows and is better suited than centralised systems to LV systems.