Determinants Of Use Research Articles

Knowledge, Prevalence and Determinants of the Use of Skin-Lightening Creams among University Undergraduates in Babcock University

The quest for lighter skin has become a dangerous obsession fueled by societal beauty standards and cultural norms. The purpose of this study was to analyze the inspiration prompting the use of these products among undergraduate students using descriptive research surveys. This study examined the knowledge, prevalence and determinant of the use of skin lightening creams among three hundred and thirty (330) undergraduates of Babcock University, Ilishan-Remo. through a simple random sampling technique using self-structured questionnaires. Data was collected with the use of SPSS and frequency count. Pearson correlation was used to draw conclusions on the hypothesized statement of study. The researcher found a significant relationship between knowledge of skin lightening creams and its determinant of use, with over half of respondents (56.37%) agreeing that lightening creams could cause kidney failure. Treatment of hyperpigmentation was the motivating factor among 57.58% of respondents. There is therefore a need for undergraduate students to be provided with adequate education regarding the dangers of skin lightening creams and be encouraged to visit appropriate health facilities for skin disorders instead of self-meditating.

Digital technologies for pediatric rehabilitation: current access and use in the European Rehatech4child survey.

Digital technologies such as robotics and treadmill-systems (RobTS), virtual-reality and active video-gaming (VR-AVG), and telehealth and apps (T&Apps) used within pediatric motor rehabilitation may promote recovery and improve function. However, digital technology uptake may be limited in clinical practice. To explore access to and use of digital technologies for pediatric motor rehabilitation (DT4R) in Europe as a function of individual and environmental factors, as well as potential barriers to their use. This observational study was based on RehaTech4child, a cross-sectional survey (2022), supported by the European Academy of Childhood Disability. Online survey available in 20 European languages. The survey was disseminated through convenience and snowball sampling to pediatric motor rehabilitation professionals in Europe. The survey included items on outcomes (access, use, purposes of use and intention to use for the three categories of DT4R, i.e. RobTS, VR-AVG and T&Apps), determinants (socio-demographics, rehabilitation practice) and barriers. The association between access and use, and individual and environmental determinants was assessed using logistic regression adjusted for age, gender and profession. Of the 1397 responses received, 635 were included. Respectively 67.7% and 74.3% of respondents reported using and having access to at least one of the three categories of DT4R. T&Apps and VR-AVG were used by 50.8% and 45.5% of respondents, respectively, and RobTS by 36.6% (P<0.001). Ease of access was the main determinant of use and frequency of use. Individual (e.g. age) and environmental (e.g. healthcare facility, patients' age) factors were access determinants. At least 70% of professionals intended to use a DT4R if available. Lack of financial resources and training were the most frequently reported severe barriers. This study found that DT4R were already used in clinical practice by around two-thirds of respondents and that they generally wished to use them even more. Access was the main determinant of use and frequency of use. To facilitate access and use of DT4R, infrastructure and financial resources should be outlined, and training opportunities provided for professionals. Practice guidance should be developed and adapted for specific age groups and rehabilitation goals.

Adherence to CPAP Therapy in Obstructive Sleep Apnea: A Prospective Study on Quality of Life and Determinants of Use.

Obstructive sleep apnea (OSA) often goes unrecognized despite common symptoms, such as excessive daytime sleepiness, fatigue, and impaired quality of life (QoL). Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA, but optimal daily usage and time needed for observable effects remain unclear. This study aimed to investigate the short-term effects of CPAP on daytime sleepiness and QoL in patients with severe OSA. Medical records were collected from 87 patients with severe OSA who initiated CPAP therapy. Also, validated questionnaires were used before and after one month of CPAP to analyze QoL-the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Cues to CPAP Use Questionnaire (CCUQ), and daytime sleepiness-the Epworth Sleepiness Scale (ESS). Multiple regression analysis was conducted to identify predictors of CPAP usage. Of the total participants aged 55.6 ± 12.5, 77% were males, and 62% were CPAP adherent. Reductions in daytime sleepiness (ESS) were noted, as well as improvements in both overall QoL (SAQLI) and specifically in the domains of daily functioning, social interactions, emotional well-being, and symptom perception. Important cues for CPAP usage recognized by patients were physicians' instructions and physicians' concern regarding their patients' condition. Furthermore, multiple regression revealed higher SAQLI scores and lower ESS scores as positive predictors of CPAP usage, along with lower AHI after one month of CPAP being associated with sufficient adherence.

Pediatric head injury guideline use in Sweden: a cross-sectional survey on determinants for successful implementation of a clinical practice guideline

BackgroundThe Scandinavian Neurotrauma Committee guideline (SNC-16) was developed and published in 2016, to aid clinicians in management of pediatric head injuries in Scandinavian emergency departments (ED). The objective of this study was to explore determinants for use of the SNC-16 guideline by Swedish ED physicians.MethodsThis is a nationwide, cross-sectional, web-based survey in Sweden. Using modified snowball sampling, physicians managing children in the ED were invited via e-mail to complete the validated Clinician Guideline Determinants Questionnaire between February and May, 2023. Baseline data, data on enablers and barriers for use of the SNC-16 guideline, and preferred routes for implementation and access of guidelines in general were collected and analyzed descriptively and exploratory with Chi-square and Fisher's tests.ResultsOf 595 invitations, 198 emergency physicians completed the survey (effective response rate 33.3%). There was a high reported use of the SNC-16 guideline (149/195; 76.4%) and a strong belief in its benefits for the patients (188/197; 95.4% agreement). Respondents generally agreed with the guideline's content (187/197; 94.9%) and found it easy to use and navigate (188/197; 95.4%). Some respondents (53/197; 26.9%) perceived a lack of organizational support needed to use the guideline. Implementation tools may be improved as only 58.9% (116/197) agreed that the guideline includes such. Only 37.6% (74/197) of the respondents agreed that the guideline clearly describes the underlying evidence supporting the recommendation. Most respondents prefer to consult colleagues (178/198; 89.9%) and guidelines (149/198; 75.3%) to gain knowledge to guide clinical decision making. Four types of enablers for guideline use emerged from free-text answers: ease of use and implementation, alignment with local guidelines and practice, advantages for stakeholders, and practicality and accessibility. Barriers for guideline use were manifested as: organizational challenges, medical concerns, and practical concerns.ConclusionsThe findings suggest high self-reported use of the SNC-16 guideline among Swedish ED physicians. In updated versions of the guideline, focus on improving implementation tools and descriptions of the underlying evidence may further facilitate adoption and adherence. Measures to improve organizational support for guideline use and involvement of patient representatives should also be considered.

ChatGPT usage and attitudes are driven by perceptions of usefulness, ease of use, risks, and psycho-social impact: a study among university students in the UAE

BackgroundThe use of ChatGPT among university students has gained a recent popularity. The current study aimed to assess the factors driving the attitude and usage of ChatGPT as an example of generative artificial intelligence (genAI) among university students in the United Arab Emirates (UAE).MethodsThis cross-sectional study was based on a previously validated Technology Acceptance Model (TAM)-based survey instrument termed TAME-ChatGPT. The self-administered e-survey was distributed by emails for students enrolled in UAE universities during September–December 2023 using a convenience-based approach. Assessment of the demographic and academic variables, and the TAME-ChatGPT constructs’ roles in ChatGPT attitude and usage was conducted using univariate followed by multivariate analyses.ResultsThe final study sample comprised 608 participants, 91.0% of whom heard of ChatGPT while 85.4% used ChatGPT before the study. Univariate analysis indicated that a positive attitude to ChatGPT was associated with the three TAME-ChatGPT attitude constructs namely, lower perceived risks, lower anxiety, and higher scores on the attitude to technology/social influence. For the ChatGPT usage, univariate analysis indicated that positive attitude to ChatGPT use was associated with being male, Arab in nationality, and lower point grade average (GPA) as well as the four ChatGPT usage constructs namely, higher perceived usefulness, lower perceived risks of use, higher scores on the behavior/cognitive construct and higher scores on the ease-of-use construct. In multivariate analysis, only TAME-ChatGPT constructs explained the variance in attitude towards ChatGPT (80.8%) and its usage (76.9%).ConclusionThe findings indicated that ChatGPT usage is commonplace among university students in the UAE. The determinants of use included the perceived usefulness, lower perceived risks, cognitive and behavioral factors, perceived ease of use, while the attitude was determined by lower perceived risks, lower anxiety, and higher scores for attitude to technology/social influence. These factors should be considered for understanding the motivators for successful adoption of genAI including ChatGPT in higher education.

Determinants of the use of modern contraceptives among women of reproductive age group in Ethiopia: A multi-level mixed effects analysis.

Modern contraceptive methods are a scientifically effective method to control the fertility of reproductive-aged groups of people. The women's use of contraceptive methods creates a birth gap and limits the number of their children. The main objective of this study is to identify the significant determinant of modern contraceptive use of reproductive-aged women in Ethiopia. We used data from 2019 Ethiopian Mini Demographic and Health Survey. This data was multi-level, taking into account factors at the individual and community levels. In order to capture the multi-level structure of this data and make more reliable and broadly applicable conclusions about the variables influencing the use of modern contraceptives at the individual and community levels, we employed a two-level mixed-effects logistic regression model. In addition, we used cross-tabulation analysis to know the percentage of modern contraception users (reproductive-aged women) across their socio-economic, demographic, and health characteristics. A total of 8196 reproductive aged (15-49) women were included in this study. From a total of 8196 reproductive-aged women, 2495(30.4%) were using modern contraceptive method and the rest 5701(69.6%) did not use any modern contraceptive methods. Among 2495 contraceptive users, 1657 (67.3%) used injections and 533 (21.7%) used implants/Norplant. At a 5% level of significance, the result from the two-level binary logistic regression model revealed that the predictors; Age of women, education level, religion, wealth index, knowledge of modern contraception method, number of died children, number of living children, family size, total children ever born and contextual region have significant effect on the use of modern contraception method. Reproductive-aged women in Ethiopia with more living children, residing in urban/agrarian region, younger, wealthier, married, and more educated, were more likely to be modern contraceptive users. The concerned bodies in Ethiopia should bring forward the intervention strategy and should expand the existed programs to improve the use of modern contraception methods among reproductive-aged women in Ethiopia. Especially, they should give special attention to reproductive-aged women of less income, resident in pastoralist region, less educated, unmarried, and haven't living child.

Genetic tapestry of Capsicum fruit colors: a comparative analysis of four cultivated species.

Genome-wide association study of color spaces across the four cultivated Capsicum spp. revealed a shared set of genes influencing fruit color, suggesting mechanisms and pathways across Capsicum species are conserved during the speciation. Notably, Cytochrome P450 of the carotenoid pathway, MYB transcription factor, and pentatricopeptide repeat-containing protein are the major genes responsible for fruit color variation across the Capsicum species. Peppers (Capsicum spp.) rank among the most widely consumed spices globally. Fruit color, serving as a determinant for use in food colorants and cosmeceuticals and an indicator of nutritional contents, significantly influences market quality and price. Cultivated Capsicum species display extensive phenotypic diversity, especially in fruit coloration. Our study leveraged the genetic variance within four Capsicum species (Capsicum baccatum, Capsicum chinense, Capsicum frutescens, and Capsicum annuum) to elucidate the genetic mechanisms driving color variation in peppers and related Solanaceae species. We analyzed color metrics and chromatic attributes (Red, Green, Blue, L*, a*, b*, Luminosity, Hue, and Chroma) on samples cultivated over six years (2015-2021). We resolved genomic regions associated with fruit color diversity through the sets of SNPs obtained from Genotyping by Sequencing (GBS) and genome-wide association study (GWAS) with a Multi-Locus Mixed Linear Model (MLMM). Significant SNPs with FDR correction were identified, within the Cytochrome P450, MYB-related genes, Pentatricopeptide repeat proteins, and ABC transporter family were the most common among the four species, indicating comparative evolution of fruit colors. We further validated the role of a pentatricopeptide repeat-containing protein (Chr01:31,205,460) and a cytochrome P450 enzyme (Chr08:45,351,919) via competitive allele-specific PCR (KASP) genotyping. Our findings advance the understanding of the genetic underpinnings of Capsicum fruit coloration, with developed KASP assays holding potential for applications in crop breeding and aligning with consumer preferences. This study provides a cornerstone for future research into exploiting Capsicum's diverse fruit color variation.

Currency Exposure and The Determinants of Corporate Hedging Practice Among Malaysian Non-Financial Firms

This study involves a two-stage analysis. Firstly, the study examines currency exposure and corporate hedging practice (proxied by foreign currency derivative (FCD)) among Malaysian non-financial firms from 1995-2016. It is found that 35.75% of the sample firms are significantly affected by the exposure. The use of FCD is also found to be significantly effective in managing the level of currency exposure. Secondly, the study further investigates the determinants of the use of FCD by incorporating both firm-specific and macroeconomic factors. The study finds almost all the firm-specific factors (liquidity, price-earning ratio, asset growth, and foreign sales) and macroeconomic factors (current account, trade, and inflation) as significant determinants behind the firms’ decision to use FCD. Interestingly, the use of FCD is also driven by specific financial events. Due to the nature of the crisis period, the effect of FCD use is only significant during the Asian financial crisis rather than the peg period and global financial crisis. The novelty of this study lies in the inclusion of the macroeconomic determinants of the FCD use. Hence, the detailed analyses may guide the decision-making process of FCD use as the analysis tackles the exposure and FCD use issues in several aspects with the inclusion of the economic information content.

User readiness as a determinant for use of big data analytics: A case of state corporations in Kenya

AbstractState corporations in Kenya are installing systems to provide real‐time data to enhance decision making, customer base growth, and revenue generation. However, these organizations must still determine their readiness for big data analytics. User readiness as a determinant for use of big data analytics in developing countries like Kenya has received limited coverage in literature. Yet, successful implementation necessitates users' preparedness and willingness to use the technology. Grounded theory was used in this study, which involved eight state corporations in Kenya. Four categories emerged from the data: user attributes, change management, ICT competence, and decision‐making culture. The proposed interventions to improve user readiness are top leadership support, user engagement, change management strategies, capacity‐building programs, and data governance. The article contributes to literature by exploring the gap between user readiness and use of big data analytics in state corporations in Kenya. It additionally offers practitioners, decision‐makers, and government officials in developing countries, factors that can increase use of big data analytics.

Determinants of use of rehabilitation services before entering disability pension: Time series analysis of insured members of the German Pension Insurance Federation in Berlin and Brandenburg

The age-standardized application rate for medical rehabilitation services of the German Pension Insurance Association has been declining since 2009. Two of the most frequent reasons for applying for rehabilitation services represent musculoskeletal disorders and mental disorders. The aim of this analysis was to identify factors influencing the utilization of rehabilitation services in the federal states of Berlin and Brandenburg. The explorative time series analysis is based on a research dataset of the German Pension Insurance Federation. Insured persons of the German Pension Insurance Federation from the federal states of Berlin and Brandenburg with a diagnosis of musculoskeletal disorders or mental disorders were included. Descriptive differences in targeted and prognostic parameters were calculated using chi-square and t-test statistics. Predictive parameters for the utilization of medical rehabilitation services were calculated using binary, logistic regression analyses. A total of 11,257 insured cases were examined. For the population of insured persons from Berlin, the use of medical rehabilitation services showed significant prognostic variables for gender, age at retirement, marital status, level of education, occupational requirement level, total accumulated earning points, gross pension level, status of a temporary pension, health insurance status, and diagnosis group. For Brandenburg, significant prognostic variables were found for age at retirement, marital status, nationality, education level, occupational requirement level, total accumulated earning points, status of a temporary pension, occupational sector, and diagnosis group. In Berlin and Brandenburg mental disorders and sociodemographic parameters are associated with an increased probability of not claiming medical rehabilitation services before the onset of reduced earning capacity. It remains to be investigated which mechanisms cause people with mental disorders to make no use of medical rehabilitation services. Future analyses should examine isolated interaction mechanisms for the utilization of medical rehabilitation services, especially in the case of existing F-diagnoses. In addition, explanations for different influencing variables between states remain to be explored.

Determinants of the Use of Big Data Technologies by Organizations in Russian Regions

A scientific discussion is unfolding around data as a new factor of production that contributes to the transformation of traditional sectors of the economy, industrial integration, and ensures interregional interaction. At the same time, the question of the relationship with such traditional production factors as labor and capital needs to be answered. The study aims to identify the determinants of organizations' use of Big Data at a regional level. The main hypothesis of the study suggests that the key determinants of organizations' use of big data technologies are digital labor, digital capital and the socio-economic characteristics of regions. In the study we proposed a modified knowledge production function which was tested on open data from the Federal State Statistics Service for 85 regions of Russia in 2021-2022. Panel models were constructed using the method of least squares, generalized feasible least squares. The study presents illustrative material made using cartograms and graphical methods. The results of the study distinguished the spatial heterogeneity in the use of Big Data technologies in Russia's regions and differentiation of the regions by volume of digital capital and digital labor. Panel data models with random effects confirmed the positive impact of digital labor and digital capital on organizations' use of Big Data. Among the socio-economic characteristics of regions as determinants of the use of big data technologies, significant effects were obtained for the share of urban population, gross regional product and share of innovation costs. The study identifies the determinants of the development of the data economy in Russian regions, considering geographic, technological, and economic differentiation. The theoretical significance of the study lies in the proposal of the author's concept of a modified knowledge production function, which can be used as a fundamental basis for the development of the theory of data economics. The practical significance of the study lies in the validity of the value of Big Data, the use of which can help institutions and government authorities find new opportunities for the development of the data economy, taking into account regional differentiation, improving the methodology for monitoring the use of digital technologies by organizations, and identifying the key factors influencing the use of Big Data technologies by organizations.

Perceptions of psychedelic personality change, determinants of use, setting and drug moderation: Toward a holistic model

AbstractBackgroundStudies have shown evidence for long-term effects of psychedelics on personality, but comprehensive models of psychedelic-mediated personality changes have yet to be explored.AimsThe present study aims to investigate (1) perceptions of personality change in the general population, (2) moderators of perceived personality change including setting and drug type, and (3) whether personality predisposes individuals to use psychedelics.MethodPaid participants with experience using psychedelic (N = 218), non-users with interest in using psychedelics (N = 104), and non-users without interest in using psychedelic (N = 104) completed an online survey following recruitment from Amazon Mechanical Turk. Psychedelic users were asked to complete written open-ended accounts of perceived personality changes that they attribute to their most intense psychedelic experience. Thematic and factor analyses were undertaken to identify themes of perceived psychedelic change and their organizational structure.Results/OutcomesThematic analyses resulted in 52 unique personality change themes, and exploratory factor analyses yielded eight thematic factors (Unitive Spiritual, Gratitude Absorption, Purpose Freedom, Compassion Understanding, Emotional Stability, Openness Perspective, Connection to Self, and Neuroticism Caution). Interest in psychedelic use among non-users was associated with higher openness and neuroticism. Psychedelic users tended to be more open and extraverted, and less neurotic than non-users, and interested non-users tended to be higher in openness than uninterested non-users.Conclusion/InterpretationThe present results inform a tentative model of how personality leads to psychedelic use, how psychedelic use leads to changes in personality, and how setting and drug moderate different types of changes in personality. Research and clinical implications are discussed, including (1) hypotheses for future prospective and experimental research, (2) the value of creating multi-faceted, holistic measures that reflect the diversity and organizational structure of possible psychedelic changes, and (3) the value of allowing such evidence to guide novel psychedelic-assisted therapeutics.

Screening for poverty and related social determinants to improve knowledge of and links to resources (SPARK): development and cognitive testing of a tool for primary care

BackgroundHealthcare organizations are increasingly exploring ways to address the social determinants of health. Accurate data on social determinants is essential to identify opportunities for action to improve health outcomes, to identify patterns of inequity, and to help evaluate the impact of interventions. The objective of this study was to refine a standardized tool for the collection of social determinants data through cognitive testing.MethodsAn initial set of questions on social determinants for use in healthcare settings was developed by a collaboration of hospitals and a local public health organization in Toronto, Canada during 2011–2012. Subsequent research on how patients interpreted the questions, and how they performed in primary care and other settings led to revisions. We administered these questions and conducted in-depth cognitive interviews with all the participants, who were from Saskatchewan, Manitoba, Ontario, and Newfoundland and Labrador. Cognitive interviewing was used, with participants invited to verbalize thoughts and feelings as they read the questions. Interview notes were grouped thematically, and high frequency themes were addressed.ResultsThree hundred and seventy-five individuals responded to the study advertisements and 195 ultimately participated in the study. Although all interviews were conducted in English, participants were diverse. For many, the value of this information being collected in typical healthcare settings was unclear, and hence, we included descriptors for each question. In general, the questions were understood, but participants highlighted a number of ways the questions could be changed to be even clearer and more inclusive. For example, more response options were added to the question of sexual orientation and the “making ends meet” question was completely reworded in light of challenges to understand the informal phrasing cited by English as a Second Language (ESL) users of the tool.ConclusionIn this work we have refined an initial set of 16 sociodemographic and social needs questions into a simple yet comprehensive 18-question tool. The changes were largely related to wording, rather than content. These questions require validation against accepted, standardized tools. Further work is required to enable community data governance, and to ensure implementation of the tool as well as the use of its data is successful in a range of organizations.

Exploring factors affecting Chinese adolescents' perceived usefulness and engagement with a stress management app: a qualitative study.

Providing adolescents with stress management interventions via mobile apps has potential for overcoming barriers to traditional in-person services, such as stigma, cost and travel. However, the effectiveness remains uncertain and engagement level remains low. Therefore, it is essential to understand adolescents' user experience of such apps, however, such research is scarce. This study aimed to address this research gap by exploring factors affecting Chinese adolescents' perceived usefulness and engagement of a stress management app, which was developed for them. A qualitative study design involving focus group interviews and inductive thematic analysis was adopted. A purposive sampling method was employed, resulting in five focus groups (n = 39 adolescents). Two themes emerged: (1) mechanism and determinants of usefulness and (2) facilitators and barriers to engagement. The app was found to be helpful in managing chronic and simple stressors by promoting positive behavior, cognition, and physical changes. Relevance to real-life situations, peer support, and planning and monitoring features were found to increase usefulness. Participants suggested adding one-on-one chat support for managing acute stressors. Multimedia, logical content arrangement, combining psychoeducation and skills training, gamification, customization, and an appealing user interface were engaging factors for adolescents, whilst text-heavy content, pedagogical and monotonous tones, technical issues were found to disengage adolescents. Stress management apps should involve simple and evidence-based coping skills training, target adolescents' real-life problems, promote positive peer influence, address both chronic and acute stressors. Additionally, such apps should have logical arrangement of content, be interactive and customizable, and involve multimedia and gamification features to engage adolescents.

Contraceptive awareness and its determinants for use among women of reproductive age: A cross sectional study

Introduction: According to the WHO, family planning is an approach to thinking and living that people and couples freely adopt in order to enhance their health and welfare based on their knowledge, attitude, and responsible choices. Each year, incorrect use of contraceptives or their failure to work as intended results in around one-third of unwanted births. The obstacles that exist in poorer nations include a lack of awareness about contraceptive techniques, the availability of supplies, their cost, or their inadequate accessibility. Method: This was a cross sectional study; conducted to asses o contraception awareness, acceptance, and adoption among women of reproductive age. Women who attended/delivered at the Saidham Hospital affiliated to Dr. Mane Medical Foundation and Research Centre (DMMFARC) Maharashtra, India were included. Face-to-face interviews were conducted while data were collected using a structured questionnaire. Result: Out of total 359 total women the majority 115 (32.02%) belonged to the 21–25 age group, while 197 (54.87%) were housewives, 112 (31.19%) had higher secondary education, 201 (54.98%) belonged to the lower socioeconomic class and were BPL cardholders, 191 (52.20%) belonged to rural areas, and Hindu populations contributed 182 (50.69%). Furthermore,165 (45.96%) study participants had one child, and 21 (5.84%) had a history of one abortion. occupation, level of education, socioeconomic class, area of residence, and religion showed statistically significant relationships with contraception usage. Conclusion: The present study concludes that the majority of women of reproductive age still do not use contraceptives and their opinion is not taken into account. More similar studies are needed to ascertain the determinants of contraceptive use and such knowledge can be used to formulate specific health education needed for adoption of family planning methods.

Seeking mental health services before and during COVID-19 Pandemic in the Acre region of Israel

Abstract Background The Covid-19 pandemic and the measures (social and physical distancing, school closure, etc.) taken to prevent the spread had remarkable psychological and social effects on the population. These measures have been linked to post-traumatic stress disorders, anxiety, depression, and other stress symptoms that negatively impact the psychological well-being. Our aim was to compare the determinants of use of psychiatric services before and during the pandemic. Methods We conducted a record-based retrospective study from two periods, before and during the Covid-19 pandemic, utilizing the electronic system Prometheus at the Mazor Mental Health Medical Center (MMHMC) located in the Acre region of Northern Israel. Results Our sample consisted of 528 newly admitted patients, 96.6% came voluntarily, 55.9% were male, with a mean age of 41.1 years (SD ± 16) and living approximately 7.1 km (SD ± 8.5) from MMHMC away. 53% were Jewish, 21.8% lived alone, and 79.9% were unemployed. The main diagnoses were psychotic disorders (16.3%), adjustment and posttraumatic stress disorders (both 13.6%), followed by depression (9.3%), anxiety (7.8%), personality disorders (4.7%), and all other diagnoses. Most patients were referred to MMHMC by their primary care physician (58.1%) or psychiatrist (41.5%), and 21.4% had a family psychiatric history. Comparing the two periods, no statistically significant differences were observed in all examined variables and clinical characteristics except for the underlying risk factors for seeking mental health services. In the pre-pandemic period, the rate of suicide attempts is 26.9%, of violence 38.8%, and of other risk factors 34.3%, while the corresponding percentages during the pandemic are 49.1%, 39.6%, and 24.2%, respectively. Conclusions Our study revealed approximately the same characteristics of people seeking mental health services during the Covid-19 pandemic. However, a significant increase in suicide attempts was observed during this period.

Optimizing Telehealth Services: A Mixed-Methods Needs Assessment Conducted Among Community Health Center Patients.

The COVID-19 pandemic increased telehealth services in federally funded community health centers (CHCs). Yet little is known about common determinants of use among CHC patients. We examined the use of telehealth among patient participants at 1 large CHC network providing care to underserved populations at urban and suburban sites in the Midwest. We conducted a mixed-methods study utilizing a sequential explanatory design. Participants were English and/or Spanish-speaking adults who attended ≥1 visits for themselves or their child over a 12-month period at any practice location. Research staff conducted a structured phone survey of eligible adults. The results subsequently facilitated purposive sampling of telehealth "users" and "nonusers" for qualitative phone interviews. The survey participants included 500 adults. Most had access to the resources needed to utilize telehealth, including a smartphone (90.4%) and home internet (83.0%). About half (50.8%) "rarely or never" had problems with internet speed, reliability, or quality. Most (81.1%) were aware of the patient portal and 59.8% had utilized video visits. Participants who were Spanish-speaking and with limited English proficiency faced some of the greatest barriers. Qualitative interview participants included 12 users and 12 nonusers of telehealth. Users found telehealth convenient and efficient, while nonusers lacked awareness about how telehealth services could be beneficial or needed assistance to sign up, join, or use telehealth. Most participants had the resources and awareness necessary to use telehealth services. Those who use them appreciate the convenience and efficiency. Nevertheless, additional support may be needed to prevent telehealth from exacerbating health inequities.

Determinants and Outcomes Associated With Skilled Nursing Facility Use After Coronary Artery Bypass Grafting: A Statewide Experience.

Skilled nursing facility (SNF) care is frequently used after cardiac surgery, but the patterns and determinants of use have not been well understood. The objective of this study was to evaluate determinants and outcomes associated with SNF use after isolated coronary artery bypass grafting. A retrospective analysis of Medicare Fee-For-Service claims linked to the Society of Thoracic Surgeons clinical data was conducted on isolated coronary artery bypass grafting patients without prior SNF use in Michigan between 2011 and 2019. Descriptive analysis evaluated the frequency, trends, and variation in SNF use across 33 Michigan hospitals. Multivariable mixed-effects regression was used to evaluate patient-level demographic and clinical determinants of SNF use and its effect on short- and long-term outcomes. In our sample of 8614 patients, the average age was 73.3 years, 70.5% were male, and 7.7% were listed as non-White race. An SNF was utilized by 1920 (22.3%) patients within 90 days of discharge and varied from 3.2% to 58.3% across the 33 hospitals. Patients using SNFs were more likely to be female, older, non-White, with more comorbidities, worse cardiovascular function, a perioperative morbidity, and longer hospital lengths of stay. Outcomes were significantly worse for SNF users, including more frequent 90-day readmissions and emergency department visits and less use of home health and rehabilitation services. SNF users had higher risk-adjusted hazard of mortality (hazard ratio, 1.41 [95% CI, 1.26-1.57]; P<0.001) compared with non-SNF users and had 2.7-percentage point higher 5-year mortality rate in a propensity-matched cohort of patients (18.1% versus 15.4%; P<0.001). The use of SNF care after isolated coronary artery bypass grafting was frequent and variable across Michigan hospitals and associated with worse risk-adjusted outcomes. Standardization of criteria for SNF use may reduce variability among hospitals and ensure appropriateness of use.

Determinants of Use of Contraceptive Methods Among Sexually Active Married Men in Nigeria

Using a cross-sectional research design, the men’s dataset of the 2018 Nigeria Demographic and Health Survey (NDHS) and a weighted sample size of 7,991 sexually active married men (15–59 years) were used to examine determinants of the use of contraceptive methods. Data were analyzed using frequency tables, proportions, Pearson’s chi-square, and multinomial logistic regression. The relative risk of using male-controlled contraception relative to not using any contraception was 3% significantly lower (arrr = 0.7, 95% CI [0.5, 1.0], p &lt; .05) among polygamous married men than for monogamists. In comparison, the relative risk of using female-controlled contraception relative to not using any contraception was 4% significantly higher (arrr = 1.4, 95% CI [1.0, 2.0], p &lt;.05) for polygamous married men compared to the corresponding risk for monogamists. Other factors influencing the risk of using male-controlled contraception include tertiary education (arrr = 2.8, 95% CI [1.9, 4.0], p &lt; .05), Yoruba (arrr = 3.8, 95% CI [2.8, 5.2], p &lt; .05), richer (arrr = 1.5, 95% CI [0.8, 1.7], p &lt; .05), and desire for more children (arrr = 0.8, 95% CI [0.7, 0.9], p &lt; .05), media exposure (arrr= 1.5, 95% CI [1.3, 1.7], p &lt; .05) and the number of sexual partners in the last 12 months (arrr = 5.7, 95% CI [4.6, 7.0], p &lt; .05). Findings suggest strengthening male-controlled contraceptive methods by sexually active married men to reduce high fertility levels.

Structural Relationship between Attributes of Technology Acceptance for Food Delivery Application System: Exploration for the Antecedents of Perceived Usefulness

The aim of this research is to explore the antecedents of usefulness in the technology acceptance model for a food delivery application system and to confirm the accountability of the technology acceptance model in the area of food delivery application systems. The determinants of usefulness are information quality, swiftness, and food quality. For data collection, this research employs Amazon Mechanical Turk. The number of valid observations is 379. For the data analysis, confirmatory factor analysis and structural equation modeling were primarily implemented. The results indicate that usefulness is positively impacted by information quality, swiftness, and ease of use. Additionally, it is found that attitude is positively influenced by usefulness. Moreover, intention to use is positively affected by usefulness and attitude. This research is worthwhile in that it provides service providers with information for constructing better systems.