Service Evaluation Research Articles

Potential and Observed Supply–Demand Characteristics of Medical Services: A Case Study of Nighttime Visits in Shenzhen

Hospital selection patterns are essential for evaluating medical accessibility and optimizing resource management. In the absence of medical records, early studies primarily used accessibility functions to estimate potential selection probabilities (PSPs). With the advent of travel data, data-driven functions have enabled the calculation of observed selection probabilities (OSPs). Comparing PSP and OSP helps to leverage travel data to understand hospital selection preferences and improve medical service evaluation models. This study proposes a selection probability-based accessibility model for calculating PSP and OSP accessibility. A case study in Shenzhen employed nighttime navigation data to reduce interference from different travel modes. The distance decay function was validated, with exponential and Gaussian functions performing best. For hospitals, the PSP distribution closely aligned with OSP, except in areas with high hospital density. This discrepancy may result from the PSP function overestimating the selection probability for nearby hospitals, a limitation that could be addressed by fitting the distance decay function to actual data. PSP-based accessibility and Gini coefficients differ from those of OSP. However, when parameters are fitted to actual data, the PSP- and OSP-based functions produce nearly identical results. Fitting to actual data can notably improve the accuracy of PSP and the corresponding accessibility outcomes. These findings may provide valuable references for medical service evaluation methodologies and offer insights for planning and management.

Lessons from a participatory community cricket breeding project in Vientiane Province, Lao PDR

Abstract Edible insect production is a key tool for sustainable development and global food security, but its social dimensions and the organisation of farming operations remain understudied. Crickets are among the most recognised edible insects for farming and offer appealing development opportunities for Lao PDR – a Southeast Asian country whose cricket farming sector has lagged behind neighbouring Thailand and which continues to experience challenging economic and food security conditions. Concerning these sustainable development and research priorities, this paper presents the case study analysis of a service evaluation of Cricket Lao Farm, which implemented a project on the distributed (off-site) production of crickets among local community members. Data collection took place from September to November 2023 and included a survey with 30 participants complemented by qualitative information from discussion groups, home visits, informal conversations, and project documentation. While small-scale farming operations ended within a year due to widespread cricket mortality of unknown cause, community-based cricket farming was in principle profitable and demonstrated strong development potential and local relevance. Furthermore, most of the community-based farmers were motivated and interested in resuming operations in the future. The analysis of this case offers important lessons for further development of the cricket farming sector in Lao PDR, highlighting the challenges of the Western social enterprise model in a development setting, the need to actively manage participation, and to develop an understanding of local community structures before commencing operations. To ensure future success, projects should include robust monitoring and evaluation plans; regular and bidirectional communication between community members and the central farm; co-development of breeding strategies, response plans, and good animal husbandry practices; and community engagement activities involving local schools.

Accessibility evaluation and multi-scenario optimization of medical services in underdeveloped city driven by multi-source data and latest policies for China

Accessibility evaluation and multi-scenario optimization of medical services in underdeveloped city driven by multi-source data and latest policies for China

A Systematic Literature Review on the Operationalization of Usability in Urban Pluvial Flooding Climate Services and the Influence of Contextual Factors

ABSTRACTExtreme weather impacts due to climate change, such as urban pluvial flooding, necessitate adaptive measures. To support decision making in climate adaptation, climate services provide information and guidance to policy makers and other stakeholders. Effective use of climate services is prohibited by usability gaps. Some causes for these gaps originate from contextual factors. However, these factors are not well understood within academic literature. Therefore, our systematic review has two research questions: (1) What dimensions of climate service usability are considered in the design and evaluation of their use and how are these operationalized?; and (2) What contextual influences may affect these identified dimensions? To this end, we analyzed 51 articles that cover one or more urban pluvial flooding climate services. Our results show several overarching categories of usability dimensions (functionality, ease of use, reducing time and effort, reliability, matching user needs, and other). However, these dimensions are not always fully operationalized by authors. Furthermore, our results show that most contextual factors originate from the meso level (within or between organizations), and in lesser extent the macro (e.g., national policies) and micro level (individual users). Here especially organizational (e.g., Does the climate service fit organizational work approaches?); and process factors (e.g., Was the climate service co‐produced?) have been shown to affect usability. We conclude that more attention should be given to usability as a concept within the design and evaluation of climate services well as to the influence of contextual influences.

Health economics and services research in symbiosis: STREAMLINEing mental health services in Austria

Abstract Objectives The cost of mental diseases exceeds 4% of GDP in Europe. In Austria, every 5th person lives with mental ill-health (MIH). Ongoing epidemiological, demographic and societal changes increase the need for easily accessible, better integrated and good value services. In STREAMLINE, we combine, harmonize and implement the latest methods in human service mapping and economic costing to optimize future service provision and financing for MIH in Austria. Methods We comprehensively assess the availability, activity and affordability of human services targeting MIH in Vienna within the health and social care, education, labour and justice sectors based on a conceptual mind map. We identify services through extensive literature, document and web searches plus expert consultations. Services are mapped and costed according to the European PECUNIA methods: classification of the main service types using the international DESDE taxonomy of human services; development of Reference Unit Costs using the PECUNIA RUC templates with primary data; validation of the results with secondary data; compilation of a comprehensive multi-sectoral service catalogue; and synthesis for spatial and policy analyses. Results We identified 756 sources, 75% individual organisations, 5% multi-organisations and 20% existing provider lists. 84% relate to health and social care, 10% labour, and 3% education and justice sectors each. 58% deliver care to adults, 37% to children & adolescents, and 5% support carers. Further service mapping and RUCs will be presented. Discussion STREAMLINE pioneers in coordinated public mental health services and economics research at scale. Assessed levels of fragmentation call for better integration, improved transition, reduced spatial inequity and increased support for carers. Results increase the feasibility of service evaluations from a societal perspective. Planned public service atlas facilitates information and access for service users and carers. Funding: WWTF Key messages • New methods for harmonized health services and economics research allow comprehensive information for optimized future mental health service planning and financing. • Assessed levels of fragmentation highlight the need for better integration, improved transition, reduced spatial inequity and increased support for carers.

Cardiovascular emergency in indonesian primary health care (PUSKESMAS): a national multicentre service evaluation study based on ESC guidelines adherence

Abstract Background Early diagnosis and prompt treatment are crucial in reducing cardiovascular (CVD) burden in the global level, especially in Indonesia with more than a half million CVD death annually. As frontliner, more than 10,000 primary healthcare (PUSKESMAS) spreading around Indonesia are pivotal in delivering CVD emergency care. However, due to the scarcity of healthcare resources, significant disparities exist between guideline recommendations and their implementation in Indonesian primary health care. Purpose Our study aims to describe current cardiovascular emergency care, assess guideline adherence, and identify key factors influencing the trend. Methods This multicentre study was conducted in 40 PUSKESMAS across Indonesia from October to December 2023. Data related to cardiovascular emergencies diagnosis, work-ups, treatment, and outcomes were gathered and then evaluated according to the ESC Guidelines. Recommendations, particularly Class I, were converted into points with respect to diagnostic and treatment domains. Guideline adherence scores were then calculated based on the percentage of accomplished points. Linear regression analysis was employed to identify factors that could explain variations in guideline adherence across all PUSKESMAS. Results 215 CVD emergency patients were reported. The most prevalent diagnosis was hypertensive crisis (n=137; 64%) with ECG done in only 26% of cases and none underwent imaging. Oral amlodipine (59%) and captopril (55%) were mostly used as antihypertensive, with none receiving intravenous. The second most common diagnosis was ACS (n=42; 20%), with ECG performed in only 71% of cases. Among 13 patients with STEMI, 69% only received aspirin, and 46% were given DAPT. Malignant arrhythmia occurred in 26 patients, with none receiving cardioversion. The most used anti-arrhythmic are bisoprolol, propranolol, and atropine. Among 23 cases of acute HF, only 39% received oxygen, while IV furosemide was used in only one case. Cardiac arrest occurred in two patients, both received CPR and epinephrine. In terms of guideline adherence, mean diagnostic score (%) was demonstrated highest in Cardiac Arrest at 100 and the lowest in Hypertensive Crisis and Acute HF at 53, while mean treatment score (%) was highest in Hypertensive Crisis at 86 and lowest in arrhythmia at 25. Linear regression suggests that human resources have a positive and significant association with diagnostic adherence scores (R2: 0.3485, p-value: 0.0450), whereas essential medicine has a strong but non-significant correlation with treatment adherence score (R2: 1.0768, p-value: 0.460). Conclusion This study has demonstrated a huge disparity between the current CVD emergency practices and guidelines in Indonesian primary healthcare. These gaps emphasised the need for improved human resources and essential medicine for primary healthcare along with the implementation of data-driven policy making concerning cardiovascular disease in Indonesia.Cardiovascular Emergency Diagnosis in InCardiovascular Emergency Work-up and Tre

Routine use of ultrasound-assisted catheter-directed thrombolysis for the management of intermediate-high risk pulmonary embolism: a service evaluation project

Abstract Background Intermediate-high risk Pulmonary Embolism (PE) has considerable morbidity. Conservative management could be sub-optimal. Ultrasound-Assisted Catheter-Directed Thrombolysis (UACDT) is used in our centre for the routine management of this presentation. Purpose We assessed the procedure safety and short-term outcomes by reviewing locally performed procedures. Methods This is an observational retrospective cohort study, with a historic control group. Our centre is a District General Hospital (DGH) in the United Kingdom, and we receive referrals from local acute hospitals. Since the introduction of this service in June 2018 until November 2023, 129 patients (2 patients/month) received routine management with UACDT for intermediate-high risk PE. The controls are 75 acute PE patients of comparable risk classes, managed from January to December 2016. We assessed procedural and in-hospital outcomes including minor, major bleeding/complications and death. We also assessed Length of Stay (LoS) in hospital, recurrent Venous Thrombo-Embolism (VTE) and re-admission rates for recurrent PE at 30 days. Reduction of oxygen requirements and improved estimated systolic Pulmonary Artery Pressure (sPAP) post-procedure were assessed as surrogate measures. Continuous variables were analysed with a Mann-Whitney U test, and categorical variables with a Chi-square Test. Results Baseline demographics are listed in Table 1. Mean duration between CT Pulmonary Angiography (CTPA) and the UACDT procedure was 1.6 (±SD 1.4) days, including inter-hospital transfer. Only 6% (8/129) of UACDT cohort received ≤12 mg standard alteplase dose. In the control group, 4% (3/75) of patients received standard 100mg systemic thrombolysis. There was no significant difference in the rates of minor (p= 0.9), major bleeding/complications (p= 0.8), or death (p= 1.0) between both groups. There was also no significant difference in rates of recurrent VTE (p= 1.0) or re-admission within 30 days for PE (p=0.1) (Table 2). LoS in hospital data were ratified, to exclude inappropriate delays (e.g. physiotherapy requirements, etc). We used the date when the patient was declared medically fit for discharge, and no significant difference was noted (p= 0.2). This was confirmed with a regression analysis of UACDT treatment effect (p= 0.9, CI= -3.5 to 3.1). Nonetheless, there was a 25% reduction of median LoS in hospital from 8 days in the controls to 6 days with UACDT. The proportion of patients requiring O2 was also reduced from 69% (89/129) to 41% (54/129) on day 1 post-procedure. A significant reduction of the estimated sPAP by TTE post-procedure was detected by a mean of 10.4 (±SD 13.9) mmHg (p= <0.01). Conclusion UACDT is generally safe with low complications rate. Compared to the control group, there was a reduction in absolute deaths and median LoS in hospital. This can be secondary to the significant acute reduction of systolic pulmonary artery pressure identified.

Should face-to-face in-person therapy be preserved for some clients with anxiety? Evaluation of Anxiety UK's psychological therapy services before and during the COVID-19 pandemic.

The COVID-19 pandemic initiated a mass switch to psychological therapy being delivered remotely, including at Anxiety UK, a national mental health charity. Understanding the impact of this forced switch could raise implications for the provision of psychological therapies going forwards. To understand whether the forced switch to remote therapy had any impact on outcomes, and if certain groups should continue to be routinely offered certain delivery modalities in future. Data were available for 2323 individuals who accessed Anxiety UK services between January 2019 and October 2021. Demographic data, baseline and discharge anxiety and depression symptoms, and mode of therapy delivery were available.Regression models were built to model (a) the mode of therapy delivery received pre-pandemic using logistic regression, and (b) outcomes pre- and post-pandemic onset within demographic groups. No statistically significant changes in baseline anxiety symptoms, demographics or outcomes were observed before and after the onset of the COVID-19 pandemic.Pre-pandemic, males were more likely to receive online video therapy than telephone therapy (Relative Risk Ratio (RRR) 1.42, [1.01, 1.99]), while older clients were less likely to receive online video therapy (RRR 0.98, [0.97, 0.99]). However, no differences in outcomes were observed post-pandemic onset within these groups, with only the number of sessions of therapy being a significant predictor of outcomes. Anxiety UK services remained effective throughout the pandemic. We observed no evidence that any demographic group had worse outcomes following the forced switch to remote therapy.

Virtual clinics in oral surgery: an equitable service for all?

Introduction Teledentistry has become more prevalent in the provision of oral healthcare since the COVID-19 pandemic. Virtual consultation clinics were introduced at Birmingham Dental Hospital as an adjunct to face-to-face (F2F) consultation clinics. This service evaluation compares virtual and F2F consultation clinics in oral surgery, with particular focus on 'did not attend' (DNA) rates.Methodology Data were collected retrospectively from all clinics conducted within the oral surgery service in April 2021. Information collected included attendance, patient demographics and complications impeding the consultation, including technical difficulties. Patients' postcodes were used to generate deprivation deciles. All data were handled sensitively in line with the Caldicott principles.Results Binomial regression analysis showed that DNA rates were more likely to occur in virtual consultation clinics compared to F2F clinics (p <0.00). DNAs were less likely to occur at review appointments (p <0.00). Lower deprivation decile ratings were associated with higher rates of DNAs, independent of clinic type (eg review or new patient) or method of consultation (virtual versus F2F) (p <0.01).Conclusion While virtual clinics are advantageous for some patient demographics and have shown promising results in other studies, it is important that the delivery of these virtual services does not continue to marginalise vulnerable patient groups and enhance pre-existing oral health inequalities.

A structural model of customer experience in rural tourism

Purpose The purpose of this study is to explore the diversification of agricultural management for development in rural tourism. Excellent service has been standardized in response to society becoming more service-oriented. However, the structure of customer evaluations of services in rural tourism and their association with customer satisfaction and customer delight remain under-investigated. Design/methodology/approach This study used survey data from the general consumer population in Japan and used SERVPERF to measure service quality post-service, focusing on rural tourism experiences. The author analyzed the mechanisms of service quality leading to customer satisfaction and value co-creation, and value co-creation leading to customer delight and the effects of customer delight compared with those of customer satisfaction, using structural equation modeling. Findings Enhancing services strongly influenced excellent services, which were considered to generate customer delight. Compared with customer satisfaction, customer delight was inferred to lead to higher customer loyalty. The results indicated that core services generated customer satisfaction, whereas enhancing services generated customer delight. Practical implications These findings provide important insights into the provision of services in rural tourism, which is becoming prevalent in society, and contribute to the diversification of agricultural management. Originality/value The originality of this study lies in the adoption of rural tourism to diversify farm management, revealing its structure as an experience that leads to customer delight through value co-creation. The author showed that customer experience as a form of value co-creation in rural tourism can lead to the creation of excellent services.

The Role of Companionship in Volunteer Homelessness Support Services: A Qualitative Study

Drawing on developments in the application of occupational science to issues of homelessness and tenancy sustainability, this paper will argue for the recognition of authentic, everyday relationships as a core part of tenancy support. Data from a small-scale evaluation of a volunteer-led homelessness support service will be explored through a framework of social support to show the importance of companionship in enabling individuals to exit homelessness. The data show that individuals valued the provision of social support from volunteers in everyday locations, as it replicated authentic relationships which individuals had sometimes lost through their experiences of homelessness. This paper argues that the facilitation of authentic, everyday relationships should be considered an important part of homelessness support.

Evaluating the outcome of a physiotherapy intervention in the treatment of mastitis, blocked ducts and engorgement in the lactating breast

Physiotherapists are well placed within the multidisciplinary team to offer safe interventions for the management of the symptoms of mastitis, blocked ducts and engorgement (MBE). However, these are not widely utilized in the UK. The purpose of this service evaluation was to evaluate patient satisfaction with treatment and outcomes following a physiotherapy intervention. The World Health Organization recommends that all infants are breastfed exclusively for 6 months. Despite the known benefits, the UK has some of the lowest breastfeeding rates in the world. A primary cause of premature cessation is pain, which can result from MBE, with mastitis alone affecting up to 25% of lactating women. The target population was breastfeeding mothers who had utilized the clinic’s mastitis service for therapeutic treatment of MBE between January 2021 and January 2023. A service evaluation was conducted using telephone questionnaires. Verbal informed consent was obtained prior to data collection. The protocol, which was uniquely developed by the principal clinicians in this service evaluation, included therapeutic ultrasound, manual therapy, advice and education. Ninety-two per cent of participants found the treatment helpful, 76.5% reported an initial improvement in symptoms within 24 h of treatment, and 76% said that the protocol helped them to continue breastfeeding for longer. The participants reported that the protocol was effective for managing the symptoms of MBE, and that it supported an increase in breastfeeding duration.

Physiotherapy management of acute perineal trauma: a patient satisfaction survey

Pelvic floor muscle (PFM) training is recommended in the immediate postpartum period because it can restore PFM function and prevent pelvic floor dysfunction. There are no national physiotherapy guidelines on how to deliver this intervention in the acute period. There is also no consensus on the need for outpatient follow-up to treat pelvic floor dysfunction that arises from perineal trauma, or as a preventative strategy in the long term. The aim of this study was to evaluate a current service provided for women with acute perineal trauma. The authors assessed patient satisfaction and compliance with physiotherapy advice, and identified preferences for future service development. One hundred and thirty patients completed satisfaction questionnaires after receiving inpatient physiotherapy treatment. Thirty consented to completing a retrospective telephone consultation about their care at 6–8 weeks postpartum. The questionnaire found high levels of satisfaction, and recorded a National Health Service Friends and Family Test score of 93. In the telephone consultation, 87% of the women reported that they were complying with ongoing PFM training. Eighty-five per cent of women who completed the questionnaire suggested that outpatient physiotherapy follow-up would be useful. Fifty per cent stated that options inclusive of outpatient follow-up would be useful for onward service development. Because of the high levels of satisfaction recorded and high compliance with the information provided in the acute postpartum period, it was concluded that the service should continue as it is. It is hoped that this service evaluation can be utilized as a benchmark for other acute and outpatient pelvic health physiotherapy services.

Influence of socio-economic variables and extension inhibitors on food sovereignty in Akwa Ibom State, Nigeria

This study assessed the influence of socio-economic variables and extension inhibitors on food sovereignty in Akwa Ibom State, Nigeria. This study identified and proffered solutions to extension inhibitors to food sovereignty. A multi-stage sampling technique was used to select one hundred and twenty respondents used for the study. Data analysis comprised the use of percentages, frequency, means and Tobit regression model. The result of the socio-economic characteristics of the respondents showed that 27.50% of the respondents were from 41 and more years of age, while 25.00% were within the age range of 31 to 40 years. 8.33% of them were in the age brackets of 20 to 30 years. Majority of the farmers were very strong, agile and could adopt extension teaching methods easily. About 49.17% of the respondents were at tertiary level of education, while 23.32% had primary level of education. The result showed the mean (x ̅) response rate of extension inhibitors on food sovereignty as follows; inadequacy of funds (x ̅ = 4.65), use of poorly trained personnel (x ̅ = 4.04), ineffective research extension linkage (x ̅ =4.21), lack of evaluation (x ̅ = 4.422), poor policy (x ̅ = 4.04) among other factors. The hypothesis showed that gender, marital status and farm size were positive and significant at 1% level of probability. The result of the HO1, showed that any increase in farm size led to a corresponding increase in the probability and intensity of extension inhibitors on food sovereignty in the study area. Also, the coefficient of education was positively signed but not significant. This showed that education though very important but had no severe influence on the extension inhibitors. In the result, there was significant relationship between socio-economic variables and extension inhibitors on food sovereignty in the study area. The study concluded that some of the inhibitors of extension on food sovereignty are; inadequate funding, lack of extension service evaluation on food sovereignty situations, ineffective research extension linkage and use of poorly trained personnel. The study also concluded that majority of the farmers are of age and well educated to positively influence extension inhibitors with the view to improving food sovereignty situations in the study area. It was recommended that women being the majority in the study area should be involved in extension activities and evaluation, with a view to improving on food sovereignty. Key words: Akwa Ibom, Extension, Food Sovereignty, Influence, Inhibitors, Socio-economic and Variables

Exploring the use of point-of-care ultrasound by pelvic health physiotherapists in the UK

National and international surveys have highlighted point-of-care ultrasound (PoCUS) as an emergent technology that is being utilized by physiotherapists across a variety of clinical specialities. It confers advantages beyond traditional physiotherapy assessment and increases treatment options for patients with pelvic health conditions. What is not known is how pelvic health physiotherapists are routinely using PoCUS, or the barriers and enablers to its use that exist specifically within this population. The aim of this service evaluation was to explore the current use of PoCUS by pelvic health physiotherapists who are part of the POGP professional network to identify barriers and enablers to wider use within clinical practice across the UK. An online survey with both multiple-choice and free-text responses was shared. Questions covered four domains of interest: (1) demographic and professional characteristics; (2) current use of PoCUS; (3) perceived barriers and enablers; and (4) training. One hundred and two pelvic health physiotherapists with varied levels of experience responded from different sectors and areas of the UK. Only 30.4% reported routine use of PoCUS in their clinical practice despite consensus that PoCUS is an important tool for the rehabilitation of pelvic health conditions. Most barriers to the use of PoCUS identified could be linked to resource limitations, training or lack of support, and were also reflected in suggestions for enablers. Most users had formal training and felt that this had been sufficient to be competent in using PoCUS in their service. Physiotherapists recognize the advantages that PoCUS offers for rehabilitation in pelvic health populations, but are often unable to access the equipment or training required. Ongoing support after training is needed to ensure that users maintain confidence and competence, especially as many work as independent practitioners and are without a direct peer network. Updates to national recommendations or guidelines to include PoCUS as a recommended tool within rehabilitation may provide the impetus needed to support its adoption across more public healthcare settings.

Large-scale acute hospital bed and mattress implementations: insights and recommendations

Background/Aims Hospital-wide replacement of beds and mattresses, often referred to as an ‘implementation’, can be an efficient way of ensuring that these products are up to date. However, large-scale implementations can be daunting for healthcare managers, with a lack of guidance to support them through this process. This service evaluation aimed to provide practical suggestions to NHS managers who are planning a hospital-wide acute hospital bed and mattress implementation from peers who have completed similar projects. Methods Interviews were conducted with a purposive sample of seven NHS staff members, all of whom had held a leading role in managing and executing an implementation project with the provider Medstrom. Exploratory, qualitative, semi-structured interviews were conducted, with data analysed through content-driven narrative analysis, using NVivo software. Results Four themes relating to large-scale bed and mattress implementation were identified: drivers; specification process; financial process; and physical implementation and training. Communication and planning were considered crucial, as was selecting a provider that could offer support throughout the implementation. Participants had been able to successfully implement a large volume of products, but all felt that a resource allowing healthcare managers to draw on the experiences of others who had previously completed a large-scale implementation project would be beneficial. Conclusions Large-scale mattress implementations are achievable with the right input and support. Learning from the experiences and knowledge of peers who have previously been involved in implementations can be very useful for healthcare managers embarking on this kind of project.

Service specification for senior care workers with traditional Chinese medicine specialty

Abstract Senior care workers specializing in traditional Chinese medicine (TCM) healthcare have become an indispensable force in institutional care, community care, and home care. The first Chinese nursing service team aimed to improve the health of the elderly by providing continuous services for physical and mental well-being, disease prevention, physical amelioration, and overall health enhancement using TCM concepts, methods, and technologies. The primary purpose of formulating this TCM health and elderly care worker service specification was to standardize services within the TCM elderly care industry, ensuring that the elderly receive better health and elderly care services supported by technical expertise. This specification outlined the basic requirements for TCM health and elderly care workers, including standards for service content, service quality control, service evaluation, and improvement. It primarily focused on the content and requirements of TCM health and elderly care services, such as constitution identification, life care, acupoint healthcare, and TCM auxiliary nursing for elderly individuals with chronic diseases. This specification is applicable to TCM health and elderly care personnel at various levels of hospitals and healthcare institutions and is noted for its strong applicability and effectiveness.

Culture and ICD-11 personality disorder: Implications for clinical practice across diverse ethnic groups.

Personality disorder (PD) in ICD-11 is defined primarily by self and interpersonal dysfunction and optionally by other qualifiers. This definition is inseparable from relativism of cultural determinants. This review aimed to synthesize the relevant aspects of the influence of culture on clinical practice and health management for this condition, aligning them to the ICD-11 PD model. In Scopus, we systematically searched for studies that included the text strings: cultur* | personality AND (disorder* OR patholog*) without any restrictions on publication date or language or other exclusion criteria, up to November 2022. Evidence suggests that cultural variables in ethnic groups (Western and non-Western) such as the individualist/collectivist philosophy, historical/generational trauma, immigration, acculturation, religion, and gender influence the etiology, semiology, epidemiology, evaluation, diagnosis, treatment, and management of health services for ICD-11 PD. We discuss the limitations and propose future lines of research on this topic based on our knowledge and experience. In this review, we provide the scientific community and clinicians with relevant cultural information to guide their practice and propose strategies to manage PD from the ICD-11 model. More research is needed using mixed study methodologies on stigma, the experiences of patients, clinicians, and health agencies, to reduce the care gaps and achieve a culturally comprehensive, inclusive, and competent use of this new model.

An evaluation of a virtual musculoskeletal podiatry service implemented to address prolonged National Health Service waiting times.

The COVID-19 pandemic had a substantial impact on healthcare systems globally, particularly in the public sector. To address the challenges posed by the pandemic, musculoskeletal (MSK) healthcare providers had to rapidly adopt virtual platforms for delivering care, representing a major shift in how healthcare was delivered. This manuscript aims to retrospectively evaluate a virtual MSK podiatry service offered by a private provider under a National Health Service commission, in terms of patient access, waiting times and patient-reported pain. This service was developed and implemented in response to the COVID-19 pandemic and the extended waiting times. A retrospective clinical service evaluation was conducted on MSK podiatry services delivered via telephone or virtual consultations. The evaluation covered a cohort of 574 referred patients over a 19-month period (July 2021 to January 2023). It analysed demographic data, initial and final visual analogue pain scores, pathology categories, orthoses prescriptions and exercise rehabilitation plans. Data from a total of 492 patients (male=152 and female=340) were analysed, with 82 patients excluded for non-attendance. The average waiting time from referral-to-first appointment and referral-to-discharge was 35 and 91days, respectively. Results showed statistically significant improvement (p<0.001) in the mean visual analogue scale when patients received orthoses with and without a rehabilitation plan (4.12±2.55 and 3.33±2.88, respectively). Most patients (61.5%) were aged 40-69, with "foot pain" being the main reported pathology category. Patients had an average of two appointments. 56.5% of patients remained virtual throughout their journey and were successfully discharged to self-management. 43.9% were discharged to other face-to face services. The study provided evidence that the virtual MSK podiatry service achieved a statistically significant reduction in patient-reported pain for various pathologies with reasonable waiting times. The service delivered favourable outcomes and complemented traditional services at a time with limited access due to the COVID-19 pandemic.

Satisfaction and preference for home delivery pharmaceutical services among patients attending primary care settings in Qatar during COVID-19 pandemic: a cross-sectional study

ObjectivesDuring the COVID-19 epidemic, due to the high risk associated with travel and group gatherings, the Ministry of Public Health in Qatar introduced home delivery of pharmaceutical services. This study...