First-time Users Research Articles

Telehealth use by walk-in patients who subsequently visited an academic emergency department: a repeated cross-sectional study during the COVID-19 summer 2021.

During the COVID-19 pandemic, telehealth use increased worldwide in a variety of medical specialities and reached new population groups. A baseline survey of telehealth use prior to admission to the emergency department (ED) conducted before COVID-19 concluded that predominantly well-educated men used telehealth. It is unclear how COVID-19 changed the use of telehealth in Swiss emergency patients. We therefore aimed to investigate (i) the frequency of telehealth use during the pandemic, and (ii) how the pandemic has influenced telehealth use and users. A repeated cross-sectional study was conducted among ED walk-in patients at a tertiary university hospital in Switzerland. The study took place one and a half years after the first confirmed COVID-19 case, during 30 shifts from 8 to 29 July 2021 and compared with the baseline survey conducted in 2019. Eligible patients were questioned about their use of, and attitudes to telehealth. A total of 1020 patients were screened for the COVID survey and 443 complete questionnaires were evaluated. A trend towards a general increase (+6.4%) in telehealth use was demonstrated (50.3%, n = 223 COVID survey vs 43.9%, n = 183 baseline survey; p = 0.058), with a shift to more female patients using telehealth in the COVID survey (female 54.9%, n = 124 vs 45.1%, n = 102; p = 0.052). During the pandemic, first use of telehealth was reported by 12.2% (n = 54) of patients, with a significant increase among patients with low educational status, and the latter patients often indicated that they did not plan to use telehealth after the pandemic. The perceived usefulness of telehealth and adherence to recommendations increased in the COVID survey compared with the baseline survey (adherence 90.3%, n = 149, vs 78.0%, n = 131; p = 0.002). We found a trend towards increased use of telehealth among Swiss ED patients. First-time users of telehealth were predominantly less educated and inclusion of these user groups may not be sustainable, as was indicated by the patients. COVID-19 led to greater adherence to telehealth recommendations and higher perceived usefulness. This could be due to the limited access to healthcare providers due to pandemic precautions. When offering telehealth, the needs of all patient groups must be considered, in order to ensure that telehealth provides the greatest benefit with lower barriers to use.

Motion and Memory in VR: The Influence of VR Control Method on Memorization of Foreign Language Orthography

A small-scale investigation of 22 first-time VR users was conducted to determine the extent to which different control methods (“Touch Mode” and “Point Mode”) influenced participants’ ability to memorize the educational content (Hebrew orthography) in an original VR game. In Touch Mode, participants selected user interface (UI) elements by physically moving their hands (and upper bodies) toward targets in virtual space, whereas in Point Mode, participants could manipulate a virtual laser pointer with their wrists to select UI targets from a stationary position. The Point Mode control method required less time to learn on average than the Touch Mode with high-medium effect size (Cohen’s d = 0.76). Ultimately, the difference in post-test scores between Touch Mode users and Point Mode users was not statistically significant (p = .294). Thus, the increased bodily motion necessitated by Touch Mode did not have a significant influence on memory function as initially hypothesized.

Identification of polypharmacy patterns in new-users of metformin using the Apriori algorithm: A novel framework for investigating concomitant drug utilization through association rule mining.

With increased concomitant chronic diseases in type 2 diabetes mellitus (T2DM), the use of multiple drugs increases as well as the risk of drug-drug interactions (DDI) and adverse drug reactions (ADR). Nevertheless, how medication patterns vary in T2DM patients across different sex and age groups is unclear. This study aims to identify and quantify common drug combinations in first-time metformin users with polypharmacy (≥5 co-medications). New users of metformin were identified from the IQVIA Medical Research Data incorporating data from THIN, A Cegedim Database (2016-2019). A descriptive cohort study explored prescription patterns in patients with polypharmacy. The Apriori algorithm, used to find frequent item-sets in databases, was first-time applied to identify and quantify drug combinations of up to seven drugs to investigate potential harmful polypharmacy patterns. The cohort included 34 169 new-users of metformin, of which 20 854 (61.0%) received polypharmacy. Atorvastatin was the most frequently co-prescribed drug with metformin overall (38.7%), in women (34.3%) and men (42.6%). In the stratified analysis, a higher proportion of women received polypharmacy (65.6%) compared to men (57.4%). Moreover, the proportion of patients receiving polypharmacy increased with age (18-39 years=30.4%, 40-59 years=50.5%, 60-74 years=70.9%, and ≥75 years=84.3%). This study is the first to identify and quantify commonly prescribed combinations of drugs compounds in patients with polypharmacy using the Apriori algorithm. The high polypharmacy prevalence at all strata indicates the need to optimize polypharmacy to minimize DDI and ADR.

Use of Slack for COVID-19 disaster response in Hyogo Prefecture.

The coronavirus disease 2019 (COVID-19) pandemic has caused great disruptions in education and healthcare systems. However, before the COVID-19 pandemic, Hyogo Prefecture did not have a centralized system for sharing information among hospitals, public healthcare centers, the government, fire departments, and medical associations. In March 2021, we used Slack,® an enterprise social network, to invite people from hospitals, healthcare centers, the government, fire departments, and medical associations to join our workspace. This study was undertaken to verify whether the use of Slack can improve information sharing during a disaster. A questionnaire on whether information-sharing tools such as Slack are useful for disaster response in Hyogo Prefecture, including for COVID-19, was administered using a Google Form. Of the 19 people who responded to the questionnaire, 15 (78.9 percent) were first-time users of Slack and 18 (94.7 percent) found it easy to use. All 19 participants stated that Slack proved useful in providing pertinent information regarding preventive measures for the control of COVID-19, and they believed that it would be a helpful tool if such disasters were to occur in the future. Regarding the launch time of Slack, 11 respondents (57.9 percent) answered that it was launched at the appropriate time, while five respondents (26.3 percent) answered that it was launched too late. The participants thought that Slack was effective for accelerating their communication. The use of Slack could also improve future disaster response communications.

Assessing Continue to Use Intention of Contactless Mobile Payment Systems of First-Time Users

Assessing Continue to Use Intention of Contactless Mobile Payment Systems of First-Time Users

Utilization of Norwegian crisis shelters before and during the COVID-19 pandemic.

The measures introduced to control the COVID-19 pandemic, including lockdowns and physical distancing, exerted considerable influence on society. The aims of this study were to examine (1) the prevalence of people seeking Norwegian crisis shelters for domestic violence during the first period of the COVID-19 pandemic (2020) compared to the year before, (2) the demography and type of violence among first-time visitors and (3) to compare the utilization of the crisis shelters and characteristics of the users between shelters in the capital and the other shelters throughout Norway. Observational study. The study was based on data from each crisis shelter in 2019 and 2020. Comparison between the 2 years were based on corresponding periods (12 March until 31 December) and analysed with t-test and chi-square tests. Total use of crises centres, residential stays and daytime visits were lower during the pandemic (n = 7102) compared to the pre-pandemic period (n = 11 814). There was a shift from daytime visits to phone contacts when the restrictions were established. There was a higher proportion of residential stays versus daytime visits during the pandemic (21.5%) compared to the pre-pandemic period (15.4%) (p ⩽ 0.001). The proportion of first-time users was higher during the pandemic compared to pre-pandemic period both for residents (52.4% vs 47.1%) and daytime visitors (10.9% vs 9.0%). Among first-time crisis shelter residents during the pandemic period, fewer reported having children at home compared to the pre-pandemic period. The background of the crisis-shelter users did not differ between the capital and rest of Norway, but the capital had relatively more residents with psychological violence and threats during the pandemic. The utilization of Norwegian crisis shelters, especially daytime visits was lower during the pandemic. There was a shift in daytime contacts from visits to phone contact at the pandemic outbreak. To ensure that information about available crisis shelters reaches the total population, these shelters should be prepared for a higher volume of phone contacts in a future pandemic situation.

PS-P03-11: EFFECT OF CLEANER COOKING FUEL (LPG) ON CARDIOPULMONARY HEALTH IN WOMEN FROM RURAL MAHARASHTRA

Background and Objective: Air pollution generated due to the use of solid fuels is recognized to be an environmental and health risk globally, especially in developing countries. Exposure to household air pollution is estimated to kill 3.8 million people worldwide. Major victims are women who are the immediate users. In an attempt to address this issue, the Indian government launched the Pradhan Mantri Ujjwala Yojana (PMUY) which provides clean LPG cooking gas to first-time users. However, it is majorly being promoted as a scheme about providing cooking gas to those who don’t have it but the health benefits of the scheme are not being focused. Accordingly, this study aimed to evaluate the effect of LPG on cardiopulmonary health in women. Design and method: A total of 997 healthy women participants (808 primary cooks and 189 secondary cooks) who cooked either with biomass or with LPG were enrolled. Systolic (SBP) and diastolic blood pressure (DBP), blood glucose was measured in all study participants and data on 24-hour personal exposure to fine particulate matter < 2.5 μm (PM2.5) and lung function (by spirometry) were measured on a subset using a standard protocol. Socio-demographic data, cooking practices and other information were collected using a validated questionnaire. Descriptive analysis was done in SPSS v26. Results: Results highlighted that SBP, DBP, mean arterial pressure, pulse pressure and glucose level were significantly higher in the biomass group compared to the LPG group in both primary and secondary cooks. The prevalence of hypertension in primary and secondary cooks was 29.5 and 33.6 respectively in biomass users compared to 21.1 and 13.4 in LPG users. Higher number of obstructive airway pattern (n = 10; 6.4% vs n = 2 1.3%), restrictive airway pattern (n = 31; 19.7 % vs n = 19; 12.5 %) and small airway obstruction (n = 55; 35.0 % vs n = 22; 14.4 %) was observed in biomass group compared to LPG group respectively. After adjusting for age, BMI and study group, it was seen that biomass exposure index (odds ratio [OR] 2.288; 95% confidence interval [CI] 1.169, 4.479, P = 0.016) and PM2.5 levels (OR 1.065; 95% CI 1.035, 1.096, P < 0.001) significantly increased the odds of having hypertension. Conclusions: Based on preliminary analysis, it can be concluded that the use of biomass is significantly associated with an increased risk of hypertension and impaired lung function. Thus, adoption of cleaner cooking fuels like LPG will have meaningful clinical and public health benefits.

Patient and provider perspectives to utilization of telemedicine in surgery.

Determine patient and provider perspectives on widespread rapid telemedicine implementation, understand the key components of a surgical telemedicine visit and identify factors that affect future telemedicine use. Compared to other specialties, the field of surgery heretofore has had limited adoption of telemedicine. During the COVID-19 pandemic Healthcare, including the surgical specialties, saw new widespread use of telemedicine. We conducted a prospective cohort study during the COVID-19 California stay-at-home and physical distancing executive orders. Utilization data were collected from clinics and compared to usage data during the same time 1 year later. All patients and providers who participated in a telemedicine visit during the study period were asked to complete a survey after each encounter and the surveys were analyzed for trends in opinions on future use by stakeholders. Over the 10-week period, the median percentage of telemedicine visits per clinic was 33% (17%-51%) which peaked 3 weeks into implementation. One hundred and ninety-one patients (48% women) with a median age of 64 years (IQR 53-73) completed the patient survey. Patients were first-time participants in telemedicine in 41% (n = 79) of visits. Fifty-seven percent (n = 45) of first-time users preferred that future visits be in-person versus 31% of prior users (p = 0.007). The median travel time from home to the clinic was 40 min (IQR = 20-90). Patients with longer travel times were not more likely to use telemedicine in the future (61% with longer travel vs. 53% shorter, p = 0.11). From the 148 provider responses, 90% of the visits providers were able to create a definitive plan with the telemedicine visit. A physical exam was determined not to be needed in 45% of the visits. An attempt at any physical exam was not performed in 84% of routine follow-up or new-patient visits, compared to 53% of post-op visits (p = 0.001). Telemedicine is a viable ambulatory visit option for surgical specialists and their patients. During rapid telemedicine deployment, travel distance did not correlate with increased use of telemedicine, and in-person visits are still preferred. However, nearly half of all visits did not need a physical exam, which favors telemedicine use.

Technology Evolution and Tax Compliance: Evidence From Rwanda

Technology and digitalisation have great potential to boost taxpayer compliance and revenue collection in Africa. Despite an increasing reliance on IT solutions for taxpayers, evidence of their effectiveness is still limited. In Rwanda, the revenue authority has introduced a more advanced version of an electronic billing machine, EBM version 2 (EBMv2), both to strengthen the tracking of transactions for enforcement purposes and to improve the experience of taxpayers. Based on a wealth of administrative data, this paper evaluates the impact of the adoption of EBMv2 on the filing behaviour of firms. Importantly, we can compare first-time adopters of EBMv2, mostly new taxpayers, with those moving from the old EBM version 1 to EBMv2. Findings reveal a significant increase in turnover, VAT inputs and VAT due, driven by new users. The probability of zero filing is reduced. Furthermore, discrepancies between VAT and income tax returns are greater, due to a much larger increase in turnover from VAT returns, mostly attributable to first-time users. We recommend that policymakers closely examine shifters who do not change their behaviour after adoption. Furthermore, we suggest that tax authorities adopt a more holistic approach to monitoring compliance across different tax categories since the positive impact on VAT does not necessarily translate into income tax.

An Evaluation Study of an Electronic Whiteboard System for Nursing Care in the Emergence Unit

The main objective of this research is to evaluate a task and alert management system denominated SHAVI (SHAred VIew), developed to be used by the Nursing team of the Emergency Unit of a University Hospital located in southern Brazil. The system was developed as a resource for managing patients clinical data and warning signs of clinical deterioration during urgency and emergency care. The research is characterized as exploratory and descriptive, with data collection carried out in the field with 21 participants, including students and professionals working in the emergency sector, through the application of a questionnaire consisting of 48 questions. The usability and user acceptance of the tool was mainly verified based on Nielsen's Usability Heuristics and the Technology Acceptance Model. The evaluation and user participation contributes to identify problems and make corrections before putting the system into use, contributing to its adoption and acceptance.The evaluation reveled that the system has great potential for use and can be considered a safety mechanism for monitoring patients in the emergence unit, but to be adopted, needs to be integrated with other systems used in the Hospital and to train first-time users.

Food insecurity and disasters: predicting disparities in total and first-time food pantry visits during the COVID-19 pandemic

In the U.S. state of Arizona, nearly one-third of households experienced food insecurity during the COVID-19 pandemic, an increase from one-fourth of households before the pandemic. Previous research on food insecurity in the wake of natural and human-instigated disasters demonstrates that groups vulnerable to food insecurity before a disaster are more susceptible to food insecurity during and after that disaster; however, less is known about whether this relationship also holds true during health-related disasters, such as the COVID-19 pandemic. We explore how the COVID-19 pandemic influenced urban food insecurity patterns by analyzing the socio-demographic characteristics of food pantry clients in Maricopa County, Arizona. Using data from Phoenix Rescue Mission (PRM), a local non-profit food service provider, two binomial logistic regression models compare the socio-demographic composition of total and first-time food pantry users before and during the pandemic. In addition to an overall increase in food pantry usage during the pandemic, we find that, while certain socio-demographic groups historically vulnerable to food insecurity experienced the predicted uptick in insecurity during the pandemic, other socio-demographic disparities were attenuated. These somewhat disparate findings illustrate the complex relationship between disasters and food insecurity in an urban context, offering several avenues for future research.

Amica: an interactive and user-friendly web-platform for the analysis of proteomics data.

Quantitative proteomics has become an increasingly prominent tool in the study of life sciences. A substantial hurdle for many biologists are, however, the intricacies involved in the associated high throughput data analysis. In order to facilitate this task for users with limited background knowledge, we have developed amica, a freely available open-source web-based software that accepts proteomic input files from different sources. amica provides quality control, differential expression, biological network and over-representation analysis on the basis of minimal user input. Scientists can use amica's query interface interactively to compare multiple conditions and rapidly identify enriched or depleted proteins. They can visualize their results using customized output graphics, and ultimately export the results in a tab-separated format that can be shared with collaborators. The code for the application, input data and documentation can be accessed online at https://github.com/tbaccata/amica and is also incorporated in the web application. The strong emphasis on dynamic user interactions, the integration of various databases and the option to download processed data, facilitate the analysis of complex proteomic data for both first-time users and experienced bioinformaticians. A freely available version of amica is available at https://bioapps.maxperutzlabs.ac.at/app/amica .

Electronic Wearable Device Use for Physical Activity in Older Adults: A Qualitative Study.

Innovative solutions to help older adults increase physical activity are critically important. In this qualitative study, we explored older adults' acceptance, capability, and experiences of using three different types of electronic wearable devices over a period of 4-24 weeks for self-monitoring and promoting physical activity. We conducted 23 semistructured interviews with older adults who participated in three physical activity intervention studies. Two researchers analyzed the data using NVivo version 12, applying a directed content analysis that was partially guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). Six themes emerged: (1) device learning, (2) hedonic motivation, (3) habit and adherence, (4) facilitating conditions, (5) effort expectancy, and (6) performance expectancy. Although most older adults (95.8%) from this study were first-time users, they reflected positive experiences and generally enjoyed using electronic wearable devices. Participants reported issues related to electronic wearable device functionalities that can be improved to better enhance user experience and motivate increased physical activity. Future research should explore the role of electronic wearable devices in older adults' physical activity with an emphasis on behavioral change over time.

Utilization Trends of Novel Hormonal Agents in Metastatic Castration-Resistant Prostate Cancer in Quebec.

The introduction of novel hormonal agents (NHAs) such as abiraterone acetate (ABI) and enzalutamide (ENZ) for metastatic castration-resistant prostate cancer (mCRPC) was an important milestone given their survival benefits, tolerability, and ease of administration relative to taxane chemotherapies. This descriptive study sought to describe the utilization trends of ABI and ENZ in patients with mCRPC in the early years after their approval in the province of Quebec in Canada. A retrospective population-based cohort was extracted from Quebec public healthcare administrative databases. The cohort included first-time users of NHAs (ABI or ENZ) from 2011 to 2016. The primary analyses aimed to describe the overall temporal trends (2011-2016) of NHA initiators by chemotherapy status (chemotherapy-naïve versus post-chemotherapy), and prescribing specialty (medical oncology versus urology versus others). The cohort comprised 2183 patients, with 1562 (72%) in the chemotherapy-naïve group and 621 (28%) in the post-chemotherapy group. While the majority of patients were post-chemotherapy NHA initiators in 2012, this proportion decreased over time and accounted for only 13% of NHA initiators by the end of 2016. Medical oncologists were the most frequent prescribers of NHAs (upwards of 60%) throughout 2012 but fell to 45% by the end of 2016. Conversely, the proportion of prescriptions by urologists increased from 22% in 2012 to 42% in 2016. Over time, there was an increasing proportion of (1) patients who initiated NHAs without prior chemotherapy treatment, (2) NHA prescribing by urologists, and (3) ENZ users. Taken together, this implies that the introduction of NHAs has altered the management of mCRPC and urologists quickly adopted NHAs into their practice.

Abstract 14762: Prospective Study Evaluating Management of Hypertension Induced by Anti-VEGF Therapy in Patient With Active Cancer: Preliminary Report From the VEGFHTN Trial

Introduction: A nti-neoplastic agents that target vascular endothelial growth factor (VEGF) are known to have cardiovascular toxicities, principally hypertension, with a reported incidence of 21-40% in first-time users. Anti-VEGF induced hypertension can be challenging to control, and significant enough to lead to a dose reduction or discontinuation of the VEGF-targeted therapy, preventing patients from completing their cancer therapy. Methods: A single center prospective cohort of patients with cancer starting anti-VEGF therapy was compared to a retrospective control cohort that was 1:1 matched on gender, race, ethnicity, cancer type, and anti-VEGF therapy. For the prospective cohort, antihypertensive medications were started per an anti-VEGF hypertension algorithm. Elevated blood pressure was defined as consecutive blood pressure readings above 140/90 mmHg and control of blood pressure defined as consecutive readings <140/90 mmHg. Time to development of elevated blood pressure and blood pressure control, number of anti-hypertensive medications needed to control blood pressure were recorded. Results: The prospective cohort consisted of 31 patients which were 1:1 matched to 31 controls who received antihypertensives per standard of care. There were 50% female patients with mean age 61.0 ± 11.9 years. The most common anti-VEGF therapies received included lenvatinib (39%) and bevacizumab (33%) and the most common cancers being treated were kidney (43%) and liver (39%). In the prospective cohort , 24 (77%) developed hypertension greater than 140/90 mmHg compared to 18 (42%) in the control cohort (p=0.174). Of those who developed hypertension the time to control of blood pressure (<140/90mmHg) was improved in the prospective algorithmic approach to anti-VEGF hypertension compared to control (30.5 ± 35.6 days vs 104.9 ± 121.2 days respectively, p=0.007). More anti-hypertensive medications were used in the prospective cohort compared to the matched control (2.6 ± 1.1 vs 1.3 ± 1.0 respectively, p<0.001). Conclusion: A significant proportion of patients receiving VEGF-targeted therapy will develop hypertension. An algorithmic approach to anti-VEGF hypertension leads to earlier blood pressure control.

Restaurant patrons’ intentions toward QR code menus in the U.S. during COVID-19: acceptance of technology adoption model (ATAM)

ABSTRACT The purpose of this study is to explain restaurant patrons’ behavioral intentions toward QR code menu utilization in restaurant servicescapes (restaurant-scapes) under pandemic constraints. The study consists of 844 participants from the U.S.and employs multivariate analyses. With only five direct determinants without interaction terms, our proposed model performed better in explaining the error variance (62%) in behavioral intentions over and beyond the extant models of technology acceptance – the unified theory of acceptance and use of technology model (UTAUT henceforth) and UTAUT2, both of which explain only 35% and 44% respectively. Our findings indicate the importance of an overlooked construct (Trialability) in a consumer context, particularly in servicescapes, and a contextual construct (hygiene) in explaining the intention to accept technology under the conditions originated by environmental factors (COVID-19). Technology acceptance models are middle-level theories attempting to explain behavioral intentions toward technology adoption, not general theories aiming to explain broad human behavior. This means that the extension of these theoretical models is necessary for particular contexts. Thus, contextual factors originating from environmental conditions (e.g. COVID-19) have a critical role in explaining behavioral intentions toward particular technology adoption. In a consumer context, acceptance of technology adoption is assumed as voluntary/quasi-voluntary. Therefore, practitioners should ensure that the purpose of technology adoption is obvious to customers. Additionally, first-time users, particularly, may need to receive assistance with operating the technology in restaurant-scapes.

FACTORS AFFECTING THE DIAGNOSTIC YIELD OF ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY IN BIOPSY OF PERIPHERAL PULMONARY NODULES IN A COMMUNITY HOSPITAL

FACTORS AFFECTING THE DIAGNOSTIC YIELD OF ELECTROMAGNETIC NAVIGATION BRONCHOSCOPY IN BIOPSY OF PERIPHERAL PULMONARY NODULES IN A COMMUNITY HOSPITAL

Pessary Management Approach Affects Likelihood of Surgery.

It is unknown whether the pessary management type influences the need for surgery. The aim of this study was to evaluate the rate of surgical treatment for pelvic organ prolapse or stress urinary incontinence with the type of pessary management (self-management or office management). We conducted a retrospective cohort study that included first-time pessary users treated at a tertiary urogynecologic clinic from 2012 to 2014 for pelvic organ prolapse, stress urinary incontinence, or both. For the primary outcome, we explored the relationship between pessary management type and the likelihood of surgery using multivariable Cox proportional hazards models. Secondary outcomes assessed relationships between patient factors (eg, demographics and clinical attributes) and pessary management type using multivariable logistics regression models. There were 218 patients included in our analysis. Of all pessary users, 59 (27.1%) required office management and 159 (72.9%) participated in self-management. Surgery was performed in 22 (35.1%) office-managed patients and 33 (19.3%) self-managed patients. Women who self-managed their pessaries were significantly less likely to undergo surgery than those who received office management (multivariable hazards ratios, 0.416; P = 0.005). In the multivariable logistic regression model for pessary management type, increasing age (odds ratio [OR], 1.098; P ≤ 0.0001), increasing body mass index (OR, 1.078; P < 0.05), and increasing genital hiatus (OR, 1.547; P < 0.05) were associated with increased odds of pessary office management compared with self-management. In a urogynecology clinic setting, pessary self-management is associated with lower rates of surgical treatment compared with office management. Factors associated with office management include increased age, body mass index, and large genital hiatus.

Working-age first-time hearing aid users’ self-reported outcomes

Objective To study patient-reported hearing aid (HA) rehabilitation outcomes, social-communicative functioning, and expectations/experiences during eight months of HA use. Design Three self-reporting instruments, the International Outcome Inventory for Hearing Aids (IOI-HA), the Quantified Denver Scale of Communicative Function (QDS), and questionnaires tapping pre-rehabilitation expectations (HA-EXP-Q1) and post-rehabilitation experiences (HA-EXP-Q2) were administered. Study sample 144 patients ages 23–66 with gradually acquired, adult-onset, mild-to-moderate sensorineural hearing loss affecting both ears who acquired their first HAs. Results According to self-reports, HA rehabilitation outcomes were good, and everyday social-communicative functioning improved after one month and after eight months of HA use. When the effects from demographic and audiological variables were analysed, younger age and positive expectations of HAs were associated with better outcomes and social-communicative functioning. The form or hearing loss severity, and the type or number of HAs did not affect outcomes. Conclusion Working-age HA users reported better HA outcomes than older adults in previous studies. Coping in work life may be a strong motivator for active HA use. Considering that younger age and positive expectations resulted in better outcomes, early rehabilitation that supports positive and realistic expectations of HA performance is essential.

Housing trajectories and the risk of homelessness among new mental health service users: Protocol for the AMONT study.

High rates of mental illness among individuals experiencing homelessness, as well as documented contacts with psychiatric services prior to episodes of homelessness, indicate that early intervention could play a key role in homelessness prevention. Decision-makers and clinical teams need longitudinal data on housing trajectories following initial contact with psychiatric services, as well as on predictors of risk of housing instability and homelessness. This paper describes the AMONT study, a mixed-methods naturalistic longitudinal cohort study of individuals identified as new psychiatric service users in seven clinical sites across the province of Québec (Canada). The goal of AMONT is to examine the housing situations of individuals over 36 months after their initial contact with psychiatric services, and to identify environmental and individual correlates and predictors of housing outcomes. Participants complete a broad battery of instruments at baseline and follow-up assessments after 24 and 36 months. We explore housing stability following an initial episode of psychiatric service use from the perspective of service users, family members, and service providers, through qualitative interviews. The findings from the AMONT study will yield a better understanding of the residential pathways of individuals with mental illness, from their first contact with psychiatric services and for 3 years subsequently. This will inform service providers, decision-makers and managers on the specific housing concerns and issues that affect first-time mental health service users. This in turn can lead to the development and implementation of evidence-informed practices and policies that aim to prevent instability and homelessness.