Follow-up Services Research Articles

Pregnancy-related risk factors and receipt of postpartum care among Texas Medicaid pregnant enrollees: Opportunities for pharmacist services

BackgroundThe United States (US) experiences the highest rate of maternal mortality of similar countries. Postpartum care (PPC) focused on chronic disease management is potentially lifesaving, especially among pregnancies complicated by risk factors such as diabetes, hypertension, and mental health conditions (MHCs), which are conditions in which pharmacists can have an impact. ObjectiveTo evaluate the prevalence of maternal mortality risk factors and their relationships with receipt of PPC among Texas Medicaid enrollees. MethodsA retrospective study included women with a delivery between 3/25/2014-11/1/2019 who were continuously enrolled in Texas Medicaid during the study period from 84 days pre-delivery to 60 days post-delivery. PPC was defined as ≥1 visit associated with postpartum follow-up services. Maternal mortality risk factors (diabetes, hypertension, and MHCs) during and after pregnancy were identified using diagnoses and medication utilization. Age, race/ethnicity, cesarean delivery, and preterm birth served as covariates. Multivariable logistic regression was used to address the study objective. ResultsThe sample (N = 617,010) was 26.5±5.7 years, primarily (52.8%) Hispanic, and 33.0% had cesarean deliveries and 9.3% had preterm births. Risk factor prevalence included: diabetes (14.0%), hypertension (14.3%), and MHCs during (6.3%) and after (9.1%) pregnancy. A majority (77.9%) had a PPC visit within 60 days of delivery. The odds of receiving PPC were 1.2 times higher for patients with diabetes (OR = 1.183; 95% CI = 1.161-1.206; P < 0.0001), 1.1 times higher for patients with hypertension (OR = 1.109; 95% CI= 1.089-1.130; P < 0.0001), and 1.1 times higher for patients with MHCs (OR=1.138; 95% CI = 1.108-1.170; P < 0.0001) than patients without, respectively. ConclusionOver three-quarters of Texas Medicaid pregnant enrollees received PPC within 60 days of delivery and risk factors were prevalent and predictive of receipt of PPC. Pharmacists can have a positive impact on maternal health by addressing hypertension, diabetes, and MHC risk factors.

The effect of web-based education delivered as part of cardiac rehabilitation on healthy lifestyle behaviors, and quality of life in patients with coronary artery disease in Turkey: A randomised controlled trial

ObjectiveThis study was conducted to evaluate the effect of web-based education delivered as part of cardiac rehabilitation (CR) on healthy lifestyle behaviors, and quality of life in patients with coronary artery disease (CAD) in Turkey. MethodThis study is a randomized controlled trial. The experimental group (n = 35) received web-based education and telephone counseling for 12 weeks after discharge, while the control group (n = 35) received standard care. ResultsPost-test healthy lifestyle behaviors scale total score and total scores of all sub-dimensions except nutrition were higher in the experimental group (p < 0.05). The post-test international physical activity total score, and VAS scale scores of the experimental group and were significantly higher (p < 0.05). The number of non-smoking patients in the post-test was statistically significantly higher in the experimental group (p < 0.05). ConclusionThe results showed that web-based education delivered as part of CR in a Turkish hospital improved healthy lifestyle behaviors, physical activity level, and quality of life in CAD. Practice ImplicationsOur study proved that web-based education delivered as part of CR, nurse follow-up, and telephone counseling services may be effective tools for CAD patients to adhere to healthy lifestyle behaviors, and to promote quality of life and smoking cessation.

OGC P13 CNS and Dietitian led clinical follow-up with support from a survivorship multi-disciplinary team meeting: A model of care for patients after oesophago-gastric (OG) cancer surgery

Abstract Background Major upper gastro-intestinal (UGI) cancer surgery in combination with chemotherapy offers the best chance of cure for patients with oesophageal and gastric cancer. However, these treatments have significant long-term side-effects resulting in a high symptom burden in this patient group. This adversely affects quality of life and places significant demands on healthcare after surgery. There is a large variation in follow-up services nationally, with little guidance on optimal practice. Methods A clinical nurse specialist (CNS) and Dietitian led clinic has been utilised in this patient group for 12 years at St Thomas’ hospital, with UGI surgeon support as required. In 2021, a survivorship multi-disciplinary team meeting (MDM) consisting of CNS, Dietitian, Gastroenterologist, UGI surgeon and psychologist was introduced. This aimed to support the clinic by discussing management of complex cases. Results Since 2011, approximately 3000 patient consults have been undertaken in the survivorship clinic. These patients benefited from specialist follow-up, expertise in symptom management, holistic needs assessments, recurrence surveillance and specialist dietetic advice. These patients were removed from surgical and oncology out-patient clinics, creating greater capacity in these services. Patient feedback has consistently supported this model of follow-up. Complex patients are discussed in the survivorship MDM which supports the clinic. Conclusions CNS and Dietitian led clinics, alongside a survivorship MDM, may provide a better model of follow-up compared to traditional surgical clinics by offering a greater breadth of expertise and consistency of follow-up. Evaluation of patient centred outcomes and economic analysis, in addition to on-going national initiatives to standardise the investigation and management of symptoms following major UGI surgery, would support replicating this model in other centres.

The Influence of the Family Functioning and Social Relationships on Child Participation After Traumatic Brain Injury

ABSTRACT Purpose To describe the relationship amongst child and family characteristics (e.g. social relationships, family functioning) and child participation after traumatic brain injury (TBI) an average of 2.65 years post-TBI (SD = 2.12). Method Cross-sectional, secondary analysis of data collected as part of a larger research project. Results N = 44 children with TBI. Analysis revealed statistically significant correlations between child participation, family functioning, and child characteristics. Conclusions School-aged children with TBI might experience chronic participation restrictions, associated with challenges in family functioning. Professionals can support children with TBI and their families through follow-up services that include a focus on family-based interventions to better support long-term outcomes for this population.

Variation in follow-up for children born very preterm in Europe.

Children born very preterm (<32 weeks of gestation) face high risks of neurodevelopmental and health difficulties compared with children born at term. Follow-up after discharge from the neonatal intensive care unit is essential to ensure early detection and intervention, but data on policy approaches are sparse. We investigated the characteristics of follow-up policy and programmes in 11 European countries from 2011 to 2022 using healthcare informant questionnaires and the published/grey literature. We further explored how one aspect of follow-up, its recommended duration, may be reflected in the percent of parents reporting that their children are receiving follow-up services at 5 years of age in these countries using data from an area-based cohort of very preterm births in 2011/12 (N = 3635). Between 2011/12 and 22, the number of countries with follow-up policies or programmes increased from 6 to 11. The policies and programmes were heterogeneous in eligibility criteria, duration and content. In countries that recommended longer follow-up, parent-reported follow-up rates at 5 years of age were higher, especially among the highest risk children, born <28 weeks' gestation or with birthweight <1000 g: between 42.1% and 70.1%, vs. <20% in most countries without recommendations. Large variations exist in follow-up policies and programmes for children born very preterm in Europe; differences in recommended duration translate into cross-country disparities in reported follow-up at 5 years of age.

Use, tolerability, benefits and side effects of orthotic devices in Charcot-Marie-Tooth disease

BackgroundShoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty.MethodsWe administered to Italian CMT Registry patients...

1 Neuropsychological Outcome After Cardiac Arrest: Results from a Sub-study of the Targeted Hypothermia Versus Targeted Normothermia After Out-of-hospital Cardiac Arrest (TTM2) Trial

Objective:To describe cognitive impairment in out-of-hospital cardiac arrest (OHCA) survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA.Participants and Methods:This was a prospective case control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. We administered an extensive neuropsychological assessment at approximately 7 months post-cardiac event, including a neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes. Z-scores of individual tests were converted to neuropsychological composite scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions). Between-group differences on the neuropsychological composite scores were investigated with linear regression. Associations between anxiety, depression, fatigue, insomnia, hypertension, diabetes, and the neuropsychological composite scores among OHCA survivors were calculated with Spearman’s rho.Results:Of 184 eligible OHCA survivors, 108 were included (mean age = 62, 88% male), with 92 MI controls enrolled (mean age = 64, 89% male). Amongst OHCA survivors, 29% performed z &lt;-1 indicating at least borderline-mild impairment in &gt;2 cognitive domains, and 14% performed z &lt;-2 exhibiting major impairment in &gt;1 cognitive domain. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = -0.37, 95% confidence intervals [-0.61, -0.12]), verbal (MD = -0.34 [-0.62, -0.07]), and visual/constructive functions (MD = -0.26 [-0.47, -0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, processing speed (MD = -0.41 [-0.74, -0.09]) and executive functions (MD = -0.69 [-1.13, -0.24]) were also worse following OHCA. Depressive symptoms were associated with worse executive functions (rs = -0.37, p &lt;0.001) and worse processing speed (rs = -0.27, p = 0.01) post-OHCA. Anxiety symptoms (rs = -0.21, p = 0.01) and general fatigue (rs = -0.24, p = 0.01) were associated with worse executive functions. Diabetes was associated with worse processing speed (rs = -0.20, p = 0.03), visual/constructive (rs = -0.29, p &lt;0.001) and executive functions (rs = -0.25, p = 0.02), while hypertension and insomnia were not significantly associated with neuropsychological test performance.Conclusions:Cognitive impairment is generally mild following OHCA, but most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed worse than MI controls. We suggest that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.

교사발달단계에 따른 중등 특수교사의 체육교과 운영 경험 및 지원 요구 분석

The purpose of this study is to analyze secondary special education teachers' experiences in operating physical education and support needs according to their stage of teacher development. To this end, a questionnaire was distributed to 300 special education teachers working in secondary schools, and the data from 148 returned responses were analyzed. The results of the study showed that 93 of the 148 special education teachers had experience in operating physical education, and they aimed to have their students acquire values and attitudes, basic movement and sports skills, and emotional stability through physical education activities. In terms of teaching form and evaluation method, novice teachers used solo teaching and direct evaluation, while experienced teachers used external instructor-led/specialist-assisted form and direct evaluation as well as external instructor evaluation, and most of the special education teachers were willing to operate physical education in the future. Lastly, the reasons for not operating physical education were heavy workload, lack of operating budget, and difficulty of cooperation among members. Second, in order to operate physical education, the needs of providing sufficient space, facilities, and equipment, cooperation among school and community members, and training opportunities were high, and statistically significant differences were found in providing training opportunities, offering follow-up services for students and establishing a local cooperation system.

In need of percutaneous coronary intervention in an arctic setting– patients’ experience of safety and quality of care: a qualitative study

ABSTRACT Patients with coronary heart disease need timely treatment for survival and optimum prognosis. There is limited research exploring patients’ experience regarding distance to percutaneous coronary intervention. The aim was to explore patients’ experiences of aspects contributing to safety and quality of care regarding health services following percutaneous coronary intervention in Northern Norway. A qualitative explorative design was used, and 15 patients participated in individual semi-structured interviews 9–16 months after treatment. The reflexive thematic analysis revealed two main themes: (1) being part of a safe system and (2) adapting to new everyday life. Feeling safe and experiencing quality care depended on whether the participants were heard within the system upon first contact, whether help was available when needed, the travel time for treatment, sufficient information, the competency of care provided by healthcare professionals, and how follow-up services were organised when adapting to everyday life. To conclude, patients undergoing percutaneous coronary intervention in an arctic context perceived healthcare services as safe when the system delivered continuous care throughout all levels. Consistent optimisation of transport time and distance to treatment, especially for rural patients, and extensively focusing on follow-up services, can contribute to improving safety and quality of care.

Evaluation of the Ministry of Health's pilot program - A personal pregnancy follow-up service

Abstract Background The Israeli Ministry of Health has developed a unique pregnancy follow-up (PF) service in the Haifa District Infant-Parent Centers, including a fixed nurse attending the necessary examinations and services, supporting and guiding the woman throughout her pregnancy. Aim To examine the differences between the participants who received PF within the pilot program (research group) and those who received standard PF (control group) regarding health behaviors, receiving information and attitudes regarding health behaviors, professional support, and satisfaction with the service. Methods Questionnaires were filled in by 293 mothers to infants- 38% of which belonged to the research group and 62% to the control group. There were no significant differences between the two groups’ characteristics. Findings Significant differences were found between the groups regarding receiving information and support, and some of the attitudes and behaviors, as well as a difference in satisfaction, in favor of the research group; e.g., 95% of the participants in the research group were vaccinated against Pertussis, as compared to 85% of the control group (z = 2.47, p&amp;lt;.001). Process model for parallel mediation revealed that receiving PF in the research group was associated with (1) More positive attitudes (Effect=0.06, SE = 0.04 CI=0.01,0.15) and receiving information (Effect=0.18, SE = 0.08 CI=0.02,0.33), which in turn were associated with more reported health behaviors (Total indirect effect=0.30, SE = 0.09 CI=0.14,0.49); (2) Receiving more support (Effect=0.16, SE = 0.04 CI=0.09,0.26), as well as more information (Effect=0.10, SE = 0.05 CI=0.01, 0.19), which in turn were associated with higher satisfaction with the PF (Total indirect effect=0.25, SE = 0.05 CI=0.16,0.36). Conclusions The findings indicate the pilot program's success in promoting pregnant women's health, among other things, due to the guidance and support provided by a fixed dedicated nurse. Key messages • Personal pregnancy follow-up is efficient for supporting and guiding women during a sensitive period for their fetus’ and their own health, and encourages compliance with health behaviors. • It is recommended to implement the program in additional districts, and to examine the findings among a wider and more diverse sample.

Challenges to Implementation of a CHW-led COPD Screening and Referral in rural Uganda

Abstract Chronic obstructive pulmonary disease (COPD) ranks as the third leading cause of global mortality. In rural areas of low- and middle-income countries (LMICs), COPD screening and diagnostic services remain often inaccessible. This study seeks to comprehend the implementation challenges of a Community Health Worker (CHW)-led program for COPD in Nakaseke, rural Uganda. During September and October 2022, this qualitative study explored the perceptions of Community Members, CHWs, and Healthcare Providers (HCPs) on challenges associated with CHW-delivered COPD screening and referral. In-depth interviews were conducted with eight CHWs and ten HCPs, along with six focus group discussions including 34 Community Members. Research assistants recorded and transcripted interviews verbatim. The thematic analysis was guided by the conceptual framework for implementation outcomes research. The acceptability of the implementation was hindered a lack of awareness about COPD, skepticism regarding the usefulness of COPD screening, and the presence of stigma surrounding the diagnostic process. Additionally, limited adoption was attributed to difficulties in accessibility and the willingness of Community Members to participate in the COPD referral process. The high patient volume, coupled with the complexity and time-consuming nature of the diagnostic and referral procedures, posed significant barriers to successful implementation. To ensure program sustainability, participants recommended increased support for CHWs, the decentralization of COPD care, and the expansion of follow-up services provided by CHWs. CHW-led interventions have great potential to deliver health care services that overcome barriers to treatment and self-management, particularly in settings with limited access to healthcare. However, prior to implementation, baseline assessments are needed to identify potential implementation obstacles and strategies that consider evidence-based approaches tailored to local contexts. Key messages • CHW-led interventions are a useful tool to alleviate barriers to COPD treatment and self-management in rural areas of LMICs where access to care is limited. • Formative assessments of the potential challenges prior to an intervention are required to address and minimize barriers to implementation and sustainability.

Design, Development, and Evaluation of an mHealth App for Reporting of Side Effects During Cytostatic Treatment: Usability Test and Interview Study.

Using mobile health (mHealth) interventions such as smartphone apps to deliver health services is an opportunity to engage patients more actively in their own treatment. Usability tests allow for the evaluation of a service by testing it out on the relevant users before implementation in clinical practice. The objective of this study was to design, develop, and evaluate the user interface of an app that would aid patients with cancer in reporting a more comprehensive summary of their side effects. The usability test was conducted by exposing patients with cancer to a prototype of an mHealth app that allowed for reporting of side effects from a chemotherapy regimen. After solving a set of 13 tasks, the test participants completed a system usability scale questionnaire and were interviewed using a semistructured interview guide. The interviews were later transcribed and analyzed. The 10 test participants had a mean age of 56.5 (SD 7.11) years. The mean total task completion time for the task-solving session was 240.15 (SD 166.78) seconds. The calculated system usability scale score was 92.5. Most participants solved most of the tasks without any major issues. A minority reported having difficulties using apps on smartphones in general. One patient never achieved a meaningful interaction with our app prototype. Most of those who engaged with the app approved of features that calmed them down, made them more empowered, and put them in control. They preferred to report on side effects in a detailed and concise manner. App features that provided specific advice could provoke both fear and rational action. The user tests uncovered design flaws that allowed for subsequent refining of an app that has the potential to enhance the safety of patients undergoing home-based chemotherapy. However, a refined version of the app is unlikely to be of value to all patients. Some might not be able to use apps on smartphones in general, or their ability to use apps is impaired because of their disease. This finding should have implications for health care providers' overall design of their follow-up service as the service must allow for all the patients to receive safe treatment whether they can use an mHealth app or not.

Covid 19 Stress and Teaching Performance of Social StudiesTeachers in Public Higher Educational Institutions in Zambales

This study sought to establish a baseline for a faculty stress management program by assessing the COVID 19 stress levels of social studies teachers at public higher education institutions in Zambales in relation to their teach performance throughout the pandemic. The results showed that there were 34-year-old female Social Studies teachers who were single, earns a Salary Grade 11 to 13, and have 0 to 3 years of experience in the field. According to the respondent's self-evaluation, they have high levels of COVID 19 Stress and rank the subscale COVID Danger and Contamination Fear as their top stressor. However, they are less likely to experience COVID Traumatic Stress Symptoms, which only cause moderate stress. The responders' performance throughout the academic year 2020–2021 was Very Satisfactory. However, there is no correlation between respondents' COVID 19 stress levels and their teaching performance. Moreover, there is no significant difference between the COVID 19 stress level of the respondents when grouped according to their age, gender, civil status and number of years in service. However, there is significant difference between the COVID 19 stress levels of the respondents when grouped according to their economic status. Given the study's preceding findings, these must be verified and further explored in future studies involving a younger and larger population due to exposure to social media. Additionally, it is urged that these workers from various fields incorporate mental health promotion as a follow-up service after the outbreak of the COVID 19 epidemic.

Behavioral Health Screening and Follow-Up Services in Pediatric Trauma Centers Across the United States.

Over 120,000 U.S. children are hospitalized for traumatic injury annually, a major risk factor for behavioral health problems such as acute/posttraumatic stress disorder (PTSD) and depression. Pediatric trauma centers (PTCs) are well positioned to address the recent mandate by the American College of Surgeons Committee on Trauma to screen and refer for behavioral health symptoms. However, most PTCs do not provide screening or intervention, or use varying approaches. The objective of this mixed-methods study was to assess PTCs' availability of behavioral health resources and identify barriers and facilitators to service implementation following pediatric traumatic injury (PTI). Survey data were collected from 83 Level I (75%) and Level II (25%) PTC program managers and coordinators across 36 states. Semistructured, qualitative interviews with participants (N = 24) assessed the feasibility of implementing behavioral health education, screening, and treatment for PTI patients and caregivers. Roughly half of centers provide behavioral health screening, predominantly administered by nurses for acute stress/PTSD. Themes from qualitative interviews suggest that (1) service provision varies by behavioral health condition, resource, delivery method, and provider; (2) centers are enthusiastic about service implementation including screening, inpatient brief interventions, and follow-up assessment; but (3) require training and lack staff, time, and funding to implement services. Sustainable, scalable, evidence-based service models are needed to assess behavioral health symptoms after PTI. Leadership investment is needed for successful implementation. Technology-enhanced, stepped-care approaches seem feasible and acceptable to PTCs to ensure the availability of personalized care while addressing barriers to sustainability.

Visual Impairment and Its Associated Factors Among Hypertensive Patients in Amhara Region Referral Hospitals, Ethiopia.

Visual impairment is one of the most common long-term effects of high blood pressure. It affects one's quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021. An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤0.05 were stated as significantly associated with visual impairment. The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9-37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86-4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3-4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32-5.62) were significantly associated with visual impairment. Nearly one-third of hypertensive patients were visually impaired from the study participants. Duration of hypertension ≥5 years, history of ocular trauma, and ever alcohol drinking was significantly associated with visual impairment among hypertensive patients. Therefore, in addition to providing medical care and follow-up services for hypertension patients, health education is needed for early and proper management of visual impairment, and to decrease their level of alcohol consumption. Furthermore, better to do this study by prospective cohort study design to identify cause-and-effect relationships.

Experience Sharing on Continuity of Healthcare Services in Internally Displaced Peoples: The Case of Tigray War Crisis.

The war and siege in Tigray led millions to displace internally. More than three-fourths of the health facilities were either destroyed or not functional as the equipment and other resources were stolen. Furthermore, the remaining functioning health facilities were flooded beyond their capacity, resulting in many patients received treatment late, and ending with complications including life loss. Mekelle City is one of the largest towns with many internally displaced people from different areas of Tigray. To provide services for the most vulnerable populations, 11 IDP clinics were opened for internally displaced people and the surrounding host community in Mekelle. A total of 6732 patients received clinical services, of which 3465 were males. The age of the patients was in ranged of 24 days to 95 years. A total of 364 patients were emergency cases and 428 outbreaks were seen. A total of 722 patients with chronic illnesses received follow-up services, the most common being hypertension (112), diabetes (79), and asthma (70). Overall, 1198 investigations were done and 1339 were referred to higher-level healthcare facilities. Upper respiratory infection (n = 976), acute gastroenteritis (n = 667), and pneumonia (n = 612) were the most common disease conditions in IDP clinics. Antibiotics were the most commonly prescribed medication for 2468 patients, followed by anti-pain/pyretic (1402). This community engagement showed us that, it is possible to continue healthcare services when health facilities get collapsed during crisis owing to the relocation and mobilization of available resources.

Follow-up analysis of quality of life in elderly patients with bone trauma: a longitudinal observational study

BackgroundThe quality of life (QoL) of elderly patients with bone trauma is significantly decreased and is affected by many complex factors. This study aims to conduct a half-year follow-up survey to clarify QoL and its influencing factors in elderly patients with bone trauma in order to provide targeted care measures for elderly patients with bone trauma.MethodsThis was a longitudinal observational study. We used the 36-Item Short Form Health Survey (SF-36) to investigate and evaluate the QoL of 100 patients with bone trauma at the time of hospital discharge and 1 month, 3 months, and 6 months after discharge. Our previous study confirmed that the SF-36 had higher reliability and validity for evaluating the QoL of elderly patients with bone trauma. At the same time, we also investigated the age, gender, location of bone trauma, and destination after discharge of those patients. Those factors that might affect the QoL of elderly patients with bone trauma were identified by univariate and multivariate analyses.ResultsThe total physiological function, role-physical, bodily pain, vitality, social functioning, role-emotional, and mental health scores of elderly patients with bone trauma gradually increased from the time of discharge to 1 month, 3 months, and 6 months after discharge, and there were significant differences (p < 0.001). However, there was no significant difference in the general health score in the different periods (P = 0.095). The total QoL scores also significantly differed (F = 118.61, P < 0.001) at the time of discharge (335.252 ± 127.572) and 1 month (285.149 ± 112.827), 3 months (479.344 ± 153.663), and 6 months after discharge (544.396 ± 166.536). The univariate analysis results showed that the location of bone trauma (P < 0.005) and the destination after discharge (P < 0.001) were the main factors affecting QoL in different periods. The results of the multivariate analysis showed that the location of bone trauma was an important factor affecting QoL (P < 0.005 in different periods). Whether to undergo surgery was a factor affecting the patients’ long-term QoL (P < 0.005 at 6 months after discharge).ConclusionsAlthough the QoL of elderly patients with bone trauma gradually improves after injury, their recovery time is long, and the influencing factors are complex. Follow-up services should continue for at least six months for these patients, and comprehensive treatment and long-term rehabilitation services should be provided.

I can feel AI failure: the impact of service failure type and failure assessment on customer recovery expectation

PurposeBased on appraisal theory and social response theory, this study aims to explore the mechanism of AI failure types on consumer recovery expectation from the perspective of service failure assessment and validate the moderate role of anthropomorphism level.Design/methodology/approachThree scenario-based experiments were conducted to validate the research model. First, to test the effect of robot service failure types on customer recovery expectation; second, to further test the mediating role of perceived controllability, perceived stability and perceived severity; finally, to verify the moderating effect of anthropomorphic level.FindingsNon-functional failures reduce consumer recovery expectation compared to functional failures; perceived controllability and perceived severity play a mediating role in the impact of service failure types on recovery expectation; the influence of service failure types on perceived controllability and perceived severity is moderated by the anthropomorphism level.Originality/valueThe findings enrich the influence mechanism and boundary conditions of service failure types, and have implications for online enterprise follow-up service recovery and improvement of anthropomorphic design.

Effect of counseling services on career choice of secondary school students in Anambra state, Nigeria

Many students have made wrong choices in their quest to making a career choice because they failed in making the right choice of counselling administrator. This study examined how counselling services affected the career decisions made by secondary school students in the state of Anambra. The specific aim at evaluating the effect of counselling orientation, appraisal, and follow-up services. The study adopted descriptive survey research design to examine the effect of counselling services on career choice of students in Anambra State. Multiple regression analysis (MRA) was used to test the hypothesis. There are an infinite number of educators and guidance counsellors in the population. Two hundred sixty-seven teachers and school counsellors were selected as the sample size. A questionnaire was used as the tool for data extraction. Data from a four-Likert scale were shown and analysed. The study found that career counselling services affect secondary school students' choices in Anambra. The results led to the conclusion that students in senior secondary schools can make wise career decisions with proper counselling services. The study recommended that directing students towards their areas of strength rather than choosing a career path that is unsuitable for them or that of their peers, can help the students with career decisions. Again, hiring counsellors with formal training and regular meetings between these counsellors and students to discuss issues that affect students' academic performance should also be a priority for school administrators.

Exploring Patients' Intentions for Usage of Video Telemedicine Follow-Up Services: Cross-Sectional Study.

Background: Data suggest that regarding completion rates and lower readmission rates, video telemedicine follow-up is as efficient as in-person consultations. However, evidence of patients' intention to adopt such service is lacking. The objective of this study was to determine the essential factors influencing Chinese patients' intention to adopt video telemedicine follow-up. Methods: The researchers extended the technology acceptance model (TAM) by incorporating trust, subjective norms (SNs), perceived risk (PR), and perceived disease threat (PDT). A survey was conducted with 793 Chinese patients, and the collected data were analyzed using the partial least-squares approach. Results: The study revealed that trust emerged as the strongest factor influencing patients' behavioral intention (BI) to use video telemedicine follow-up, followed by SNs, perceived ease of use (PEOU), and perceived usefulness (PU). PR and PDT had no significant influence on patients' intention to adopt video telemedicine follow-up. PEOU mediated the relationship between trust, SNs, and BI, and PU mediated the relationship between trust and BI. The study also found that gender, age, and usage experience moderated certain relationships in the model. Conclusions: Our findings support the use of the extended TAM in understanding individual's motivations for using video telemedicine follow-up in China. In addition, this study contributes to the existing literature on telemedicine promotion by identifying significant mediation mechanisms. These findings have practical implications for planning, creating, and implementing improved video telemedicine follow-up services.