Free Services Research Articles

The Role of Mediation in the Settlement of Family Disputes in Kazakhstan: A Sociological Study

The study aimed to examine the importance and necessity of using mediation in resolving family disputes in Kazakhstan. From February to August 2020, a sociological study was conducted in Kazakhstan to identify the main causes of modern family problems, the functions of mediation and mediators in dispute resolution. The study involved 1,200 respondents. Data collection methods included both quantitative and qualitative approaches. The study was based on a survey of respondents in major cities of Kazakhstan. The study showed that factors such as lack of love and understanding, financial difficulties, and interference from relatives contribute to the escalation of family disputes leading to breakups. It also confirmed the important role of mediators in reaching appropriate and effective solutions, emphasizing the need to strengthen mediator training, legislative support for free mediation services for vulnerable groups, guaranteed payment for mediation services, and promotion of mediation through local media and service centers.

Maternal and newborn health prioritization in Yobe State, Nigeria: analysis of stakeholders' perspective.

Maternal and newborn mortality and morbidity in conflict-affected northeastern areas of Nigeria, such as Yobe State, are disproportionately higher than those in the rest of the country. There is limited evidence on the factors that influence maternal and newborn health (MNH) policymaking and implementation in this region, particularly with respect to the impact of conflict and context-specific issues. This study explores the political, economic and health system factors that drive the prioritization of MNH policies in Yobe State. The aim of this study was to elucidate the conflict-related factors influencing MNH outcomes, which could inform targeted interventions to improve MNH. The study is a descriptive case study that relies on multiple data sources and is guided by the Health Policy Analysis Triangle. We reviewed national and subnational research, technical reports and policies related to reproductive health and the MNH in Nigeria since 2010. Following stakeholder mapping, we identified and invited prospective participants in the MNH policymaking space. Nineteen stakeholders from the government, civil society and nongovernmental organizations, donor agencies, and public and private sector health providers in Yobe State participated in the semistructured in-depth interviews. Data were collected from November 2022 through January 2023 and were thematically analysed via Dedoose software. MNH services in Yobe State have received considerable attention through initiatives such as the National Midwifery Service Scheme, free MNH services, training of midwives with deployment to rural areas, and health facility renovations. The effective implementation of MNH services and policies faces challenges due to insufficient funding, and sustainability is hampered by changes in governance and political transitions. The Boko Haram insurgency exacerbated the humanitarian crisis in Yobe State and disrupted MNH services due to the displacement of populations and the decline in the number of health workers. Additionally, sociocultural and religious beliefs hinder timely access to and utilization of MNH services. Although policies and guidelines for MNH services exist in the state, they are inadequately disseminated to health providers, which affects their effective implementation across facilities. Collaboration and intersectoral coordination platforms exist, but competition and rivalries among unions, political entities, and implementing agencies sometimes impede progress. Enhancing MNH services in Yobe state requires increased commitment for funding through the Northeast Development Commission rehabilitation fund; strengthening the health workforce, safety and retention plan; promoting gender inclusivity within the health sector; and addressing sociocultural barriers to women's health-seeking behaviors. Concrete, time-bound plans for policy dissemination are necessary to ensure effective service implementation.

Ensuring accessibility and inclusion in the 1·1·2 emergency line. Mediation between life and death

In a Europe without borders, there is a quintessential emergency hotline that serves its citizens when their lives are at risk: 1·1·2. The Valencian Community (Spain) receives many visitors each year who, together with the migrant population, make use of this free public service in several languages. The main aim of this paper is to revise the legal framework that regulates the linguistic provisions in the Emergency Call Reception Centre (ECRC) to determine how accessibility and inclusion are guaranteed for speakers of foreign languages. In an attempt to analyse this reality, the aims of this descriptive and qualitative study are twofold. On the one hand, it examines the most common types of incidents received during the year 2021 (in English, French, and German); and, on the other hand, it focuses on how these calls are managed to ensure effective communication between the visitors that come from other countries and the authorities in the Valencian region.

비대면 상담서비스 운영 변화와 과제: 국내 사이트를 중심으로

Objectives This study aims to identify operational changes and challenges in the development of non-face- to-face counseling by comparing the past and present usage of contactless counseling in the context of the rapid increase in the use of contactless counseling due to the spread of COVID-19 and the development of information technology. Methods For comparison with the past, we used the survey methodology from a previous study (Kim, Kye-hyun, & Lim, Eun-mi, 2000) and analyzed 113 counseling sites, including five items (‘service target’, ‘service operator’, ‘counseling method’, ‘counseling content’, and ‘usage fee’) and two additional items (‘counselor’s expertise’ and ‘guidance on using non-face-to-face counseling’) as survey indicators. Results First, we found that counseling methods, which were limited in the early days of non-face-to-face coun-seling, are now being diversified through the development of technology and the expansion of media use. Second, we observed a new way of connecting counselors by establishing platforms for non-face-to-face counseling at large portal sites and private counseling organizations, not limited to the free services provided by public in-stitutions in the past. Third, although guidance for non-face-to-face counseling is currently provided, there is a lack of information on the expertise and confidentiality of counselors. Conclusions This study aims to identify the current status of non-face-to-face counseling in Korea by comparing the past and present operation status of non-face-to-face counseling in Korea, and to identify development tasks. It is expected to provide various implications on the need to strengthen the awareness, professionalism, and eth-ical considerations of non-face-to-face counseling.

A Novel Method for Identifying Patients with High Risk of Litigation in Plastic Surgery: Introducing the FATIMA Acronym.

In recent years, there has been an upward tendency in the number of claims against Plastic Surgeons in some countries, while remaining among the most litigated specialists worldwide. Identifying the most frequent traits in Plastic Surgery claimants could aid surgeons in performing better patient selection and avoid liability. The three main legal databases in Spain were consulted for Plastic Surgery litigations in Spain over a five-year period. Data from the plaintiffs, defendants and judicial processes were collected. In addition, expert witnesses were interviewed and data from the main medico-legal association in Spain was collected. This data was contrasted with the available literature regarding litigation in Plastic Surgery worldwide. A total of 199 court resolutions were analyzed, two expert witnesses were interviewed and "The Patient's Advocate Association" of Spain was consulted. The most frequent traits observed in the plaintiffs were summarized in the acronym FATIMA that describes a Female patient using Antidepressants or Anxiolytics, presenting body Tattoos, suing after undergoing a breast surgery with the use of Implants, Middle-aged and with Access to free legal services. The use of the acronym FATIMA in the identification of patients with high risk of litigation in Plastic Surgery could aid surgeons in performing adequate patient selection and avoiding medical liability. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Utilization of cervical cancer screening services among women aged 18 to 59 years in Laikipia East Sub-County, Kenya

INTRODUCTION Cervical cancer, a preventable disease, continues to be the leading cause of death resulting from cancers in Kenya. Despite free cervical cancer screening services in all government hospitals in Laikipia County, the screening uptake remains low at 19% compared to the WHO target of 70%. Hence, understanding the barriers and facilitators is important in informing targeted interventions. MATERIALS AND METHODS A mixed-method cross-sectional study was done in Laikipia East Sub-County, Kenya, between July and August 2022. The participants were women aged between 18 to 59 years. Data was collected on demographic factors and cervical cancer screening utilization. Also, qualitative data was collected using 5 FGDs and 6 KIIs to get more insights. Chi-square tests and odds ratios were calculated using STATA version 15 to assess associations and determine the level of significance. RESULTS Out of the 272 participants, 32.4% (n=88) had ever screened for cervical cancer. The logistic regression analysis indicates that as women age, their likelihood of undergoing screening increases, particularly for those aged 50-59, who show a tenfold higher likelihood of screening [ OR 10.40 (3.20-33.82), p-value <0.001]. Conversely, unemployment is associated with a reduced likelihood of screening [OR 0.42 (0.18-0.99), p-value 0.047] while individuals earning 50-200 USD per month exhibit an increased likelihood [OR 2.25 (1.30-3.87) p-value 0.004]. However, religion, marital status, and education level factors do not show a significant association with the utilization of cervical cancer screening as indicated by p-values of 0.735, 0.069, and 0.765, respectively. CONCLUSION AND RECOMMENDATIONS Laikipia county government offers free cervical cancer screening in all government-run facilities but many, especially those aged 25-49, lack awareness. It is vital to boost awareness through community education on cervical cancer causes and prevention, emphasizing screening as preventive. Affordable treatment is also crucial for community reassurance post-diagnosis.

Health workers’ perceptions on refugees’ access to healthcare and right to health in Turkiye

Abstract In Turkey, over the past decade, the influx of refugees has significantly influenced migration policy and consequently, health policy for refugees, shaping the perspectives of healthcare workers towards refugees. To gauge healthcare workers’ perceptions regarding refugees’ access to healthcare and their right to health, a survey was conducted across three hospitals in two cities (n = 547). The drop-collect methodology was used, obtaining consent in advance. Healthcare workers (HCWs) were classified into four groups: doctors (n: 139), nurses and midwives (n: 201), other healthcare professionals (n: 58) and non-healthcare professional (n: 137). Additionally, twelve people who did not want to disclose their profession were excluded from the statistics when comparing responses by profession. According to HCWs’ experiences, the most common obstacles faced by refugees included language barriers due to not knowing Turkish, the absence of interpreters in hospitals, cultural disparities, and financial constraints. Among HCWs, 89.8% (n = 491) believe that health constitutes a fundamental human right, yet only 55.8% (n = 305) advocate for free emergency services for all. Furthermore, 43.1% express concerns that providing healthcare to refugees might attract more refugees, and 38% suggest that only individuals deemed healthy through health screening upon entry should be permitted into the country. Responses to inquiries about the prevalent issues varied across cities and occupational groups. Despite the majority of HCWs adopting a right-based approach to health, it is evident that some lean towards a deservingness perspective regarding refugees’ access to healthcare. Consequently, there is a pressing need for collaboration among various sectors to furnish adequate information and training for HCWs on migrants’ rights and prejudice. This should be a part of migration policy, leading to a more migrant-friendly health system. Key messages • Collaboration among diverse sectors is urgently needed to provide healthcare workers with thorough information and training on the rights of migrants and addressing prejudice. • Implementing training programs for healthcare workers as a component of migration policy is essential for building a migrant-friendly healthcare system.

Evaluation of specific offers for mothers with mental stress

Abstract Background As part of the Austrian early intervention programme ‘Frühe Hilfen’, specific interventions (a psychotherapeutic short-term intervention and a therapeutic group) were implemented in some regions. An evaluation was carried out to gain general insights into the need for and benefits of psychosocial services as well as in-depth information on the benefits of the two selected services. The results of the project should also enable further conclusions/recommendations for appropriate services. Methods Mixed-methods approach: qualitative (focus groups, individual interviews, online surveys, participant observation) and quantitative (screening questionnaires) instruments involving a large number of relevant stakeholders and actors. Data analysis: content-structuring qualitative content analysis according to Kuckartz; descriptive analysis of the screening questionnaires. Results The analysis revealed a great need for specific psychosocial services for this target group as well as a high level of satisfaction with the psychosocial services utilised. However, all respondents pointed out barriers to the utilisation of psychosocial services. The evaluation results show that the two specific services make an important contribution to improving the well-being of mothers with mental health problems. Both services largely reach their target group well and, thanks to their focus, contribute to the well-being of mothers with mental health problems. The effectiveness of the service is underpinned by the fact that all participants perceive a reduction in mental stress and notice a reduction in stress during the screenings. Conclusions Based on the evaluation results, it is generally recommended that low-threshold, free and needs-based services be established or expanded. In addition, there is a need for more educational and public relations work on psychosocial stress/diseases and more information on support services. Key messages • There is a great need for psychosocial support among mothers. • The high level of satisfaction with the services evaluated indicates that more such services are needed to support families.

The usage of family audiobooks as a legacy for grieving children — an exploratory quantitative analysis among terminally ill parents and close persons

BackgroundSince 2017, terminally ill parents with dependent children under the age of 18 have been able to record an audiobook for their dependent children. This service allows them to narrate how they would like to be remembered in their voice. The family audiobook is a professionally supported, voluntary, free service that is unique in Germany. There is little research on digital memories for children. The study aims to understand how this service is used and its influence on children through responses of terminally ill parents and close persons.MethodsAn anonymous online survey, accessible between September 2023 and November 2023, was conducted among terminally ill parents and their close persons with support from the Family Audiobook Association in Germany. Analyses were carried out using SPSS.Results186 respondents, 95 terminally ill parents, and 91 close persons completed the online survey. Almost all terminally ill parents felt eased to have recorded a family audiobook. The two groups showed differences in how they used the family audiobook and how often they listened to it. While some children listen to the family audiobook with their bereaved parents or friends, other children are not yet ready for this, according to the open-ended responses of terminally ill parents and close persons.ConclusionsThe family audiobook provides a valuable opportunity for terminally ill parents with dependent children under the age of 18 to tell their own biographical story, offer support to the bereaved in remembering, and preserve the voice of the deceased for the children. In addition, this approach could help healthcare professionals to reduce the stress associated with providing end-of-life care for terminally ill parents.

Assessment of Clinical Toxicological Resources in Countries Belonging to the World Health Organization's Regional Office of the Eastern Mediterranean.

Poison Centers are vital to prevent and manage exposures to chemicals, toxins, and ionizing radiation. However, many countries still lack sufficient poison information center services. Within the World Health Organization's Eastern Mediterranean Regional Office (EMRO) region, we were not able to identify a formal assessment of its toxicological resources. We sought to assess the clinical toxicological resources in the EMRO region and the attitudes, needs, andperspective of the workforce in thatregion. METHODS: This was a two part survey study. First, wedeveloped a poison center questionnaire and scoring system based on the World Health Organization's Guidelines for Establishing a Poison Center; thisinstrument wasadministeredby phone to poison center directors and faculty in the EMROregion. Questions assessed for the presence or absence of important poison center capabilities listed in the WHO guidelines, and points were assigned based on response. Secondly, we administered an electronicworkforce survey to clinical toxicology professionals in the region; participanteligibility for the workforce survey was based on themembership roster ofMENATOX. Out of 22 EMRO countries, 16 countries have an established poison center, and 14 of 16 participated in the poison center survey. The results reflected a wide variability in capabilities amongcountries. Areas such as call centers, clinical toxicology units, laboratory services, and data management were relatively lacking while some other areas including toxicovigilance, chemical incidents and emergencies, antidotes/antivenoms, poisoning information sources, and the availability of free services were relatively stronger.Twenty-seven out of 32 workforce respondents were physicians. Results from that survey highlighted a desire for more support from government and better compensation. Our studyidentified areas of need for the EMRO region.The poison center survey results reflect large disparities amongcountries with some areas being stronger than others. The workforce survey highlighted issues such as compensation and government recognition. Overall, a formal assessment of individual poison centers can provide benchmarks to drive improvement of services, but further research is needed to identify and characterize country-specific needs.

Cat Caring Behaviors and Ownership Status of Residents Enrolling a Cat in a Free Sterilization Program.

Most cats entering animal shelters in Australia are less than 12 months old and emanate from low socioeconomic areas. Many are unidentified and may be either owned or semi-owned cats (cats cared for by someone who does not consider themselves the owner). In Australia, approximately 33% of cats entering shelters and pounds are euthanized annually, adversely affecting the mental health of staff involved. Our study investigated cat ownership and caregiving behaviors of cats enrolled in the Australian Pet Welfare Foundation's Community Cat Program, which included free sterilization, microchipping, and preventive healthcare. The suburbs targeted in Ipswich, Australia had a high per capita cat intake into animal shelters. We surveyed 1094 cat owners and semi-owners. Most cats were under 12 months old (79%), primarily domestic short-haired (69%), and acquired through informal channels such as friends, family, or as strays. Veterinary care was limited, with only 15% of cats having visited a veterinarian and 28% being vaccinated. Prior to hearing about the free sterilization program, 88.5% of participants identified as owners, while 11.5% were semi-owners. Before completing the survey, these semi-owners transitioned from an informal caregiving relationship to becoming owner of the cat/s. Of the semi-owners, 93% indicated that their transition to ownership was driven by feelings of responsibility, emotional attachment, and access to free sterilization services. These findings suggest that targeted interventions, such as accessible veterinary care and sterilization programs, are crucial in encouraging semi-owners to take full ownership of cats, improving cat welfare, and reducing unplanned breeding. Supporting this transition helps curb overpopulation and fosters improved caregiving, benefiting both cats and communities.

The Relationship between Covid-19 and Consumption Patterns of Poor Households

Objective: This research aims to analyze the relationship between Covid-19 and Consumption Patterns of Poor Households. The phenomenon of the Covid-19 pandemic has caused various social and economic changes. Changes in behaviour and preferences are an important part of the research by emphasizing the analysis of changes in expenditure during the Covid-19 pandemic and post-Covid-19. Method:This research is in the form of quantitative descriptive, the type of data used by researchers is primary data using a questionnaire that refers to the IFLS (Indonesian Family Life Survey) questionnaire. Primary data includes questionnaires and poor people during and postpandemic in 2019 and 2022 in rural and urban areas. The research area includes several village comparisons of Bandar Lampung City, South Lampung Regency, and Pringsewu Regency. The multiple linear methods are performed with the t-test in pairs using the statistical tool Stata. Results: The results of the study concluded that in the different tests there was no difference in food expenditure during the Covid-19 and post-Covid-19 period, between urban and rural areas, because of the tendency to have both low food expenditures during the pandemic and increase in post- pandemic. The food consumption patterns of the two regions still tend to buy the same staples. There is a difference in non- food expenditures during the rural Covid-19 period is higher because health and urban costs are lower, in the post-Covid-19 rural areas are lower and urban areas are higher. Conclusion and suggestions: The advice to the government, as cases of the Covid-19 pandemic, rise again, is to focus on providing free health services to the poor, because the expenditure on health services is quite large during the covid-19 pandemic. The government is also expected to be able to provide prolonged food staples to poor households plus complementary ingredients such as fruits, vegetables, milk, meat, and foods with high nutrition and protein.

Pay for a free service, access to cesarean section in the slums of Dakar

BackgroundIn sub-Saharan Africa, equitable access to cesarean section remains a major challenge for reducing maternal and neonatal mortality, particularly among disadvantaged populations. This situation is further exacerbated in slums, where women face significant financial barriers to accessing expensive healthcare services, such as cesarean. Within this context, this paper aims to study access to emergency cesarean services among women living in the slums of Dakar, considering the free cesarean policy implemented in Senegal since 2005.MethodQuantitative data were collected using a cross-sectional retrospective approach, from 18 health facility managers and 260 women living in slums in Dakar who had undergone cesarean delivery between July and December 2022. The surveys aimed to collect socio-demographic data on women and the costs they paid to have a cesarean section, as well as on the application of the policy of free caesarean sections by public health facilities. The data were processed using Stata.ResultsThe results indicated that poor women residing in Dakar slums do have access to emergency cesarean section services in public health facilities. However, a significant portion of these women come from impoverished households and lack higher education, making them more vulnerable to financial constraints when seeking a C-section. Despite cesarean sections being performed primarily based on medical necessity, regardless of the woman's economic status, ethnicity, or educational background, women often find themselves having to pay substantial amounts to undergo the procedure. This is particularly concerning, as cesarean sections are intended to be entirely free in public health facilities in Senegal. Health facility managers attribute this financial burden to the State, which recurrently delays reimbursements for cesarean sections, forcing them to charge women higher prices for the procedure.ConclusionA more rigorous enforcement of the policy for free cesarean section could greatly enhance access to this obstetric practice for women living in the slums of Dakar.

Potential impact of rotavirus vaccine introduction in India’s Universal Immunisation Programme on private sector vaccine utilisation: an interrupted time series analysis

BackgroundDespite free immunisation services through the Universal Immunisation Programme (UIP), around 14% of Indian households seek immunisation in the private sector. We examined the potential impact of rotavirus vaccine (RVV) introduction in the Universal Immunisation Programme (UIP) on private-sector rotavirus vaccine utilisation.MethodsWe analysed nationally representative private-sector vaccine sales data. The intervention under consideration is RVV introduction in the UIP in selected Indian states. The outcome is the ‘monthly RVV sales volume’—a proxy for vaccine utilisation. We performed a Poisson regression interrupted time series analysis to detect the pre-intervention trend, post-intervention level change and trend change relative to the pre-intervention for monthly rotavirus vaccine utilisation.ResultsPoisson segmented regression analysis showed that immediately after RVV introduction in the UIP private-sector RVV sales showed a decline in Rajasthan by 37.4% (Incidence Risk Ratio (IRR): 0.626; 95% CI: 0.504–0.779), in Tamil Nadu by 26% (IRR: 0.740; 95% CI: 0.513–1.068), in Uttar Pradesh-East by 72.2% (IRR: 0.278; 95% CI: 0.178–0.436) and in Kerala by 3% (IRR: 0.970; 95% CI: 0.651–1.447). Rajasthan, Tamil Nadu and Kerala had sustained reduction in the postintervention trend relative to the preintervention trend by 20.1% (IRR: 0.799; 95% CI: 0.763–0.836), 6.4% (IRR: 0.936; 95% CI: 0.906–0.967) and 3.3% (IRR: 0.967; 95% CI: 0.926–0.960) per month, respectively. However, in Haryana and UP-west, in the first-month post-UIP introduction, the private-sector RVV sales increased by 101% and 3.8%, respectively which was followed by a sustained decrease of 14.2% (IRR: 0.858; 95% CI: 0.688–1.070) and 5.8% (IRR: 0.942; 95% CI: 0.926–0.960) per month, respectively. In terms of long-term impact, the private sector RVV sales post-UIP introduction decreased at a monthly rate of 4.4% (IRR: 0.956, 95% CI: 0.939–0.974) in Rajasthan but increased by 5.5% (IRR: 1.055; 95% CI: 1.040–1.070) in UP-east, 0.3% (IRR: 1.003, 95% CI: 0.976–1.031)) in Kerala and 0.2% (IRR: 1.002, 95% CI: 0.993–1.011) in Tamil Nadu whereas Haryana and UP-west had a reduction in RVV utilisation by 2.8% (IRR: 0.972; 95% CI: 0.955–0.990) and 1% (IRR: 0.990; 95% CI: 0.982–0.998), respectively.ConclusionsThe study provides evidence that access to RVV through UIP leads to a reduction in private-sector RVV utilisation. We recommend strengthening UIP to expand the basket of new vaccines.

Meeting Men Where they are: Motivators and Barriers to Accessing Health Services through a Men's Mobile Wellness Clinic, October 2019 to March 2020, Blantyre, Malawi.

In Malawi approximately, 88.3% people living with HIV are aware of their HIV status. Significant gaps are among men aged 15-34 years; only 72% know their HIV status. To reach men, Jhpiego, in collaboration with the Ministry of Health (MOH), implemented the Men's Mobile Wellness Clinic (MMWC) at workplace settings in Blantyre, Malawi between October 2019 and March 2020. We conducted a descriptive qualitative study to understand motivators and barriers to MMWC service uptake by employees and employers. Primary data was drawn from in-depth telephone interviews from four study populations: employers who accepted or declined to host the MMWC at their worksite, and employees who accessed or did not access the services. We performed a thematic analysis using Nvivo 12 software to identify patterns and themes across the dataset. Main reasons given for using the service among male employees were a desire to know their health status, availability of free health services at the workplace, and good quality services offered by MMWC staff, and support from their supervisor. Men who did not access services stated reasons such as work-clinic scheduling conflicts, lack of adequate promotion of the service, and miscommunication on the criteria about who should attend the MMWC. Employers who accepted to host the MMWC stated convenience and employee's rights to know their health status. Those who declined either stated that employees did not want the services or COVID-19 preventive measures by the MOH between October 2019 and March 2020 restricted participation. This study underscores the potential utility of MMWC services including HIV testing among men. The desire to know their health status, availability of free MMWC services at the workplace, good quality services offered by MMWC staff, and the endorsement of MMWC by supervisors were main motivators to access the MMWC services. Sensitizing supervisors and employees about the benefits of the MMWC services, strengthening demand creation, and clarifying eligibility are important to facilitate MMWC uptake among men in Malawi.

Strategies for LinkedIn-Based Guest Speaker Recruitment and Establishment of Engaging and Comfortable Classroom Discussions: A Case Study from an Operations Management Course

This article describes workable strategies for instructors to introduce highly interactive question and answer (Q&A) sessions with accomplished guest speakers from industry. Two innovative strategies serve as the key factors behind the series’ success: (1) using LinkedIn to partner with guest speakers, especially university alumni, who possess expertise in specific operations management disciplines, and (2) implementing a novel structured Q&A approach that enables alignment with learning objectives while maximizing quality student engagement. Our approach accesses the resumes of tens of thousands of college alumni listed on LinkedIn and utilizes free cloud-based services such as Google Forms and Google Sheets for question submission (by students), review (by instructors), and selection (by the guests). These successfully implemented strategies (1) match qualified speakers to relevant course content, (2) boost student engagement by ensuring the participation of all students, (3) promote content alignment by first filtering out irrelevant student questions, and (4) increase speaker preparation and comfort level.

Employment and retirement among workers who develop vision loss in midlife.

Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased. The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement. Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not. Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement. The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences.

Survey on the Current Status of Elderly Health Services in 1,305 Medical Institutions in Guangxi.

To investigate the current status of elderly health services in medical institutions at all levels within Guangxi Province, China. Using a purposeful sampling method, a questionnaire survey was conducted from July 24, 2023 to October 24, 2023 on the general situation, human resources, rehabilitation medicine, nursing services, and the development of hospice care at 1305 medical institutions in Guangxi. Among the surveyed 1305 medical institutions in Guangxi, 172 (13.18%) had established departments of geriatrics, while 293 (22.45%) boasted departments of rehabilitation medicine. Furthermore, 909 (69.66%) of these institutions offered annual free physical examination services to individuals aged 65 and above. Notably, a total of 362 medical institutions, encompassing both comprehensive hospitals and grassroots hospitals, were recognized as elderly-friendly institutions, accounting for 31.4% of the surveyed sample.The highest demand for talents in medical institutions at all levels included specialized physicians/general practitioners (74.6%), traditional Chinese medicine practitioners (63.1%), rehabilitation therapists (56.1%), and specialized nurses for the elderly (41.7%). A total of 1038 medical institutions conducted popular science activities on elderly health, accounting for 79.5% of the total, focusing mainly on disease prevention (89.21%), nutritional diets (84.68%), rational medication use (79.77%), physical exercise (68.21%), and mental health (60.79%). Only 88 medical institutions provided hospice care services, accounting for 6.7% of the total. Guangxi medical institutions' elderly services are inadequate. Geriatrics and rehab departments are scarce, talent is lacking, and hospice care is underdeveloped. As aging accelerates, the country and society must support elderly care. Governments should introduce talent incentives, and medical institutions should enhance services, foster a positive work environment, and advance Guangxi's elderly health agenda.

Enabling patients with health-related social needs.

183 Background: Addressing health-related social needs (HRSNs) is essential to help ensure patients surviving cancer achieve optimal outcomes. Socioeconomic and environmental insecurities can make it challenging for patients to successfully complete their treatments. The US Oncology Network (The Network), has partnered with Findhelp, a resource facilitation tool enabling anyone with internet access to connect with community-based organizations providing discounted or free social services to meet resource needs. This alliance enables an enhanced level of assistance for patients in need, supporting optimal outcomes for those disadvantaged by various circumstances, such as HRSNs impacted by social drivers of health (SDoH). Methods: Beginning April 25 th , 2024, patients utilizing Navigating Cancer’s patient portal, across 302 community-based oncology clinics serving nearly 500,000 patients annually, could access information through a Findhelp website unique to practices in The Network. The investigators are collecting engagement data based on click rates to the Findhelp website link via the patient portal, the number of unique visitors to The Network’s Findhelp application, and the county, city, and zip code of users accessing the application. Data from the Findhelp website will be assessed to determine which insecurity categories (i.e. food, housing, goods, transit, health, money, care, education, work, legal) and areas across the nationwide network of practices receive the highest engagement, and if there is variability based on subgroup analyses. The subgroup analyses will be performed based on patient demographics and include age, gender, race, and geographic location. Results: Initial retrospective results from this prospective study reveals the average number of searches by patients prior to go-live was 106/day. Post go-live averages have been 4,369/day, a 4,037% uplift in engagement. Top searched needs have been health (26.5%), food (22.3%), and housing (21.1%). Additional data elements are being derived from aggregated, de-identified patient engagement and search activity by geographic location categorized by resource insecurity. Conclusions: Conclusions are being drawn based on outcome measures and cross walking with search and referral activities. The goal of the collaboration is to increase awareness of technologies and local organizations within communities bridging the resource gap by way of facilitating services through the Findhelp platform; ultimately empowering patients to overcome health-related social needs and barriers to care leading to improved access.

Legal provision for the rights of persons who receive rehabilitation assistance

The research is devoted to the problems of legal provision of the rights of persons who receive rehabilitation assistance. The author examines the norms of international and national legislation that enshrine the rights of citizens in the field of healthcare. The works of scholars who have examined the peculiarities of exercising certain patients’ rights are studied. The article describes the legislative acts regulating the rights of a patient in a rehabilitation institution in Ukraine. It is indicated that certain patient rights are enshrined in the Civil Code of Ukraine and the Fundamentals of Healthcare Legislation. Special rights of the patients of rehabilitation institutions are provided for by the Laws of Ukraine “On Rehabilitation in the Healthcare Sector” and “On Rehabilitation of Persons with Disabilities in Ukraine”. The classification of patient's rights into socio-economic, legal, informational, ethical and those related to ensuring the quality of rehabilitation care is proposed. It is indicated that informational rights include the right to information about rights and obligations, diagnosis, functional limitations, nature of treatment, and preservation of medical confidentiality. It is concluded that socio-economic rights consist in the possibility of access to free rehabilitation services at the expense of budgetary funds under the programme of State medical guarantees. It is noted that ethical rights provide for a humane and respectful attitude of medical personnel towards patients. Among the legal rights of the patient is the possibility of judicial and administrative protection of the patient’s rights by applying to law enforcement agencies and courts. The patient has the right to qualified rehabilitation care. Proposals for amendments to the current legislation are made. The necessity to systematise patient rights and provide for them in a separate Law of Ukraine “On Protection of Patients’ Rights” is emphasised.