Health Care Services Research Articles

The Association Between Victimization and Perpetration of Physical Intimate Partner Violence and Unmet Healthcare Needs Among Married Women in South Korea.

This study assessed physical intimate partner violence (IPV) experiences and examined their association with unmet healthcare needs among married women in South Korea. We analyzed data from a nationally representative longitudinal survey of 6,533 women at baseline. Participants were asked yes/no questions about their experiences of physical IPV victimization and perpetration over the past year. The responses were classified into four categories of IPV experience: "none," "victimization only," "perpetration only," and "both victimization and perpetration." At baseline, 0.9% reported being victimized only, and 25.9% reported both victimization and perpetration. The prevalence of unmet healthcare needs over the past year at baseline was 0.8%. Compared to women without any IPV experience, women in the IPV "victimization only" category had greater unmet healthcare needs (OR: 5.49, 95% CI [2.30, 13.12]) after adjusting for sociodemographic variables. Experiencing IPV perpetration only and both IPV victimization and perpetration were not statistically significantly associated with unmet healthcare needs. These results imply that physical IPV victims face difficulties accessing healthcare services which could exacerbate health inequalities over time. Moreover, this study suggests that it is necessary to distinguish IPV victims from those who experience IPV victimization only and those who experience both IPV victimization and perpetration.

Downstream healthcare use following breast cancer screening: a register-based cohort study

BackgroundFor evaluation of breast cancer screening and informed prioritisation, it is important to examine the downstream healthcare use associated to participation. The objective of this study is to determine the...

RELAKA: Robust ECC based Privacy Preserving Lightweight Authenticated Key Agreement protocol for healthcare applications

With the advancement of cutting-edge technologies, the Internet of Medical Things (IoMT) has assisted the healthcare sector by facilitating interaction between healthcare service providers and patients in remote areas. In IoMT, wearable or implantable sensors collect the patient’s record and share the information through a public network. Health-related information about the patient must be protected from a variety of attacks by the adversary since it is sensitive and extremely vulnerable to attacks. The sensor equipment that is implanted in the patient is also resource-constrained and has a low power capacity. The entities involved in the communication must be authenticated with one another in order to protect patients’ health information, anonymity, and reliability. While several authenticated key agreement protocols have been proposed, many suffer from high computational costs and storage cost, making them unsuitable for lightweight applications. This paper proposes a secure three-factor robust Elliptic Curve Cryptography (ECC) based mutually authenticated and key agreement protocol known as RELAKA for the IoMT environment, utilizing the benefits of one-way hash function. In proposed scheme, all entities, including the healthcare service providers and wearable sensors, are authenticated by the medical server. Subsequently, a secret key is established for each communication session and shared between all the entities. Additionally, mechanism for appropriate user revocation and re-registration is integrated to provide additional security in cases where a user’s QR code is tampered with by the attacker. The privacy of the proposed protocol is investigated by the potential use of zero knowledge proof. Furthermore, the efficacy of the authentication is examined by challenge and response mechanism. The informal security analysis demonstrates its resistance to threats such as DoS, impersonation, message modification, password guessing, and so on. The performance evaluation of RELAKA protocol indicates that the execution, communication, and storage costs is reduced by 87.59%, 43% and 60.71% respectively. Moreover, the outcomes of the AVISPA simulation illustrate that the RELAKA successfully evades both active and passive attacks. In addition, real-world testbed environment is developed with Raspberry pi 4 model B and the experimental results verifies the robustness of the proposed protocol. According to theoretical analysis and experimental evaluation, the RELAKA scheme is more secure and efficient than the existing protocols.

A narrative review on allergy and exposure to domestic and non-domestic animals: favorable and unfavorable effects.

The aim of this contribution was to highlight the "favorable" and "unfavorable" roles of domestic and non-domestic animals on airway sensitization processes and on the type/severity of the clinical symptoms induced by their exposure. We performed a literature research in MEDLINE for allergic manifestations and animals. Pets can be "allergy friends" through mechanisms related to hygiene hypothesis and translational aspects, the dual role of IgG4 antibodies for pets, and their promising role as healthcare service animals (dogs). On the contrary, animals can be "allergy enemies" when inducing allergic sensitization and respiratory symptoms (sometimes leading to severe reactions), and also due to cross reactivity with other pets allergens, indirect exposure and ubiquity of their allergens, cross reactivity between Can f 5 and human prostate-specific antigen (PSA). Moreover, in some cases they can trigger anaphylaxis, induce occupational asthma, and act as pests. Finally, we must outline the modest efficacy of allergen immunotherapy (AIT) for their allergens. From a strictly allergological perspective, it is evident that the "negative" aspects resulting from exposure to domestic / non-domestic animals outweigh the "positive" aspects. As a consequence, it is up to humans to seek new ways to balance the pros and cons by exploring research areas that can allow the best possible coexistence with subjects at risk of allergy with domestic and non-domestic animals.

Transformative Impact of AI and Cloud Technologies: A Comparative Analysis across Healthcare, Retail, and Mobile Financial Services

This article examines the transformative impact of artificial intelligence (AI) and cloud technologies across healthcare, retail, and mobile financial services sectors. Through a comprehensive analysis of industry-specific applications, we explore how these technologies are revolutionizing operational efficiency, customer experiences, and innovation in each domain. In healthcare, we investigate the role of CI/CD automation and scalable cloud infrastructure in improving system reliability and patient care. The retail sector analysis focuses on AI-driven customer insights and supply chain optimization. For mobile financial services, we examine AI applications in fraud detection and real-time analytics. The findings reveal significant improvements in operational efficiency, decision-making processes, and customer satisfaction across all three industries. However, we also identify unique challenges and opportunities specific to each sector. This article contributes to the growing body of literature on digital transformation and provides valuable insights for industry professionals and policymakers navigating the integration of AI and cloud technologies in their respective fields.

Research on healthcare data sharing in the context of digital platforms considering the risks of data breaches

BackgroundWithin China's healthcare landscape, the sharing of medical data has emerged as a pivotal force propelling advancements in the insurance sector and enhancing patient engagement with healthcare services. However, medical institutions often exhibit reluctance toward data sharing due to apprehensions regarding data security and privacy safeguards. To navigate this conundrum, our research introduces and empirically validates a model grounded in evolutionary game theory, offering a robust theoretical framework and actionable strategies for facilitating healthcare data sharing while harmonizing the dual imperatives of data utility and privacy preservation.MethodsIn this paper, we construct an evolutionary game model involving medical institutions, big data innovation platforms, and insurance companies within the context of digital platforms. The model integrates exogenous causes of data breaches, endogenous causes of data breaches, compensation payments, government penalties, subsidies, unreasonable fees, claims efficiency, and insurance fraud.ResultsThe stability analysis of the evolutionary game identifies eight equilibrium points among medical institutions, platforms, and insurance companies. Numerical simulations demonstrate convergence toward strategy E7 = (0, 0, 1), suggesting a trend for medical institutions to adopt a fully anonymous information-sharing strategy, platforms to implement strict regulation, and insurance companies to opt for an auditing approach. Sensitivity analysis reveals that the parameters selected in this study significantly influence the players' behavioral choices and the game's equilibria.ConclusionsWhen breaches occur, medical institutions tend to seek co-sharing between platforms and insurance companies. This promotes enhanced regulation by platforms and incentivizes insurance companies to perform audits. If the responsibility for the breach is attributed to the platform or the insurance company, the liability sharing system will push healthcare organizations to choose a fully anonymous information sharing strategy. Otherwise, medical institutions will choose partially anonymous information sharing for more benefits. In case of widespread data leakage, the amount of compensation shall augment, and the role of compensation shall replace the role of government supervision. Then, the government shall penalize them, which shall reduce the motivation of each subject.

Assessment of the Level of Awareness and Knowledge of Covid-19 among rural population in Khulna, Bangladesh

Objective: The objective of the study was to find out level of Awareness and knowledge about covid-19 among rural population in Bangladesh. Methods: A cross-sectional descriptive type of study was carried out in Bathiaghata Upazilla, Khulna from 25.11.21 to 25.12.2021. Adult persons, 455 (male 181 and female 274) with mean age ± SD was 24 ±1.5 years, selected purposively from the households in the adjacent villages were included in the study as respondents. Results: Among the respondents, 97.4% heard about covid-19. Of them, 292 (71.6%) had knowledge that the disease is transmitted by cough, sneezing, direct contact and the proportion of the respondents who knew about symptoms like high fever, headache, cough, loss of taste and loss of smell were 50.1%, 16.7%,16% and 7.4%, respectively. Most of the respondents received health care services from MBBS doctors (87.3%). The majority of the respondent (76.5%) identified who heard about prevention of covid-19 by wearing mask, as a good preventive practice against covid-19 infection, followed by frequent hand washing (18.4%) which is eventually important for the prevention of covid-19. Conclusion: It was a unique study that describing adult heath related knowledge on covid-19 among adult population in a rural area. The study results suggest a further need to strengthen health education about covid-19 among rural population in Bangladesh. Mediscope 2024;11(2): 62-67

Patient Satisfaction with Primary Health Care Services in Qatar: A Quality Improvement Study in a Government Staff Clinic

Introduction: Patient satisfaction (PS) is a crucial measure of healthcare quality to ensure effective healthcare systems. Most previous studies focused on PS in primary health care centers, tertiary hospitals, or other settings while only a few addressed PS in staff/employee clinic settings. This study aimed to measure PS and identify factors affecting PS in a government staff clinic in Qatar. Methods: A cross-sectional quantitative research design based on a self-administered validated questionnaire was employed. The study population consisted of employees who visited the “Primary Health Care Corporation” staff clinic for a “physical” consultation between January and November 2023. Phone numbers were extracted from 942 patients’ electronic medical records. SMS texts containing links to the online questionnaire were sent. SMS and telephone reminders were conducted to reach a sufficient sample size. Results: 262 participants yielded a 28% response rate. 92% were satisfied with the overall primary health care services with aspects involving clinic accessibility (86%), physicians’ skills (84%), consultation duration (90%), condition explanation (87%), screening recommendations (80%), and shared decision-making (86%). These variables correlated significantly with the overall PS. Multivariate logistic regression analysis identified two key predictors of PS in the staff clinic: satisfaction with overall GP performance (OR=5.00; 95% CI=1.27–19.78; p=0.022) and satisfaction with overall nursing care (OR=27.88; 95% CI=5.83–133.27; p<0.001). Conclusion: The primary health care services provided in the staff clinic exceeded expectations across structural, clinical, and technical aspects. These results align with the “Qatar National Vision 2030” to foster a mentally and physically resilient population.

Pros and cons of digital access to healthcare services and healthcare utilization: a quasi-experiment

ObjectivesWe study the introduction of a web portal allowing women to manage their appointments in the public cervical cancer screening program of an Italian Local Health Unit (LHU). We investigate how this intervention affects program participation and the ability of the LHU to collect information on women's screening outside the program.MethodsWe use administrative data from the LHU and a difference-in-differences design to compare outcomes of women in the treated group (n=870), who could reschedule appointments either through phone calls or through the portal, and the control group (n=768), who could only reschedule by phone.ResultsThe portal reduces the number of appointments rescheduled by phone (b = −0.176, 95% CI = −0.228 to −0.114, p < 0.001). It also makes women more likely to report both screenings outside the program (b = 0.049, 95% CI = 0.006–0.912, p < 0.05) and the various reasons for canceling their appointments. However, the portal also decreases the probability of screening (b = −0.156, 95% CI = −0.216–0.096, p < 0.001). Two-thirds of this reduction is due to increased unjustified no-shows (b = 0.099, 95% CI = 0.043–0.155, p < 0.001).ConclusionsDigital innovations increase efficiency of screening programs. However, they may discourage screening, by triggering behavioral biases such as limited attention and procrastination. Pairing portals with frequent reminders may help to boost participation.

Pre and post diagnostic dementia care in four Scottish prisons

Background and purposeThe number of older people in prisons is increasing across the globe. Many have poor physical and mental health, higher prevalence of head injury, cognitive impairment and dementia than found in community populations. Meeting the complex needs of this vulnerable group has become an increasing concern for prison and prison healthcare services. The aim of this multi method qualitative study was to investigate how men with diagnosed or suspected dementia were identified, assessed, and cared for in Scottish prisons. It also explored the lived experience of individuals being assessed for or diagnosed with dementia within four prisons. The data from twenty nine interviews was thematically analysed and used to collaboratively propose principles for dementia care in prison and present the resultant co-designed care pathway.ResultsAt the time of data collection almost all the men known to have a dementia diagnosis or suspected dementia had complex health and social care needs, and some were living with advanced dementia. Prison healthcare staff reported taking a ‘case by case’ approach to their pre- and post-diagnostic care. Meeting these prisoner’s needs was complicated by the absence of organisational leads for care of older adults or people with dementia and there was no pathway or model in place to guide staff. Prison healthcare teams often had difficulty accessing specialist community services to support diagnosis. There was a lack of dementia education and knowledge about how to provide pre and post diagnostic dementia care in this setting amongst staff. The findings arising from this research have informed the co-production of two important evidence informed innovations namely a Model of Care and a pre- and post-diagnostic Care Pathway.ConclusionThis research adds insights critical to understanding the adequacy of current approaches to meeting dementia related needs within the prison setting. To our knowledge this paper offers the first co-produced evidence informed pre- and post- diagnostic dementia care pathway and model of care for use in prisons. These could serve as tools for change that could enable prison healthcare staff to deliver the right care, at the right time, by the right people, and provide an opportunity to assess risk and plan care for the future.

INCIDÊNCIA DE SÍFILIS NA POPULAÇÃO CARCERÁRIA MASCULINA ENTRE OS ANOS DE 2000 À 2024: UM ESTUDO DE REVISÃO INTEGRATIVA DA LITERATURA

This study analyzed the incidence of syphilis among the male prison population in Brazil from 2000 to 2024. It emphasizes that syphilis, caused by Treponema pallidum, is a Sexually Transmitted Infection (STI) with high prevalence in this vulnerable group, primarily due to poor hygiene conditions and limited access to healthcare services. An integrative literature review was conducted, including eight articles that met the inclusion criteria of studies published between 2000 and 2024 specifically addressing syphilis in the male prison population. Articles focusing on other STIs without direct relevance and studies with inadequate methodologies were excluded. The search was performed in the databases PubMed, BVS, MedLine, and Scielo, using descriptors such as “syphilis,” “prison population,” and “Sexually Transmitted Infections (STIs).” The findings indicate a high incidence of syphilis, exacerbated by risk practices such as unprotected sex and the sharing of syringes, along with the absence of adequate health policies. The study highlights the urgent need for effective interventions, including systematic screening and health education, to control the spread of the disease and improve the quality of life for inmates. These measures are essential not only for the health of prisoners but also for preventing the transmission of syphilis to the broader population.

Talent Management in Healthcare: The New Strategic Objective

In today’s rapidly evolving healthcare landscape, effective talent management has become a critical priority for any organization seeking exceptional and safe care, whilst driving a positive outcome and impact in people’s lives. This article delves into the intricacies of talent management in healthcare, from an operational standpoint, aiming to capture how the frontline workforce perceives talent management. It is hypothesized that by implementing comprehensive talent management strategies, healthcare institutions would be able to address the current challenges posed by the worldwide workforce shortages. The increasing demand for healthcare services has prompted organizations and governments to proactively approach talent management to attract and retain the right individuals with the right skills to remain competitive and even functional. Employee engagement initiatives, along with a robust culture of continuous learning and phycological safety, where individuals can be at optimal performance and positively impact patient experience and outcome, significantly reduce turnover rates and ensure workforce stability (Dyrbye et al., 2017).

Are random price generators useful for health policy processes and analysis? effectiveness of random price generators in health policy processes and analysis

This paper discusses why using random price generators in an economic model for medical markets may be useful. It summarizes the different steps for the development of the model and describes an original contribution of the physicians’ choice model with random drug prices applied to Type 2 diabetes in the US. Pharmaceutical markets have been supply-driven to boost life science and medical technologies; however, with the widening inequalities inside national health systems and the global agenda for universal health coverage, more economic research is being done to strengthen the analysis of demand for healthcare services. Research, especially, examines more disaggregated levels of demand systems to understand the heterogeneity of physicians’ choices and better capture patient needs. It can also be an approach to calibrate supply and demand adjustments in medical markets. This paper argues that choice modeling is particularly relevant, using random price generators in a structural model where a demand approach is useful. If validated by additional experimental studies, this first study by Professors Huttin & Hausman (2021) could be used in advanced value assessment frameworks. Random price generators on medical markets could also be tested with additional models that fit oligopolistic market structures (e.g., models for differentiated product markets such as the Berry–Levinsohn–Pakes model). It may also help with a policy analysis process that addresses major disruptive transformations of market dynamics, evolving boundaries in science, fast digitalization, and artificial intelligence-based information systems.

Combating infections under siege: Healthcare challenges amidst the military assault in Gaza

AbstractThe ongoing Israeli military assault on Gaza has caused a devastating collapse of healthcare infrastructure, resulting in an unprecedented surge in infectious diseases. The destruction of sanitation systems, restrictions on medical supplies, and displacement of civilians have created an environment conducive to the rapid spread of waterborne, vector‐borne, and antibiotic‐resistant infections. This paper draws from the insights of local Palestinian healthcare workers and recent medical missions conducted by FAJR Scientific, the Palestine American Medical Association, and Doctors Without Borders, examining infection control efforts under extreme constraints. The missions encountered major challenges, such as the absence of sterile equipment, inadequate access to clean water, and disrupted healthcare services. These conditions have exacerbated the spread of diseases such as hepatitis, meningitis, and polio, with severe impacts on Gaza's pediatric population. Efforts to implement infection control measures, such as telemedicine consultations, wound care protocols, and antibiotic stewardship, were heavily impeded by the ongoing blockade. The paper underscores the critical importance of lifting the siege to allow humanitarian access and to address the root causes of the infectious disease crisis in Gaza. It also highlights the resilience of Palestinian healthcare workers who continue to provide care under these dire circumstances. The recommendations outlined aim to support future medical teams working in conflict zones by providing practical strategies for infection prevention and control amidst such sustained violence. These efforts are contingent on international intervention and an end to the systematic blockade that has weaponized healthcare access.

The Economic Impact of Post-Traumatic Stress Disorder Among Patients with Systemic Autoimmune Diseases During the COVID-19 Pandemic

Background: The present work aimed to estimate the economic impact of PTSD following COVID-19 in a population of patients affected by systemic autoimmune disease (SAD) using a cost-of-illness approach and accounting for the perspective of society. Methods: Considering data collected from SAD patients enrolled in a specialized outpatient clinic in the Tuscany region, Italy, generalized linear models and LASSO logistic regression were used to evaluate the impact of PTSD on costs and its relevance as a possible predictor of being a high-cost patient, respectively. Results: Considering 301 SAD patients, 161 (51.2%) of whom were diagnosed with PTSD, the overall costs were EUR 3670 [890; 40,529] per patient/year among patients with PTSD and EUR 2736.7 [283; 21,078] per patient/year among those without PTSD (p-value < 0.001), with differences mainly attributable to significantly greater direct non-healthcare and indirect costs. PTSD was estimated to increase overall costs (β = 0.296 (0.140), p-value = 0.035), direct non-healthcare (β = 1.193 (0.392), p-value = 0.002), and indirect costs (β = 3.741 (1.136), p-value = 0.001). PTSD diagnosis was also significantly associated with the likelihood of being a high-cost patient. Conclusions: Findings from the present study offer a novel perspective on the economic impact of COVID-19 and provide valuable data for policymakers to better understand the demand for healthcare services and associated costs.

Shared decision-making with patients with complex care needs: a scoping review

BackgroundA number of patients have complex care needs that arise from interactions among multiple factors, such as multimorbidity, mental health issues, and social vulnerability. These factors influence decisions about healthcare and health services. Shared decision-making (SDM), a collaborative process between patients and professionals, is known to improve the quality of the decision-making process. However, follow-up challenges of patients with complex care needs (PCCNs) can lead to SDM specificities.ObjectiveTo identify specificities of SDM with PCCNs.MethodsWe conducted a scoping review using the Joanna Briggs Institute (JBI) methodology. We conducted a systematic search across MEDLINE, CINAHL, PsycINFO, and Academic Search Complete databases. Empirical studies about SDM with PCCNs published between 1997 and 2023 were eligible for inclusion. We conducted a mixed thematic analysis using deductive (Ottawa Decision Support Framework and Interprofessional Shared Decision-Making Model) and inductive approaches. Following Arksey & O’Malley’s and Levac et al.’s methodological recommendations, we consulted experts (researchers, healthcare professionals, and patient partners) to enhance the findings.ResultsTwelve studies were included in the review. Overall, our results demonstrated the importance of recognizing some specificities of SDM with PCCNs, such as the simultaneous presence of multiple decisions and the multidisciplinary and intersectoral nature of the healthcare and health services they receive.ConclusionThis scoping review highlights some specificities that must be considered in SDM with PCCNs to maintain its already-known benefits and ensure positive health and decision-making outcomes.

Functional difficulty among children in Malaysia – findings from the National Health and Morbidity Survey (NHMS) 2019

IntroductionData on child functioning and disability are important for public policy development which aimed at reducing child disability prevalence and strengthening the provision of appropriate and timely health care services. This study reports the prevalence of functional difficulty in Malaysian children aged 2–17 years and its associated sociodemographic factors and epilepsy.MethodsData on children aged 2–17 years (n = 4576) were generated from the National Health and Morbidity Survey (NHMS) 2019, a population-based cross-sectional survey. Functional difficulty in children was assessed using the United Nations Children’s Fund (UNICEF)/Washington Group on Disability Statistics (WG) Child Functioning Module (CFM). The questionnaires were administered to the parents or guardians of the children via face-to-face interviews. Functional difficulty, defined as having difficulty in at least one domain, was examined for its prevalence and associations with sociodemographic variables and the epilepsy variable in children using descriptive analysis and multiple logistic regression.ResultsThe overall prevalence of functional difficulty among children aged 2–17 years was 4.7%. Multiple logistic regression analysis revealed that older children, children from households whose heads of household had a lower education level and children who have epilepsy were significantly more likely to experience functional difficulty (p < 0.05). Children of Chinese ethnicity were less likely to experience functional difficulty compared to children of Malay ethnicity.ConclusionsThis study provides baseline findings on the prevalence of functional difficulty among children in Malaysia using nationally representative data. Although the prevalence was relatively low, the information is important for the planning of strategies to improve the development and well-being of children in Malaysia and for achieving the Sustainable Development Goals (SDGs).

Weight loss maintenance in primary health care: a randomised controlled trial.

This study evaluates the maintenance of a clinically meaningful weight loss (≥ 5 %) after 12 and 36 months of participation in an intervention to promote fruit and vegetable (FV) consumption. A randomised controlled trial was conducted in a primary health care service. For 7 months, participants in the control group (CG) and in the intervention group (IG) performed guided physical exercise three times/week; the IG also participated in collective activities to promote FV consumption. This study selected participants (n 267) who showed clinically meaningful weight loss after nutritional intervention. Sociodemographic, health and body weight data were collected in a face-to-face interview at baseline (T0) and after intervention (T1). Participants were reassessed after 12 (T2) and 36 months (T3) by telephone interview, and the self-reported weight was corrected. The outcome measures weight changes at three time points: M1, comparing T2 with T1; M2, comparing T3 with T2; and M3, comparing T3 with T1. The generalised estimating equation, adjusted for individual characteristics, was used. Participants in the CG showed an increase of 4·2 kg (P < 0·001) at M1 and 4·6 kg (P < 0·001) at M3, while IG individuals showed an increase of 3·6 kg (P < 0·001) at M1 and 3·8 kg (P < 0·001) at M3. The between-group analyses show the effect of nutritional intervention on the maintenance of weight loss at M2 (P = 0·033). Although CG and IG participants increased in weight, the nutritional intervention was associated with maintenance over the long term. This reveals the importance of the promotion of FV consumption for body weight maintenance.

A "silent storm": uncovering the escalating crisis in mental healthcare for children and adolescents in Slovenia during and after the COVID-19 pandemic.

Our aim was to assess the burden of children and adolescents' mental health problems on the Slovenian outpatient healthcare system before, during and after the pandemic. In a retrospective analysis of healthcare indicators from 2008 to 2023, we analysed data from the National Institute of Public Health. Key domains included initial visits for mental and behavioural disorders (MBDs) to primary care for the population aged 0-19; the number of referrals to an initial assessment with a child and adolescent psychiatrist (CAP) at the secondary level for the population aged 0-17 along with the corresponding waiting times; and the number of urgent referrals for the population aged 0-17 to emergency mental health centres at the tertiary level. The calculations included rates per 1000 people. Descriptive statistics and diagrams were used to compare the data. Segmented linear regression analysis (SLR) was conducted on the primary healthcare data to identify the distinct temporal point indicating an increase. Comparing the average rates of the 2020-2022 period to those of the 2018-2019 period, there was a 20% increase in initial visits to primary care, a 23% increase in the referral rate to a CAP at the secondary level, and a 41% increase to the tertiary level of care. In secondary care, a four- to sevenfold increase in waiting times for the initial CAP assessment was observed between 2019 and 2023. The incidence of initial visits to primary healthcare services for MBD increased from 2008 to 2019 (average annual growth rate of 4.5%). The average annual growth rate for the 2020-2022 period tripled to 13.9%. The SLR showed that the trend of accelerating growth could have begun in 2017 for the 0-5 age group and possibly for the 15-19 age group as well. After the initial decline in 2020, all levels of the Slovenian healthcare system faced an increased burden of MBD in children and adolescents from 2021 to 2022 compared to pre-pandemic levels. Nevertheless, a portion of this increase aligns with longitudinal growing trends from 2008 onwards. Tackling the crisis requires urgent national action, significant improvement in organization, and investments in mental health.

Development and Evaluation of a Care Needs Scale for Parents of Children With Tourette Syndrome.

BACKGROUND: Tourette syndrome (TS) is a chronic neurodevelopmental disorder that begins in school-age children. Although TS is not life-threatening, the tics and comorbidities can impact a child's physical and mental health, as well as interpersonal interactions. Understanding the care needs of parents of children with TS is essential for providing healthcare services that effectively support these children. The aim of the study was to develop and evaluate the psychometric properties of the care needs scale for parents of children with TS (CNS-PCTS) in Taiwan. METHODS: This study used a methodological design. The scale was developed by preliminarily identifying relevant items and dimensions through a systematic review of the literature. A pilot test with 30 participants and exploratory factor analysis (EFA) confirmed the subscales and items pertaining to the care needs of the parents. Data analysis included content validity, item analysis, internal consistency, test-retest reliability, and EFA. The Chinese version of the Pittsburgh Sleep Quality Index was adopted to assess the discriminant validity of the CNS-PCTS. RESULTS: Two hundred fifty-six parents of children with TS completed the scale. The scale-level content validity index was 0.92. The EFA revealed that the CNS-PCTS consisted of 13 items, with the factor loadings ranging from 0.656 to 0.83, and covered 3 factors: getting information about TS, assisting children in social engagement, and obtaining parenting support. The discriminant validity showed a positive correlation between the Chinese version of the Pittsburgh Sleep Quality Index and the CNS-PCTS. Cronbach's α coefficients of the subscales ranged from 0.89 to 0.94, and the intraclass correlation coefficient was 0.94. CONCLUSION: The CNS-PCTS demonstrated satisfactory psychometric properties. It helps health professionals understand parents' care needs and assess the effectiveness of interventions. Confirmatory factor analysis can be performed in future studies to provide more rigorous validity.