Human Services Research Articles

A Transaction Cost Approach to Policy-Mandated Collaborations: Evidence from North Carolina

ABSTRACT In human services domains, policymakers mandate formal collaborations and alliances between public service agencies as part of policy implementation. We examine mandated child welfare collaborations in a stratified random sample of North Carolina counties, finding that agencies experienced frictions associated with collaboration fatigue and unclear goals. Access to private information, the ability to combine collaborations, and even serving lunch were conduits for successful collaboration. Agencies that did not engage faced high costs and saw little marginal benefit. We argue that policymakers looking to improve collaboration should communicate the value propositions to the agencies involved. They should also fund lunch.

Bibliometric Analysis Examining Triage and Digital Triage Results in Emergency Departments

New technologies developed for triage systems can have positive effects on health care professionals. The research was conducted to identify and visualize the studies conducted between 2001 and 2024 on triage and digital triage systems in emergency departments and reveals global trends on this subject. The data were obtained from the "Web of Science Core Collection" database on February 8th, 2024. Performance analysis, scientific mapping, and bibliometric analyses were performed using the VOSviewer (1.6.15) software program. Data from 236 publications were analyzed in the study. The most publications were by Alcock J (n= 3), the most publications by country were published in the USA (n= 114), Harvard University (n= 19) was the institution that published the most, the United States Department of Health Human Services (n= 25) supported publications among the funding institutions, and the most publications were published in the Emergency Medicinal Journal (n=8). The results obtained from the study reveal the triage and digital triage systems used in emergency services, provide a general perspective on the subject, and guide future research on this subject.

Long-Acting Cabotegravir Plus Rilpivirine in People with HIV with Adherence Challenges and Viremia: Current Data and Future Directions.

Long-acting injectable cabotegravir plus rilpivirine (LA CAB/RPV) is currently US Food and Drug Administration (FDA)-approved and HIV treatment guideline-endorsed as a switch strategy for patients with HIV (PWH) who are virologically suppressed on oral ART without a history of treatment failure. Recent changes to the International Antiviral Society-USA (IAS-USA) and U.S. Department of Health and Human Services' (DHHS) Panel on Antiretroviral Guidelines recommend the consideration of LA CAB/RPV in select PWH with viremia who are unable to achieve suppression with oral ART due to suboptimal medication adherence. In this article, we review the existing data on this off-label use of LA CAB/RPV, discuss the motivations and specific caveats implicit in the guidelines change, and propose next steps in exploring this novel treatment in this vulnerable patient population.

Analysis of Spatio-Temporal Relationship Between Ecosystem Services and Human Footprints Under Different Human Activity Gradients: A Case Study of Xiangjiang River Basin

Clarifying the relationship between human activities and the provision of ecosystem services has received significant interest in recent years because of a growing need for sustainable socio-ecological system development. Using multi-source remote sensing data, we assessed the spatial and temporal distribution of the human footprint index and five ecosystem services under four human activity gradients from 2010 to 2020 in the Xiangjiang River Basin. The five ecosystem services include water supply, soil conservation, food production, habitat quality, and carbon sequestration. The relationship between human footprint and ecosystem services was analyzed from quantitative and spatial perspectives. The results showed that over the past 10 years, water supply and habitat quality decreased by 4.59% and 16.49%, respectively. The other three services increased, and the upstream area of the basin had a higher level of ecosystem services provision. The human footprint index increased by 28.83% over the 10 years and was characterized by point and patchy clustering in the middle and lower reaches. In terms of quantitative characteristics, the relationship between human footprint and ecosystem services was primarily negative. The ecosystem services were sensitive to the human footprint index within the 0−0.4 range. In terms of spatial characteristics, the relationship was dominated by trade-offs. The risky “high–low” trade-offs were mainly distributed in the middle and lower reaches. As the gradients of human activity increased, the maximum fluctuation in ESs was 43%, and the maximum fluctuation in human footprint was 28%, making their relationship more complex. Our results identified response thresholds of ecosystem services to human activities, providing a guide for ecological management and sustainable development of basins.

First experiences with the introduction of genetic counselors in human genetic services in the German-speaking countries.

In 2019, the Medical University of Innsbruck introduced the first Genetic and Genomic Counseling master's program in the German-speaking countries. A major challenge of this process was the absence of practicing Genetic Counselors (GC) in these countries, leading to a lack of experience with GCs in medical genetic services and the absence of a legal framework for the profession. Consequently, student placements within the program commenced with neither the students nor their supervising consultants having any previous experience of collaborative teamwork between clinical geneticists and GCs. To share insights from the initial implementation phase, supervising consultants from the seven student placement institutes were invited to participate in semi-structured interviews guided by open-ended questions. From these interviews, three models of interprofessional teamwork between GCs and clinical geneticists emerged: (1) the alternating or tandem model, (2) qualified preliminary and follow-up patient interviews, and (3) the provision of genetic (counseling) services without genetic counseling in the legal sense. In addition, the interviewees provided recommendations for addressing legal concerns and for the effective establishment of appropriate compensation structures for GCs within the German-speaking countries. Clinical geneticists taking part in the study estimated that the integration of GCs could potentially enhance their counseling capacity by as much as 50%. Importantly, they did not foresee any reduction in counseling quality caused by the inclusion of GCs. This study provides evidence that the GC profession can provide additional skills to human genetic services and positively impact both patient support and overall capacity of genetic services also in the German-speaking countries.

AI Virtual Assistants in Human Services: Empowering Customers and Caseworkers

Abstract—This paper explores the transformative role of AI virtual assistants (VAs) in human services, highlighting their potential to enhance communication, streamline processes, and improve customers’ and caseworkers' overall experience. By examining technology applications and challenges, the aim is to comprehensively understand how VAs can empower the human services industry. Keywords—AI Virtual assistant, Natural language Processing, Machine learning, Caseworker assistant, Customer assistant

Looking back to shape the future: Trajectories and resilience of social-ecological systems in the Global South.

In complex Social-Ecological Systems (SES), the interplay between ecological and social components shapes trajectories that impact human well-being and ecosystem services. While SES dynamics have been studied in static conditions, there has been less attention to how said systems respond to shocks and stressors over time and space. This special issue presents a collection of articles that use diverse methodologies-ranging from system dynamics modeling to participatory approaches-to analyze past SES changes and discuss future scenarios. Case studies from regions including Brazil, Colombia, Mexico, Honduras, Chile, Ethiopia and Mongolia illustrate key variables influencing social-ecological transitions and provide insights into potential policy strategies to support sustainable SES. The studies underscore the need for multi-scalar approaches to SES research that explicitly theorize and empirically assess trajectories across space and time.

Prevalence and predictors of coronary heart disease among individuals with and without obesity in North Dakota.

Coronary heart disease (CHD) is the most common cardiovascular disease in the United States and heart disease is the leading cause of death in North Dakota. Although obesity is a major risk factor for CHD, some studies have reported an inverse relationship between body mass index (BMI) and CHD outcomes. Understanding the epidemiology of CHD among individuals with and without obesity is essential to guide health planning. Therefore, the objectives of this study were to estimate the prevalence and identify predictors of CHD among North Dakota adults with and without obesity. Behavioral Risk Factor Surveillance System data from 2017 to 2021 were provided by the North Dakota Department of Health and Human Services. Weighted prevalence estimates and 95% confidence intervals (CIs) were computed for CHD and potential risk factors among respondents with and without obesity (BMI ≥30 kg/m2). Multivariable logistic regression was used to identify significant predictors of CHD in both groups. A total of 17,092 respondents were included in the study. Respondents with obesity had a higher prevalence of CHD (4.7%, 95% CI: 4.2-5.4) than those without obesity (3.0%, 95% CI: 2.7-3.4). Predictors of CHD among both groups included age, sex, self-reported general health, high blood pressure, high cholesterol, chronic obstructive pulmonary disease, and diabetes. Having a personal doctor (Odds Ratio [OR] = 1.91, 95% CI: 1.13-3.23) and arthritis (OR = 1.72, 95% CI: 1.34-2.22) were significant predictors of CHD among respondents without obesity, but not among those without obesity. While the prevalence of CHD was significantly higher among adults with obesity compared to those without obesity, the findings of the stratified analysis indicated that predictors of the condition tended to be similar for the two groups. This study provides useful information to guide health planning and control programs that aim to reduce the burden of CHD in North Dakota.

Understanding We Can Do This COVID-19 vaccine campaign elements through message frames and emotional appeals

This study looks into the message frames, emotional appeals, and approaches used in the We Can Do This COVID-19 vaccine campaign by the U.S. Department of Health and Human Services (HHS). A quantitative content analysis of 145 audio-visual campaign elements was guided by framing theory. Results indicate that the campaign messages primarily focused on vaccine benefits and used an informational approach to messaging. Consistent use of hope is observed alongside frames, such as vaccine information, facts and findings, and preventive measures. The moral obligation frame uses a more negative appeal (i.e., guilt) across the campaign elements. Additionally, while informational messages incorporate a more fear appeal, sadness, guilt, and hope remain the consistent emotional appeals in the transformational message approach. The findings of this study can serve as a valuable resource for the U.S. Government authorities and other healthcare experts in the implementation of comparable vaccination campaigns.

Why train? Compatible and incompatible institutional logics in violence prevention and management training

A critical component of ensuring safe workplaces is training in preventing and managing violent behavior. This article examines the institutional logics underpinning such training programs, investigating their design, rationale, and impact on everyday practices within human services. Despite extensive research on the content, effects, and experiences of these training programs, there is a notable gap in understanding the rationale behind their development. This study aims to fill this gap by exploring why violence prevention and management training is structured as it is and how institutional logics affect training and practice. This research identifies seven institutional logics that shape these programs through an in-depth qualitative analysis of three Norwegian human service training programs – encompassing mental health care, child welfare services, and Norway’s national welfare agency. Some of the logics are complementary. Others are incompatible, leading to significant practical implications. Data collection included qualitative document analysis and interviews with representatives from the training communities. The study contributes to a better understanding of the factors influencing the training program design and influence, not the least, by underscoring their duality as measures of improving service delivery and ensuring safe working conditions.

Serologic Evidence of Recent Infection with Highly Pathogenic Avian Influenza A(H5) Virus Among Dairy Workers - Michigan and Colorado, June-August 2024.

Since April 2024, sporadic infections with highly pathogenic avian influenza (HPAI) A(H5) viruses have been detected among dairy farm workers in the United States. To date, infections have mostly been detected through worker monitoring, and have been mild despite the possibility of more severe illness. During June-August 2024, CDC collaborated with the Michigan Department of Health and Human Services and the Colorado Department of Public Health and Environment to implement cross-sectional serologic surveys to ascertain the prevalence of recent infection with HPAI A(H5) virus among dairy workers. In both states, a convenience sample of persons who work in dairies was interviewed, and blood specimens were collected. Among 115 persons, eight (7%; 95% CI=3.6%-13.1%) had serologic evidence of recent infection with A(H5) virus; all reported milking cows or cleaning the milking parlor. Among persons with serologic evidence of infection, four recalled being ill around the time cows were ill; symptoms began before or within a few days of A(H5) virus detections among cows. This finding supports the need to identify and implement strategies to prevent transmission among dairy cattle to reduce worker exposures and for education and outreach to dairy workers concerning prevention, symptoms, and where to seek medical care if the workers develop symptoms. Timely identification of infected herds can support rapid initiation of monitoring, testing, and treatment for human illness, including mild illness, among exposed dairy workers.

Machine learning insights into regional dynamics and prevalence of COVID-19 variants in US health and human services regions

BackgroundThe COVID-19 pandemic arising from the emergence of SARS-CoV-2 in late 2019 has led to global devastation with millions of lives lost by January 2024. Despite the WHO’s declaration of the end of the global health emergency in May 2023, the virus persists, propelled by mutations. Variants continue to challenge vaccination efforts, underscoring the necessity for ongoing vigilance. This study aimed at contributing to a more data-driven approach to pandemic management by employing random forest regression to analyze regional variant prevalence.MethodsThis study utilized data from various sources including National COVID Cohort Collaborative database, Bureau of Transportation Statistics, World Weather Online, EPA, and US Census. Key variables include pollution, weather, travel patterns, and demographics. Preprocessing steps involved merging and normalization of datasets. Training data spanned from January 2021 to February 2023. The Random Forest (RF) Regressor was chosen for its accuracy in modeling. To prevent data leakage, time series splits were employed. Model performance was evaluated using metrics such as MSE and R-squared.ResultsThe Alpha variant was predominant in the Southeast, with less than 80% share even at its peak. Delta surged initially in Kansas City and maintained dominance there for over 5 months. Omicron subvariant BA.5 spread nationwide, becoming predominant across all Health and Human Services regions simultaneously, with New York seeing the earliest and fastest decline in its share. Variant XBB.1.5 concentrated more in the Northeast, but limited data hindered full analysis. Using RF Regressor, key features affecting spread patterns were identified, with high predictive accuracy. Each variant showed specific environmental correlations; for instance, Alpha with air quality index, Delta with ozone density, BA.5 with UV index, and XBB.1.5 with land area and income. Correlation analysis further highlighted variant-specific associations.ConclusionsThis research provides a comprehensive analysis of the regional distribution of COVID-19 variants, offering critical insights for devising targeted public health strategies. By utilizing machine learning, the study uncovers the complex factors contributing to variant spread and reveals how specific factors contribute to variant prevalence, offering insights crucial for pandemic management.

Patient Health Record Protection Beyond the Health Insurance Portability and Accountability Act: Mixed Methods Study

Background The security and privacy of health care information are crucial for maintaining the societal value of health care as a public good. However, governance over electronic health care data has proven inefficient, despite robust enforcement efforts. Both federal (HIPAA [Health Insurance Portability and Accountability Act]) and state regulations, along with the ombudsman rule, have not effectively reduced the frequency or impact of data breaches in the US health care system. While legal frameworks have bolstered data security, recent years have seen a concerning increase in breach incidents. This paper investigates common breach types and proposes best practices derived from the data as potential solutions. Objective The primary aim of this study is to analyze health care and hospital breach data, comparing it against HIPAA compliance levels across states (spatial analysis) and the impact of the Omnibus Rule over time (temporal analysis). The goal is to establish guidelines for best practices in handling sensitive information within hospitals and clinical environments. Methods The study used data from the Department of Health and Human Services on reported breaches, assessing the severity and impact of each breach type. We then analyzed secondary data to examine whether HIPAA’s storage and retention rule amendments have influenced security and privacy incidents across all 50 states. Finally, we conducted a qualitative analysis of textual data from vulnerability and breach reports to identify actionable best practices for health care settings. Results Our findings indicate that hacking or IT incidents have the most significant impact on the number of individuals affected, highlighting this as a primary breach category. The overall difference-in-differences trend reveals no significant reduction in breach rates (P=.50), despite state-level regulations exceeding HIPAA requirements and the introduction of the ombudsman rule. This persistence in breach trends implies that even strengthened protections and additional guidelines have not effectively curbed the rising number of affected individuals. Through qualitative analysis, we identified 15 unique values and associated best practices from industry standards. Conclusions Combining quantitative and qualitative insights, we propose the “SecureSphere framework” to enhance data security in health care institutions. This framework presents key security values structured in concentric circles: core values at the center and peripheral values around them. The core values include employee management, policy, procedures, and IT management. Peripheral values encompass the remaining security attributes that support these core elements. This structured approach provides a comprehensive security strategy for protecting patient health information and is designed to help health care organizations develop sustainable practices for data security.

From Motivation to Action: The Role of Green Human Resource Management and Public Service Motivation in Promoting a Circular Economy in Cambodia

From Motivation to Action: The Role of Green Human Resource Management and Public Service Motivation in Promoting a Circular Economy in Cambodia

Judge dismisses ADA retaliation claim

The plaintiff was a Black woman with anxiety and depression who worked for Oklahoma Human Services in the capacity of a child welfare specialist.

Uses of the Trauma of Others: Insights from Two Ethnographic Studies of Human Service Workers

Uses of the Trauma of Others: Insights from Two Ethnographic Studies of Human Service Workers

A Preliminary Study: Neurological, Immunological, and Endocrine Aspects of Healthcare Workers without Burnout Syndrome

Summary: Healthcare workers are vulnerable to stress and burnout, which can affect the Hypothalamus-Hypophysis Axis (HHA) pathway. This pathway can involve psychological, neurological, immunological, and endocrine aspects. These can be evaluated using the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a heart rate variability tool, laboratory tests using salivary immunoglobulin-A (sIg-A), T-cell regulator (TC), endorphins, and salivary cortisol (SC) levels. Purpose: This study aimed to describe the neurological, immunological, and endocrine aspects of healthcare workers without burnout syndrome Methods: A quantitative descriptive study was conducted to describe the psychological, neurological, immunological, and endocrine aspects of healthcare workers. Purposive sampling was used. Findings: Sixty-two participants took the MBI-HSS, and 30 participants without burnout were selected. There were 28 nurses, with an average age of 28 years old. About 93,3% of the participants were female, 80% worked at the emergency department, and 60% had over three years of working experience. From HRV test results, 14 participants were within the normal range (50-100 ms). The average -endorphine serum level is 481,93 pg/ml. Around 60% of participants showed normal SC levels, and 40% showed low SC levels (mean 5,72 ng/ml). Around 90% showed normal sIg-A and 10% high sIg-A levels (mean 501,6 g/ml). The average TC was 23% CD4, with 8,1% CD25 and 6,4% CD127. Conclusion: This study found that average healthcare workers showed normal HRV, endorphins, SC, sIg-A, and T cell regulators, representing neurological, immunological, and endocrine aspects. Therefore, further study is needed to determine the impact of burnout syndrome on these aspects.

Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis

BackgroundFentanyl and its analogs contribute substantially to drug overdose deaths in the United States. There is concern that people using drugs are being unknowingly exposed to fentanyl, increasing their risk of overdose death. This study examines temporal trends and spatial variations in the co-occurrence of fentanyl with other seized drugs. MethodsWe identified fentanyl co-occurrence (the proportion of samples of non-fentanyl substances that also contain fentanyl) among 9 substances or substance classes of interest: methamphetamine, cannabis, cocaine, heroin, club drugs, hallucinogens, and prescription opioids, stimulants, and benzodiazepines. We used serial cross-sectional data on drug reports across 50 states and the District of Columbia from the National Forensic Laboratory Information System, the largest available database on the U.S. illicit drug supply, from January 2013 to December 2023. FindingsWe analyzed data from 11,940,207 samples. Fentanyl co-occurrence with all examined substances increased monotonically over time (Mann-Kendall p<0.0001). Nationally, fentanyl co-occurrence was highest among heroin samples (approx. 50%), but relatively low among methamphetamine (≤1%), cocaine (≤4%), and other drug samples. However, co-occurrence rates have grown to over 10% for cocaine and methamphetamine in several Northeast states in 2017-2023. InterpretationFentanyl co-occurs most commonly with heroin, but its presence in stimulant supplies is increasing in some areas, where it may pose a disproportionately high risk of overdose. FundingThis work was partly supported by FDA grant U01FD00745501. This article reflects the views of the authors and does not represent the views or policies of the FDA or US Department of Health and Human Services.

RPA Demystified: How Software Robots are Revolutionizing Customer Service

Robotic Process Automation (RPA) is revolutionizing customer service by introducing software robots capable of handling repetitive tasks with unprecedented efficiency and accuracy. This article explores the transformative impact of RPA on customer service operations, drawing parallels with everyday automation experiences to demystify the technology. Through case studies and empirical evidence, we examine how RPA streamlines processes such as data entry, ticket routing, and customer data retrieval, leading to significant improvements in operational efficiency and customer satisfaction. The article addresses common misconceptions about RPA, emphasizing its role as a complement to human workers rather than a replacement. We analyze the synergy between RPA and human customer service representatives, highlighting increased employee productivity and job satisfaction. The article also delves into the future prospects of RPA in customer service, including emerging trends like cognitive RPA, while discussing potential obstacles to widespread adoption and strategies for successful implementation. By presenting a comprehensive overview of RPA's capabilities, benefits, and challenges in the customer service domain, this article provides valuable insights for organizations seeking to enhance their customer service operations through automation.

Exploring the Implementation Methods of AI-Driven Robots in Media Interaction Experience Design

The purpose of this study is to deeply explore the innovative implementation methods of artificial intelligence (AI)-driven robots in media interactive experience design. Firstly, this paper expounds how AI-driven robot technology can provide users with a more natural and intelligent interactive experience through natural language processing (NLP), speech recognition, computer vision and other technologies, thus enhancing users' sense of participation and immersion. In order to realize the efficient application of AI-driven robot in media interaction, this study proposes a series of implementation methods, including improving the accuracy and personalization of robot interaction by using NLP and deep learning algorithm; Identify user expressions and gestures through computer vision technology to enhance the naturalness of interaction; Multi-modal interactive technology is used to integrate multi-sensory channel information to provide comprehensive interactive experience; Use deep learning technology to train the robot's ability to perceive and understand users' needs, and introduce emotion analysis technology to realize more humanized service; By constructing user portraits, we design personalized interaction schemes that adapt to different scenarios and users. In the experimental part, three different scenes, library, shopping mall and museum, are selected to verify the effectiveness of the design scheme. The results show that the AI-driven robot significantly improves the user's satisfaction and emotional experience under the personalized interaction scheme.