Unavailability Of Services Research Articles

Sterilize Methods Comparison for Soils: Cost, Time, and Efficiency

Soil sterilization is generally used to eliminate or reduce microbial activity in studies involving microbial inoculations, soil enzymes, among others. Achieving an adequate sterility condition is not straightforward due to the variety of resistance structures that are generated in soil microbial ecosystems and the reservoirs that can form between soil aggregates. This is why finding an effective method to achieve good sterilization is important in methodological terms, so the present work aims to compare the effectiveness of three widely used methodologies to sterilize soil and to evaluate their cost/benefit in terms of time and inputs invested. Four treatments were tested: gamma irradiation, sterilization cycles at different times: three cycles of 1 h each and four cycles of 15 min each, and chloroform vapors. The evaluation and comparison of all samples sterilized by the different methodologies were based on the total aerobic heterotrophic bacterial count. The results of this study suggest that it is more efficient to use autoclaving methods because the process is more accessible in terms of equipment and methodologies, and the final results are the same. In the case of this work, sterilization with chloroform vapors had to be rejected. While the use of gamma radiation may be more efficient in terms of time, it can be a costly and inaccessible service for some laboratories that do not have the equipment. Therefore, the most viable options in terms of time, cost, and benefit are those using autoclaves. Among these, shorter treatment times mean a reduction in the cost of using the equipment, so the option of 15-minute cycles is desirable.

Interactive anomaly-based DDoS attack detection method in cloud computing environments using a third party auditor

Cloud computing environments are indispensable components of the majority of information technology organizations and users' lives. Despite multiple benefits of cloud computing environments, cloud users (CUs) as well as cloud service providers (CSPs) may experience unpleasant conditions by detrimental results of distributed denial of service (DDoS) attacks such as unavailability of cloud services or lengthy response times of the services. In this paper, we provide a threshold anomaly-based DDoS attack detection method to protect cloud environments against DDoS attack. Our proposed method is introduced to reduce DDoS attack consequences in CSPs. Our suggested method includes three newly defined components: 1. A third party auditor (TPA) which acquires direct interaction with each datacenter of the CSP, 2. A zone delimiter (ZD) which encapsulates the sensitive internal specifications of a CSP from TPA, and 3. A protocol which is defined to coordinate TPA, ZD, and CSPs for DDoS attack detection via TPA. We analyze our proposed method by determining and conducting a simulation strategy for an intrusion detection system in CSPs. Results illustrate that interactive communication between TPA and datacenters of CSPs improves the user experience of CUs in the time of DDoS attacks by reducing excessive attack filtering stages. Moreover, by using an intrusion detection system (IDS), we investigate efficiency of the proposed method to recover CSPs from DDoS attacks. We further indicate the efficiency of our proposed method by providing accuracy and qualitative comparisons with other existing methods.

The Challenge of Accessibility and Inaccessibility of Guidance and Counseling Services in Schools based on Recent Studies: Improving Accessibility

This paper examined recent global studies on the accessibility of guidance and counseling services to provide an understanding on what we know about the nature of accessibility and inaccessibility of guidance and counseling services in schools. The insights from this study are meant to provide some solutions to improve the accessibility of guidance and counseling services in schools to meet the needs of the students in the era of 24/7 with emphasis on client perspective.

Does stronger primary care improve access to health services for persons with spinal cord injury? Evidence from eleven European countries

Objective To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI). Design Data analysis of the International Spinal Cord Injury (InSCI) cross-sectional, community-based questionnaire survey conducted in 2017-2019. The association between the strength of primary care (Kringos et al., 2003) and access to health services was established using univariable and multivariable logistic regression analysis, adjusted for socio-demographic and health status characteristics. Setting Community in eleven European countries: France, Germany, Greece, Italy, Lithuania, the Netherlands, Norway, Poland, Romania, Spain and Switzerland. Participants 6658 adults with chronic SCI. Intervention None. Outcome measures Share of persons with SCI that reported unmet healthcare needs as a measure of access. Results Twelve percent of the participants reported unmet healthcare needs: the highest in Poland (25%) and lowest in Switzerland and Spain (7%). The most prevalent access restriction was service unavailability (7%). Stronger primary care was associated with lower odds of reporting unmet healthcare needs, service unavailability, unaffordability and unacceptability. Females, persons of younger age and lower health status, had higher odds of reporting unmet needs. Conclusions In all investigated countries, persons with chronic SCI face access barriers, especially with service availability. Stronger primary care for the general population was also associated with better health service access for persons with SCI, which argues for further primary care strengthening.

Models of threats to cloud services

Cloud services have become popular due to their advantages over traditional computing. The cloud provides remote access to software, hardware, and other services. This has allowed companies to be more productive and enabled remote work. Cloud services have fewer hardware and infrastructure requirements, which reduces the cost of maintaining and supporting information technology. The future success of organizations will depend, not least, on the extent to which they implement cloud computing in their operations. According to forecasts, spending on cloud IT technologies will continue to grow and in 2025 will exceed spending on traditional IT technologies. Security of cloud services is becoming a critical issue as more and more companies complete their digital transformation. Despite the many benefits, cloud services also face their own security threats and challenges. Since cloud services store and process a significant amount of sensitive information, a cloud breach can lead to data leaks that can hinder business development and cause significant damage to a company's reputation. There are risks associated with the unavailability of cloud services in case of technical problems and dependence on external providers. Therefore, companies should carefully assess potential threats and take appropriate measures to protect their data and business in general when using cloud services. There are many methods to help determine how prepared your organization is for the growing number of threats. Threat modeling is one of the methods for predicting and preparing for possible threats. Using modeling frameworks allows you to allocate resources and plan possible actions during an attack. There are many modeling frameworks available, but it is important to remember that these frameworks have their advantages and disadvantages, so the choice depends on the context and needs of a particular system. Analyzing, evaluating, and comparing existing methods for modeling and protecting against threats in cloud services is the main objective of this article.

Challenges and Opportunities for Children with Autism Spectrum Disorder during the Pandemic: Parents’ Views in the Limelight

The Covid-19 pandemic has disrupted many facets of human existence, including the experiences of the most vulnerable members of society. This study aimed to explore the lived experiences of children with autism spectrum disorder (ASD) during the pandemic through the lens of their parents. It specifically aimed to delve into the challenges and opportunities these children encountered during these trying times. Using a phenomenological inquiry, six purposefully selected parents whose children have ASD were interviewed and observed to generate rich and detailed information about the phenomenon, which was fortified by the participants’ shared photographs by virtue of the photovoice methodology. The analysis brought out five themes from the gathered data; three focused on challenges: (1) putting up with the unavailability of special services, (2) catching up with the demands of modular education, and (3) running into emotional breakdowns. Meanwhile, two themes focused on opportunities: (4) increased time for family bonding and (5) acquisition of new life skills. The study’s findings highlight significant implications to government and educational leaders on the interventions and programs needed by children with ASD as they thrive in the midst of the pandemic.

Architecture for IoT applications based on reactive microservices: A performance evaluation

The Internet has evolved from a network interconnecting computers to a complex ecosystem integrating devices of the most varied types, and enabling the amalgamation of the physical and virtual worlds. Integrating these heterogeneous devices fosters novel services and applications that generate value-added information and actionable knowledge for the end-user. Several challenges are involved in the design and building of IoT ecosystems, which have fostered research in the field, in search of patterns, guidelines, methods and tools that support such activities. In terms of architectural patterns, the microservice architectural style has been increasingly adopted in the development of IoT applications and services. Its adoption promotes some essential properties in IoT, such as scalability and extensibility. As there are always tradeoffs involved in every architectural decision, it is important to analyze whether the benefits brought by the use of microservices do not come at the expense of some loss or degradation of application performance. Recent research has analyzed the performance interference of microservices based on edge computing applications. However, a comprehensive assessment of the performance impact of characteristics inherent to the use of reactive microservices on IoT applications is still missing in the literature. In this paper, we present an experimental evaluation of the performance of IoT applications that make use of an architecture based on reactive microservices. The architecture was proposed by our group in a previous work and was tailored for reliable IoT applications running at the edge of the network. The experiments presented in this paper analyze the application performance based on various benchmark scenarios. In addition, we performed load and scalability testing of an IoT application that adopts the architecture components in a hybrid scenario (real devices and emulated devices). The results obtained were promising. The architecture had a good response to the increase in the workload, not presenting errors, crashes or instabilities due to the increase in IoT data traffic. Moreover, analyzing the overhead generated by the architecture components, there was no performance reduction or service unavailability. Such results point to the fact that the adoption of microservices in the construction of IoT systems can bring effective benefits without jeopardizing their performance due to eventually generated overheads.

Xel: A cloud-agnostic data platform for the design-driven building of high-availability data science services

This paper presents Xel, a cloud-agnostic data platform for the design-driven building of high-availability data science services as a support tool for data-driven decision-making. We designed and implemented Xel based on four main components: (a) a high level and driven-design framework for end-users to select analytic and machine learning tools from a service mesh and coupling them into the form of processing pipelines; (b) a new recursive ETL processing model to automatically convert the pipeline designs into infrastructure-agnostic software structures, which are deployed on multiple infrastructures; (c) an orchestration model for transparently managing the data delivery throughout each stage of the processing pipelines used in data science systems; and (d) a data decentralized model to transparently mask service unavailability such as cloud outages and unavailability of either applications or data. Real users created, by means of Xel, data science services such as deep learning analysis of scientific publications, clustering of movie reviews, and a cancer exploratory study. These services were evaluated as case studies that revealed the efficacy of this platform design for enabling end-users to create multiple types of data science pipelines without programming nor making configurations, and automatically masking unavailability of cloud resources and data. This platform is currently used to create a national cancer observatory and big data systems for fusing suicide, mental health, drug consumption and macroeconomic datasets to find spatiotemporal patterns.

Matching Assistive Technology, Telerehabilitation, and Virtual Reality to Promote Cognitive Rehabilitation and Communication Skills in Neurological Populations: A Perspective Proposal

Neurological populations (NP) commonly experience several impairments. Beside motor and sensorial delays, communication and intellectual disabilities are included. The COVID-19 pandemic has suddenly exacerbated their clinical conditions due to lockdown, quarantine, and social distancing preventive measures. Healthcare services unavailability has negatively impacted NP clinical conditions, partially mitigated by vaccine diffusion. One way to overcome this issue is the use of technology-aided interventions for both assessment and rehabilitative purposes. Assistive technology-based interventions, telerehabilitation, and virtual reality setups have been widely adopted to help individuals with neurological damages or injuries. Nevertheless, to the best of our knowledge, their matching (i.e., combination or integration) has rarely been investigated. The main objectives of the current position paper were (a) to provide the reader with a perspective proposal on the matching of the three aforementioned technological solutions, (b) to outline a concise background on the use of technology-aided solutions, (c) to argue on the effectiveness and the suitability of technology-mediated programs, and (d) to postulate an integrative proposal to support cognitive rehabilitation including assistive technology, telerehabilitation, and virtual reality. Practical implications for both research and practice are critically discussed.

Oncologists' Knowledge, Practice and Attitude toward Fertility Preservation: A National Survey.

Improved chemotherapy and radiotherapy treatment protocols, fortunately, increased the rates of cancer survivors over the years. However, these treatments may result in infertility or subfertility. Oncologists are considered the gateway for knowledge about cancer and its treatments' effects. Several studies showed that many oncologists do not discuss fertility preservation with their patients. This study aimed to explore the perspective of oncologists in Oman on fertility preservation. A cross-sectional study of physicians and surgeons dealing with patients with cancer was conducted from June 2021 to December 2021. A standardized and validated questionnaire was used to collect data. Participants reported that they are knowledgeable about sperm cryopreservation and gonadotropin-releasing hormone agonists use but not other methods of fertility preservation. About 94% of the participants reported that they need more knowledge about fertility preservation. More than half of the participants had never encountered cancer patients who used ovarian cryopreservation, testicular tissue cryopreservation, in vitro fertilization with embryo cryopreservation and oocyte cryopreservation. The majority (78%) agreed that discussing fertility preservation with newly diagnosed cancer patients is a high priority. Oncologists in Oman are supportive of fertility preservation. The lack of knowledge and unavailability of well-structured fertility preservation services in Oman hinders the initiation of fertility preservation discussions.

Abstract P5-07-15: Impact of Integrative Therapies on Patients with Metastatic Breast Cancer

Abstract Background: Integrative therapies are shown to support cancer patients’ treatment plans, help with side effect management, and improve patients’ quality of life ([1-9]). In 2017, the American Society of Clinical Oncology endorsed the Association of Integrative Oncology’s Clinical Practice Guidelines highlighting their importance in breast cancer care. Recent studies suggest that more evidence is needed to bring attention to the role of integrative therapies in advanced breast cancer care [4, 7, 8, 10]. This analysis explores participants’ experiences with a wellness program implemented by Unite for HER (UFH), a non-profit organization that delivers integrative therapies and support services such as whole food nutrition services, medical acupuncture, oncology massage therapy, counseling, reiki, meditation, yoga, and fitness classes to patients with breast, metastatic breast, and ovarian cancer. As of April 2022, there were over 1,700 women diagnosed with metastatic breast cancer (MBC) participating in UFH locally and nationally. Methods: UFH members completed a survey about the impact of the UFH Wellness Program on the overall quality of life, including measures on side-effect management, OTC/prescription drug utilization rate, stress reduction, changes to wellness habits, and the social and emotional challenges associated with living with MBC. In total, 119 unique UFH members with MBC answered online surveys distributed by email in 2020 and 2021. Survey questions were designed to evaluate the impact of the UFH Wellness Program. Descriptive analyses of survey questions and open-ended comments were conducted to assess program impact. Results: All respondents were MBC patients/survivors. No other demographic information was collected. While 2020 respondents received mostly in-person services for part of their program, all 2021 respondents received primarily virtual services due to the Covid-19 restrictions. Despite the inaccessibility of in-person services, the satisfaction levels with the wellness program did not drop significantly in 2021. More than two-thirds of respondents (80% in 2020, 67% in 2021) indicated that the therapies offered through UFH Wellness Program significantly improved the side effects of their treatment for MBC. Notably, more than a quarter of respondents (28% in 2020, 26% in 2021) specified that due to UFH integrative therapies they were able to reduce or eliminate one or more OTC/prescription drugs to manage side effects. At the same time, the majority reported experiencing reduced levels of stress after utilizing integrative therapies offered by UFH (93% in 2020, 81% in 2021), as well as improvements in their emotional wellbeing (95% in 2020, 83% in 2021), and quality of life during or after treatment for MBC (97% in 2020, 96% in 2021). Also, 86% of respondents in both years indicated that UFH services, such as nutrition counseling, cooking classes, and exercise classes, helped them adopt and maintain healthier habits in their life. Furthermore, a qualitative analysis of open-ended comments found that 1) respondents expressed deep gratitude and appreciation for UFH integrative therapies, 2) noted that they would otherwise not be able to access such therapies due to financial barriers, and 3) helped them feel better prepared to cope with the psychosocial aspects of their MBC experience. Discussion: These results suggest that integrative therapies such as those offered by UFH can play a significant role in improving patients’ outcomes by reducing stress and drug utilization to manage side effects and improving patients’ well-being and quality of life during metastatic breast cancer treatment. These findings highlight the importance of choosing integrative oncology programs to support MBC patients’ needs in managing the psychosocial and physical side effects of the disease. This project was supported by a grant from individual donors in 2020 and 2021. References Citation Format: Elif Andac-Jones, Maria B. Gonzalo, Gail Kelly, Susan Weldon. Impact of Integrative Therapies on Patients with Metastatic Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-07-15.

Barriers and facilitators to help-seeking for mental health problems in prison: A qualitative interview study with incarcerated males in Northern Norway.

IntroductionThe prevalence of mental disorders is considerably higher among incarcerated individuals than in the general population, but this burden is not matched by a proportional use of mental health services. Studies have found that incarcerated males are reluctant to seek help for mental health problems. Gaining knowledge of factors that influence incarcerated individuals to access or avoid professional help for mental health problems is important for tailoring interventions to address the mental health needs of this population. Promoting mental health service utilization among people in prison has the potential to reduce prison suicide rates and increase institutional functioning, thereby providing safer conditions for peers and staff, promoting rehabilitation, and reducing recidivism upon release.ObjectivesThis study explores personal, interpersonal, and systemic aspects that motivate incarcerated individuals to approach or avoid seeking help for mental health problems. While prior studies have primarily focused on barriers to help-seeking, this study also sheds light on facilitators for seeking professional help for people in prison.MethodsIndividual in-depth interviews were conducted with sixteen incarcerated males from three prisons in Northern Norway. The data analysis was inspired by Grounded Theory.ResultsThe majority of participants shared positive personal perspectives related to professional help-seeking, whereas the barriers were predominantly perceived to be of an interpersonal and systemic nature. Aspects that encouraged help-seeking were: regarding mental health treatment as necessary for successful rehabilitation, sufficient knowledge of when and how to contact mental health services, support from peers, having a higher ranking in the prison hierarchy, health services that are out-reaching, and prior positive experiences with professional help. The barriers to professional help-seeking were: lack of information about when and how to access mental health services, challenges with the self-referral system, perceived unavailability of services, confidentiality issues, and a prison climate that favoured a tough appearance.ConclusionsThe participants appeared to be more positive to seeking professional help for mental health problems than reported in previous studies with incarcerated individuals. Interpersonal and systemic aspects were emphasized by the participants as barriers to accessing mental health services; some participants even perceived these services to be unavailable to them. The results are relevant for designing interventions to promote help-seeking for mental health problems among people in prison.Disclosure of InterestNone Declared

Barriers and facilitators to oral PrEP uptake among high-risk men after HIV testing at workplaces in Uganda: a qualitative study

BackgroundMen in Uganda contribute significantly to new HIV infections annually yet PrEP uptake among them is low and those initiated are likely to discontinue usage. We explored the barriers and facilitators to PrEP uptake among high-risk men employed in private security services with negative HIV results after testing at workplaces in Uganda.MethodsAn explorative qualitative study comprising in-depth participant interviews. Data were collected via telephone calls and manually analyzed by inductive content analysis.ResultsFifty-six (56) men participated, 27(48.21%) had heard about PrEP, and 29(51.79%) were willing to initiate it. Four categories emerged for the facilitators of PrEP uptake including the perceived need for HIV prevention, awareness creation, availability, and sexual freedom. Six categories emerged for the barriers to PrEP uptake. These were: Inaccessibility of PrEP services, Misinformation, Knowledge deficit, Medication-related barriers, Potential for increased risky sexual behavior, and Perceptions about PrEP use.ConclusionThe findings suggest the need for healthcare providers to offer information regarding PrEP and HIV prevention services and mass sensitization campaigns to facilitate uptake. Participants recommend mass roll-out of PrEP to lower-level facilities and accessible pick-up points for men such as workplaces. The men also suggested the use of longer-acting PrEP modalities such as an injectable option or an option that is utilized specifically by the female partner. Finally, the stigma surrounding PrEP use could be reduced by the separation of PrEP and ART services at health facilities, or special pick-up days to reduce waiting times.

Reimagining eating disorder spaces: a qualitative study exploring Māori experiences of accessing treatment for eating disorders in Aotearoa New Zealand

BackgroundHealth, illness, and the body are conceptualized within the cultural context of a society. The values and belief systems of a society, including media portrayals, shape how health and illness present. Traditionally, Western portrayals of eating disorders have been prioritized over and above Indigenous realities. This paper explores the lived experiences of Māori with eating disorders and their whānau (family/support system) to identify the enablers and barriers to accessing specialist services for eating disorders in New Zealand.MethodKaupapa Māori research methodology was used to ensure the research supported Māori health advancement. Fifteen semi-structured interviews were completed with Māori participants including; those with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, and binge eating disorder), and/or their whānau. Structural, descriptive, and pattern coding was undertaken within the thematic analysis. Low’s spatializing culture framework was used to interpret the findings.ResultsTwo overarching themes identified systemic and social barriers to accessing treatment for Māori with eating disorders. The first theme, was space, that described the material culture within eating disorder settings. This theme critiqued eating disorder services, including idiosyncratic use of assessment methods, inaccessible service locations, and the limited number of beds available in specialist mental health services. The second theme, place, referred to the meaning given to social interactions created within space. Participants critiqued the privileging of non-Māori experiences, and how this makes a place and space of exclusion for Māori and their whānau in eating disorder services in New Zealand. Other barriers included shame and stigma, while enablers included family support and self-advocacy.ConclusionMore education is needed for those working in the space of primary health settings about the diversity of those with eating disorders to enable them to look beyond the stereotype of what an eating disorder looks like, and to take seriously the concerns of whaiora and whānau who present with disordered eating concerns. There is also a need for thorough assessment and early referral for eating disorder treatment to ensure the benefits of early intervention are enabled for Māori. Attention given to these findings will ensure a place for Māori in specialist eating disorder services in New Zealand.Graphical

Improving service delivery at primary healthcare facilities for achieving Universal Health Coverage: Examining the effects of insecurity in such facilities in Enugu State, Nigeria

Background: Availability of health services at the primary healthcare (PHC) level is crucial to the achievement of Universal Health Coverage (UHC). However, insecurity of PHC facilities inspires unavailability of health services. From perspectives of primary health service providers, we examined the effects of insecurity at rural and urban PHC facilities in Enugu, Nigeria. Methodology: The study adopts a qualitative method using in-depth interviews and non-participant observation. The study sites were eight (8) PHC facilities (rural/urban) that were purposively selected. The first author interacted with the health workers and made extensive observations on infrastructure, policing, and other security gaps affecting the facilities. Findings: While health workers wish to provide services as stipulated, the fear of getting hurt or losing their properties to hoodlums scares them, especially during the dusk hours. Owing to infrastructure deficits and lack of security personnel, incidents of losing phones, stolen babies and facility items/consumables, and patients being attacked were said to be recurring. The absence of power supply during the dusk hours tend to heighten their fears, hence health workers close before it gets dark, not minding the consequences on health service users. Conclusion: The issue of insecurity of lives of both the health workers and their clients is paramount to the optimal use of services in the PHC facilities. Insecurity is a priority concern for the health workers, and if not addressed could cause them to completely shun working in certain areas, or shun their jobs completely, with dire consequences for the achievement of UHC.

Challenges in Accessing and Delivering Maternal and Child Health Services during the COVID-19 Pandemic: A Cross-Sectional Rapid Survey from Six States of India.

Globally, the COVID-19 pandemic and its prevention and control policies have impacted maternal and child health (MCH) services. This study documents the challenges faced by patients in accessing MCH services, and the experiences of health care providers in delivering those services during the COVID-19 outbreak, explicitly focusing on the lockdown period in India. A cross-sectional study (rapid survey) was conducted in 18 districts from 6 states of India during March to June, 2020. The sample size included 540 MCH patients, 18 gynaecologists, 18 paediatricians, 18 district immunisation officers and 108 frontline health workers. Bivariate analysis and multivariable analysis were used to assess the association between sociodemographic characteristics, and challenges faced by the patients. More than one-third of patients (n = 212; 39%) reported that accessing MCH services was a challenge during the lockdown period, with major challenges being transportation-related difficulties (n = 99; 46%) unavailability of hospital-based services (n = 54; 23%) and interrupted outreach health services (n = 39; 18.4%). The supply-side challenges mainly included lack of infrastructural preparedness for outbreak situations, and a shortage of human resources. A holistic approach is required that focuses on both preparedness and response to the outbreak, as well reassignment and reinforcement of health care professionals to continue catering to and maintaining essential MCH services during the pandemic.

Exploring the emotional costs of abortion travel in the United States due to legal restriction

ObjectivesPregnant people have traveled across state and national borders for the purpose of abortion since at least the 1960s. Scholarship has robustly documented the financial and logistical costs associated with travel, but less work has examined the emotional costs of abortion travel. We investigate whether abortion travel has emotional costs and, if so, how they come about. Study designWe conducted in-depth interviews with 30 women who had to travel across state borders in the United States for abortion care because of their gestation. We analyzed findings thematically. ResultsInterviewees described having to travel to obtain abortion care as emotionally burdensome, causing distress, stress, anxiety, and shame. Because they had to travel, they were compelled to disclose their abortion to others and obtain care in an unfamiliar place and away from usual networks of support, which engendered emotional costs. Additionally, travel induced feelings of shame and exclusion because it stemmed from a law-based denial of in-state abortion care, which some experienced as marking them as deviant or abnormal. ConclusionsPeople who have to travel for abortion care experience emotional costs alongside financial and logistical costs. The circumstances of that travel—specifically, being forced to travel because of legal restriction and service unavailability—are foundational to the ensuing emotional burdens. Findings add to the emerging literature on how laws and other structures produce the stigmatization of abortion at interpersonal and individual levels. ImplicationsWith abortion bans following the overturning of the right to abortion and existing gestational limits in the US, more people will have to travel for abortion care. Attention to the emotional costs of abortion travel can help providers understand what their patients may be experiencing when they present for care.

Disruptions in Accessing Women's Health Care Services: Evidence Using COVID-19 Health Services Disruption Survey.

The world is experiencing the Coronavirus pandemic and the aftermath consequences leading to lockdown and travel restrictions. The pandemic has brought a far-reaching impact on various sectors, including the economic, and health sectors. Therefore, this study analyses the possible impact of the COVID-19 pandemic on the disruption - in accessing family planning measures i.e. contraception facilities; and in seeking help from women organizations for health services. This study has used the COVID-19 health services disruption survey-2020 and data was obtained from the Institute of Health Metrics and Evaluation. This survey was conducted in 76 countries using the smartphone-based premise data collection platform. Respondents were individual members of the general population ages 15-49 years who were identified as women. Data were collected from 12,354 respondents. Our data analysis has been done on both aggregate samples as well as region-wise samples (i.e. Africa, Asia, Europe, and Latin America & the Caribbean) to assess the change in levels of service delivery in both pre-COVID and post-COVID periods. Descriptive statistics results shows that two particular reasons - unable to access due to lockdown restrictions (5.4%), and fear of being infected with COVID-19 (9.7%) were reported as mostly impacting the access to contraception facilities due to lockdown restriction. Further, the logit regression using socio-economic and demographic variables suggests that geographical location (rural), and poor financial status turned out negative and significant, showing higher odds of facing difficulty than the reference category for the aggregate sample. The region-wise analysis suggests that Europe and Asia are the regions with the highest percentage of respondents reporting unavailability of services during COVID-19. The study concludes that pandemic-related emergencies affect the health care system, especially women-related health care services. The implication of our study indicates the requirement of a supply chain strategy for managing health care demand during emerging situations. So, the disruptions and bottlenecks in health care facilities should be addressed by various governments through appropriate policies and interventions.

Mobile Application Development for Disease Diagnosis based on Symptoms using Machine Learning Techniques

In recent times most of the people die due to unavailability of proper diagnosis and medical services. In such cases the patient doesn't have quick access to medical services or face difficulties in using them. This could be very helpful in those remote regions where proper medical services are not available in hand or the patient is in need of immediate medical attention. Therefore, we created a self-assessment application which uses the power of machine learning to predict around 40 diseases, based on the symptoms of the disease. In self-assessment it is important that the prediction from the model stays fairly accurate. The existing machine learning techniques suffer from various drawbacks, including decreased accuracy, which is of primary importance in such cases. Our proposed system diagnoses diseases from the symptoms using the following steps. Firstly, data preprocessing was done and then the data was passed through various machine learning classification models, like K Nearest Neighbor, Support Vector Machine, Decision Tree, Random Forest Classifier, Naïve Bayes and Artificial Neural Network. After performing hyper parameter optimization, the probability vectors of all the models are added and then divided by the number of models. The number of diseases to be shown on application screen depends on the threshold values. The predicted disease(s) is received from the model and they are sent back to the application, where they are shown to the user. Our model proves to be the best when compared to the existing models.

Stress and coping strategies among parents of children with cancer at Tikur Anbessa Specialized Hospital paediatric oncology unit, Ethiopia: a phenomenological study

ObjectiveThis study explores sources of stress, conditions that help reduce stress levels and coping strategies among parents of children with cancer receiving chemotherapy at Tikur Anbessa Specialized Hospital (TASH) in...