Limited Opening Hours Research Articles

Daily changes in household water access and quality in urban slums undermine global safe water monitoring programmes.

Global drinking water monitoring programmes and studies on water quality in urban slums often overlook short-term temporal changes in water quality and health risks. The aim of this study was to quantify daily changes in household water access and quality in an urban slum in Malawi using a mixed-method approach. Household drinking water samples (n=371) were collected and monitored for E. coli in tandem with a water access questionnaire (n=481). E. coli concentrations in household drinking water changed daily, and no household had drinking water that was completely safe to drink every day. Seasonal changes in drinking water availability, intermittent supply, limited opening hours, and frequent breakdown of public water points contributed to poor access. Households relied on multiple water sources and regularly switched between sources to meet daily water needs. There were generally similar E. coli levels in water samples considered safe and unsafe by residents. This study provides the first empirical evidence that water quality, water access, and related health risks in urban slums change at much finer (daily) temporal scales than is conventionally monitored and reported globally. Our findings underscore that to advance progress towards Sustainable Development Goal (SDG) Target 6.1, it is necessary for global water monitoring initiatives to consider short-term changes in access and quality.

Global pandemic and business performance

The COVID-19 pandemic is anticipated to continue to the year 2022 and could lead to several business failures if entrepreneurs do not respond adequately. Thus, the purpose of this study is to introduce a framework that captures the impacts and potential responses to the ongoing pandemic. To do that, we conducted telephone interviews with ten entrepreneurs who operate enterprises within Nigeria. Data collected for analysis were transcribed, chronologically arranged, coded, and thematically analyzed using NVivo. Our findings revealed that, during the pandemic, businesses experienced limited opening hours, a decline in their clients' patronage, lower turnover, and employee demotivation. In response, business owners should consider re-strategizing their business activities, maintaining connections with clients, and exploiting available support measures. Our findings have profound theoretical and practical implications. For entrepreneurs and policymakers, they offer insights into the form of challenges confronting businesses during a pandemic. It also provides response activities that entrepreneurs could adopt to mitigate the impact of an epidemic on their enterprises’ performance. For the field of entrepreneurship, it advances the need to integrate public health (health-related issues) into entrepreneurship study and consider its multiple levels of influence on the performance of businesses.

A qualitative study of facilitators and barriers to participate in a needle exchange program for women who inject drugs

BackgroundWomen who inject drugs (WWID) show higher levels of injecting risk behaviour compared to men, putting them at risk of contracting HIV and hepatitis C (HCV). Compared to men, WWID are also less present in harm reduction programs such as needle exchange programs (NEP). The aim of this study is to investigate reasons for, and barriers to, participation in NEP among WWID in Sweden, and to identify measures that could be taken to strengthen the program and increase participation among WWID.MethodIn-depth interviews (IDIs) were conducted with 20 WWID who had participated in the Stockholm NEP for at least six months and was over 18 years old. IDIs were audio recorded and transcribed et verbatim. Qualitative content analysis was used to identify themes.ResultsThe need for sterile injection equipment was identified as the main driver to join and remain in the NEP program. Continuous participation in the NEP was further driven by easy access to a multitude of health-related services. The most valued service was the sexual and reproductive health services (SRHR), allowing participants to access contraceptives, cervical cancer screening and sexually transmitted infections testing (STI-testing). NEP staffs’ respectful treatment of participants further contributed to program participation. However, participants also expressed a number of concerns around NEP participation, which created barriers to joining. These included losing custody or visitation rights to children, male partner jealousy and violence, unwillingness to spend time in the waiting area and fear of receiving positive HIV/HCV test results. Practical barriers included limited opening hours and travel distance to the NEP. To strengthen the program, most participants requested additional SRHR services. Most participants also proposed some form of “women only” access to the NEP, to strengthen the feeling of the NEP as a safe space.ConclusionThis study identified factors that may increase uptake of NEP among WWID. Additional SRHR services and “women only” access are recommended to be implemented and evaluated as part of NEP. These findings may inform and improve the current scale-up of NEPs in Sweden to ensure equal access to services.

Youth access clinics in Gippsland: Barriers and enablers to service accessibility in rural settings.

Approximately 15 years ago, four youth access clinics (YACs) were established in the Gippsland region to improve mental and general healthcare for young people living in the region. The aim of the study was to examine the barriers and enablers for young people accessing the YACs in Gippsland. Using qualitative methodology, nine female YAC staff members and seven youth YAC consumers were interviewed. Thematic analysis was utilized to identify important and consistent themes in the data derived through the consultation process. Barriers under four themes were identified: environmental (eg, limited transport); service (ie, limited opening hours); client (eg, parent permission) and staff (ie, retention of staff). Enablers were identified as environmental (ie, high social proximity), service (eg, funding), client (ie, awareness of service) and staff (eg, champion staff). The success of new rural service models will likely depend on learning from what has already worked in some of the many small communities in this region. Beyond learning, further success and uptake of new service offerings will be enhanced through understanding community needs, obtaining community support and enhancing high social proximity.

"That's a double-edged sword": Exploring the integration of supervised consumption services within community health centres in Toronto, Canada.

Supervised consumption services (SCS) have been integrated into community health centres in Toronto. We draw on qualitative interviews and ethnographic observations to examine the implementation contexts of these SCS. Participants' perspectives on the integration of SCS within CHCs were mixed. Some participants identified the benefits of integrated SCS such as convenience and access to other health and social services. However, others identified negative consequences of integration, including building design, lack of privacy and anonymity, and limited hours of operation. These perspectives highlight the ways in which contextual factors affect the experiences of clients in accessing SCS, and suggest that various factors need to be considered in order to improve service uptake.

Patients’ Satisfaction regarding Treatment and Perceived Barriers: A Study of Social Health Insurance Scheme in Kaski District

The main objective of this paper is to assess the level of patient satisfaction, to assess barriers faced by users of social health insurance during receiving treatment in the hospital, and to find out the relationship of participants' satisfaction with their selected demographic variables. This paper is a cross-sectional descriptive study and covers 354 samples that were selected by systematic sampling technique. The modified version of Assessment of Patients Satisfaction Scale (SAPS) consisting of seven structured items is used to collect the data through the face to face interview. The results of the study indicated that 158 (44.6%) participants are between the age group of 40-59 years and the majority of them i.e. 232 (65.5%) are females. Out of 354, most of the participants 292 (82.5%) are enrolled in the social health insurance scheme for more than 6 months. The study findings indicated that more than half 186 (52.5%) participants are satisfied, followed by 152 (42.9%) are dissatisfied, and 16(4.5%) of participants are very dissatisfied with the treatment service under the social health insurance respectively. The most common barriers faced by the participants while utilizing the health insurance services are unavailability of necessary drugs, long waiting times, limited opening hours, and complex billing system for insurance patients. Hence, the service availability time should be extended and availability of health personnel, medicines as well as other services should be improved that can increase satisfaction among users of health insurance.

Engaging Fathers in Early Obesity Prevention During the First 1,000 Days: Policy, Systems, and Environmental Change Strategies.

Fathers are critical stakeholders in childhood obesity prevention but are difficult to engage. This review presents a new approach to engaging fathers in obesity prevention during the first 1,000days. The review focuses on five existing health and social service programs, including prenatal care, pediatric care, the Special Supplemental Nutrition Program for Women, Infants, and Children, home visiting, and Early Head Start. For each program, the obesity prevention services provided, evidence of father engagement, and barriers thereto are outlined. Subsequently, policy, systems, and environmental strategies are outlined to address the noted barriers and promote father engagement. Although the programs hold great promise in bringing obesity prevention services to fathers, barriers to their engagement are present in the inner (e.g., limited hours of operation, lack of father-specific materials and programming) and outer (e.g., lack of model programs, best practice models, and consistent funding) settings of programs. Policy, systems, and environmental strategies to increase father engagement focus on earmarked funding, changes to national practice guidelines and practitioner training requirements, and the establishment of father-engagement performance metrics. Increasing father involvement in the specified programs will likely increase their engagement in early obesity prevention in an efficient and sustainable manner.

Pengembangan Algoritma Hybrid Restart Simulated Annealing with Variable Neighborhood Search (HRSA-VNS) untuk penyelesaian kasus Vehicle Routing Problem with Time Windows (VRPTW)

<p><em>Determining the vehicle routing is one of the important components in existing logistics systems. It is because the vehicle route problem has some effect on transportation costs and time required in the logistics system. In determining the vehicle routes, there are some restrictions faced, such as the maximum capacity of the vehicle and a time limit in which depot or customer has a limited or spesific opening hours (time windows). This problem referred to Vehicle Routing Problem with Time Windows (VRPTW). To solve the VRPTW, this study developed a meta-heuristic method called Hybrid Restart Simulated Annealing with Variable Neighborhood Search (HRSA-VNS). HRSA-VNS algorithm is a modification of Simulated Annealing algorithm by adding a restart strategy and using the VNS algorithm scheme in the stage of finding neighborhood solutions (neighborhood search phase). Testing the performance of HRSA-VNS algorithm is done by comparing the results of the algorithm to the Best Known Solution (BKS) and the usual SA algorithm without modification. From the results obtained, it is known that the algorithm perform well enough in resolving the VRPTW case with the average differences are -2.0% with BKS from Solomon website, 1.83% with BKS from Alvarenga, and -2.2% with usual SA algorithm without any modifications.</em></p><p><em>Keywords : vehicle routing problem, time windows, simulated annealing, VNS, restart</em></p>

Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

BackgroundAccess to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers’ experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC.MethodsData was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers’ Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013).ResultsIn total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10–1.94), workplace- (AOR = 1.31, 95% CI 1.05–1.63), and community-level violence (AOR = 1.41, 95% CI 1.04–1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03–1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34–2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59–7.57) emerged as independent correlates of institutional barriers to health services.DiscussionDespite Canada’s UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex workers’ health and human rights.

Barriers to Cervical Screening Among Sex Workers in Vancouver.

We longitudinally examined the social, structural, and geographic correlates of cervical screening among sex workers in Metropolitan Vancouver, British Columbia, to determine the roles that physical and social geography play in routine reproductive health care access. Analysis drew on (2010-2013) data from an open prospective cohort of sex workers (An Evaluation of Sex Workers' Health Access). We used multivariable logistic regression with generalized estimating equations (GEE) to model correlates of regular cervical screening. At baseline, 236 (38.6%) of 611 sex workers in our sample had received cervical screening, and 63 (10.3%) were HIV-seropositive. In multivariable GEE analysis, HIV-seropositivity (adjusted odds ratio [AOR] = 1.65; 95% confidence interval [CI] = 1.06, 2.58) and accessing outreach services (AOR = 1.35; 95% CI = 1.09, 1.66) were correlated with regular cervical screening. Experiencing barriers to health care access (e.g., poor treatment by health care staff, limited hours of operation, and language barriers) reduced odds of regular Papanicolaou testing (AOR = 0.81; 95% CI = 0.65, 1.00). Sex workers in Metropolitan Vancouver had suboptimal levels of cervical screening. Innovative mobile outreach service delivery models offering cervical screening as one component of sex worker-targeted comprehensive sexual and reproductive health services may hold promise.

A branch-and-bound algorithm for shift scheduling with stochastic nonstationary demand

Many shift scheduling algorithms presume that the staffing levels, required to ensure a target customer service, are known in advance. Determining these staffing requirements is often not straightforward, particularly in systems where the arrival rate fluctuates over the day. We present a branch-and-bound approach to estimate optimal shift schedules in systems with nonstationary stochastic demand and service level constraints. The algorithm is intended for personnel planning in service systems with limited opening hours (such as small call centers, banks, and retail stores). Our computational experiments show that the algorithm is efficient in avoiding regions of the solution space that cannot contain the optimum; moreover, it requires only a limited number of evaluations to encounter the estimated optimum. The quality of the starting solution is not a decisive factor for the algorithm׳s performance. Finally, by benchmarking our algorithm against two state-of-the-art algorithms, we show that our algorithm is very competitive, as it succeeds in finding a high-quality solution fast (i.e., with a limited number of simulations required in the search phase).

Self-Medication: A Nationwide Representative Survey on Motives, Reasons and Sources on Consuming Over-the-Counter Medication

Self-medication, meaning the autonomous treatment of self diagnosed diseases with non-prescription drugs, has become an increasingly relevant topic - not the least because since 2004 most non-prescription drugs were no longer refunded by statutory health insurance, due to the GKV-Modernisierungsgesetz. In light of the above, the central questions that motivate this paper are the following: - Where does the german population obtain information about non-prescription drugs? - Which health impairments are treated with non-prescription drugs before seeing a doctor and for what reasons? - Which habits, experiences and estimates concerning self-medication are shared? To answer these questions the GfK market research institution in Nürnberg conducted a survey treating different topics from 7(th) to 21(st) December 2012. The sample selected by the quota method is considered to be representative for the population of men and women aged 14 and above in Germany and is based on a total of 1 976 personal interviews. 94.9% of those questioned did treat at least one of the 25 symptoms included in the survey with non-prescription medicine before potentially seeing a doctor. The most common place to obtain information about OTC products is pharmacies. The symptoms most commonly treated by oneself are cold symptoms and headaches. The evidence from this study suggests a variety of factors explaining this behavior. Most of the respondents do not want to see a doctor over minor issues, i. e., think their health problems are not severe enough require consulting a doctor. Furthermore long waiting times and limited opening hours are mentioned. The majority of the respondents had good experiences with self-medication. However, some of the participants keep their OTC use from their treating physicians. In conclusion, it becomes evident that both opportunities and risks come with self-medication. Strategies to capitalize those opportunities and mitigate these risks are presented, with the trusted relationship between physician and patient playing critical role.

Emerging Opportunities for Commercial Recreation

The commercial recreation industry faces new opportunities due to the changing economic climate and its impact upon public recreation providers (Outdoor Industry Association, 2012). Those recreation opportunities historically offered by public entities are transforming and as a result recreationists are experiencing more park closures, limited hours of operation, a reduction in quality, and ultimately dissatisfaction (Crompton, 1999; Koeberer, 2011). There is a shift occurring and this opens up a wide market for new commercial recreation operators to fulfill this gap. For trail-based recreation this usually requires a sizable piece of land that often precludes most potential market interests. However, with a new approach to commercial recreation enterprise via partnerships, this market can be better utilized while serving a distinct population. The Kingdom Trails Association (KTA) in northeastern Vermont is a model success story for this type of partnership enterprise and offers valuable information for other entrepreneurs wishing to create similar opportunities. KTA provides 110 miles of well-designed trails on 57 different private land owner parcels and two public sites. Facing similar challenges of a commercial business, they have grown to fulfill a new niche in trail-based recreation and now draw over 60,000 visitors a year, have an economic impact of more than $5.6 million, and are entirely self-funded. The story of how this entity grew from an idea by a few local mountain bikers to become “Best Trail System in North America” (Bike magazine, 2008), and “Best of New England” (Travel and Life, 2011), provides a unique look into developing trends in outdoor recreation and ways that commercial interests can serve them.

A Branch-and-Bound Algorithm for Shift Scheduling with Nonstationary Demand

Many shift scheduling algorithms presume that the staffing levels, required to ensure a target customer service, are known in advance. Determining these staffing requirements is often not straightforward, particularly in systems where the arrival rate fluctuates over the day. We present a branch-and-bound approach to estimate optimal shift schedules in systems with nonstationary demand and (stochastic) service level constraints. The algorithm is intended for personnel planning in small-scale service systems with limited opening hours (such as small-scale call centers, banks, and retail stores). Our computational experiments show that the algorithm efficiently explores the solution space and quickly finds an optimum (even if an inferior starting solution is used).

Interactive three-dimensional geovisualization of space–time access to food

A majority of literature about food deserts is focused on geographic access to food retailers by a buffered distance differentiating high and low access. An overlooked facet in this representation is that food acquisition is not only geographically dictated, but it is also temporally constrained. Food retailers invariably have limited opening hours that create a temporal restriction for shoppers. In this paper, a three-dimensional (3D) construct was proposed to delineate the limited food access to a retailer location across space and over its time of operation. Food retailer data in Columbus, OH, USA were collected for examining the variation of food access on both spatial and temporal scales. This study also employed the technique of interactive 3D modeling in a geographic information system (GIS) to visualize the food environment to delimit where and when food is accessible on a daily basis. The interactive 3D geovisualization (visualization of geographic information) of space–time access contributed to improving the representation of food environment and exploring the inequity of food access across space and over time. The development of this geovisualization context for food science studies could assist public health professionals and government stakeholders in understanding the effect of temporal access and improving food access for regions with limited operation hours in policy formulation.

Valuing the quality of strategic ferry services to remote communities

Ferry service quality is important to the economic and social prosperity of remote island and coastal communities. This paper shows how users value the quality attributes of ferry routes serving long distance traffic. It therefore adds to the thin evidence base on willingness to pay values for changes in ferry frequency and operating hours of strategic routes with low frequencies and limited hours of operation. An important finding, from a ferry management perspective, is that the quality of the ferry service matters to users. The value of increasing the operating day and reducing headways for ferry services of a strategic nature is positive. Ensuring the operating day is of a similar length to the working day is more important to users than extending the service into the evening or night. Users also do not seem to value headways below 3h. Given an environment of fiscal constraints and falling subsidy levels, ferry operators in remote regions should in the first instance maintain the operating day and reduce frequencies — should headways already be lower than 3h. If there is a need to reduce the operating day ideally it should not be reduced below that of the working day.

Bedouin-Arab women's access to antenatal care at the interface of physical and structural barriers: A pilot study

Since 2000, the Israeli Public Health Services have established eight Maternal-and-Child-Health (MCH) stations in unrecognised Bedouin-Arab villages in South Israel in order to reduce barriers to healthcare. The goals of this pilot study were: (1) to explore the new MCH stations’ impact on antenatal care (ANC) accessibility; and (2) to compare access to ANC between women from villages with MCH stations and women from villages without MCH stations. The study combined quantitative and qualitative methods including structured interviews with 174 MCH service users, review of 158 ANC records and 16 in-depth interviews with Bedouin-Arab women. The establishment of MCH stations in unrecognised villages has improved physical access to ANC and secondarily diminished other barriers related to financial and sociocultural dimensions of women's access to healthcare, thus enhancing women's options for independent healthcare-seeking; yet, limited opening hours, staff shortages and communication problems hamper ANC delivery at the new MCH stations. This pilot study indicates that the MCH stations’ establishment in unrecognised villages was a successful intervention, which improved women's access to ANC. Even though current service delivery challenges need to be overcome to achieve the intervention's full potential, its replication should be considered in further villages.

Health-seeking challenges among homeless youth.

Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults. The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons. This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults. Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general). Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services.

Missteps, Misunderstandings, and Missed Opportunities: HIV Testing Among Young African Americans

Missteps, Misunderstandings, and Missed Opportunities: HIV Testing Among Young African Americans

Characteristics of Supervised Visitation Programs Serving Child Maltreatment and Other Cases

Supervised visitation programs allow parents who may be a risk to their children or to another parent to experience parent–child contact while in the presence of an appropriate third party. Use of a ‘‘neutral third party’’ to oversee such contact has long been recognized as essential in child maltreatment cases in which the child has been removed from the home. This paper presents the results of an exploratory study of the structural and functional characteristics of 47 supervised visitation programs in Florida. Findings indicated that programs are typically operated on small budgets, with the related challenges of limited hours of operation, delayed or denied services to families in need, small and/or unpaid staff, and inadequate security measures. Recommendations for stable and sufficient funding as well as statutory legitimization are provided. [Brief Treatment and Crisis Intervention 7:291–304 (2007)]