Need For Services Research Articles

Progress towards achieving national goals for improved quality of life among cis-gender Black women with HIV.

Data from the CDC's Medical Monitoring Project indicate that the United States is on track to meet one of five National HIV/AIDS Strategy (NHAS) Quality of Life goals among cisgender Black women, specifically, hunger/food insecurity. Substantial work needs to be done to improve self-rated health and to decrease unmet need for mental health services. Enhanced and coordinated action are necessary to reach all Quality of Life goals in this NHAS priority population.

Assessing the need for a dietetic service for patients attending a chemotherapy day unit

Assessing the need for a dietetic service for patients attending a chemotherapy day unit

Revolutionizing Healthcare: The Transformative Power of Artificial Intelligence

Abstract: The field of radiology is changing due to artificial intelligence (AI), which presents hitherto unheard-of chances to improve diagnostic efficiency and accuracy. The transformational potential of AI in radiology is examined in this research, with particular attention to how it might expedite clinical workflows and completely change picture interpretation. The first section of the abstract emphasizes the rising need for radiological services as well as the difficulties radiologists have in organizing massive amounts of patient data while maintaining prompt and precise diagnosis. The article goes on to discuss AI as a potent tool that radiologists may use to analyze pictures more confidently, spot abnormalities, and make clinical choices more quickly. The transformational potential of artificial intelligence (AI) in radiology is examined in this research, with a focus on how AI might enhance diagnostic efficiency and accuracy. It presents the potential of artificial intelligence (AI) to transform radiological practice by highlighting its strengths in image interpretation, anomaly detection, and clinical decision assistance. But there are drawbacks to using AI in radiology, including concerns about data privacy and algorithm transparency. In order to guarantee patient safety and confidence in AI-enabled radiological techniques, the study highlights the significance of responsible AI implementation. The study concludes by highlighting the revolutionary effects of AI on radiology and highlighting its potential as a tool to improve healthcare delivery and diagnostic accuracy.

Supplemental Material for Service Needs and Neurobehavioral Functioning Following Traumatic Brain Injury in U.S. Military Personnel

Supplemental Material for Service Needs and Neurobehavioral Functioning Following Traumatic Brain Injury in U.S. Military Personnel

Clients’ expectations and experiences with providers of menstrual regulation: a qualitative study in Bangladesh

BackgroundMenstrual Regulation (MR) has been legal in Bangladesh since 1979 in an effort to reduce maternal mortality from unsafe abortion care. However, access to high-quality and patient-centered MR care remains a challenge. This analysis aimed to explore what clients know before going into care and the experience itself across a variety of service delivery sites where MR care is available.MethodsWe conducted 26 qualitative semi-structured interviews with MR clients who were recruited from three different service delivery sites in Dhaka, Bangladesh from January to March 2019. Interviews explored client expectations and beliefs about MR care, the experience of the care they received, and their perception of the quality of that care. We conducted a thematic content analysis using a priori and emergent codes.ResultsClients overall lacked knowledge about MR care and held fears about the damage to their bodies after receiving care. Despite their fears, roughly half the clients held positive expectations about the care they would receive. Call center clients felt the most prepared by their provider about what to expect during their MR care. During counseling sessions, providers at in-facility locations reinforced the perception of risk of future fertility as a result of MR and commonly questioned clients on their need for MR services. Some even attempted to dissuade nulliparous women from getting the care. Clients received this type of questioning throughout their time at the facilities, not just from their medical providers. The majority of clients perceived their care as good and rationalized these comments from their providers as coming from a caring place. However, a handful of clients did report bad care and negative feelings about their interactions with providers and other clinical staff.ConclusionProviders and clinical staff can play a key role in shaping the experience of clients accessing MR care. Training on accurate knowledge about the safety and effectiveness of MR, and the importance of client communication could help improve client knowledge and person-centered quality of MR care.

“I do not know the advantages of having a general practitioner” - a qualitative study exploring the views of low-acuity emergency patients without a regular general practitioner toward primary care

BackgroundEmergency departments (ED) worldwide have to cope with rising patient numbers. Low-acuity consulters who could receive a more suitable treatment in primary care (PC) increase caseloads, and lack of PC attachment has been discussed as a determinant. This qualitative study explores factors that contribute to non-utilization of general practitioner (GP) care among patients with no current attachment to a GP.MethodQualitative semi-structured telephone interviews were conducted with 32 low-acuity ED consulters with no self-reported attachment to a GP. Participants were recruited from three EDs in the city center of Berlin, Germany. Data were analyzed by qualitative content analysis.ResultsInterviewed patients reported heterogeneous factors contributing to their PC utilization behavior and underlying views and experiences. Participants most prominently voiced a rare need for medical services, a distinct mobility behavior, and a lack of knowledge about the role of a GP and health care options. Views about and experiences with GP care that contribute to non-utilization were predominantly related to little confidence in GP care, preference for directly consulting medical specialists, and negative experiences with GP care in the past. Contrasting their reported utilization behavior, many interviewees still recognized the advantages of GP care continuity.ConclusionUnderstanding reasons of low-acuity ED patients for GP non-utilization can play an important role in the design and implementation of patient-centered care interventions for PC integration. Increasing GP utilization, continuity of care and health literacy might have positive effects on patient decision-making in acute situations and in turn decrease ED burden.Trial registrationGerman Clinical Trials Register: DRKS00023480; date: 2020/11/27.

Exploring the perceptions and experiences of community rehabilitation for Long COVID from the perspectives of Scottish general practitioners’ and people living with Long COVID: a qualitative study

ObjectivesTo explore the experience of accessing Long COVID community rehabilitation from the perspectives of people with Long COVID and general practitioners (GPs).DesignQualitative descriptive study employing one-to-one semistructured virtual interviews analysed...

Adverse Childhood Experiences, Women Who Are Sex Trafficked, and Social Service Utilization: Implications for Social Work.

The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p < .001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings.

Prohibiting Political Party Membership as a Condition for Receiving Political Service Retirement Benefits under Ethiopian Law: A Comparison with Kenya and Tanzania

Abstract This article questions the justification for restricting political party membership as a condition for receiving political service retirement benefits in Ethiopia (a restriction first imposed through the Administration of the President of the Federal Democratic Republic of Ethiopia Proclamation and endorsed in the Rights and Benefits of Outgoing Heads of State and Government, Senior Government Officials, Members of Parliament and Judges Proclamation). After reviewing relevant law, literature and comparative experience from Kenya and Tanzania, the article argues that prohibiting political party membership without a pressing need for non-partisan service is an unjust restriction on the right to freedom of political party membership. Benefits for retiring high-ranking government officials are part of the right to social security and should not be disallowed based on political party membership.

The role of financial support in preventing the need for child protection services: a mixed method study on the effects and pathways of additional income support

ABSTRACT Previous studies show that household economic insecurity is associated with poor child health and an increased risk of child maltreatment. Therefore, it can be assumed that family financial support can also prevent the need for child protection services. This study asks: What is the association of families’ poverty and granted additional income support with the need for child protection services, and through which pathways does this effect arise? The research is mixed method, and based on Finnish municipality-specific statistical data in 2019 (Sotkanet Indicator Bank, 294 municipalities) and interviews with Finnish social workers (N = 23). Linear regression analysis and qualitative methods were employed. The study shows that poverty has a positive association with the need for child protection services, but on the other hand, additional income support buffers this effect. The research has also revealed pathways through which additional income support prevents the need for child protection services. Through the interviews, pathways of immediate material help, alleviating economic stress and supporting parenting, as well as strengthening social inclusion were identified. Furthermore, the importance of social work and its cooperation practices emerged in the study.

Outcomes of Comprehensive Service Delivery and Early Interventions in Countering Youth Exclusion

AbstractThe high rates of young people not in employment, education, or training (NEET) are an international concern. At the core of the European Union’s (EU), policy agenda is the reduction of youth unemployment and the active engagement of as many young people as possible in the workforce. The need for holistic services, interagency collaboration, and early intervention have been highlighted as important measures to reduce the risk of youth becoming NEET and subject to long-term unemployment. However, although highlighted as important, little is known about how these factors affect NEET rates. This study addresses this issue by exploring whether comprehensive service delivery, including holistic and collaborative approaches, and early interventions aimed at preventing youth from disengaging from education or employment, may explain the outcome of local NEET rates. Empirically, this study consists of multiple steps. An initial multilevel regression analysis of all Norwegian municipalities provided the basis for strategically selecting 18 municipalities based on their consistently higher or lower NEET rates than predicted when controlling for individual and structural factors that are shown to impact NEET risk. Semi-structured interviews in these municipalities regarding local work with NEETs provided the data, which were analysed using a fuzzy-set qualitative comparative method (fsQCA). The results suggest that the engagement of public employment and social services (PESS) in early intervention measures aimed at preventing youth from ending up in a NEET situation, combined with either extensive collaboration with other services or a holistic-oriented local (mental) healthcare service, may indeed explain lower NEET rates.

Innovating Services for Justice-Involved Individuals with Fetal Alcohol Spectrum Disorder: The In Reach Project

ABSTRACT Fetal Alcohol Spectrum Disorder (FASD) is a term describing the range of neurocognitive, physical, behavioral, and learning difficulties resulting from prenatal alcohol exposure. Individuals with FASD are at an increased risk, relative to those without FASD, for justice system involvement. To address this concern, the Willow Winds Support Network developed and implemented the In Reach project to provide FASD-specific services and supports to residents and staff of justice facilities in Alberta, Canada. Semi-structured interviews revealed facilitators of the project’s success, emerging outcomes, and the perceived need for FASD-specific services in justice facilities. Research, practice, and policy implications are discussed.

Current clinical practice of Irish physiotherapists and occupational therapists in the assessment and treatment of spasticity in adults

Purpose This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in adults, to inform and improve spasticity management practice. This study also aims to describe therapists’ knowledge, confidence and perceived barriers in the management of spasticity. Design/methodology/approach A cross sectional survey design study was completed, and respondents were recruited through an online survey. Findings In total, 92 respondents from a wide range of clinical settings revealed there is considerable variation in services available nationally for adults presenting with spasticity. There were significant inconsistencies across all areas of practice. The majority of respondents (94%) did provide intervention to patients with spasticity, yet three quarters did not have access to a specialist spasticity clinic, and the majority (82%) did not feel they were providing sufficient treatment intensity for spasticity. Originality/value These findings provide a unique insight into the assessment and treatment practices of Irish physiotherapists and occupational therapists. These results demonstrate the need for further upskilling and specialist high-quality spasticity services nationally.

Neighborhood material versus social deprivation in Canada: different patterns of associations with child and adolescent mental health problems.

In a nationwide study, we aimed to study the association of neighborhood deprivation with child and adolescent mental health problems. We used data from the Canadian Health Survey on Children and Youth (N = 47,871; age range: 1-17years) and linked these to Neighborhood Material and Social Deprivation data calculated using Canada's Census of Population. Using a series of logistic regressions, we studied the association between living in deprived areas and mental health problems among children and youth. We used bootstrap replicate weights for all analyses and adjusted them for individual sociodemographic characteristics. In the adjusted model, the parent-reported developmental disorder was associated with more socially deprived neighborhoods (OR 1.29; 95% CI 1.07, 1.57 for most vs. least deprived quintiles). However, mental health service need or use was associated with living in less materially deprived areas (OR 0.78; 95% CI 0.63, 0.96 for most vs. least deprived quintiles). Among mental health problemsreported by the youth (12-17years old), poor/fair general mental health, alcohol drinking, and cannabis use were associated with neighborhood social deprivation in the adjusted models. In contrast, poor/fair general mental health, suicide ideas, alcohol drinking, and cannabis use were all negatively associated with higher materially deprived quintiles. Our study provides further support for the existing evidence on the association between neighborhood deprivation, particularly social deprivation, and the mental health of children and adolescents. The findings can help public health policymakers and service providers better understand and address children's mental health needs in their neighborhoods.

The use of telecytology for the evaluation of thyroid nodules fine-needle aspiration biopsy specimens: a systematic review.

Fine needle aspiration biopsy (FNAB) is currently the gold standard for diagnosis and treatment of thyroid nodules, but the growing need for anatomic pathology services in small communities is becoming a challenge. Telecytology (TC) is defined as the electronic transmission of cytological digital images, and allows for the collection of samples, primary diagnosis, and other applications without the physical presence of a pathologist. Our aim is to systematically report, summarize, and critically analyze the most up to date applications of TC to thyroid nodules FNAB evaluation. We performed a systematic literature review by searching PubMed, Embase, and Cochrane Library databases. Only studies published in peer-reviewed scientific journals were included. Data were extracted using the PICO framework and critically analyzed. PRISMA guidelines were applied, and the risk of bias in the included studies was assessed using the ROBINS-I tools. The methodological quality was assessed following GRADE criteria. We included 13 observational studies, resulting in a total of 3856 evaluated FNAB specimens. The majority of studies (63.6%) showed an excellent concordance rate of diagnosis via TC and conventional cytology. TC can be used to perform preliminary assessment of samples with a concordance rate ranging from 74 and 100%, showing a significant reduction of the non-diagnostic rate. Image quality was referred to as perfect or nearly perfect in most cases, regardless of telecytology technique. Telecytology could be a valuable implementation for thyroid FNAB evaluation both for primary diagnosis and preliminary assessment of samples.

Trauma exposure across the lifespan among individuals engaged in treatment with medication for opioid use disorder: differences by gender, PTSD status, and chronic pain

BackgroundThere is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain.MethodsA cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind–body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression.ResultsParticipants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%).ConclusionThe study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment.Trial registrationNCT04082637.

Response of NiCrAl-bentonite abradable seal coatings to thermal/salt corrosion

The growing need for engine services in marine environments has resulted in increasing salt and coupled corrosion of abradable seal coatings (ASCs). In this study, the response of NiCrAl-bentonite ASCs to thermal/salt corrosion was assessed. The results indicated that NiCrAl-bentonite ASCs could provide excellent protection for TC4 alloys in marine environments. NiCrAl-bentonite ASCs retained their low hardness and high strength and exhibited good abradability in chloride-rich environments. Compared with the Al-, Ni-, and YSZ-based coatings, the proposed coating demonstrated improved synergy between strength and hardness/abradability. This research provides valuable insights into the reliable use of NiCrAl-bentonite ASCs in marine environments.

Access to Psychiatric and Education Services During Incarceration in the United States.

Individuals with psychiatric disorders are incarcerated at disproportionately high rates and often have low educational attainment. Access to psychiatric and education services within prisons has been described as inadequate, but recent data are lacking. The authors sought to assess the association of psychiatric disorders with both educational attainment before incarceration and access to psychiatric and education services during incarceration. Data were from the 2016 Survey of Prison Inmates, a national survey of adults incarcerated in U.S. state and federal prisons (N=24,848). Multinomial regression was used to identify associations of educational attainment before incarceration with psychiatric disorders and sociodemographic factors. Multivariable logistic regression models were used to assess associations of psychiatric disorders with access to psychiatric and education services during incarceration and with sociodemographic factors. Before incarceration, 57.3% of survey respondents had less than a high school diploma. Across four education and psychiatric services, only 8.4%-44.8% of respondents reported participating in these services during incarceration, despite 57.3% reporting a psychiatric or learning disorder. Psychiatric disorders were associated with lower educational attainment before incarceration and lower access to education services during incarceration. Psychiatric disorders were associated with higher odds of access to psychiatric services during incarceration. Men had lower educational attainment before incarceration and lower odds of accessing psychiatric and education services during incarceration. Incarcerated people had a high need for psychiatric and education services. Individuals with psychiatric disorders had lower odds of participating in education services during incarceration, highlighting the need for policies and services that increase participation.

The chiropractors' dilemma in caring for older patients with musculoskeletal complaints: Collaborate, integrate, coexist, or separate?

The world's elderly population is growing at a rapid pace. This has led to an increase in demand on the health and welfare systems due to age-related disorders, with musculoskeletal complaints driving the need for rehabilitation services. However, there are concerns about health services' ability to meet this demand. While chiropractic care is gaining recognition for its benefits in treating older adults with musculoskeletal disorders, there is limited scientific literature on chiropractors' role and experiences in this area. To bridge this gap, we interviewed 21 chiropractors in Great Britain, the Netherlands, Norway, and Sweden. Inductive qualitative content analysis was used to analyse the interviews, and despite differences in integration and regulation between the countries, several common facilitators and barriers in caring for and managing older patients with musculoskeletal complaints emerged. While participants expressed optimism about future collaborations with other healthcare professionals and the integration of chiropractic into national healthcare systems, they also highlighted significant concerns regarding the existing healthcare infrastructure. The participants also felt that chiropractors, with their non-surgical and holistic approach, were well-positioned to be the primary point of contact for older patients. However, there were some common barriers, such as the affordability of care, limited integration of chiropractic, and the need to prioritise musculoskeletal complaints within public healthcare. Our findings suggest that chiropractors experience their clinical competencies as an underutilised resource in the available healthcare systems and that they could contribute to and potentially reduce the escalating burden of musculoskeletal complaints and associated costs among older patients. Additionally, our findings highlight the desire among the participants to foster collaboration among healthcare professionals and integrate chiropractic into the national public healthcare system. Integrating chiropractors as allied health professionals was also perceived to improve coordinated, patient-centred healthcare for older adults.

Artificial Intelligence for Detecting Periodontitis: Systematic Literature Review

Background The determination of the diagnosis of inflammatory periodontitis is generally based on clinical examination, which is then strengthened by radiographic examination. Still, the inequality of assessment of clinical conditions, along with limitations of radiographic interpretation, makes determining the diagnosis of the periodontal disease difficult. The use of artificial intelligence as a digital system approach is believed to reduce costs, time, the need for medical services, and medical errors that may occur due to human factors. Objective This systematic review study is to analyze the use of dental and panoramic radiographs combined with the use of artificial intelligence in establishing the diagnosis of periodontitis based on the parameters of periodontal disease severity according to the 2017 American Academy of Periodontology/European Federation of Periodontology Workshop (pocket depth, clinical attachment loss (CAL) and the pattern and level of alveolar bone damage that occurs). Methods Journal searches for articles published in English were carried out through the PubMed and Scopus databases in the 2011-2021 period, using the search terms periodontitis, periodontal disease, food impaction, trauma occlusion, periapical radiograph, panoramic, machine learning, artificial intelligence, and periodontal bone loss, after going through article selection, two suitable articles were obtained. Results Two studies fell into the analyzed category. Both list periodontal bone loss as a parameter that marks periodontitis, and the use of panoramic photos in detecting this parameter assisted by Convolutional Neural Networks as artificial intelligence. Conclusion The use of panoramic radiographs and Convolutional Neural Networks as artificial intelligence that serves as a tool to detect periodontal bone damage has almost the same results as experienced clinicians In order for this method to be developed in the future to help clinicians establish the diagnosis, more clinical and image data will be required.