Utilization Patterns Research Articles

Conservation perceptions and attitudes regarding monitor lizards in West Bengal, India

Local and illegal exploitation of wildlife is particularly widespread in highly populated and bio-diverse countries such as India. In such countries, illicit utilization practices and how these are perceived among local communities are commonly not well-documented. Due to a lack of data, and environmental education measures to protect ecosystems and biodiversity, the extent of this exploitation appears immense and often goes unnoticed. Therefore, in 2019, a series of awareness workshops targeting the conservation of wildlife focused on monitor lizards (Varanidae) was conducted in five districts of West Bengal, India. The environmental awareness workshops were conducted through PowerPoint slide presentations and questionnaires collecting baseline data from the participants regarding their perceptions and relationships to the three species of Varanus recorded for West Bengal. Our findings reveal specific human attitudes and varying local utilization patterns of monitor lizards. This study was the first to communicate and spread awareness in the study areas about why the conservation of local wildlife such as Varanus species is important for ecosystems and human well-being based on the ‘Nature Contributions to People Concept’.

Strategies for feeding tilapia in smallholder aquaculture systems: a study of aquaculture feed access and availability in two districts of Northern Province, Zambia

ABSTRACT Aquaculture contributes to agricultural development, economic growth, and poverty reduction initiatives in Zambia. In northern and rural regions of the country, development requires improvements to the management of local and farm-generated inputs. Fish farmers have limited market access and purchasing power, which restricts access to commercial inputs, such as formulated feeds and chemical fertilizers. Instead, farmers adopt integrated-agriculture-aquaculture (IAA) practices, whereby on-farm resources supply essential inputs. Research is limited regarding local systems of resource management, and this hinders development of innovations for improving efficiency. This mixed-methods study explored local patterns of resource utilization. Smallholders (n = 63) participated in surveys and interviews regarding resource management. A series of quantitative analyses, including descriptive statistics, principal component analyses (PCA), and multinomial logistic regression (logit) models, identified relationships between these resources, household livelihood, and system productivity. Qualitative analyses explored farmer perceptions regarding seasonal resource availability. Results suggested that livestock manure, homemade feeds comprising maize and soybean, garden residues, and kitchen wastes were the most frequently selected inputs. Logit models of feeding intensity found that income, proximity to Luwingu Town, experience in aquaculture, and access to extension services were key household resources. High-intensity feeding strategies incorporated commercial feeds, chemical fertilizers, as well as home-made feeds containing a wide diversity of both high- and low-quality ingredients. Low-intensity feeding strategies incorporated only farm waste and termites. Potential innovations that may improve system performance in resource poor contexts are considered and recommendations for additional research are offered.

Does Intellectual Capital Influence Firm's Financial Performance in Bangladesh?

This paper aimed to find the effects of intellectual capital and its components on firms’ financial performance in Bangladesh. A sample of 100 firms comprised of 48 manufacturing, 21 services, and 31 banking companies was studied for five years from 2017 to 2021, setting 500 firm-year observations. Data was collected purposively from secondary sources, such as annual reports of sampled companies. The robust fixed-effect regression model using STATA 14.2 software was applied to test the hypothesis due to autocorrelation and heteroscedasticity problems. The regression results documented that overall IC, human capital efficiency (HCE), and capital employed efficiency (CEE) positively and significantly enhanced the ROA and ROE of the firms. However, structural capital efficiency (SCE) and relational capital efficiency (RCE) negatively and insignificantly influenced the same. The study contributes to resource-based theory using econometric methods to extend the samples of both financial and non-financial companies. This study helps investors, managers, policy-makers, governments, and accounting regulatory bodies regarding the utilization pattern of invisible and tangible resources in Bangladeshi firms.

Ten‐year analgesic utilization patterns and economic implications in Portugal

AbstractAimsThis study evaluated the 10‐year consumption and economic patterns of classical analgesics, adjuvants and opioids in Portugal (2012‐2022), and conducted a comparative analysis between Portugal, Spain and Denmark to explore the consumption patterns among these countries for 2022.MethodsData on sales and national health service (NHS) costs were obtained from the Portuguese National Authority of Medicines and Health Products. Sales data were converted to defined daily dose (DDD) per 1000 inhabitants per day according to the Anatomical Therapeutic Chemical (ATC) classification/DDD methodology, while comparisons between Spain and Denmark were evaluated with the chi‐square test, when appropriate.ResultsThe findings reveal that classical analgesics use in Portugal remained stable during the period 2012‐2022, with ibuprofen being the most consumed. Adjuvants, specifically gabapentinoids, experienced an 84% increase in use, primarily attributed to pregabalin. Weak opioids, led by tramadol, witnessed a 117% rise in use, while strong opioid use, led by tapentadol, increased by 618%. Portugal presented the lowest overall opioid consumption when compared to Denmark and Spain in 2022. Economic trends indicated a heightened NHS expenditure on analgesics, primarily driven by increased opioid use. Notwithstanding, there was no significant burden on relative expenditure over the 10‐year period.ConclusionsPortugal presented a major increase in both weak and strong opioid prescriptions, aligning with the trends for Spain and Denmark. The development and approval of generic medicines and vigilant market monitoring are imperative strategies for managing the escalated costs resulting from heightened consumption, particularly concerning opioids.

Adverse events associated with oseltamivir and baloxavir marboxil in against influenza virus therapy: A pharmacovigilance study using the FAERS database

Background Influenza virus is a widespread pathogen that poses significant health risks to humans. Oseltamivir and Baloxavir Marboxil are commonly utilized medications for both treating and preventing influenza infections. Despite their widespread use, there remains a need to thoroughly investigate their safety profiles and potential adverse reactions. Objective This study aims to comprehensively analyze the adverse events associated with oseltamivir and baloxavir marboxil in real-world clinical settings, with the goal of assessing their safety and potential risks in the management of influenza virus infections. Methods We conducted a retrospective analysis utilizing data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database, spanning from the first quarter of 2004 to the third quarter of 2023. The analysis encompassed examination of drug utilization patterns, types of adverse events reported, patient demographics, and other pertinent factors. Results From the first quarter of 2004 to the third quarter of 2023, FAERS collected over 17,035,521 adverse event reports (AE reports). Among these reports, there were 38,384 reports associated with oseltamivir, and 3,364 reports associated with baloxavir marboxil. Oseltamivir and Baloxavir Marboxil were primarily used for the treatment of influenza virus infections, accounting for 62.43% and 67.49% of their total usage, respectively. The main adverse reactions reported for oseltamivir were vomiting (case reports = 1402) followed by confusional state (case reports = 353), while for baloxavir marboxil, adverse reactions mainly centered around off-label use (case reports = 378) and intentional product use issues (case reports = 278). In terms of systemic adverse reactions, oseltamivir primarily affected psychiatric disorders (n = 45), whereas baloxavir marboxil mainly impacted the gastrointestinal system (n = 7). Additionally, regarding adverse reactions in pregnant women, the occurrence of normal newborns was a significant signal for oseltamivir, suggesting a certain level of safety during maternal use. Conversely, reports of adverse reactions such as respiratory arrest were documented for baloxavir marboxil, while no such reports were associated with oseltamivir. Conclusion This study provides a comprehensive analysis of the adverse reactions observed with the clinical use of oseltamivir and baloxavir marboxil, revealing the safety and risks associated with these two drugs in the treatment and prevention of influenza virus infections. Firstly, although both drugs are used for influenza treatment, they exhibit different types of adverse reactions. Oseltamivir predominantly affects the psychiatric system, while baloxavir marboxil primarily impacts the gastrointestinal system. Additionally, oseltamivir demonstrates a certain level of safety for use in pregnant women, while reports of adverse reactions such as respiratory arrest are associated with baloxavir marboxil. Despite the clinical significance of this study, limitations exist due to the voluntary nature of data reporting, which may lead to reporting biases and incomplete information. Future research could employ more rigorous prospective study designs, integrating clinical trials and epidemiological studies, to more accurately assess the safety risks of oseltamivir and baloxavir marboxil.

Hunting, fishing, and foraging in times of conflict: the implications of choosing safety in the Mississippian Central Illinois River Valley

ABSTRACT This study investigates the impact of intraregional conflict on food security and subsistence practices in the Central Illinois River Valley (CIRV) during the Mississippian period, particularly between AD 1200 and 1400, a time characterized by escalations in intergroup violence. Utilizing integrated faunal and botanical datasets from two critical archaeological sites – the Lamb site, representing the preconflict phase, and the C. W. Cooper site, indicative of the conflict onset phase – this research elucidates how prolonged warfare necessitated substantial adaptations in subsistence strategies among CIRV Mississippian communities. While much previous research has centered on elite aspects of Mississippian warfare, this study shifts the focus to the broader societal impacts on the daily lives of residents of the CIRV. Findings demonstrate significant shifts in foraging behaviors and resource utilization patterns, reflecting strategic responses to the challenges and hazards posed by persistent warfare. By highlighting the adaptability of these communities in the face of warfare and environmental stressors, this research contributes valuable perspectives to the anthropological understanding of the interrelations between warfare and food systems.

Trends of antiseizure medication utilization among pregnant people in four Canadian provinces from 1998 to 2023; a study from the Canadian mother-child cohort active surveillance initiative (CAMCCO)

BackgroundEpilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health.MethodsThis study analyzed trends in ASMs use among pregnant people in four Canadian provinces over 20 years (Manitoba, Saskatchewan, Alberta, and Quebec). Descriptive statistics were utilized to examine the characteristics of the population, with the frequency and patterns of ASM use estimated throughout each trimester. Linear regression models were developed to analyze yearly patterns of ASM utilization for the overall study population, as well as for people with and without epilepsy.ResultsAmong 1,317,141 pregnant individuals across four provinces, 0.7% had epilepsy. Of the total pregnancies, 1.7% (n = 22,783) were exposed to ASMs, comprising 4,392 from pregnant people with epilepsy (PPWE) and 18,391 from those without epilepsy (PPWOE). Results demonstrated varying trends in ASM usage between provinces, with an overall increase in usage among people without epilepsy in Manitoba, Saskatchewan, and Alberta. ASM use among PPWOE surged significantly in Manitoba (24.2–149.1 per 10,000 pregnant people), Saskatchewan (29.4–107.0 per 10,000), and Alberta (65.7–241.7 per 10,000) (p < 0.05). In Alberta, PPWE’s ASM exposure also rose, from 23.6 in 2008 to 43.0 per 10,000 pregnant people in 2021, while Quebec witnessed a decrease from 59.2 in 1998 to 45.5 per 10,000 pregnancies in 2015. Analysis of ASM use by trimester illustrated a substantial decline among PPWOE from 365 days pre-pregnancy to the third trimester in all provinces. ASM utilization by drug class showcased significant shifts, with second-generation ASMs experiencing a notable rise. Carbamazepine, once prominent, declined, making way for lamotrigine. Regional variations underscore diverse preferences, such as clonazepam’s sustained popularity in Manitoba and Quebec.ConclusionThe study identified increasing trends in ASM use, particularly the increased use of second-generation ASMs, and differences in prescription patterns for pregnant individuals with and without epilepsy. These findings reveal changing ASM use patterns, including increased second-generation ASM use and regional disparities, providing valuable insights into real-world prescription practices.

Abstract 4119868: Statin and PCSK9 Inhibitor Utilization and Spending in Medicaid between 2018 to 2022: A National Analysis

Introduction: Low-income working-aged adults in the Medicaid program have a high burden of cardiovascular risk factors and disease, but often face barriers accessing necessary therapies. Little is known about contemporary patterns of utilization and spending on lipid-lowering therapies in Medicaid programs. Goal: To evaluate national trends in utilization and spending on statins and proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) in Medicaid. Methods: We performed a serial cross-sectional study using the Medicaid Spending by Drug Database, which contains national-level Medicaid spending data for medications partially or fully reimbursed by Medicaid for the approximately 84 million beneficiaries. We evaluated annual trends in utilization (prescription fills) and total spending for statins and PCSK9i from 2018 to 2022, both overall and by individual drug formulation. Spending was adjusted for inflation and reported in 2022 US dollars. Results: Medicaid beneficiaries filled 20.4 million statin prescriptions in 2018 compared to 20.3 million in 2022, representing a 0.4% decrease. However, Medicaid spending on statins decreased by 7.1%, from $246.2 million to $226.8 million over the same period. Prescription fills for generic Rosuvastatin increased the most (0.79 million to 2.6 million, +224.2%), while fills for brand-name Crestor decreased the most (0.065 million to 0.003 million, -95.2%). Medicaid beneficiaries filled 121,737 prescriptions for PCSK9 inhibitors in 2022 compared to 7,617 in 2018 (+1498%), coinciding with a 640% increase in total spending ($8.9 million to $65.7 million). Repatha Sureclick was the most filled PCSK9i in Medicaid with 80,503 fills in 2022, representing $43.9 million in total Medicaid spending. Conclusions: Despite almost no change in statin utilization between 2018 and 2022, Medicaid spending on statins fell by approximately $20 million, driven by a shift from brand-name to generic formulations. In contrast, spending on PCSK9 inhibitors increased by $57 million as these medications became more widely used. Understanding these trends is critical as Medicaid programs work to ensure access to effective cardiovascular therapies while also identifying opportunities for cost efficiencies nationwide.

Impact of Family Mutual Aid System for Personal Medical Insurance Accounts on Paediatric Patients’ Outpatient Utilisation Patterns and Costs: a difference-in-differences analysis

Abstract This study explores the effect of the transformation of paediatric healthcare through the implementation of the Family Mutual Aid System (FMAS) for personal medical insurance accounts, among paediatric patients at a children’s hospital (Hospital A in Shanghai, China). We conducted a cohort study in the endocrinology department of Hospital A from August 2021 to July 2023 to assess the impact of the FMAS enrolment on patients’ annual outpatient visits, annual outpatient expenditures, and the allocation of these costs among the Basic Medical Insurance Pooling Fund and patients’ out-of-pocket (OOP) expenses, with a further subdivision into online and offline consultations. Analysis employed a weighted Difference-in-Differences approach within a fixed-effects model following Propensity Score Matching. The study encompassed 10,975 paediatric patients, divided into those enrolled in the FMAS (observation group) and those not (control group). Enrolment in FMAS was associated with a statistically significant increase in annual outpatient visits by an average of 1.107, predominantly attributed to an uptick in offline consultations. Additionally, there was a substantial 38.9% rise in annual outpatient costs. Detailed analysis revealed a 52.5% increase in costs covered by the medical insurance pooling fund, while patients’ OOP expenses decreased by an average of 69.2%. These findings highlight the beneficial effects of FMAS enrolment on healthcare service utilization and risk-sharing mechanisms of medical insurance.

Accessibility and Utilization of Contraceptives and Its Associated Factors among Students of Tertiary Institutions in Nigeria

Introduction: The use of modern contraceptives among young citizens has been documented to be effective in reducing STIs, unwanted pregnancies, as well as teenage pregnancy. Therefore, it has become necessary to determine utilization patterns of contraceptive services among young individuals as it is very critical for planning to meet the reproductive needs of young persons. Methods: A descriptive cross-sectional research design was adopted for the study. The study was conducted using 404 undergraduates from two tertiary institutions. Simple random sampling was utilized in the study. Structured self-administered questionnaire was used for data collection. Data were analyzed using descriptive and inferential statistics of chi-square test at p < 0.05. Results: About 53.5% are between 18–22 years with a mean age of 22.62 ± 2.948; 51.5% are males, 88.6% still single. About 51.9% do not have access to contraceptives, and 66.83% are not utilizing contraceptives. Side effect of the drugs, lack of access to modern contraceptives, lack of money to access it and lack of appropriate knowledge of the one to use are major factors for non-utilization. Gender was not significantly associated with utilization of contraceptives (p = 0.204). A statistically significant association was observed between religion of the respondents and utilization of contraceptives (p = 0.013), and between accessibility of contraceptives and their utilization (p < 0.001). Conclusion: There is poor accessibility and utilization of modern contra- ceptives among young people. Individual’s religion and accessibility could influence utilization.

Profiles of Nonpharmacologic Treatment Receipt in the First 10 Weeks Following a New Back Pain Diagnosis Among Active Duty Soldiers: A Latent Class Analysis

ABSTRACT Introduction US service members experience high rates of back pain. Guidelines prioritize nonpharmacologic treatment (NPT) as first-line pain treatments; however, NPT utilization patterns research is limited. This study examined NPT patterns of care within the first 10 weeks following an index back pain diagnosis. Materials and Methods Data were from the Substance Use and Psychological Injury Combat Study and included 222,427 active duty soldiers with an index back pain diagnosis following return from Afghanistan/Iraq deployment in 2008–2014. We fit a series of latent class analysis models to identify homogenous subgroups of soldiers with NPT utilization during the 10-week period and measured associations with soldier characteristics and clinical characteristics within 90 days before the back pain diagnosis, with the distinct NPT utilization classes. Approval for this study was granted by the Brandeis University Committee for Protection of Human Subjects (Institutional Review Board #14153) and the Uniformed Services University Institutional Review Board. Results Only half of the soldiers received any NPT within their 10-week early treatment window. Latent class analysis identified 4 classes over the 10-week early treatment window: Class 1 (None/Low NPT, 65%); Class 2 (High and Decreasing NPT, 15%); Class 3 (Low and Increasing NPT, 13%), and Class 4 (Sustained NPT, 7%). Soldier clinical characteristics from the 90-day preperiod window were most important in distinguishing class membership in relation to Class 1, particularly comorbid pain conditions, diagnosis of traumatic brain injury, receipt of prescription opioids, and receipt of invasive surgery. Conclusions Patterns of weekly NPT utilization during an early treatment window following a new back pain diagnosis varied temporally, with approximately half of soldiers using NPT. Half of the soldiers did not receive any NPT within their 10-week early treatment window, which highlights opportunities for increasing use of NPT utilization among military members with a new back pain episode. Future research is needed in the Military Health System to examine the extent to which NPT patterns are associated with pain management outcomes.

Buprenorphine Administration and Prescribing at Emergency Departments: A National Analysis from 2014-2021.

Emergency department (ED)-initiated buprenorphine provides a low barrier access point and safety net to mitigate opioid overdose risk and increase treatment engagement. We sought to describe trends and patterns of buprenorphine utilization from the ED using national data. This is a retrospective review of the National Hospital Ambulatory Medical Care Survey between 2014 and 2021. Our primary outcomes were trends in ED buprenorphine utilization. We described patient demographics, visit characteristics, and conducted trend analyses. We utilized logistic regression to determine predictors of buprenorphine prescribing. Between 2014 and 2021, there were 341,875 ED visits in which buprenorphine was administered, with no change over time (P = 0.08). There were 392,031 visits where buprenorphine was prescribed at ED discharge, with an increase over time (P = 0.01). The largest rise in rate for discharge prescriptions occurred between 2019 and 2020 (37,737 [0.03%] visits vs 126,041 [0.10%]) (233% increase in rate, P < 0.0001). Although there was an increase in buprenorphine prescribing at ED discharge, there was no increase in administration. The acceleration in prescribing between 2019 and 2020 suggests that the ED may have been a safety net for patients who lost access to addiction care during COVID-19. Future studies should explore reasons for disparities and barriers to buprenorphine utilization.

Racial Disparities in Utilization and Outcomes of Cervical Disc Arthroplasty.

Retrospective study. We examined racial disparities in (1) cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) utilization and (2) CDA in-hospital outcomes. ACDF and CDA are established treatments for cervical disc disease. While CDA may offer certain advantages over ACDF, its utilization patterns have not been comprehensively explored. This study of 2012 to 2019 discharges from the National Inpatient Sample included White, Black, and Hispanic patients aged 18 years and older who underwent elective ACDF or CDA. Patient demographics, comorbidities, cervical spine diagnoses, and hospital characteristics were extracted. Survey-weighted logistic regression modeled the adjusted association between race and CDA (vs. ACDF) utilization; an interaction between race and year examined temporal changes in disparities. For CDA outcomes, multivariable logistic regression was used for binary outcomes (nonhome discharge, combined complications, and dysphagia) and linear regression for length of stay. The cohort included 712,355 weighted procedures (97.6% ACDF; 84.2% White, 9.7% Black, 6.1% Hispanic). CDA utilization increased from 1.0% of the procedures in 2012 to 3.8% in 2019. Black and Hispanic patients had significantly lower odds than White patients of receiving CDA versus ACDF (OR=0.77, 95% CI: 0.66-0.89, P=0.001; OR=0.80, 95% CI: 0.69-0.93, P=0.003) respectively. There was no statistically significant interaction between race and discharge year (P=0.50). For in-hospital CDA-specific outcomes, Black (vs. White) patients were more likely to experience dysphagia (OR=2.70, 95% CI: 1.53-4.78, P=0.001) and combined complications (OR=3.10, 95% CI: 1.91-5.05, P <0.001). There were no significant differences in any CDA outcome for Hispanic versus White patients. This study revealed decreased utilization of CDA versus ACDF in minority patients, a pattern that persisted over time despite overall increasing CDA utilization. In addition, a higher burden of dysphagia and combined complications following CDA in Black patients warrants further examination. III.

WHO/INRUD prescribing indicators with a focus on antibiotics utilization patterns at outpatient department of Adigrat general hospital, Tigrai, Ethiopia: a retrospective cross-sectional study

BackgroundThe World Health Organization (WHO) defines rational use of drug as a state in which medications are received by patients appropriately according to their clinical needs and individual requirement, for adequate period and at the right cost. More than 50% of all medicines are prescribed, dispensed, or sold inappropriately worldwide. This study aimed to evaluate the prescribing patterns in Adigrat general hospital, Tigrai, Ethiopia.MethodsA retrospective cross-sectional study was done to evaluate prescription patterns. A systematic random sampling technique was used to select 600 prescriptions and the prescriptions were reviewed using WHO/International Network of Rational Use of Drugs prescribing indicators. Data was collected from prescriptions dispensed from 01 March 2023 to 30 March 2024 at outpatient pharmacy of Adigrat general hospital. Data was analyzed using SPSS version 21 and a p-value < 0.05 was declared statistically significant.ResultsA total of 1088 medicines were prescribed in 600 prescription encounters, giving an average number of 1.8 (± 0.83) medicines per encounter. The percentage of medicines prescribed by generic name was 91.5% while 98.7% of the medicines were prescribed from essential medicine list (EML). Besides, the percentages of encounters containing at least one antibiotic and one injection were 44.5% and 7.2%, respectively. A total of 340 antibiotics were prescribed in 267 encounters. Penicillins (34.4%), macrolides (23.8%) and fluoroquinolones (17.1%) were the most prevalent antibiotics classes. The “Access” and “Watch” groups covered 54.4% and 45.6% of the total antibiotics prescribed, respectively. Being under 18 years old [Adjusted Odds Ratio (AOR): 9.830, CI: 4.062–23.786], being prescribed with three medicines (AOR: 3.247, CI: 1.571–6.708) and certain diagnosis like diseases of the respiratory system (AOR: 3.750, CI: 2.136–6.584) were significantly associated with antibiotic prescribing.ConclusionThis study showed deviations of prescribing patterns from WHO standards. The percentage of prescriptions with antibiotic was far from WHO optimal value. The use of antibiotics from “Access” group was below WHO standard. The percentage of medicines prescribed by generic name and the percentage of encounters with injection also deviated from WHO standard. Antibiotics prescribing showed significantly association with age, number of medicines and certain diseases.

Cocoyam Utilisation Pattern among Rural Households in Ekiti State, Nigeria

Cocoyam Utilisation Pattern among Rural Households in Ekiti State, Nigeria

Healthcare utilisation patterns and drivers amongst inflammatory bowel disease patients in the outpatient clinic.

Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, impose an escalating burden on healthcare systems globally, with a rising prevalence contributing to increased costs. This study explored healthcare utilisation patterns and its drivers amongst IBD patients in an outpatient clinic. A longitudinal cohort study was conducted at a Dutch academic teaching hospital. IBD patients (n = 180) were followed for 1 year and were categorised based on disease activity and consultation frequency. Healthcare utilisation was assessed through consultations and laboratory tests. Patient-reported outcomes and biochemical disease activity were measured, and subsequently the reasons for consultations were analysed. The frequency of outpatient healthcare utilisation exceeded the recommended IBD care guidelines by two-fold. Comorbidities were the leading reason for consultations (40.4%), followed by remission induction, medication changes and pending test results. Moreover, clinical disease activity, reported problems with self-care, daily activities and pain were predictive of an increase in annual consultations. This study identified factors influencing healthcare utilisation in IBD outpatients. Personalised care pathways using eHealth technologies have the potential to reduce unnecessary consultations and optimise resource allocation.

Telehealth utilization among patients with chronic disease: Insights from the 2022 Health Information National Trends Survey.

Telehealth has been effectively used for managing chronic disease conditions; however, utilization patterns vary across populations. This study aims to examine the prevalence of telehealth utilization, the associated factors of telehealth modality (e.g., audio, video) among patients with chronic diseases, and the role of health literacy. Participants with at least one diagnosed chronic disease from the 2022 Health Information National Trends Survey (HINTS 6) data (n=3686) were analyzed. Differences in participant characteristics between telehealth users and non-users were compared using χ² statistics. Multinomial logistic regression models were employed to investigate factors associated with telehealth modality. About 52% of participants reported using telehealth in the past 12 months, with 34.7% using audio-only modality. Telehealth use was highest among participants with depression (61.6%) and lowest among those with high blood pressure (47.6%). Participants over 75 years old (OR, 3.11 [95% CI, 1.99-4.85]; P < 0.001) were more likely to use audio-only modality compared to the youngest group (18-34 years). Respondents with a higher educational level (bachelor's degree: OR, 0.77 [95% CI, 0.59-1.00], P = 0.049; post-baccalaureate degree: OR, 0.60 [95% CI, 0.43-0.82]; P < 0.001) and higher health literacy (OR, 0.81 [95% CI, 0.66-0.99]; P =0.04) were more likely to use audio-video modality compared to their counterparts. Telehealth use varied across demographics and chronic diseases, revealing significant disparities. Elderly individuals, those with lower socioeconomic status, and those with lower health literacy tended to use the audio-only modality. Providing support for digital platforms and health literacy can empower patients with chronic diseases to effectively use telehealth for self-management.

The COVID-19 pandemic and blood utilisation in South Africa.

The COVID-19 pandemic, first reported in December 2019, affected every sector of every country worldwide. Health services were the first to experience the direct impact. Blood services were advised to decrease blood utilisation in anticipation of reduced blood collections. The South African National Blood Services (SANBS) saw a substantial decline in blood demand following the institution of strict national lockdown measures, but the impact of the epidemic and various mitigation strategies remained unknown. This retrospective study reviews red blood cell (RBC) utilisation during a 4-year period from 2019 to 2022 in the South African (SA) population, stratified by public and private healthcare sectors. To measure the impact of COVID-19, blood utilisation pre COVID-19 was compared with an acute COVID-19 period and a post-acute period. Each period covered 450 days. Blood utilisation was evaluated against the background of reported COVID-19 cases and national lockdown regulations. With the onset of the COVID-19 pandemic, overall RBC utilisation dropped by ~17%. The initial decline was more pronounced in the public sector. Overall, utilisation recovered to pre-COVID-19 levels in the post-acute COVID-19 period, but at different rates in the public and private sectors. There was a significant change in RBC utilisation during the course of the COVID-19 pandemic, much more pronounced in the public sector, which services 85% of the SA population. During the post-acute COVID-19 period, blood utilisation recovered, but at a much slower rate in the public sector. The COVID-19 pandemic accentuated the differences in blood utilisation patterns between the public and private healthcare sectors in SA, and each sector's resilience in adapting to the challenges of the epidemic.

Access to University Mental Health Services: Understanding the Student Experience: L'accès aux services universitaires de santé mentale : comprendre l'expérience des étudiants.

To describe student access to university mental health services and barriers and gaps in support. This multiple cohort study used self-report data from 4,138 undergraduate students who completed the U-Flourish Well-Being Survey at the start and completion of first year from 2018 to 2023. The survey incorporated validated measures of mental health symptoms, barriers to care, and open-text questions about the mental health care experience and perceived gaps. Quantitative analyses summarized utilization patterns and barriers. An interpretive qualitative analysis identified common themes about support services and opportunities for improvement from the student perspective. At university entry, 43% of students screened positive for anxiety and/or depression, 30% reported a lifetime mental disorder and 23% a lifetime history of self-harm. Over first year, 15% of students surveyed accessed university mental health services. Access was more likely in students identifying as older, gender diverse, female, having a prior mental disorder and those who screened positive for anxiety or depression. Common attitudinal and practical barriers reported included thinking problems would resolve (74%), being uncomfortable sharing (73%), and not knowing how to get help (50%). Common stigma barriers included concerns about what family or friends might think. Students expressed that both campus-based well-being and mental health care offered during flexible hours and accessible through online booking were important. Student-tailored mental health literacy may be a sustainable approach to address the attitudinal and practical barriers identified. If such barriers are reduced, an increased service demand would be expected and improved efficiencies needed. A clear Statement of Services, an online singular point of access with embedded triage to signpost students to indicated levels of care, and clearly worked-out care pathways including to community-based services would better align with a stepped care model, improve efficiency and access, and foster realistic expectations around university mental health support.

SOHUPDS+: An Efficient One-phase Algorithm for Mining High Utility Patterns over a Data Stream

Existing algorithms for mining high utility patterns over a data stream are two-phase algorithms that are not scalable due to the large number of candidates generation in the first phase, particularly when the minimum utility threshold is low. Moreover, in the second phase, the algorithm needs to scan the database again to find out actual utility for candidates. In this paper, we propose one-phase algorithm SOHUPDS+ to mine high utility itemsets in the current sliding window of the data stream with respect to absolute or relative minimum utility threshold. To facilitate SOHUPDS+, we propose a data structure IUDataListSW+ , which stores and maintains utility and upper-bound values of the items in the current sliding window when sliding window advances. In addition, we propose a transaction merging strategy, called BitmapTransactionMerging , which saves execution time for utility and upper-bound values computations in denser datasets. Moreover, we propose update strategies to utilize mined high utility patterns from the previous sliding window to update high utility patterns in the current sliding window. The results of experiments illustrate that SOHUPDS+ is more efficient than the state-of-the-art algorithms in terms of execution time as well as memory usage in most of the experiments on various datasets.