Service Center Research Articles

Outcomes from an Early Adopters Home Hospital Accelerator for Acute Care at Home.

Following the Centers for Medicare and Medicaid Services' approval of the Acute Hospital Care at Home waiver, an increasing number of health care organizations launched Home Hospital (HH) programs in the USA. Ongoing barriers include access to HH expertise and a standard, comprehensive set of implementation tools. We created the HH Early Adopters Accelerator to bring together a network of health care organizations to develop tools ("knowledge products") necessary for HH implementation. To demonstrate the feasibility of the Accelerator approach for generating and implementing relevant, high-quality knowledge products. Mixed methods evaluation of the Accelerator. Surveys and qualitative interviews of Accelerator participants were conducted. Surveys elicited feedback on the knowledge products, including time spent on development, perceived utility and quality, and implementation success. The qualitative interviews gathered more in-depth information on topics covered in the surveys. Eighteen healthcare organizations and 105 individuals participated in the Accelerator. The Accelerator reached its goal and developed 20 knowledge products in 32 working weeks (more efficient than expected). Participants agreed that the knowledge products were useful (developers: 98.1%; stakeholders: 93.8%), of high quality (developers: 96.8%), and would improve patient care if implemented in their HH program (developers: 91.7%; stakeholders: 91.2%). Two thirds (66.7%) of the participating organizations who had implemented knowledge products at 3 months continued utilizing knowledge products in their HH program at 1 year. Agreement that knowledge products improve patient care persisted (92% strongly agreed or agreed) at 1 year. Several programs created new tools, policies, and workflows as a result of implementing the knowledge products. The Accelerator created high-quality, comprehensive knowledge products that healthcare organizations found useful for safe HH implementation 1 year later. The Accelerator approach can feasibly help healthcare organizations safely bridge the gap between innovation and standard practice.

Defects in Value Associated With Hospital-Acquired Conditions: How Improving Quality Could Save U.S. Healthcare $50 Billion.

Hospital-acquired conditions in the United States are considered avoidable complications but remain common statistics reflecting on health system performance and are a leading cause of patient fatality. Currently, over 3.7 million patients experience a hospital-acquired condition in the United States each year, which costs the U.S. healthcare delivery system an excess of $48 billion. Evidence-based clinical practice guidelines for common hospital-acquired conditions (e.g., infections, falls, pressure injuries) to reduce risk to the patient. In each of these instances, preventing the outcome with these guidelines costs less than treating the outcome, in addition to keeping the patient safe from harm. By applying the framework of defects in value to hospital-acquired conditions, we estimate that U.S. health systems could avert this $48 billion in spending on treating harmful hospital-acquired conditions; more so, these systems of care could recuperate over $35 billion after investing proportionally in a system that delivers greater quality by preventing hospital-acquired conditions over treating them. Currently, the Centers for Medicare and Medicaid Services only withholds reimbursements for hospital-acquired conditions and penalizes health systems with high rates of these outcomes. However, payers do not offer any reward-based incentives for hospital-acquired condition prevention. A series of policy and health system solutions, including tracking of hospital-acquired condition rates in electronic health records, identifying centers of excellence at reducing rates of harm with the use of clinical practice guidelines, and rewarding them monetarily for reduced rates could create equal-sided risk and opportunity to engage health systems in improved performance.

Early palliative care involvement in gastrointestinal malignancies: A community cancer center perspective.

198 Background: Early involvement of palliative care (PC) specialists enhances quality of life for patients with advanced gastrointestinal (GI) cancer. Methods: This retrospective study evaluated patients with newly diagnosed stage III and IV GI cancer seen at a large community cancer center between 10/1/22 and 9/30/23. We compared patients seen by a PC provider in clinic at least once to those without an outpatient PC visit within the one-year study period. Results: 283 patients with stage III/IV colorectal (42%), gastroesophageal (23%), pancreatic (16%), hepatobiliary (12%), and other GI cancers (8%) received care within the study period (Table). Of these, 49 (17%) had at least one PC clinic visit, and 234 (83%) had no PC visits. Patients with pancreatic (35% vs 12%) and hepatobiliary cancer (20% vs 10%) were over-represented in the group receiving PC vs those without PC, while patients with colorectal cancer were under-represented (20% vs 47%). Greater percentages of patients in the group receiving PC completed advanced care planning (ACP) documents (63% vs 24%) and died during the study period (65% vs 15%). Conclusions: A minority of patients with GI malignancies at a large community cancer center are seen by an outpatient PC provider during the first year after diagnosis. These patients are more likely to have tumor types associated with worse prognosis, to complete ACPs, and to die within one year. Broader delivery of early PC will require expanded services in community cancer centers and continued development of tools for identifying patients most likely to benefit. The distribution of gastrointestinal cancer between outpatient palliative care visit and no outpatient palliative care visit. Primary cancer PC No PC Total Colorectal 10 (20% | 8%) 110 (47% | 92%) 120 (42% | 100%) Gastroesophageal 10 (20% | 16%) 54 (23% | 84%) 64 (23% | 100%) Pancreatic 17 (35% | 39%) 27 (12% | 61%) 44 (16% | 100%) Hepatobiliary 10 (20% | 30%) 23 (10% | 70%) 33 (12% | 100%) Other GI 2 (4% | 9%) 20 (9% | 91%) 22 (8% | 100%) Total 49 (100% | 17%) 234 (100% | 83%) 283 (100% | 100%) PC: Palliative care.

European Trends in Local Public Administration: Adapting to Globalization

The trend of globalization, accompanied by the dynamic development of social systems, places national states in a completely new position, in which institutions and administrative systems must be adapted. Any intervention in the field of public administration reform implies changes in major components, including central administration, local administration and public services. On the other hand, the development of democracy calls for the establishment of a new relationship between citizens and the administration, increasing and strengthening the role of local authorities and reconsidering the partnership with civil society. There are numerous reasons for the structural and functional modernization of the public administration in Romania, starting from the need for more efficient functioning of government institutions to the aspiration to become a member of the European Union. The present study aims to address these aspects, taking into account the impact of the reform measures at the public administration level that have been undertaken recently. Through the coherent and continuous development of the decentralization process in the next period, we will be able to witness the increase in the quality and efficiency of public services, and local administrations will respond to the demands of citizens and local development in an improved way. Keywords: development, Europe, municipalities, public administration

Rapid detection of depression by volatile organic compounds from exhalation

Depression is a pervasive and often undetected mental health condition, which poses significant challenges for early diagnosis due to its silent and subtle nature. To evaluate exhaled volatile organic compounds (VOCs) as non-invasive biomarkers for the detection of depression using a virtual surface acoustic wave sensors array (VSAW-SA). A total of 245 participants were recruited from the Hangzhou Community Health Service Center, including 38 individuals diagnosed with depression and 207 control subjects. Breath samples were collected from all participants and subjected to analysis using VSAW-SA. Univariate and multivariate analyses were employed to assess the relationship between VOCs and depression. The findings revealed that the responses of virtual sensor ID 14, 44, 59, and 176, which corresponded respectively to ethanol, trichloroethylene or isoleucine, octanoic acid or lysine, and an unidentified compound, were sensitive to depression. Taking into account potential confounders, these sensor responses were utilized to calculate a depression detection indicator. It has a sensitivity of 81.6% and a specificity of 81.6%, with an area under the curve of 0.870 (95% CI = 0.816-0.923). Conclusions: exhaled VOCs as non-invasive biomarkers of depression could be detected by a VSAW-SA. Large-scale cohort studies should be conducted to confirm the potential ability of the VSAW-SA to diagnose depression.

SEISMIC RESPONSE IN MUARA BANGKAHULU SUB-DISTRICT, BENGKULU CITY, USING THE CONCEPT OF WAVE PROPAGATION

The position of Bengkulu Province, which is flanked by the subduction zone between the Euro-Asian and Indian-Australian plates to the west, and the Sumatra Fault zone to the east, makes Bengkulu City one of the areas prone to earthquake disasters. Muara Bangkahulu District is one of the sub-districts in Bengkulu City. Muara Bangkahulu sub-district is an area that functions as a government centre, trade and service centre, and one of the education centres in Bengkulu City. This study aims to determine the ground response in the Muara Bangkahulu sub-district area during an earthquake. The wave propagation method used in this study is a one-dimensional equivalent of linear and nonlinear modelling that propagates earthquake waves from bedrock to surface. The results of this study are Peak Ground Acceleration (PGA), amplification factor, earthquake acceleration time history, and acceleration spectra response. The results of this analysis will be compared between equivalent linear and nonlinear values. The results of this study can also help us realise and further consider the value of seismic design in the Muara Bangkahulu sub-district area, mainly if a stronger earthquake occurs in the future.

Revisiting the effects of state anesthesia policy interventions: A comprehensive look at certified registered nurse anesthetist service provision in U.S. hospitals from 2010 to 2021.

Rural hospitals in the United States often rely on nonphysician providers such as advanced practice nurses to care for their patients. One important role that is served by advanced practice nurses is that of anesthesia provider (certified registered nurse anesthetist or CRNA). In 2001, Centers for Medicare & Medicaid Services (CMS) passed an opt-out law affording state governors the right to loosen physician supervision requirements on CRNAs in their respective states, thus potentially improving access in targeted areas. Since then, 24 states have adopted these opt-out provisions. We aim to understand the extent to which the CMS opt-out law has resulted in increased CRNA service provision in hospitals, especially in rural areas. The study used a longitudinal design. We compiled 2010-2021 American Hospital Association data, which includes 4,464 unique U.S. hospitals observed an average of 8 times annually (35,863 total hospital-year observations). We model CRNA services provision at the hospital level using longitudinal mixed effects generalized linear models that incorporate state, county, and hospital control variables. Using descriptive statistics and mixed effects generalized linear models, we discovered that adopting opt-out provisions does not universally result in increased CRNA service provision in U.S. hospitals. Notably, opt-out provisions do not improve access in rural counties. However, in supplemental analysis, we discover some of the conditions under which the likelihood of CRNA service provision is influenced. Hospitals often utilize CRNAs to staff their hospitals. However, many hospitals use both CRNAs and physician anesthesiologists; this can be a potential source of contention and confusion, given the lack of uniformity in thescope of practice policies. We offer some suggestions with regard to the effects of state interventions into the field, and how they might impact this dispute. Lastly, policymakers should consider additional measures to address rural access limitations, as the opt-out policy does not seem to be working as intended.

Risk of hypoglycaemia among people with type 2 diabetes not treated with insulin: A retrospective analysis of Medicare Advantage beneficiaries.

In 2022, the Centers for Medicare & Medicaid Services released proposed changes to Medicare's continuous glucose monitoring (CGM) coverage policy, making individuals with a history of problematic hypoglycaemia eligible for CGM coverage, irrespective of insulin use. This study estimated the burden of hypoglycaemia in Medicare Advantage beneficiaries with noninsulin-treated type 2 diabetes (T2D). We retrospectively analysed US healthcare claims data using Optum's deidentified Clinformatics® database. Noninsulin-treated beneficiaries were identified in the 16 years from January 2007 to March 2023. Hypoglycaemia-related encounters (HREs) were those accompanied by a hypoglycaemia-specific ICD-9/10 diagnosis code in any position on the claim or the first or second position. HREs following the first claim related to T2D were reported by setting (ambulatory or inpatient/emergency department [ED]). HREs were identified in 689,853 (21.4%) of 3,229,695 noninsulin-treated Medicare Advantage beneficiaries, of whom 82.9% (n = 571,581) had ≥1 HRE in an ambulatory location and 26.8% (n = 184,833) in an ED/inpatient location. Use of sulfonylurea (odds ratio [OR]: 4.33 confidence interval [CI: 4.27-4.38]), evidence of end-stage kidney disease (OR: 2.87 [CI: 2.79-2.94]), hypertension (OR: 3.09 [CI: 3.04-3.15]) and retinopathy (OR: 2.94 [CI: 2.82-3.07]) were the strongest predictors of an HRE (p < 0.001). These findings show that HREs are prevalent in noninsulin-treated diabetes and identify a large number of patients who may benefit from CGM. Because >80% of HREs occur in the ambulatory setting and >70% occur in patients not taking sulfonylureas, primary care providers should be aware of the latest eligibility criteria for Medicare's coverage of CGM and not restrict this technology to their sulfonylurea-treated patients.

Formulate a Waste Bank Management Model in Pekanbaru City by Recycling The Material for Environmental Hygiene

Background and objectives: With various policies and systems at each waste bank, the effectiveness of waste banks in attracting people to manage their waste has not been running well, so they have not been able to provide solutions to the waste problem in Pekanbaru City and have not been integrated. This research aims to formulate a waste bank management model in Pekanbaru City. Method: This research uses quantitative and qualitative research methods with a descriptive approach. This research was conducted using questionnaires, interviews, and observations. Interviews were conducted using Google form with the Director of the Main Waste Bank (BSI), Chair of the Waste Bank Unit (BSU), Business Actors, NGOs, Academics, Head of the Sumatra Ecoregion Development Control Center (P3ES), Environmental and Hygiene Service Officials, Subdistrict Heads and Village Heads. Results: The characteristics of the waste bank in Pekanbaru City regarding planning are inadequate. In terms of organization, it is well structured, but most of the members have multiple jobs. In terms of direction, it has been implemented, but not evenly. In terms of control, it is still manual and has not utilized technology. The dominant factor in waste bank management in Pekanbaru City is economic factors, with a p-value &lt;0.001. Conclusion: The waste bank management model in Pekanbaru City is to control the higher prices given to BSU and customers, so BSI must carry out integrated processing of segregated waste that has been collected at BSI by recycling the material.

Long COVID in children and adolescents: a historical cohort study with a population-based control group from Iran

BackgroundAfter recovering from the acute phase of COVID-19, some of the infected children manifest long COVID symptoms. The present study aims to identify long COVID symptoms in children and adolescents admitted to hospitals in Bushehr, Iran, during 2021 to 2023, and compare them with the non-affected group.MethodsThis historical cohort study with a population-based control group was conducted on 141 children and adolescents with COVID-19 hospitalized in Bushehr city hospitals and 141 non-affected peers. Out of 10 comprehensive health service centers in Bushehr city, 5 centers were selected by random sampling and the non-Covid-19 group was chosen from them (matched by gender and age with the affected group). The data were collected using the data recorded in the patients’ records, conducting telephone interviews and completing the prevalent long COVID symptom form. Data were analyzed using SPSS version 18. Descriptive statistics, Chi-square/Fisher’s exact tests, and stepwise logistic regression were used. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with p < 0.05 as the significance level.ResultsThe mean age of the hospitalized children with COVID-19 was 79 ± 5.24 months old, 57.4% of whom were boys. Also, 46 individuals of the COVID-19 group (32.6%) manifested long COVID symptoms. The most prevalent symptoms included fatigue (54.3%), impaired attention or concentration (41.3%) and depression or anxiety symptoms (34.7%). Among the hospitalized children experiencing long-term COVID symptoms, 65.2% exhibited moderate disease severity. A significant relationship was identified between disease severity and muscle and joint pain (P = 0.025), as well as between the length of hospital stay and cough (P = 0.022), weight loss (P = 0.047), and symptoms of depression or anxiety (P = 0.008). Older age [(6–11 y; OR = 3.18, CI = 1.03–9.88); (12 ≥ y; OR = 4.57, CI = 1.40-14.96)] and having history of smoking or being exposed to secondhand smoke (OR = 12.45, CI = 3.14–49.36) were considered as risk factors for long COVID.ConclusionsThe variables of age and history of exposure to tobacco smoke exhibited a significant independent relationship with the occurrence of long-term COVID symptoms in children hospitalized due to COVID-19. Specifically, as age increases and the history of tobacco smoke exposure rises, the likelihood of experiencing long-term COVID symptoms also increases.

Analysis of Educational Needs of Home Care Nurses: Utilizing Borich’s Needs Assessment and the Locus for Focus Model

Purpose: This study analyzed educational needs of home care nurses to improve the quality of home care service and identify priority educational subjects. Methods: This study analyzed the training priorities of 54 home care nurses working at community service centers or public health centers in Seoul, Korea, using the Borich Needs Assessment and the Locus of Focus model. The home care nurses’ tasks were categorized into 21 tasks and 85 task elements. Results: Six priority educational subjects were identified: 1) health assessment and monitoring, 2) nursing records and information management, 3) health education and counseling techniques, 4) home care supplies management, 5) recipient identification and communication skills, and 6) care recipient classification and management. Activities related to one-on-one health management, such as health screening, measurements, and disease management counseling, were found to be high priorities. In contrast, small group program planning and operation were rated as a low priority. Conclusion: This study underscores the importance of incorporating identified educational needs into training curricula for home care nurses. Regular assessment and integration of these needs into educational programs are crucial for enhancing nursing competence and service quality.

Oil and fat industry of the Eastern region of the Republic of Kazakhstan: growth reserves, economic potential

The aim is to study the trends and problems of development of the oil and fat industry of the East Kazakhstan region. Methods - statistical-economic in the study of phenomena and processes occurring in the oil-fat segment, calculative-constructive - to identify possible alternative directions of increasing the volume of production of the oil-fat subcomplex in the future, abstractlogical - to analyze the current situation in the oil-fat sector of the region, comparative - to compare the indicators of economic activity of this food industry by different criteria depending on the final objectives. Results - on the basis of statistical information and other official sources the questions concerning the produced agricultural products, their processing and the sphere of trade in finished goods were considered, at that, the final main product is edible and technical vegetable oils. Conclusions - detailed monitoring allowed to reveal the reasons restraining the expansion of the oil and fat industry in the region, in particular, limited provision of necessary raw materials, low percentage of utilization of production capacities of oil refineries, insufficient supply of high quality seeds. Measures to stabilize the output of oil and fat products have been proposed. These are, first of all, the use of innovative technologies in the production cycle, the formation and functioning of various integrated structures in the agro-industrial complex, which will increase the efficiency of enterprises and solve the issues of food security of the country. High-technology and equipment of advanced brands will significantly reduce the cost of processed products, and cooperation of producers with the support of service centers will make it possible to increase the sown areas of this oilseed crop. It is necessary to use innovative technologies, the implementation of which will contribute to the production of high-quality environmentally friendly food products that are in demand in domestic and foreign markets.

A study to assess the knowledge and utilization regarding services available in the primary health Centre among women residing in a selected rural community area, Udupi

The study assessed the knowledge and utilization of primary health centre services among 100 women in a rural Udupi community using descriptive research designs and a structured self-administered knowledge questionnaire. The tool's reliability and validity were tested with nursing and medicine experts. The collected data was analyzed using descriptive and inferential statistics. The study found that 84% of women had poor knowledge scores about primary health centre services, with a mean of 17.62. 100% utilized these services and practiced a balanced diet to prevent nutritional disorders. Factors like number of children had no significant association with knowledge scores, indicating partial acceptance of hypothesis H1. The study found that most women lack knowledge about primary health center services, but use them and consume balanced diets to prevent nutritional disorders.

Optimizing Internal Supervision: The Role of Time and Location in Enhancing Health Center Service Quality in Kendari

Introduction: The problem in this study is the data on the achievement of health center accreditation in Kendari City, namely: 10 intermediate health centers (66%), 2 basic (13%), 2 main (13%) and 1 plenary (6.6%). This data indicates that not all health centers have implemented service standards according to PMK 46 of 2015 concerning Health Center Accreditation Standards, this condition provides an illustration that technical guidance and supervision carried out at the Health Center have not been carried out optimally. The purpose of this study was to analyze the relationship between internal supervision strategies and improving the quality of health services as a managerial function at the Kendari City Health Center. Method: This type of research is quantitative Observational using Cross Sectional Study design. The population of the study were all health center leaders, Personal Health Efforts managers, Public Health Efforts managers and quality managers totaling 60 people at Kendari City health centers. The sampling method used the Total Sampling technique. Result: The results of the chi-square test on the supervision time variable obtained a value of X2 hit = 17.019, the location of supervision obtained a value of X2 hit = 13.081. Conclusion: There is a relationship between the time of supervision and the location of supervision with the improvement of service quality at the Kendari City Health Center.

Audit of Lithium Monitoring in a Mental Health for Older Persons (Dublin North City Central) Service

Abstract Background Lithium is a psychotropic medication used for the treatment of bipolar affective disorder and augmentation for treatment resistant depression. Lithium monitoring is essential due to the narrow therapeutic range of serum lithium and the potential for toxicity. Other medications with similar risk profiles, such as warfarin, have established monitoring programmes. Older adults receiving lithium therapy are at an increased risk of adverse events, given the prevalence of medical co-morbidities and changing pharmacokinetics. The authors of this audit identified the lack of formalized lithium monitoring programme in the Mental Health Service for Older Persons (MHSOP). The aim of this audit to compare monitoring practices in the MHSOP against the current gold standard Irish Medication Safety Network (IMSN) for Prescribing and Monitoring of Lithium Therapy. Methods A survey of all community medical charts identifying patients attending the service receiving lithium therapy was completed. Data collected pertained to diagnosis, treating consultant, lithium dose, if the patient received educational material, compliance with ECG and blood monitoring. Results The MHSOP active case load was 682 patients, 14 patients were prescribed lithium therapy. Cycle 1 of the audit demonstrated poor compliance of lithium monitoring against the gold standard. A lithium pack was inserted in patient files to prompt all clinicians to follow the recommended standardized monitoring of lithium therapy as per the IMSN guidelines. In cycle 2 of the audit there was an improvement in recording blood monitoring across the patient group. Conclusion The audit demonstrated improvement in compliance with international guidelines following the intervention. It was recommended that a formalized Lithium Clinic was a needed resource for the MHSOP. The lithium monitoring pack will continue to be added to clinical files, included in Non-Hospital Consultant (NCHD) induction and multi - disciplinary teaching sessions. It is proposed that the audit be repeated in one year to longitudinally assess compliance.

Impact of Organisational Climate on Employee Well-Being and Healthy Relationships at Work: A Case of Social Service Centres

Multiple studies highlight the crucial role of management of a positive organisational climate, which in turn contributes to employee well-being and healthy workplace relationships and mitigates the occurrence of negative behaviour, including harassment at the workplace. Furthermore, contemporary scholars emphasise the importance of open and transparent communication channels in reducing workplace tensions and improving employee mental health. However, the interrelationship between organisational climate, open communication, employee well-being, and negative behaviours in the workplace is a complex phenomenon. Despite the relevance and interest in organisational climate on employee well-being, limited efforts have been devoted to the area of relationships and causality, and straightforward answers about the objective links between these phenomena and their general nature remain complex. Therefore, this study aims to strengthen the understanding of the impact of the organisational climate on employee well-being and negative behaviours in the workplace. This is the first study that applied causality to the investigated problem to identify statistical relationships between the variables. This study was conducted in Lithuanian social service centres and schools, focussing on professionals with a high psychological risk at work due to their nature. This study offers valuable contributions and provides a comprehensive and profound insight into the management field, focussing on the impact of the organisational climate. The values of harassment in the workplace are explained by the values of organisational climate and employee well-being. This study demonstrates that improving the organisational climate contributes to employee well-being and healthy relationships and reduces the prevalence of negative behaviours in the workplace. This study introduces the academic and practical implications and suggests the pathways for further research.

Optimizing hierarchical classifiers with parameter tuning and confidence scoring

Hierarchical classifiers play a crucial role in addressing complex classification tasks by breaking them down into smaller, more manageable sub-tasks. This paper continues a series of works, focused on the technical Ukrainian texts hierarchical classification, specifically the classification of repair works and spare parts used in automobile maintenance and servicing. We tackle the challenges posed by multilingual data inputs – specifically Ukrainian, Russian, and their hybrid – and the lack of standard data cleaning models for the Ukrainian language. We developed a novel classification algorithm, which employs TF-IDF victimization with unigrams and bigrams, keyword selection, and cosine similarity for classification. This paper describes a method for training and evaluating a hierarchical classification model using parameter tuning for each node in a tree structure. The training process involves initializing weights for tokens in the class tree nodes and input strings, followed by iterative parameter tuning to optimize classification accuracy. Initial weights are assigned based on predefined rules, and the iterative process adjusts these weights to achieve optimal performance. The paper also addresses the challenge of interpreting multiple confidence scores from the classification process, proposing a machine learning approach using Scikit-learn's GradientBoostingClassifier to calculate a unified confidence score. This score helps assess the classification reliability, particularly for unlabeled data, by transforming input values, generating polynomial parameters, and using logarithmic transformations and scaling. The classifier is fine-tuned using hyper parameter optimization techniques, and the final model provides a robust confidence score for classification tasks, enabling the verification and classification results optimization across large datasets. Our experimental results demonstrate significant improvements in classification performance. Overall classification accuracy nearly doubled after training, reaching 92.38 %. This research not only advances the theoretical framework of hierarchical classifiers but also provides practical solutions for processing large-scale, unlabeled datasets in the automotive industry. The developed methodology can enhance various applications, including automated customer support systems, predictive maintenance, and decision-making processes for stakeholders like insurance companies and service centers. Future work will extend this approach to more complex tasks, such as extracting and classifying information from extensive text sources like telephone call transcriptions.

Recovery From Severe Mental Illnesses: The Influence of Personal and Psychosocial Factors in Community Settings.

Severe mental illnesses (SMIs) represent a significant public health challenge with substantial personal, economic and societal burdens. Despite treatment advances, recovery outcomes for SMI patients remain variable. This study aimed to investigate the influence of personal and psychosocial factors on recovery among SMI patients in community health settings. This cross-sectional study was conducted in 23 community health service centres in Nanjing, China. We recruited 924 participants diagnosed with SMIs, using a random sampling method. The relationships between individual, psychosocial factors and patients' recovery status were analysed by multiple linear regression. The mediation effect of medication adherence was further tested by the Sobel test with bootstrapping. The mean score of the Morningside Rehabilitation Status Scale (MRSS) of 924 patients with SMIs was 49.82 ± 41.52. The main influencing personal factors of recovery status were age, marital status, education, average annual income and duration of illness. Patients who were accepted by their families tended to have better recovery outcomes, while stigma and social impairment may hinder recovery. Medication adherence played a mediating role between psychosocial factors and recovery status. This study highlights the crucial role of psychosocial factors in the treatment and recovery of SMI patients. Furthermore, medication adherence emerged as a mediating factor. Implementing targeted interventions and policies addressing identified psychosocial barriers can offer promising avenues for improving recovery outcomes for SMI patients in community settings.

From informal farmland rental to market‐oriented transactions: Do China's Land Transfer Service Centers help?

From informal farmland rental to market‐oriented transactions: Do China's Land Transfer Service Centers help?

Analysis of the Current Situation of Service Capacity of Medical Social Workers in Shanxi Province and the Conception of Cultivation Pathway

Objective: This study aims to analyze the current status of service competence of medical social workers in Shanxi Province and to conceptualize the cultivation path. Methods: A questionnaire survey was conducted among 88 staff members and 120 residents of eight community health service centers in Shanxi Province to understand the population’s knowledge of the connotation of medical social workers and their needs. Results: Currently, the staff and residents of the community health service centers in Shanxi Province have a low level of knowledge and a high demand for medical social workers. It is recommended to expand the scope of practice of medical school students and design a series of training programs for medical social workers to better meet the needs of community healthcare and promote the implementation of the Healthy China Strategy.