Navigation Services Research Articles

Exploring self-determined solutions to service and system challenges to promote social and emotional wellbeing in Aboriginal and Torres Strait Islander people: a qualitative study.

Many Aboriginal and Torres Strait Islander people living on Kaurna Country in northern Adelaide experience adverse health and social circumstances. The Taingiwilta Pirku Kawantila study sought to understand challenges facing Aboriginal and Torres Strait Islander communities and identify solutions for the health and social service system to promote social and emotional wellbeing. This qualitative study applied Indigenous methodologies undertaken with Aboriginal and Torres Strait Islander governance and leadership. A respected local Aboriginal person engaged with Aboriginal and Torres Strait Islander community members and service providers through semi-structured interviews and yarning circles that explored community needs and challenges, service gaps, access barriers, success stories, proposed strategies to address service and system challenges, and principles and values for service design. A content analysis identified the breadth of challenges in addition to describing key targets to empower and connect communities and optimize health and social services to strengthen individual and collective social and emotional wellbeing. Eighty-three participants contributed to interviews and yarning circles including 17 Aboriginal community members, 38 Aboriginal and Torres Strait Islander service providers, and 28 non-Indigenous service providers. They expressed the need for codesigned, strengths-based, accessible and flexible services delivered by Aboriginal and Torres Strait Islander workers with lived experience employed in organisations with Aboriginal and Torres Strait Islander leadership and governance. Community hubs and cultural events in addition to one-stop-shop service centres and pre-crisis mental health, drug and alcohol and homelessness services were among many strategies identified. Holistic approaches to the promotion of social and emotional wellbeing are critical. Aboriginal and Torres Strait Islander people are calling for places in the community to connect and practice culture. They seek culturally safe systems that enable equitable access to and navigation of health and social services. Aboriginal and Torres Strait Islander workforce leading engagement with clients is seen to safeguard against judgement and discrimination, rebuild community trust in the service system and promote streamlined access to crucial services.

"A very different place from when the pandemic started": Lessons learned for improving systems of care for families of children with medical complexity.

Coronavirus disease 2019 (COVID-19) created unprecedented challenges for everyone, but especially families of children with medical complexity (MC) who rely on a comprehensive range of health and social services in their daily lives. Yet despite this, there are limited studies exploring caregiver perspectives regarding access to health and social services during the pandemic. To address this gap, we aimed to explore how health and social services can better meet the needs of children with MC and their families. Sixteen parents residing with their children with MC (from birth to 18years) in British Columbia, Canada participated in semi-structured interviews between July 2021 and April 2022. Findings revealed two different areas to improve services for families of children with MC, those relating to technology and family-centered care. Parents prioritized expanding the use of digital communication tools to support service navigation and scheduling. Virtual platforms were viewed as being valuable for building connections with other families and their community. In terms of family-centered care, parents emphasized the importance of policies recognizing the physical, emotional, and financial needs of the family. Findings have important implications for improving services to enhance the well-being and quality of life of children with MC and their families.

Turning the Page on Breast Cancer in Ohio: Lessons learned from implementing a multilevel intervention to reduce breast cancer mortality among Black women.

Turning the Page on Breast Cancer (TPBC) uses a multilevel approach to reduce breast cancer (BC) mortality among Black women. TPBC intervenes by (1) improving health care facilities' ability to conduct effective BC screening, follow-up, and treatment; (2) involving community-based organizations; and (3) providing education and personal risk information through a culturally relevant website. Ohio has among the worst BC mortality rates in the United States for Black women. TPBC is in its third year of providing targeted interventions in 12 Ohio counties with particularly high BC rates among Black women. TPBC enrolls health care facilities, collects organizational and patient data, and conducts key informant interviews to inform the provision of appropriate evidence-based interventions. TPBC engages Black communities through community-based organizations and social media advertising. The TPBC website offers BC information, connects Black women to community BC resources, and provides access to a risk-assessment tool. TPBC has provided tailored information packets, evidence-based interventions, and systematic support for improving the tracking and follow-up of breast health care among patients in 10 clinical partnerships. The project has provided education at community events monthly since mid-2021. The TPBC website (http://endbreastcancerohio.org) is promoted through social media (primarily Facebook) and community events to reach Black women aged 25-70 years. To date, 4108 unique users have visited the website, of whom 15.9% completed the risk assessment. Novel strategies are needed to address persistent disparities in BC outcomes among Black women. TPBC demonstrates the potential effectiveness of multiple methods of community-based, clinic-based, and web-based engagement. Turning the Page on Breast Cancer (TPBC) aims to reduce breast cancer mortality among Black women in Ohio by conducting multilevel, community-engaged interventions in 12 counties. Women are provided risk information and education at virtual and in-person community events and through a community-friendly website that was launched in November 2020. Almost 4000 women have visited the website, which offers community-targeted information, urges screening for individuals at elevated risk, and offers access to patient navigation services; 655 users have used a breast cancer risk-assessment tool on the site. Community-based organizations conduct educational efforts. TPBC partners with health care facilities, which are taught to improve their ability to conduct effective breast cancer screening, follow-up, and treatment. So far, TPBC has provided educational information, evidence-based intervention lists, tailored information packets, and ongoing quarterly support to partners in 10 counties. Evaluation will focus on aggregated data for screening and genetic testing referral at the clinic level.

A descriptive study of screening and navigation on health-related social needs in a safety-net hospital emergency department

BackgroundHealth-related social needs (HRSN) have been associated with worse clinical outcomes, increased Emergency Department (ED) utilization and higher healthcare costs. The ED is uniquely positioned to bring HRSN screening to the bedside and develop effective interventions. We evaluated whether navigation services for high-risk patients led to the resolution of HRSN. MethodsNavigators screened a convenience sample of patients for HRSN with the Accountable Health Communities Screening Tool from October 2019 to January 2022. Patients with HRSN were considered high-risk if they had at least two ED visits in the previous 12 months. Patients who were high-risk were eligible for navigation including community referrals and one-on-one close follow-up. The HRSN status (resolved, in-progress, unable to resolve) was queried from the Centers for Medicare and Medicaid database. The state hospital association provided data on ED visits and inpatient hospitalizations within 6 months of the screening visit. ResultsOf 185,470 ED visits, HRSN screening occurred in 4050 (2%). HRSN were self-reported in 48% (1944) of patient visits, with 71% of these (1379) considered high-risk. 15% of high-risk patients with HRSN opted out of navigation. Food insecurity was the most identified HRSN (35%) followed by housing instability (26%), transportation needs (24%) and utility assistance (15%). Food insecurity was the most resolved HRSN (39%, in-progress 32%) followed by utility assistance (37%, in-progress 26%), transportation needs (35%, in-progress 35%) and housing instability (28%, in-progress 36%). High-risk visits in which the patient or guardian accepted navigation were less likely to be associated with an ED visit within 6 months of the screening visit (51%) compared to high-risk patients in which the patient or guardian opted out of navigation (61%, p < 0.001), but there was no difference in inpatient hospitalizations (p = 0.427). ConclusionsDuring the study period, one-third of HRSN were successfully resolved with another one-third in-progress. Navigation in high-risk patients was associated with fewer subsequent ED visits.

Segmenting Patients With Diabetes With the Navigator Service in Primary Care and a Description of the Self-Acting Patient Group: Cross-Sectional Study.

The aim of patient segmentation is to recognize patients with similar health care needs. The Finnish patient segmentation service Navigator segregates patients into 4 groups, including a self-acting group, who presumably manages their everyday life and coordinates their health care. Digital services could support their self-care. Knowledge on self-acting patients' characteristics is lacking. The study aims are to describe how Navigator assigns patients with diabetes to the 4 groups at nurses' appointments at a health center, the self-acting patient group's characteristics compared with other patient groups, and the concordance between the nurse's evaluation of the patient's group and the actual group assigned by Navigator (criterion validity). Patients with diabetes ≥18 years old visiting primary care were invited to participate in this cross-sectional study. Patients with disability preventing informed consent for participation were excluded. Nurses estimated the patients' upcoming group results before the appointment. We describe the concordance (%) between the evaluation and actual groups. Nurses used Navigator patients with diabetes (n=304) at their annual follow-up visits. The self-acting patients' diabetes care values (glycated hemoglobin [HbA1c], urine albumin to creatinine ratio, low-density lipoprotein cholesterol, blood pressure, BMI), chronic conditions, medication, smoking status, self-rated health, disability (World Health Organization Disability Assessment Schedule [WHODAS] 2.0), health-related quality of life (EQ-5D-5L), and well-being (Well-being Questionnaire [WBQ-12]) and the patients' responses to Navigator's question concerning their digital skills as outcome variables were compared with those of the other patients. We used descriptive statistics for the patients' distribution into the 4 groups and demographic data. We used the Mann-Whitney U test with nonnormally distributed variables, independent samples t test with normally distributed variables, and Pearson chi-square tests with categorized variables to compare the groups. Most patients (259/304, 85.2%) were in the self-acting group. Hypertension, hyperlipidemia, and joint ailments were the most prevalent comorbidities among all patients. Self-acting patients had less ischemic cardiac disease (P=.001), depression or anxiety (P=.03), asthma or chronic obstructive pulmonary disease (P<.001), long-term pain (P<.001), and related medication. Self-acting patients had better self-rated health (P<.001), functional ability (P<.001), health-related quality of life (P<.001), and general well-being (P<.001). All patients considered their skills at using electronic services to be good. The patients in the self-acting group had several comorbidities. However, their functional ability was not yet diminished compared with patients in the other groups. Therefore, to prevent diabetic complications and disabilities, support for patients' self-management should be emphasized in their integrated care services. Digital services could be involved in the care of patients willing to use them. The study was performed in 1 health center, the participants were volunteers, and most patients were assigned to self-acting patient group. These facts limit the generalizability of our results. RR2-10.2196/20570.

Detecting Turning Relationships and Time Restrictions of OSM Road Intersections from Crowdsourced Trajectories

OpenStreetMap (OSM) road networks provide public digital maps underlying many spatial applications such as routing engines and navigation services. However, turning relationships and time restrictions at OSM intersections are lacking in these maps, posing a threat to the accuracy and reliability of the services. In this paper, a new turn information detection method for OSM intersections using the dynamic connection information from crowdsourced trajectory data is proposed to address this problem. In this solution, the OSM intersection structure is extracted and simplified and crowdsourced trajectories are projected onto OSM road segments using an improved Hidden Markov Model (HMM) map matching method that explicitly traces the turning connections in road networks. Optimal path analysis increases the turning support related to short road segments. On this basis, this study transforms complex turning identification scenarios into the simple analyses of traffic connectivity. Furthermore, a voting strategy is used to identify and calculate turning time restrictions. The experimental results, using trajectory data from three cities in China, show that the turning relationships can be detected at a precision of 90.71% with a recall of 96.55% and an F1-value of 93.54% in Shanghai. For Wuhan, the precision is 95.33% and the recall is 95.00%, with an F1-value of 95.16%. The precision and recall when identifying turning time restrictions both reach 90% in Xiamen. These results demonstrate the effectiveness of the proposed turning detection method.

A Visual Odometry Pipeline for Real-Time UAS Geopositioning

The state-of-the-art geopositioning is the Global Navigation Satellite System (GNSS), which operates based on the satellite constellation providing positioning, navigation, and timing services. While the Global Positioning System (GPS) is widely used to position an Unmanned Aerial System (UAS), it is not always available and can be jammed, introducing operational liabilities. When the GPS signal is degraded or denied, the UAS navigation solution cannot rely on incorrect positions GPS provides, resulting in potential loss of control. This paper presents a real-time pipeline for geopositioning functionality using a down-facing monocular camera. The proposed approach is deployable using only a few initialization parameters, the most important of which is the map of the area covered by the UAS flight plan. Our pipeline consists of an offline geospatial quad-tree generation for fast information retrieval, a choice from a selection of landmark detection and matching schemes, and an attitude control mechanism that improves reference to acquired image matching. To evaluate our method, we collected several image sequences using various flight patterns with seasonal changes. The experiments demonstrate high accuracy and robustness to seasonal changes.

Rostering of air traffic controllers – current practices in Europe, key performance trade-offs and future opportunities

The process of staff planning and rostering is one of the key factors affecting the performance of an Air Navigation Service Provider in terms of capacity and cost-efficiency delivered to airspace users. This paper gives a summary of previous works and current rostering practices applied at Area Control Centres (ACCs) in Europe. Furthermore, it identifies key trade-offs between rostering flexibility, capacity and productivity by establishing a relationship between ACC demand, rostering flexibility in place and the number of Air Traffic Control Officers (ATCOs) needed, as well as by exploring how varying rostering practices applied in ACCs affect spare capacity in the system. To that end, an initial mathematical model for optimizing ATCO staffing requirements has been proposed and tested on a case study involving three representative ACCs, reflecting different hourly variability in demand. The results suggest that - for different combinations of shift patterns and capacity profiles - substantial variation exists in both the minimum number of ATCOs and the associated spare ACC capacity. It has also been shown that a certain amount of spare capacity is inevitably present in the system due to inability to perfectly match ATCO hours with demand. Different options and enablers for exploiting such capacity are also discussed in the paper.

Clinician's commentary to accompany barriers to referral and evaluation and corresponding navigation services for toddlers screening positive for autism spectrum disorder.

Comments on the original article by Hightshoe, et al., (see record 2024-10422-003) regarding barriers to referral and evaluation and corresponding navigation services for toddlers screening positive for autism spectrum disorder. This article described how a largely Latinx sample experienced unique barriers and how the (autism family navigators) AFNs were able to respond directly to the needs of families by remaining flexible. It appears that AFNs were engaging in cultural humility by considering each family's culture and social factors, like when they advocated for adequate interpretation services for collaborative planning meetings. The current author would be interested to know more about the cultural training and skills used to facilitate engagement and build rapport. The case studies illustrate the necessity of having good working relationships in which families can indicate potential barriers, such as not being able to confirm an appointment with a facility or potential bias due to lack of insurance or immigration status, that need to be discussed to create an effective plan of intervention. These disclosures reveal areas of vulnerability that were only able to be discussed through the creation of safe space. Therefore, it would be essential to know how these working relationships were built and the geopolitical protections or risks (e.g., immigration healthcare policies that may impact mixed-status families) that could contribute to AFN and patient engagements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Barriers to referral and evaluation and corresponding navigation services for toddlers screening positive for autism spectrum disorder.

Children from disadvantaged populations receive referrals, diagnoses, and services for autism spectrum disorder (ASD) late or not at all. We describe barriers to referral for and receipt of evaluation for ASD among young children from disadvantaged families and activities by autism family navigators (AFNs) to address these barriers. Trained AFNs offered navigation to families of children aged 16-30 months with positive ASD screens from community health center clinics in 2015-2018. AFNs interviewed families to identify perceived barriers to care and documented system barriers and navigation activities. We coded, categorized, and described barriers and AFN activities. Case studies illustrate barriers and navigation activities. Of 22 participating mothers, 82% were Latinx and 64% were native Spanish-speaking; 71% had household incomes <$30,000/year and 57% had no high school diploma. Half of the families experienced five or more barriers to ASD evaluation, most commonly pragmatic barriers. Information barriers/needs were 5 times more common among Spanish-speaking than English-speaking mothers. One-fifth of families identified negative experiences or expectations of care. System barriers included incomplete screening tests, inadequate referrals, and waiting lists. AFNs implemented navigation activities, most frequently categorized as care coordination (95%), education (68%), social/emotional support (36%), family advocacy (27%), and self-advocacy coaching (23%). AFNs also trained providers and staff to improve screening and referral implementation. In this largely Latinx sample, families experienced numerous barriers to obtaining ASD evaluations for their screen-positive children, likely reflecting the complexity of negotiating both healthcare and educational systems. Trained AFNs can assist parents to overcome barriers to timely diagnosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patients' experiences undergoing breast evaluation in Rwanda's Women's Cancer Early Detection Program.

There is urgent need for interventions to facilitate earlier diagnosis of breast cancer in low- and middle-income countries where mammography screening is not widely available. Understanding patients' experiences with early detection efforts, whether they are ultimately diagnosed with cancer or benign disease, is critical to optimize interventions and maximize community engagement. We sought to understand the experiences of patients undergoing breast evaluation in Rwanda's Women's Cancer Early Detection Program (WCEDP). We conducted in-person semi-structured interviews with 30 patients in two districts of Rwanda participating in the WCEDP. Patients represented a range of ages and both benign and malignant diagnoses. Interviews were recorded, transcribed, translated, and thematically analyzed. Participants identified facilitators and barriers of timely care along the breast evaluation pathway. Community awareness initiatives were facilitators to care-seeking, while persistent myths and stigma about cancer were barriers. Participants valued clear clinician-patient communication and emotional support from clinicians and peers. Poverty was a major barrier for participants who described difficulty paying for transport, insurance premiums, and other direct and indirect costs of hospital referrals in particular. COVID-19 lockdowns caused delays for referred patients. Although false-positive clinical breast exams conferred financial and emotional burdens, participants nonetheless voiced appreciation for their experience and felt empowered to monitor their own breast health and share knowledge with others. Rwandan women experienced both benefits and burdens as they underwent breast evaluation. Enthusiasm for participation was not reduced by the experience of a false-positive result. Reducing financial, logistical and emotional burdens of the breast diagnostic pathway through patient navigation, peer support and decentralization of diagnostic services could improve patients' experience.

Design Of Helicopter Entry Point At Perum LPPNPI Kendari Branch

This research aims to design a helicopter entry point design that matches the needs of users at Kendari Airport. The method that will be used in this research is the Research and Development method, to be precise Research and Development Level 1. The population used in this research are ATC personnel at Perum LPPNPI Kendari Branch, expert teaching staff in the ATC field, and experts in Procedures for Air Navigation Services and Aircraft Operations (PANS-OPS). Data collection techniques used are documentation studies and interviews. The data processing technique used is the data analysis technique which consists of data reduction, data presentation, and verification. The author made this design based on the applicable rules using the AutoCAD 2022 application media, Global Mapper, and Google Earth Pro. At present, there is no helicopter entry point at Perum LPPNPI Kendari Branch, so when the air traffic controller provides service to the helicopter it will make confusion for the helicopter pilot regarding the flight path that must be passed for the approach.

BDS PPP ambiguity resolution using B1I/B2I/B3I/B1C/B2a observations with regional reference network augmentation

ABSTRACT BeiDou navigation satellite system with global coverage (BDS-3) has been fully operational since July 2020, currently providing the positioning, navigation and timing service together with regional BDS-2. In addition to the legacy signals of B1I and B3I, the BDS-3 also transmits several new signals such as BIC, B2a and B2b, which brings new opportunities for rapid ambiguity resolution (AR) of BDS precise point positioning (PPP). In this contribution, a multi-frequency (MF) rapid PPP-AR method with regional network augmentation was proposed. Firstly, BDS five-frequency observations were introduced into uncombined double-differenced models to retrieve regional augmentation corrections at the server. Thereafter, a cascade PPP-AR strategy using extra-wide-lane, wide-lane and narrow-lane ambiguity was employed at the user. Once ambiguities were fixed to integers, the phase correction accuracy could reach about 3 cm on average overall BDS frequencies in the network with inter-station distances of 100–200 km. Subsequently, the statistical results of seven-day simulated kinematic experiments showed that over 99% of epochs on average realized PPP-AR. Correspondingly, the positioning accuracy of the MF fixed solution reached 1.8, 1.9, 4.7 cm in the east, north and up components, respectively, improving by 5–15% compared with the dual-frequency scheme. Moreover, several vehicle-borne experiments under different urban scenarios were also conducted. Under an open-sky or a relatively open highway scene, the BDS-MF scheme similarly exhibited good performance, and over 98% of epochs achieved rapid PPP-AR with a positioning accuracy better than 3 cm. More encouragingly, for this BDS-challenged experiment with an average satellite number of 8.6, although only 72.06% of epochs were available due to serious signal blockages caused by overpass, tunnels or tall buildings, the horizontal positioning accuracy could still remain 7 cm on average.

GNSS-5G Hybrid Positioning Based on Joint Estimation of Multiple Signals in a Highly Dependable Spatio-Temporal Network

The Global Navigation Satellite System (GNSS) has been widely used in every area of our daily life to provide accurate Positioning, Navigation, and Timing (PNT) services. However, due to the multipatch effect and an obstructed view of the satellite, GNSS receivers are susceptible to large-ranging errors, which are particularly prevalent in urban areas where precise positioning is indispensable. The deployment of the high-spatial-density Fifth-Generation (5G) network makes it possible to provide a broad area with high-precision positioning service. Obviously, it promoting the deep integration of the GNSS system and the 5G mobile communication network and establishing a Highly Dependable Spatio-temporal Network (HDSN) have become an inevitable trend. The existing algorithm for the fusion of multiple signals has difficulty settling problems such as the fast fluctuation of available signal sources and the poor stability of multi-scale multi-type signal estimation in GNSS-5G hybrid networks. Here, we propose a Square Root Unscented Stable Filter (SRUSF) for GNSS and 5G joint positioning with a compact coupled filter group architecture in a highly dependable spatio-temporal network. A stabilized coefficient is added to guarantee positive covariance of the estimation error. The possibility of divergence of filtering results due to the variation in signal sources and the incomplete agreement between the system model and the actual situation are reduced. The simulation results show that the proposed SRUSF method substantially enhances the positioning accuracy and reliability compared with the other five joint estimation methods for multiple signals. This work will enable the terminal of mass users to provide timing and positioning services with unprecedented accuracy and dependability under the GNSS and 5 G-based spatio-temporal network’s architecture.

The impact on patients of the tertiary-primary healthcare interface in kidney failure: a qualitative study.

Clinicians and patients have reported fragmentation in the primary and tertiary healthcare interface. However, perspectives of service navigation and the impacts of fragmentation are not well defined, particularly for patients transitioning to dialysis. This study aimed to define patient perspectives of the functioning of the health service interface and impacts on healthcare experiences and engagement, informing patient-centred and outcomes-focused service models. A qualitative study was conducted through semi-structured interviews with 25 dialysis patients (16 males) aged 34-78 receiving dialysis across a multi-site tertiary service. Transcripts were analysed thematically. Three main themes were identified: (1) The Changing Nature of General Practitioner (GP) Patient Relationships; (2) Ownership and Leadership in Kidney Care; and (3) The Importance of Nephrologist-GP Communications. Patients perceived an unreliable primary-tertiary service interface which lacked coordinated care and created challenges for primary care continuity. These impacted perceptions of healthcare provider expertise and confidence in healthcare systems. Patients subsequently increased the healthcare sought from tertiary kidney clinicians. The fractured interface led some to coordinate communication between health sectors, to support care quality, but this caused additional stress. A fragmented primary-tertiary healthcare interface creates challenges for patient service navigation and can negatively impact patient experiences, leading to primary care disengagement, reduced confidence in health care quality and increased stress. Future studies are imperative for assessing initiatives facilitating health system integration, including communication technologies, healthcare provider training, patient empowerment, and specific outcomes in health, economic and patient experience measures, for patients transitioning to dialysis.

Readiness of Galileo PNT Service for NATO Operations Threats and Challenges

In the domain of the Defense ICT-based technology: (Information and Communication Technology), most of the worldwide defense operations, including the North Atlantic Treaty Organization (NATO) operations, are significantly relying on the space support services. One of the most essential services is the Positioning, Navigation and Timing (PNT) service, which is currently provided by the United States’ Global Positioning System (GPS). The GPS has become a global utility comparable to the internet, and it does not ‘just’ provide positioning data, but also provides the most important civilian/military use of the timing signal, which synchronizes all the communication and the encryption in all operations. While the USA has formulated first requirements to strengthen the resiliency of GPS in terms of the availability of accuracy, the availability of integrity and the availability of continuity, NATO has additional options to improve resiliency by integrating the European Galileo constellation. This paper focus mainly on the military implications of these two Global Navigation Satellite Systems (GNSS), to order to enrich the knowledge of the NATO members and policymakers about the PNT options available to the alliance, as well as addressing the various threats and challenges facing the PNT services.

The Experience of Home Parenteral Therapy: A Thematic Analysis of Patient Interviews.

A limited number of studies have explored patients' experience with home parenteral (injectable) therapy (HPT) in the UK. To explore the immediate-, short-, and long-term experience of patients with self-management of any home parenteral therapy with the intention for developing a guideline for service development in the United Kingdom. An interview-based study of patients receiving HPT. Invitations were posted to all patients on the hospital HPT register. The sessions were conducted by telephone for all consenting patients. The interviews were recorded, transcribed, and analysed thematically. Participants completed the 'Health Education Impact Questionnaire' (heiQ) before and after the education session. Of the 640 patients invited to participate in the study, 45 (7%) patients completed the interviews and the education session. An interview analysis revealed that the patients' experiences of HPT were generally positive, but the levels of training and support received showed wide individual variations. The patients had experienced periods of doubt and uncertainty, where they would have appreciated quick access to professional advice to alleviate their concerns. There was a reliable positive change (10.5-18.4%) from before and after the education sessions in six out of the eight domains on the heiQ questionnaire (health-directed behaviour, self-monitoring and insight, constructive attitudes and approaches, skill and technique acquisition, social integration and support, and emotional distress) and moderate change in two domains (5.3% in positive and negative engagement in life, and 2.6% in health services navigation). Self-administered parenteral therapy at home is a valuable option, but training and preparation standards should be optimised across hospitals and the wider NHS.

The Prevalence of Congenital Color Vision Abnormality Among Patients Attending a Tertiary Eye Care Center in Southern India.

Background and objective Color vision abnormality is a condition where the faculty to identify one or more primary colors is either defective (anomalous) or absent (anopia). Occupations like armed forces, merchant navy, navigation, and police and fire services require normal color vision. There is a scarcity of data in the literature regarding the prevalence of congenital color vision abnormality in patients in South India. In light of this, the present study aimed to find the prevalence of congenital color vision abnormality in patients attending the Outpatient Department (OPD) at a tertiary eye care center in South India. Materials and methods This was a descriptive cross-sectional study conducted at a tertiary eye care center in South India from December 2014 to December 2016. Patients with a best-corrected visual acuity of 20/20, normal direct and consensual pupillary light reflex, normal anterior segment, and undilated fundus examination were included. Color vision was assessed using Ishihara pseudoisochromatic plates, American Optical Hardy-Rand-Rittler (AO HRR), and then the Farnsworth Munsell D15 arrangement test. All the results were tabulated and statistically analyzed. Statistical significance was calculated using the ANOVA test. Results A total of 371 patients were screened for color vision abnormality; 184 (49.59%) patients were males and 187 (50.40%)were females. Out of 371 patients in the study, 363(98.10%) had normal color vision while eight patients (2.16%) had color vision abnormality. Of the eight patients with color vision abnormalities, six (75%) had abnormal color vision on all three tests and two(25%) had an abnormality on only two tests (Ishihara and AO HRR). Out of 184 males in the study, eight patients (4.34%) had abnormal color vision while none of the 187 females had color vision abnormality; this difference was statistically significant (p=0.03). Conclusions Early diagnosis and providing education and awareness of this condition are necessary as part of guiding young people with regard to their career options and we recommend that all children should undergo color vision screening before entering high school.

Community Health Center Staff Perspectives on Financial Payments for Social Care.

A growing crop of national policies has emerged to encourage health care delivery systems to ask about and try to address patients' social risks, e.g., food, housing, and transportation insecurity, in care delivery contexts. In this study, we explored how community health center (CHC) staff perceive the current and potential influence of fee-for-service payments on clinical teams' engagement in these activities. We interviewed 42 clinicians, frontline staff, and administrative leaders from 12 Oregon CHC clinical sites about their social care initiatives, including about the role of existing or anticipated financial payments intended to promote social risk screening and referrals to social services. Data were analyzed using both inductive and deductive thematic analysis approaches. We grouped findings into three categories: participants' awareness of existing or anticipated financial incentives, uses for incentive dollars, and perceived impact of financial incentives on social care activities in clinical practices. Lack of awareness of existing incentives meant these incentives were not perceived to influence the behaviors of staff responsible for conducting screening and providing referrals. Current or anticipated meaningful uses for incentive dollars included paying for social care staff, providing social services, and supporting additional fundraising efforts. Frontline staff reported that the strongest motivator for clinic social care practices was the ability to provide responsive social services. Clinic leaders/managers noted that for financial incentives to substantively change CHC practices would require payments sizable enough to expand the social care workforce as well. Small fee-for-service payments to CHCs for social risk screening and navigation services are unlikely to markedly influence CHC social care practices. Refining the design of financial incentives-e.g., by increasing clinical teams' awareness of incentives, linking screening to well-funded social services, and changing incentive amounts to support social care staffing needs-may increase the uptake of social care practices in CHCs.

An Intelligent Framework for Cyber-Physical Satellite System and IoT-Aided Aerial Vehicle Security Threat Detection.

The small-drone technology domain is the outcome of a breakthrough in technological advancement for drones. The Internet of Things (IoT) is used by drones to provide inter-location services for navigation. But, due to issues related to their architecture and design, drones are not immune to threats related to security and privacy. Establishing a secure and reliable network is essential to obtaining optimal performance from drones. While small drones offer promising avenues for growth in civil and defense industries, they are prone to attacks on safety, security, and privacy. The current architecture of small drones necessitates modifications to their data transformation and privacy mechanisms to align with domain requirements. This research paper investigates the latest trends in safety, security, and privacy related to drones, and the Internet of Drones (IoD), highlighting the importance of secure drone networks that are impervious to interceptions and intrusions. To mitigate cyber-security threats, the proposed framework incorporates intelligent machine learning models into the design and structure of IoT-aided drones, rendering adaptable and secure technology. Furthermore, in this work, a new dataset is constructed, a merged dataset comprising a drone dataset and two benchmark datasets. The proposed strategy outperforms the previous algorithms and achieves 99.89% accuracy on the drone dataset and 91.64% on the merged dataset. Overall, this intelligent framework gives a potential approach to improving the security and resilience of cyber-physical satellite systems, and IoT-aided aerial vehicle systems, addressing the rising security challenges in an interconnected world.