Demand For Services Research Articles

Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany

Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany Abstract: With the Digital Healthcare Act, Germany has taken a decisive step toward promoting high-quality, evidence-based digital health applications (DiHAs). Presently, there is a significant gap in the provision of mental health services throughout Germany, particularly regarding children and adolescents and especially in the aftermath of the COVID-19 pandemic. DiHAs as low-threshold, location- and time-independent additional mental health services - may offer a way to address this situation. Particularly in the emerging generation of digital natives, there is a high demand for digital mental health services. However, despite the rapidly growing supply of DiHAs for adults, there is a lack of approved DiHAs for children and adolescents with mental disorders. Rather, the demand for care is left to the unregulated market of diverse internet- and mobile-based interventions; early studies have questioned the evidence base, safety, and quality. This discrepancy arises from various specific challenges and risks that reduce incentives to develop DiHAs for this particularly vulnerable target group, including (1) limited evidence, (2) high complexity in study execution, (3) high complexity in the development of applications, (4) poorly researched specific risks, and (5) high regulatory requirements. This article discusses these challenges and risks and outlines the perspectives for a high-quality, safe, and evidence-based digital mental healthcare for children and adolescents.

Physical therapy registries worldwide: A systematic review.

Nowadays, the demand for physical therapy services has grown significantly over the last few decades due to an aging population, a rise in chronic conditions, and increased awareness of the benefits of physical therapy for injury recovery and managing various health issues. Collecting and managing data from physical therapy services is highly significant and beneficial. One of the information management systems that facilitates data collection related to physical therapy services is a physical therapy registry. In this systematic review, we aimed to identify physical therapy registries worldwide and examine the characteristics and data elements of each registry. PubMed, Scopus, Web of Science, and IEEE databases were searched from inception until March 19, 2023 by using keywords and Medical Subject Headings (MeSH) terms regarding "registries" and "physical therapy." The criteria for inclusion in the study were: (1) studies with the English language; (2) original studies, and online access to the physical therapy registry is available; (3) full-text available; (4) studies related to the aims of the study, and (5) studies that have sufficient available information regarding the minimum datasets and other characteristics physical therapy registry. The methodological quality of the included studies was independently assessed by two reviewers using the Effective Public Health Practice Project's (EPHPP) quality assessment tool. Sixteen studies were eligible to be included. The findings of this review indicated that the oldest physical therapy registry was established in 1992, while the newest one was established in 2017. The USA has the highest number of physical therapy registries (n = 7). Ten registries were funded by the government, and the data source for most registries was collected in clinics (n = 11). The geographical coverage of 10 registries was national. All registries collected administrative data (such as sociodemographic data, healthcare provider's data, and others) and clinical data (such as diagnosis, type of physical therapy intervention, pain location, comorbidities, and others) through web-based systems. The data collection method in half of the registries was retrospective (n = 8 out of 16). According to the EPHPP quality assessment tool, 11 studies (73%) were rated as moderate, 3 (20%) as weak, and 1 (7%) as strong. This systematic review found that most developed countries have implemented web-based physical therapy registries to collect administrative and clinical data at the national level. It is recommended that developing countries design and implement similar registries based on these characteristics and extracted data elements. Additionally, these registries should be designed to enable data sharing and interoperability with other international health information systems.

Analysis of 4G/LTE Network Performance in North-Central Nigeria: A Comprehensive Drive Test Approach

The proliferation of mobile devices and escalating demand for data services have resulted in a substantial increase in data traffic across Nigeria, especially in the North Central region due to heavy migration of individuals and organizations towards Abuja, the federal capital. However, despite the growing adoption of 4G/LTE networks in North Central Nigeria, users encounter persistent challenges in accessing high-speed internet and poor service network. This study investigates the performance of 4G/LTE networks in North-Central Nigeria using a comprehensive drive test methodology carried out in Abuja, Lafia and Makurdi. It covered a duration of 3hrs (12.00noon to 15.00pm) for 3days (3rd - 6th January, 2024). For each test day, drive tests covered a period of data measurements divided into 3,600 time-steps, with each time-step sized at 1sec; and scaled to 1:150 units. Key metrics including network speed, latency, uptime, coverage, and signal power were evaluated across major Mobile Network Operators. Result shows that D-NGN has the highest mean speed (9.543Mbps), packet loss (2.007%), uplink percentage (97.714%), and Network coverage (87.514%). It has the least latency (25.921) but high packet loss (2.007%). However, C-NGN shows lowest mean speed (6.638Mbps), uplink percentage (38.706%) and Signal power (-78.057dBm) but lowest mean packet loss (0.121%). A-NGN has the highest mean signal power (-61.867dBm) while B-NGN has highest latency (44.070ms) and lowest Network coverage (60.731%). This reveals that D-NGN has dominance in network performance, outperforming A-NGN, B-NGN, and C-NGN. It is recommended that MNOs in North-Central Nigeria should strategically enhance their network infrastructure to improve service delivery, particularly in suburban and rural areas where performance lags. D-NGN, the frontrunner in network speed and coverage, could further solidify its market leadership by addressing identified latency and packet loss issues especially in Makurdi. Moreover, MNOs with lower performance metrics could invest in expanding coverage and optimizing network configurations to meet user demands, thereby increasing competitiveness and customer satisfaction across the region.

Genetics Navigator: protocol for a mixed methods randomized controlled trial evaluating a digital platform to deliver genomic services in Canadian pediatric and adult populations

IntroductionGenetic testing is used across medical disciplines leading to unprecedented demand for genetic services. This has resulted in excessive waitlists and unsustainable pressure on the standard model of genetic healthcare....

Research on the Transformation and Development of Investment Bank FICC Business of CITIC Securities Company Limited

In the current financial environment, with the continuous expansion of China's economic output and the continuous expansion of demand for financial services, the mutual influence of the international market is gradually deepening. Deepening the development of FICC business has become the core breakthrough point for the high-quality development of securities companies. Since its development, the FICC business (i.e. capital intermediary business) under the investment banking system of CITIC Securities has been involved in fixed income, foreign exchange, commodities, etc. However, there is still a significant gap in its development compared to international investment banks. Taking the current research status of FICC business at home and abroad as the background, taking CITIC Securities Company as an example, analyze the development status of its FICC business from multiple perspectives. Analyze the development bottlenecks in various aspects such as overall capital scale, traditional business and internationalization level, talent team structure, and technological innovation ability, and propose targeted solutions to improve the risk management system, expand the FICC business chain, accelerate technology investment, improve organizational structure, and leverage synergies to promote the transformation and development of CITIC Securities' FICC business and support the high-quality development of the securities and finance industry.

Centralized multi-robot logistic system: An approach using the island model genetic algorithm as task scheduler

The practicality allied with technological and logistical advances led customers increasingly to join e-commerce. This phenomenon was even more expanded during the COVID-19 pandemic. Because of the growing demand for logistic services, warehouses must adapt and seek faster and more efficient processes. A means to achieve that is to use mobile robots in transportation-related tasks. However, their effectiveness is only achieved if the system has an efficient work distributor. This research developed a centralized coordination architecture using the island model genetic algorithm for multi-robot logistic task allocation. The coordination receives, allocates, and monitors tasks performed by robots with different payload capacities and average speeds. The architecture was developed upon the robotic operating system. Thus, any robot with a robotic operating system-based internal system can work under the coordination of this architecture. On the results, the task scheduler, developed in previous work, had the evaluation complemented. The scheduler based on the island model genetic algorithm allocates more tasks than the standard genetic algorithm when using the same heuristic. Regarding coordination architecture, the system successfully managed a group of robots in a simulated environment. It also detected and notified failures during task execution. Therefore, this system provides a complete task scheduling, allocation, and monitoring solution.

Fiscal Policy’s Function in Reducing Economic Downturn

Fiscal policy drives a nation’s economic activity by taxing and spending by the government. It is essential for preventing economic downturns. Generally, it operates as follows: A rise in government spending Business and consumer spending typically decreases during recessions, which lowers the economy’s total demand. The government can spend more on infrastructure, services, and public initiatives to make up for this. Quick economic stimulation results in more demand for goods and services as well as the creation of jobs. Tax Rebates: Lower taxes generate more cash for businesses and consumers alike. More money is available for both individuals and companies to invest in and expand their businesses. It is possible to counteract the drop in private sector demand by increasing spending and investment. Transfer Payments: The government may also raise transfer payments to pay for social security, unemployment insurance, and other welfare programs. These payments shield the purchasing power of those who are adversely affected by the recession and aid in stabilizing the economy. Automatic Stabilizers: Without the need for new legislation, some components of fiscal policy automatically promote economic stabilization. For instance, lower-class and impoverished households benefit from automatic stabilizers that reduce taxes in reaction to slower economic development and falling revenues. Unemployment insurance and progressive income taxes are two instances of these stabilizers. As a result, aggregate demand is sustained. Debt and Budget Deficits: During a recession, the government may have a budget deficit if expenditure exceeds revenue. This may lead to an increase in the national debt, but this is typically justified as a benefit to the economy. The theory is that the economy will eventually recover from the short-term debt increase due to the stimulus’s long-term impacts, improving the country’s financial situation. The Multiplier Effect: The economy may be impacted in a number of ways by the government’s increased expenditure and tax incentives. For example, when the government funds a new infrastructure project, the workers employed to complete it spend their earnings on goods and services, increasing demand and economic activity as well as the profits of themselves and other firms. Generally speaking, the goal of fiscal policy is to boost the economy during recessions in order to lessen their severity and hasten their recovery.

Feasibility study on the use of uçá crab waste in civil construction

The construction sector has undergone significant evolution in response to the needs generated by social transformations over time, experiencing various technological revolutions that have transformed the methods and materials used, from the rudimentary techniques of ancient civilizations to the technologies provided by scientific evolution. These transformations foment the demand for basic services, the search for technological and commercial innovation to continue meeting the needs of the population, which, consequently, has increased the production and accumulation of waste, especially organic waste and those from the food sector, such as the exoskeleton of the Uçá crab. The constant consumption of these crustaceans generates an abundance of waste improperly discarded in the environment, which can lead to negative impacts on fauna and flora. In short, as a form of mitigation, the partial use of Uçá crab shells in construction is proposed. Therefore, this study aims to investigate sustainability in the construction sector through the use of Uçá crab waste, through a bibliographic analysis of the topic addressed.

The military–industrial complex as a variety of capitalism and threat to democracy: rethinking the political economy of guns versus butter

This paper examines the military–industrial complex (MIC), which is a prototype widely imitated by other business sectors. Collectively, they constitute a variety of capitalism which can be termed the poly-industrial complex (PIC). Understanding the MIC is critical to understanding contemporary US capitalism, US international policy, and the drift toward Cold War II. The MIC exerts a massive societal impact. It twists economic activity toward military spending; twists the character of technical progress; is socially corrosive via its capture of politics and government; twists societal understanding of geopolitics to increase demand for war services; promotes militarism and increases the likelihood of war; and promotes proto-fascist drift because militarism drips back into national politics. Given these features, the MIC is of first-order significance and the consequences of failure to understand it are likely to be grim. Politics is at the center of possibilities for change. This raises questions whether the demand for change can be mustered, and whether the political system will permit it.

Using an organizational change model to improve lung cancer surgery services over five years.

Lung cancer is the most common cause of cancer death in the UK resulting in 21% of all cancer deaths. In 2016, local lung cancer surgery services required improvement due to under-representation in cancer resections and resource scarcity during the pandemic, which affected critical care bed availability and extended postoperative stays. The aim of this service improvement was to increase the number of lung cancer resection; develop minimally invasive techniques and reduce the use of Critical Care Unit beds by 35% (a subsequent goal). A five-year plan, guided by Kotter's 8-step change model, was initiated to address these issues. This model promotes sustainable change by setting clear goals, effective communication, and stakeholder involvement. Initial changes included hiring a thoracic surgeon experienced in uniportal video assisted thoracoscopy and enhanced recovery protocols. The team grew to three thoracic surgeons by 2020. The service increased operating theatre days and adopted new postoperative practices to reduce complications and hospital stays. Lung Cancer Multidisciplinary Team Meetings were consistently covered by thoracic surgeons, ensuring comprehensive care. Data on surgical activity were collected from departmental databases and national audits, with internal audits conducted regularly. Statistical significance was tested using chi-square tests with P values <0.05. The number of surgical procedures more than doubled, with primary lung cancer resections increasing nearly three-fold from 12.8% to 29.8% over six years. Postoperative complications and mortality rates remained low. Critical care bed usage dropped significantly during the pandemic, with new protocols enabling safe recovery in general surgical areas. The successful expansion of thoracic surgical services was attributed to the dedicated minimally invasive surgeons, enhanced recovery measures, and skilled staff. The change model facilitated efficient and dynamic progress. With the introduction of lung cancer screening programs, the demand for surgical services is expected to rise. The effective change model will be re-applied to meet this demand. The organizational change model, focused on patients and staff, achieved sustained quality improvement in lung cancer care despite challenging conditions like the coronavirus disease 2019 pandemic.

Analysis of health behavior changes among residents in depopulation areas in Korea: a cross-sectional study based on Community Health Survey data from 2010 to 2019

Objectives: The total population of Korea began to decline in 2019; in particular, the population in rural areas has been rapidly decreasing and is aging. Therefore, the government has designated depopulation areas and is seeking ways to support them. To assess whether health disparities exist between areas with population decline and those without, this study used community health survey data to observe temporal changes in health behaviors between the two types of areas. Methods: The analysis used Community Health Survey data from 2010 to 2019, and regional classification was divided by depopulation areas designated by the Ministry of the Interior and Safety. Trends in health behavior and chronic disease prevalence between depopulation and non-depopulation areas were analyzed. All analyses were conducted using complex sample analysis procedures in SAS 9.4 software. Results: The smoking rate steadily decreased in both depopulation and non-depopulation areas, whereas the high-risk drinking rate increased slightly. The walking practice rate did not improve in depopulation areas compared to non-depopulation areas. Furthermore, nutritional labeling usage rate was consistently lower in depopulation areas than in non-depopulation areas, with the gap being the largest. The prevalence of obesity, diabetes, and hypertension showed that the gap between depopulation and non-depopulation areas is continuously increasing. Conclusions: Health behaviors in depopulation areas have not improved, and the prevalence of chronic diseases is increasing rapidly. Therefore, the demand for health care services that support healthy lifestyle practices and chronic disease management in these areas is expected to increase.

Constructions of carer identity for people supporting someone with depressive or anxiety symptoms: a qualitative study

ABSTRACT Objective Research examining mental health carers’ perceptions of their role and adoption of the carer label is rare, and non-existent for carers of a person with depressive or anxiety symptoms specifically. This study aimed to understand how carers of people with depressive or anxiety symptoms perceive their identity, how they interpret the carer label and the implications of role ambiguity. Method Using a phenomenological qualitative design, 14 carers of people with depressive or anxiety symptoms participated in semi-structured interviews between June 2022 and July 2022. Reflexive thematic analysis of transcribed interview data identified four themes. Results Carers defined their identity based on their primary objective of supporting the care recipient to lead an independent life. Carers reported that the carer label had a diminishing effect on the care recipient’s independence, which served as a barrier to carers adopting the term and self-identifying as carers. In the initial phases of caring, carers attributed their negative experiences to role ambiguity. Over time, for some carers, role ambiguity enabled deeper relationships and personal growth. Discussion Adopting the carer label is challenging for this carer group. Barriers to self-identification may limit accessibility and demand for appropriate resources and services. Future research into carer identity is still required.

A qualitative study on the psychological support service experiences and demands of mothers of school-age children with disabilities

A qualitative study on the psychological support service experiences and demands of mothers of school-age children with disabilities

Socio-Economic Factors Influencing Growth of Small and Medium Enterprises in Mombasa County, Kenya

Small and Medium Enterprises (SMEs) contribute over 70% of jobs, contribute to GDP, aid industrial development, satisfy local demand for services, innovate and support large firms with inputs and services. However, the SMEs in Mombasa County are constantly faced with the threat of failure where three out five fails at infancy. The study investigated the influence of economic factors (taxation, finance access and wages and unemployment) on growth of SMEs in Kenya, in Mombasa County. The specific objectives of the study were; to explore the effect of taxation on growth of SMEs, to find out the effect of Financial Access on growth of SMEs, to determine the effect of wages on growth of SMEs operating, and to evaluate the effect of general unemployment on growth of SMEs operating in Mombasa County. This study employed the institutional theory of growth, the Schumpeter theory of growth and the Endogenous growth theory anchored the study. An explanatory research design was used so as to meet the research objectives. The target population was 54,245 registered SMEs and a sample size of 246 was derived using the Cochran, statistical formula. The list of registered SMEs in Mombasa formed the study population. A Systematic Random Sampling was used from a sample of 246 SMEs was drawn. Data was collected using a structured questionnaire. Multiple regression Analysis technique was the main technique to find the effect of social economic factors on SME growth. to analyze the data using the Statistical Package for Social Sciences with a significance level set at 0.05. Findings showed that SE conditions are just modest level. Correlation results showed that Taxation conditions (r=.344, p=.000), Financial Access (r=.430, p=.000), Wages affordability (r=.241, p=.000) are positively and significantly correlated with SME growth. Regression results showed that SE factors; Taxation conditions (=.268, p=.000), Financial Access ( =.383, p=.000), Wages ( =.182, p=.015) and Unemployment ( = -.170, p=.045) has significance effect on SMEs growth. Conclusions; Socioeconomic can reverse the current trend of high SMEs failure rate. Socioeconomic factors can buck the present trend of a high failure rate among SMEs. The study recommended that the county and national governments should implement measures enhancing tax benefits for SMEs such as utilizing the taxes prudently. Additionally, the SMEs should adopt strategies that enhance internal financial capabilities so as to incase their revenue streams. Moreover, it is recommended the SMEs to have a working and sustainable wage policy that is able to attracts and keeps talented workforce and therefore ensure continued business growth. By using a multi-sectoral approach, both local and national governments should prioritize and focus on short- and long-term policies that lower the rising rates of unemployment.

Survey on Cloud Computing Security

One of the most popular IT subfields today is cloud computing. With a simple Internet connection, it enables users to access cutting-edge information, technology, and infrastructure. Because of the numerous benefits offered, most international organizations have started to move toward cloud computing environments during the last few decades. Companies and organizations find cloud computing appealing because it eliminates the need to plan for provisioning and enables them to start with modest resources and progressively raise them as service demand increases. Cloud computing presents opportunities for research as well as obstacles. The security and privacy of data in cloud systems are important issues. Now that cloud computing technology is developing quickly, it is more convenient for businesses to move their workload there. It asks for a smaller investment and guarantees quick delivery of cutting-edge technologies. Cloud security is of the utmost importance. It is susceptible to cyberattacks that exploit its vulnerabilities in an insecure cloud environment. This puts the cloud environment’s assets, resources, and data in danger. In this paper, we reviewed some cloud computing studies about various attacks on cloud computing services. This paper’s main objective is to give readers a better understanding of security issues and solutions.

Fostering sustainable consumer behaviour: Unravelling the determinants of repair intentions for smart appliances

Consumer demand for repair services is vital for prolonging product lifespan, yet factors influencing the repair intention for smart appliances remain unclear. Addressing this gap, we propose an extended theory of planned behaviour, incorporating four additional constructs: environmental knowledge, cost of repair, financial benefit, and data security. We collected data from 383 participants in the United Kingdom, which we analysed using a partial least squares approach. Results reveal that the cost of repair, perceived behavioural control, attitude, and financial benefit directly impact repair intention, while subjective norms do not. Environmental knowledge indirectly influences repair intention through attitude mediation, and data security's impact is not moderated by attitude. This extended theory offers a theoretical foundation for future related studies, providing insights for repair providers, environmental NGOs, and policymakers. Our findings can inform interventions promoting repair behaviour and guide policies incentivising consumers, thus increasing the demand for repair services.

Education Expenses and Their Relationships with the Accounting Indicators of Capixabas Municipalities

Currently, public managers have the challenge of combining intense demand for essential services for the population with limited financial resources. Due to this fact, they submit themselves to gradually seek more efficiency in decision making. The literature shows us that analysis via indicators extracted from accounting balance sheets is one of the vital mechanisms to contribute to this purpose. Thus, the research aimed to answer the following question: Are the accounting indicators, calculated through the balance sheets of the municipalities of Espírito Santo, related to the amount invested in education? Regarding the methodology, it is a bibliographic and quantitative research. To answer the research question, the following statistical methods were used: descriptive statistics, multiple linear regression and Pearson correlation. The results found indicate that some quotients used in the research, such as Budget Result Quotient (BRQ), Current Liquidity (CL) and Debt Composition (DC), showed a statistically significant relationship with the amount invested in education. Through the results, we note the importance of using accounting indicators to suggest ways that can help public managers in making a decision to invest more or not, that is, whether it is better to increase or reduce their assets and liabilities in order to increasingly improve the services provided to society, generating more efficiency and quality for its stakeholders.

The Role of Inflation and Foreign Investment on Economic Growth in Banten Province

Inflation and foreign investment have an important impact on economic growth in a province, including Banten Province. Investment can open up extensive employment opportunities. This research method uses a literature review method. Literature review is an important stage in research which aims to collect, analyze and summarize information from various sources relevant to the research topic. The research results show that high inflation can reduce people's purchasing power, so that household consumption can decrease. When inflation is out of control, people will be more careful in spending, which can affect demand for goods and services. High inflation rates can create uncertainty in the market, thereby reducing investors' interest in investing. Conversely, low and stable inflation can encourage greater investment

Experiences of podiatrists in the delivery of routine foot care with self-management

Objective: Explore the experiences of podiatrists in the provision of foot care and identify gaps in promoting self-care to their patients. Methods: This study adopted a qualitative research paradigm comprising semi-structured interviews with 16 podiatrists from diverse clinical settings and varying experiences from February to May 2023. The data was analyzed inductively to develop themes. Results: Four themes emerged from the data: 1) Provision of nail care service, 2) Perceived reasons for referral for podiatric nail care, 3) Self-management with various patient sub-groups, and 4) Effectiveness of self-management, all from our participants’ perspective. Podiatrists agree that pathological nails and high-risk feet warrant continual podiatry care. However, the majority are ambivalent about providing care for non-pathological nails due to fear, indifference, lack of social support, and physical limitations. Interviewees reported the importance of managing patients’ expectations of the role of podiatry in nail care from the first visit to avert potential over-reliance on the service. Clear explanations and equipping patients with the appropriate tools helped promote self-management. Conclusion: This paper examined the complexity of the demand for podiatry nail care services, focusing on podiatrists’ perspectives. It emphasized the importance of effective communication with patients to clarify the purpose of podiatry and to ensure sustainable podiatry care for the future. Level of evidence V; Therapeutic studies - investigating the results of treatment; Expert Opinion.

An Alternative Reinforcement Learning (ARL) control strategy for data center air-cooled HVAC systems

Energy efficiency of data center is of great concern globally due to their large amount of energy consumption and the foreseeable growth in the demand of digital services in the future. Advanced control strategies are needed to reduce energy consumption. However, the optimization of data center HVAC control is a challenge task due to the complexity of the thermal dynamic models of buildings and uncertainties associated with both server loads and outdoor temperature. In this paper, we propose a new control strategy called Alternately-Reinforcement Learning-control(ARL), which realizes the alternating control of RL and proportional, integral and derivative (PID) for optimizing the control of air-cooled HVAC systems in data centers. The control object of the ARL is the speed set of the compressor and the condensing fan, and the control goal is to minimize energy consumption while maintaining temperature stability. The applied RL algorithm is Deep deterministic policy gradient (DDPG) and Proximal policy optimization (PPO). We pre-train the ARL strategy in offline environment firstly and deploy it in real data center environment for online testing. The test results show that the ARL has significant advantages in maintaining temperature stability while reducing energy consumption, and the PPO algorithm performs better than the DDPG algorithm. Compared with the PID algorithm, the PPO algorithm can save energy by 5.27%, and the temperature control effect can be improved by 3.27%,which indicates the feasibility of the ARL for implementation in real data centers.