Demand For Services Research Articles

Sustainable Development of Urban Agglomerations around Lakes in China: Achieving SDGs by Regulating Ecosystem Service Supply and Demand through New-type Urbanization

The mechanism through which New-type Urbanization (NU), as a new direction in urban development, influences the Sustainable Development Goals (SDGs) by regulating the Ecosystem Services (ES) supply and demand remains to be determined. It is particularly true in urban agglomerations around lakes, characterized by severe human-land conflicts, where socio-economic development is closely linked to water. We selected China’s urban agglomerations around lakes as the study area. We investigated the spatio-temporal heterogeneity of NU and the Ecosystem Service Supply and Demand Ratio (ESDR) from 2000 to 2018. We specifically focused on the dynamic trends of SDG 2 (Zero Hunger), SDG 13 (Climate Action), and SDG 15 (Life on Land). Furthermore, we utilized Structural Equation Modeling (SEM) to reveal the direct effects and indirect pathways through which NU influences the achievement of SDGs in the study area, emphasizing the differentiated performance of this mechanism across various urban agglomerations around Lakes. The results indicated that the ESDR has a particularly evident downward trend in urban centers along lakes, rivers, and road networks in spatial terms. The level of NU in urban agglomerations around lakes has increased by about 50% overall. It geographically exhibits three main spatial distribution patterns: “diffusion along the lake,” “homogeneous distribution,” and “diffusion along the river.” NU directly inhibits the achievement of SDGs but indirectly promotes the improvement of ESDR for food production and soil conservation, thereby indirectly facilitating the achievement of SDG 2 and SDG 15, but has an inhibitory effect on SDG 13. By regulating ESDR, NU is most effective in achieving SDGs in the urban agglomerations around Poyang Lake and Dongting Lake but has a significant inhibitory effect on the urban agglomeration around Hongze Lake. This research provides quantitative evidence for the urban planning shift, terrestrial ecosystem function restoration, and SDGs achievement in urban agglomerations around lakes. It also offers new insights from China for the sustainable urban construction of urban agglomerations around lakes worldwide.

Prerequisites of hybridization of university financing as a tool for ensuring sustainability and strategic development

Purpose. To assess the state of budget financing of Ukrainian HEIs, determine their funding structure, and identify prerequisites for developing hybrid financing as a tool for stability and strategic development. Methodology. Dynamic and structural analysis, the Hirschman-Herfindahl index (HHI(DI) and such methods as quantitative, arithmetic mean, limit values, graphic, visualization, and system methods were used in the research process. The practical testing of research hypotheses was carried out on the basis of a comprehensive approach to the financing of HEIs of Ukraine and a panel sample of 35 universities, which takes into account rating indicators, industry and regional aspects. Findings. Transformation processes at various levels are linked to trends such as reduced budget funding, structural changes, staff and student migration, decreased demand for additional services, and military factors, creating prerequisites for hybrid university funding. The article identifies conditions for hybrid financing, highlights negative trends in HEIs budget financing –including systemic underperformance and inflation impacts – and analyzes income diversification in Ukrainian universities using the HHI(DI). Limiting and average values were determined using the quantitative method, which made it possible to classify universities into sustainable (HHI(DI)  0.55) and risky (HHI(DI) > 0.55) ones; tendencies towards a slight diversification of universities’ incomes are revealed; a conceptual model is proposed of hybrid financing of universities to expand their financial autonomy, based on cooperation between university management, stakeholders, and staff core, with the aim of creating value propositions which satisfy the needs of stakeholders and generate cash flows; a new approach to the division of hybrid financing tools into three groups is proposed: passive or image-based, active-intellectual, and passive-innovative ones. This approach is innovative in the development of financial strategies for universities. Originality. New tools for making management decisions aimed at ensuring financial stability and developing financial strategies for universities are proposed. In particular, they include an original approach to the classification of universities into sustainable and risky ones based on the value of the HHI; the conceptual model of hybrid financing of universities, which promotes the expansion of their financial autonomy; the innovative approach to the division of hybrid financing instruments into three categories: passive or image-based, active-intellectual, passive-innovative. Practical value. The study’s results can be used to make management decisions on expanding financial autonomy of universities. The introduction of the conceptual model of hybrid financing will contribute to the diversification of income, increase in financing, as well as ensuring financial stability and strategic development of universities.

Factors that influence the need for mental health services for older adults in Europe

Abstract Background Mental health is an integral component of health, and affects close to a 100 million Europeans. Little is known about the predictors of older adult’s mental health demand among health systems in European countries. This study is based on the Andersen’s Behavior Model, that predicts that predisposing characteristics, enabling factors, and behavioral factors, influence need or demand factors of healthcare services. Aim This study has two overall objectives: (i) to investigate the determinants of older adults’ mental health services demand; and (ii) examine the relationship between predisposing characteristics, and enabling resources, with services demand. Methods Data from Wave 9, of the of the cross-national panel dataset of the Survey of Health, Ageing and Retirement in Europe (SHARE) were examined using a sample of 47, 345 older adults. Analysis: The Omnibus test was used to evaluate the fit model and Multinomial Logistics Regression were performed to test the null hypothesis that predisposing characteristics, enabling resources, and behavioral factors are not predictors of need or demand. Findings Predisposing characteristics such as gender (b=-.43, s.e.=.017, p<.001) and age (b=-1.96, s.e.=2.2, p<.001), and enabling factors such as homecare (b = 2.40, s.e.=0.1, p<.001), social support (b=-.26, s.e.=0.012, p<.001), financial support receiving (b=.51, s.e.=.086, p<.001), income (b=.09, s.e.=.009, p<.001), and behavioral factors such as use of technology are predictors of mental health services need or demand [Chi-Square= 3319.58, df = 15 and p <.001]. Implications for Policy and Practice Initiatives for the care of older adults should not only aim to increase access to care services for sub populations such as older adults with mental health but also consider enabling resources such as financial and social support and behavioral factors such as use of technology. Key messages • Demand for mental health services for older adults are influenced by predisposing, enabling and behavioral factors. • Investing in financial services, social support and technology may reduce the demand for mental health services among older adults.

Monitoring violence in healthcare. A lesson from the pandemic

Abstract Introduction Violence against healthcare workers is a serious, underreported, and underestimated problem. Only a few healthcare companies have efficient violence monitoring systems and risk assessment is often entrusted to non-validated algorithms. The monitoring system implemented in 2005 in a public health company allowed for an accurate analysis of the phenomenon. Methods For the entire observation period (2005-2023), the one-year prevalence of violent incidents (physical assaults, threats, and harassment) has been reported by all during the periodic medical examination in the workplace. Furthermore, after each periodical inspection of workplaces, the occupational doctor requested a detailed description of violent events that occurred in the department, using the Violent Incident Form distributed online anonymously. Results In 2005/6 the one-year prevalence of physical assaults was 8.2%. Prevention efforts led to a moderate reduction in the rate (7.8% in 2011/12). A collapse in rates was observed in 2021 (3.2%). In 2022, physical violence rose again to 5.6%. Harassment affected 19.6% of workers in 2005/6, falling to 7.2% in 2021 and rising again to 21.6% in 2022. Physical violence perpetrated by patients was more frequent in psychiatric services (OR 25.7, CI95% 11.1; 59.6) and violence perpetrated by visitors in emergency and urgence services (OR 8.8, CI95% 3.8; 20.5) than in general services. Workers attributed the drop in attacks primarily to the filtering of access to work areas, which limited the presence of visitors and relatives. The lower demand for services had also resulted in an optimal ratio between staff and patients, improving the quality of care. Furthermore, in the very first pandemic phase, health workers enjoyed a very favorable consideration from the population, which had further reduced the causes of conflict. Conclusions The pandemic has shown that better relationships between patients/visitors and staff are effective in reducing violence. Key messages • Monitoring of violence against healthcare workers shows that it has decreased during the pandemic. • HCWs believe that (i) limiting visitor access (ii) better balancing demand for services and (iii) better opinion towards HCWs were the causes of the reduced rate of violence.

Mapping the landscape of front door frailty in the United Kingdom: Lessons for further afield.

The ageing global population is posing a significant challenge to healthcare systems worldwide. Healthcare needs have become more complex and the demand for services is ever increasing. Identification of frailty at the front door of hospitals can prompt comprehensive geriatric assessment and streamline patients to the most suitable clinical area. The United Kingdom has set a priority to develop front door services given the pressure on the National Health Service. A British Geriatrics Society survey has demonstrated that the majority of frailty assessments occur in the emergency department using the Clinical Frailty Scale. This survey prompted the creation of the setting up services guide and its key principles using a collaboration of experience from across the country. Understanding the systems that already exist and creating a network to enable a flow of care towards community teams is crucial to the successful provision of modern frailty attuned care.

Functioning in Older Adults: Prevalence and Implications for Policy and Digital Services

Abstract Background Actions maintaining and promoting functioning, and proactively preparing for the surge in demand for services in near future, are needed as the population is aging. Policy actions need to base on up-to-date picture of the situation. We examined the prevalence of limitations in different dimensions of functioning in the older population. Methods Data consisted of participants aged 75 years or older (n = 9,686) in the nationally representative Healthy Finland Survey in 2022. The questionnaire included questions on various aspects of functioning (physical, cognitive, psychosocial, need and use of help), quality of life, internet use and digital competence. Weighted prevalence of functional limitations by age (75-79, 80-84, 85-89, ≥90 years) was analyzed for men and women using logistic regression, sampling design and non-response acknowledged. Results Difficulties in most aspects of functioning increased rapidly with age. In ≥ 90-year-olds, one third experienced major difficulties in activities of daily living (vs. 4% in 75-79-year-olds), and 30% of men and 45% women aged 90 or over experienced major difficulties in getting out of their home (vs. 4% in 75-79-year-olds). The prevalence of loneliness doubled by age, from 9% in the youngest to 21% in oldest age group. The corresponding increase in psychological distress was from 9% to 15%. Need for help increased dramatically with age, but the unmet need among those needing help did not, being around 20% in all age groups. In ≥ 90-year-olds, 83% of men 92% of women reported little or no internet skills (vs. 40% in 75-79-year-olds), and 55% of men and 75% women did not use digital services at all, i.e. neither independently nor with help from others (vs. 25-28% in 75-79-year-olds). Conclusions Difficulties in functioning and need of help were common among the oldest age groups which underlines the urgency to ensure sufficient resources for elderly care. Key messages • While developing health and social care services, equal access to services must be ensured even for those not able to use digital services. • Functioning must be supported not only by measures aimed at the individual, but also by improving the environment so that people with a lower level of functioning can cope with their everyday lives.

Socio-economic factors affecting spatial inequalities in pregnancy-related ambulance attendances in Greater London

Exploring inequalities in ambulance and pre-hospital demand is important to improve service equity and reduce wider health inequalities. Maternity incidents amongst ambulance demand are a key area of focus because of the specialized care that is needed for patients, as well as the impact of wider determinants of health on pregnancy outcomes. Since there are spatial inequalities amongst pregnant patients who call for an ambulance, the aim of this study is to assess the underlying factors associated with pregnancy related ambulance complaints, to determine why maternity patients utilize the ambulance service. Local indicators of spatial autocorrelation were used to identify clusters of ambulance maternity demand within Greater London (UK). A negative binomial regression model was used to explore associations between socioeconomic, environmental, accessibility and demographic variables. Our results reveal that neighborhoods with low adult skills (i.e. qualifications/English language abilities) have a higher rate of demand. Moreover, our results imply that the demand for ambulance services may not be directly tied to health outcomes; rather, it might be more closely associated with patients' reasons for calling an ambulance, irrespective of the actual necessity. The benefits of identifying factors that drive demand in ambulance services are not just linked to improving equity, but also to reducing demand, ultimately relieving pressure on services if alternative options are identified or underlying causes addressed. Doing so can improve health inequalities by firstly, improving ambulance care equity by directly supporting a better allocation of resources within ambulance systems to target patterns in demand.

Mental health benefit uptake of women before and during the perinatal period in Austria

Abstract One in five women may experience a perinatal mental illness (PMI) during pregnancy and up to one year after giving birth, during the so-called perinatal period. Although there is strong evidence that this can have a negative effect on the children’s future health, many mothers do not receive any treatment. To determine whether and what type of mental health services women in Austria claim during the perinatal period, the uptake of five key mental health insurance benefits was analysed using pseudonymised health insurance data from Austria’s largest insurance, ÖGK. In 2017 and 2018, 131,025 ÖGK insured women gave birth, representing 80% of all births in Austria in the two years. Of these women, almost 20% claimed at least one benefit during the perinatal period. Including the year before pregnancy this number increased to 25%. Most often, only one benefit was claimed in only one of the analysed periods (the year before pregnancy, pregnancy, and the year after birth). Psychotherapy was claimed most often, while hospital admissions occurred the least. Further, the youngest (≤ 20 years) and the oldest (≥ 41 years) women claimed benefits more frequently than at other ages. After adjustment for the shorter pregnancy period, benefit uptake was generally highest during pregnancy and lowest after giving birth. Considering the shortage of specialised perinatal mental health services in Austria, the uptake of the five analysed types of services was high and corresponds to international prevalence figures on PMI. The actual number may be even higher, considering the services and the women not covered in the available data. As there is a lack of a perinatal mental health infrastructure and specialised healthcare staff in Austria, this warrants further investigations into the quality of care provided to the women and more training and education concerning mental problems occurring during the perinatal period. Key messages • Around a quarter of women claim mental health benefits during the perinatal period, most often psychotherapy services. • Substantial demand for mental health services during the perinatal period calls for comprehensive infrastructure and quality assessments of available options.

Customer Satisfaction Towards Food Delivery Services in Selangor

This study explores the key factors influencing customer satisfaction with food delivery services at UiTM Puncak Alam, Selangor. Despite the rising demand for food delivery services, issues surrounding the quality and accuracy of delivered food remain significant challenges. This study seeks to address these concerns by identifying and analyzing the determinants that shape customer satisfaction with food delivery services in Malaysia, specifically in Puncak Alam. We adopted a quantitative research approach to gain comprehensive insights into these issues. We collected data using judgment sampling, a non-probability sampling technique and used the Statistical Package for Social Sciences (SPSS) to analyze the responses through descriptive statistics and correlational analysis. The study involved a structured survey of 357 respondents, investigating the impact of three key variables—food quality, app ease of use, and food packaging—on customer satisfaction. The findings provide important implications for businesses and institutions looking to enhance the quality of food delivery services and elevate customer satisfaction levels. By identifying these critical factors, the research offers valuable insights that can help food service providers, policymakers, and industry stakeholders refine their strategies. These insights will not only improve the customer experience but also encourage broader adoption of food delivery services within the Malaysian population. Ultimately, the study’s conclusions hold significance for enhancing service quality and fostering customer loyalty in the increasingly competitive food delivery industry.

Efficient and secure service function chain deployment method for delay optimization in air traffic information network

The air traffic information network is fundamental for ensuring the efficient and safe operation of flights. However, with the increasing demands of air traffic services, the rigidity of the traditional air traffic information network has become increasingly pronounced. Network function virtualization (NFV) technology presents an effective solution to address this issue. Within the NFV environment, the deployment of service function chains (SFC) forms the basis for achieving end-to-end air traffic services. This paper addresses the low delay and high security requirements inherent in air traffic services and proposes an efficient and secure SFC deployment for delay optimization (ESSFCD-DO) method. Primarily, the paper conducts a theoretical analysis of SFC deployment, and derives four key principles related to SFC delay, security, and resource cost. Subsequently, based on these principles, the ESSFCD-DO method is developed, which encompasses the virtual network function (VNF) aggregation algorithm for security and resources cost optimization (VNFAA-SRCO), the VNF deployment algorithm based on topology aware (VNFD-TA), and the algorithm for deploying virtual links based on k-shortest path. Experimental results demonstrate that, in comparison to other SFC deployment methods within this domain, ESSFCD-DO achieves significant optimizations in terms of end-to-end delay of SFC and long-term revenue-cost ratio, while ensuring security and service request acceptance rate.

Consumption Values and Green Purchase Behaviour among University of Uyo Students in Akwa Ibom State, Nigeria

The need to maintain a healthy lifestyle has led to a significant increase in the demand for goods and services that are environmentally friendly. However, previous investigations suggest that not only companies and the government, but also students, who play a significant role in consumption activities, should initiate solutions to environmental issues. In this study, the researchers investigate the influence of consumption values (functional, social, emotional, conditional, and epistemic) on the green purchase behaviour of university students in Akwa Ibom State, Nigeria. A cross-sectional research design was adopted for this study. A simple random sampling technique was used to draw 400 students from selected faculties of the University of Uyo. A structured questionnaire measured on a five-point Likert scale was used to collect data from the respondents. The collected data were tested and analysed using a simple linear regression approach. Findings from the study show that consumption values (functional value, social value, emotional value, conditional value, and epistemic value) have a significant influence on the green purchase behaviour of students in Akwa Ibom State. The researchers recommend that students should develop strategies that will improve their consumption behaviour towards purchasing environmentally friendly products.

Interrelationships Among Individual Factors, Family Factors, and Quality of Life in Older Chinese Adults: Cross-Sectional Study Using Structural Equation Modeling.

China's rapidly aging population necessitates effective strategies for ensuring older adults' quality of life (QOL). While individual factors (IF) and family factors (FF) are known to influence QOL, existing research often examines these factors in isolation or focuses on specific subpopulations, overlooking potential interactions and mediating pathways. This study aims to examine both direct and indirect pathways connecting IF and FF to older adults' QOL, focusing on the mediating roles of health risks (HR) and health care service demand (HSD). This study uses structural equation modeling (SEM) to analyze cross-sectional data from 8600 older participants in the 2015 China Health and Retirement Longitudinal Study (CHARLS), a nationally representative study using a multistage probability proportional to size sampling method. Among the 8600 participants, the majority (5586/8502, 65.7%) were aged 60-70 years, with a near-equal distribution of males and females at around 50%. The average PCS score was 76.77, while the MCS score averaged 59.70. Both IF (β=0.165, P<.001) and FF (β=0.189, P<.001) had a direct positive effect on QOL. Furthermore, the indirect effects of IF (β=0.186, P<.001) and FF (β=0.211, P<.001) through HR and HSD were also significant. In the direct model, IF and FF had a greater impact on MCS (β=0.841) than on PCS (β=0.639). However, after including the 2 mediating factors, HR and HSD, the influence of IF and FF on MCS (β=0.739) became consistent with that on PCS (β=0.728). Subgroup analyses revealed that the direct effect of IF on QOL was significant in the 60-70 age group (β=0.151, P<.001) but not in those over 70 years old (β=0.122, P=.074). Comorbidity status significantly influenced the pathway from HR to HSD, with older adults having 2 or more chronic diseases (β=0.363) showing a greater impact compared to those with fewer than 2 chronic diseases (β=0.358). Both IF (education, per capita disposable income, and endowment insurance) and FF (satisfaction with a spouse and children) directly impact the QOL in older people. Meanwhile, IF and FF have equal influence on QOL through the mediating role of HR and HSD. Recognizing the interplay among these factors is crucial for targeted interventions to enhance the well-being of older adults in China.

Brief psychodynamic psychotherapy for adolescents and their families in crisis: a pilot study

ABSTRACT The global rise in adolescent self-harm and suicidal behaviours has intensified the demand for mental health services in the UK. This has further strained already underfunded and understaffed resources, resulting in longer waiting times and increased emergency department visits among teenagers. To address the overwhelming need for effective community-based emergency support, a brief psychodynamic crisis therapeutic intervention was developed within a CAMHS adolescent crisis team, inspired by child psychotherapist Ruth Schmidt Neven’s work on time-limited psychotherapy with adolescents and their families. This 12-session intervention offers both individual therapy for the adolescent and sessions for their parents, along with regular family reviews. Two psychotherapists work closely together on each case – one with the young person, the other with the parents. The brief model views crises as opportunities for deeper understanding, moving beyond diagnostic and symptom-centred approaches, as well as standard risk management and safety-planning strategies, and underlines the centrality of parent involvement in adolescent crisis work. This paper outlines the intervention’s theoretical foundation, guiding principles, and practical design, and presents preliminary findings from a pilot study of 22 cases, run over two and a half years. Early results suggest broad potential for this psychodynamic crisis approach in various adolescent crises, and merit further investigation.

Theories and Methods for Indoor Positioning Systems: A Comparative Analysis, Challenges, and Prospective Measures

In the era of the Internet of Things (IoT), the demand for accurate positioning services has become increasingly critical, as location-based services (LBSs) depend on users’ location data to deliver contextual functionalities. While the Global Positioning System (GPS) is widely regarded as the standard for outdoor localization due to its reliability and comprehensive coverage, its effectiveness in indoor positioning systems (IPSs) is limited by the inherent complexity of indoor environments. This paper examines the various measurement techniques and technological solutions that address the unique challenges posed by indoor environments. We specifically focus on three key aspects: (i) a comparative analysis of the different wireless technologies proposed for IPSs based on various methodologies, (ii) the challenges of IPSs, and (iii) forward-looking strategies for future research. In particular, we provide an in-depth evaluation of current IPSs, assessing them through multidimensional matrices that capture diverse architectural and design considerations, as well as evaluation metrics established in the literature. We further examine the challenges that impede the widespread deployment of IPSs and highlight the potential risk that these systems may not be recognized with a single, universally accepted standard method, unlike GPS for outdoor localization, which serves as the golden standard for positioning. Moreover, we outline several promising approaches that could address the existing challenges of IPSs. These include the application of transfer learning, feature engineering, data fusion, multisensory technologies, hybrid techniques, and ensemble learning methods, all of which hold the potential to significantly enhance the accuracy and reliability of IPSs. By leveraging these advanced methodologies, we aim to improve the overall performance of IPSs, thus paving the way for more robust and dependable LBSs in indoor environments.

Ethical issues after the earthquake in Turkey: A qualitative study on nurses' perspectives.

After natural disasters, the urgent need for survival and rescue operations for those trapped in the rubble results in a heightened demand for healthcare services. Nurses are pivotal in addressing the consequences of such calamities. Nurses operating in critical conditions encounter numerous challenges, including safety issues and ethical quandaries. The ethical considerations primarily revolve around the limitations, duties, and modified norms of care administered by nurses during disasters, presenting both significant and complex challenges. The study was designed to elucidate the nature and essence of nurses' care experiences and to offer an in-depth depiction of the ethical dilemmas while attending to individuals injured in the earthquake. A descriptive phenomenological design was used in this research. A total of 16 nurses who worked for at least 7 days in field hospitals in any of the earthquake regions after the 2023 earthquake in Turkey participated in the research. The research was conducted between March 13 and March 20, 2023. Data were collected by face-to-face interview method with a semistructured form. The steps of Colaizzi's phenomenological method were used to analyze the qualitative data. The study involved a group of 16 Turkish nurses, aged between 20 and 36 years. Through data analysis, four primary themes, 14 subthemes, and 25 codes were identified. The principal themes derived from the interviews included "humanitarian duties," "non-adherence to ethical principles," "respect for the injured," and "medical errors." In this intricate process, it becomes paramount to enhance support for nurses in the domains of management, education, and psychosocial assistance, thereby nurturing their individual and professional acumen, commitment, and ethical sensitivity. Refining the guidelines and professional standards that encapsulate the principles to be adhered to by nurses in disaster scenarios, coupled with providing comprehensive training in both medical and ethical competencies, represents a significant avenue for advancement. Focused training on crisis management will enable nurses to render ethically informed decisions and bolster their professional proficiency. Natural disasters, including earthquakes, pose significant ethical challenges for healthcare professionals, especially nurses who play a pivotal role in delivering care during these emergencies. Issues such as resource allocation and triage, the duty of care and ensuring continuity of care, informed consent and communication, cultural sensitivity, and providing psychosocial support are critical ethical considerations for nursing policies in earthquake situations. Addressing these ethical issues in nursing policies related to earthquakes is crucial for maintaining the integrity of healthcare delivery, preserving public trust, and ensuring the well-being of both the injured and healthcare providers during times of crisis.

Improving Laryngeal Procedure Workflow: Moving From the Operating Room to the Outpatient Setting.

Laryngology disease burden is growing while theater capacity is falling. Over half a million patients are waiting for ENT care in England alone (1). The demand for laryngology services has continued to grow significantly, particularly post-COVID (2). Meanwhile, the number and efficiency of ENT theater lists are reduced (3). To tackle the growing backlog, NHS England has emphasized the need for innovative strategies by separating elective from emergency services and by increasing the resilience of elective delivery (4). The establishment of an office-based laryngology procedure clinic is a potential solution. We offer a narrative review and audit of our experience in founding an in-office laryngology procedure service within a tertiary NHS center with the aim of streamlining this setup process for other interested ENT units. We outline an in-depth exploration of the personnel, equipment, and processes necessary to establish an in-office procedure clinic. Our experience showed that the procedure clinic functions well when implemented within the framework of existing ENT elective and emergency services. Although there is initial investment required in terms of money, effort, and time, our outcomes show that the clinical and economic benefits of the clinic outweigh the costs, also allowing for patients to access investigations and treatments reliably and efficiently. Setting up a laryngology in-office procedure clinic within the NHS confers patient, organizational, and economic benefits. It provides a novel and resilient approach in addressing the growing backlog of patients awaiting laryngology care and should be popularized in the current health care environment. Level 4 Laryngoscope, 2024.

Ohio programs support recovery, students seeking BH careers

Responding to the growing demand for mental health care services by strengthening the pipeline of behavioral health professionals and creating job opportunities for people in recovery from a mental health or substance use disorder, Ohio Gov. Mike DeWine has recently announced two programs to serve both needs.

Business landscape and growth determinants of micro- and small enterprises working in WASH sector: evidence from Ethiopia

This study aims at assessing business landscape and growth determinants of micro- and small enterprises working in WASH sector. The study also investigates the effect of determinant factors on enterprise growth. The study population comprised 6000 enterprises working in six cities. The study used varieties of data collection instruments including questionnaire administered with randomly selected enterprises and collected valid data from a total of 300 enterprises; conducted 24 Key informant interviews with different officials in the Cities who are concerned with WASH products and services including private WASH goods and service suppliers; conducted 12 FGDs with utility officers; community representatives; enterprise owners to triangulate the data come up with the questionnaire result. The WASH business landscape in Ethiopia faced several challenges that hinder its ability to create demand for WASH products and services among enterprises. These challenges include inadequate and ineffective demand creation efforts, low capacity of private commercial operators, limited financial services available to both the private sector and households, inadequate business support services at the local level, and inadequate workspace for WASH enterprises. However, there are also several drivers of WASH sector development in the city, such as increased government commitment to supporting access to WASH services through policies and budget support, support from development partners like the World Bank, and an increase in the city’s population. The structural equation modeling result revealed that finance resources, administrative skills, marketing competence, and technical support were found to be significant. However, infrastructure facility was found insignificant. The study recommended that the government and stakeholders come together to support enterprises and play their roles in the growth of enterprises in Ethiopia.

Economic burden of sarcopenia-related disability in the elderly population: a study in Iran

ObjectiveSarcopenia is linked to escalating health costs, heightened risk of physical disability, diminished quality of life and an increased demand for care services. This study aimed to assess the economic impact of sarcopenia-related disability in Iran. A prevalence-based economic burden study was conducted utilizing the Population Attributable Risk (PAR) method, based on 2022 price index. Prevalence data for sarcopenia, categorized by gender and disease severity, were extracted from recent comprehensive studies. The relative risk of sarcopenia disability was determined from the most robust available evidence. Subsequently, direct medical costs, direct non-medical costs, and indirect costs for each individual with sarcopenia were computed and adjusted to 2022 values to estimate disability costs.ResultsTaking into account the prevalence of sarcopenia and the Iranian population across various age groups, 2,192,168 adults aged ≥ 60 years with sarcopenia in Iran were included. The total PAR of sarcopenia for men and women was estimated at 49% and 28%, respectively. The cumulative direct medical costs, direct non-medical costs, and indirect costs amounted to $215.1 million, $7.76 million, and $34.1 million, respectively. Additionally, the average total economic burden of sarcopenia-related disability in Iranian population aged ≥ 60 years was estimated at $257.1 million.

Challenges and opportunities for strengthening palliative care services in primary healthcare facilities: perspectives of health facilities in-charges in Dar es Salaam, Tanzania

BackgroundWith the rise of non-communicable diseases in Tanzania, palliative care (PC) is increasingly needed to improve the quality of life for these patients through pain and symptom management and providing...