Types Of Services Research Articles

Validation and Reliability Study of The Turkish Version of The Health Services Access Scale

Background/aim: The aim of this study is to establish the Turkish validity and reliability of the Healthcare Access Scale and to determine whether perceptions of healthcare access vary according to demographic variables. Materials and methods: Data for the research were collected through surveys of 468 participants across Turkey. Exploratory factor analysis and confirmatory factor analysis were conducted in the process of adapting the Healthcare Access Scale. In addition, t-tests and ANOVA tests were used to determine variations in access to healthcare according to demographic variables. The factors obtained from the exploratory factor analysis were confirmed by confirmatory factor analysis. The fit index values of the five-dimension health care access scale were found to be in the good fit range. Results: As a result of the difference analyses carried out, no significant differences were found in the perceptions of access to healthcare according to gender, age and educational level. However, various differences were observed between the groups in terms of the type of hospital services received, income level and frequency of hospital visits in the past year. In conclusion, this study makes a significant contribution to the literature by testing the appropriateness, validity and reliability of the Healthcare Access Scale. Conclusion: This study makes a significant contribution to the literature by testing the appropriateness, validity and reliability of the Healthcare Access Scale. Key words: Health Services, Health System, Validity and Reliability, Access to Health Services, Turkish Validity, Health

A case study of the development of a valid and pragmatic implementation science measure: the Barriers and Facilitators in Implementation of Task-Sharing Mental Health interventions (BeFITS-MH) measure

BackgroundFew implementation science (IS) measures have been evaluated for validity, reliability and utility – the latter referring to whether a measure captures meaningful aspects of implementation contexts. We present a real-world case study of rigorous measure development in IS that assesses Barriers and Facilitators in Implementation of Task-Sharing in Mental Health services (BeFITS-MH), with the objective of offering lessons-learned and a framework to enhance measurement utility.MethodsWe summarize conceptual and empirical work that informed the development of the BeFITS-MH measure, including a description of the Delphi process, detailed translation and local adaptation procedures, and concurrent pilot testing. As validity and reliability are key aspects of measure development, we also report on our process of assessing the measure’s construct validity and utility for the implementation outcomes of acceptability, appropriateness, and feasibility.ResultsContinuous stakeholder involvement and concurrent pilot testing resulted in several adaptations of the BeFITS-MH measure’s structure, scaling, and format to enhance contextual relevance and utility. Adaptations of broad terms such as “program,” “provider type,” and “type of service” were necessary due to the heterogeneous nature of interventions, type of task-sharing providers employed, and clients served across the three global sites. Item selection benefited from the iterative process, enabling identification of relevance of key aspects of identified barriers and facilitators, and what aspects were common across sites. Program implementers’ conceptions of utility regarding the measure’s acceptability, appropriateness, and feasibility clustered across several common categories.ConclusionsThis case study provides a rigorous, multi-step process for developing a pragmatic IS measure. The process and lessons learned will aid in the teaching, practice and research of IS measurement development. The importance of including experiences and knowledge from different types of stakeholders in different global settings was reinforced and resulted in a more globally useful measure while allowing for locally-relevant adaptation. To increase the relevance of the measure it is important to target actionable domains that predict markers of utility (e.g., successful uptake) per program implementers’ preferences. With this case study, we provide a detailed roadmap for others seeking to develop and validate IS measures that maximize local utility and impact.

Effects of COVID-19 pandemic on psychiatric and psychological consultation-liaison contacts in a general hospital in North-East of Italy: a retrospective study

BackgroundThe COVID-19 pandemic has prompted significant changes in healthcare, particularly affecting psychiatric and psychological Consultation-Liaison (CL) services in general hospital settings.AimTo assess the effects of COVID-19-related restrictions on utilization of psychiatric and psychological CL services in Northeast Italy during 2020, and to compare it to the use of services in the previous year (2019).MethodsThe study collected data on psychiatric and psychological consultations in 2019 and 2020 from a hospital database. It categorizes consultations by type of patient (inpatient or outpatient) and referral source (hospital wards, general practitioners, other specialists). Pandemic-related restrictions were classified as “lockdown,” “intermediate restrictions,” and “no or reduced restrictions” based on the Covid Stringency Index (CSI). Poisson regression models were employed to analyze the data.ResultsThe findings reveal a significant 28% increase in the number of psychiatric and psychological consultations in 2020. Consultations for outpatients increased by 51%, while those for inpatients decreased by 11%. However, the lockdown and intermediate restriction phases were deemed responsible of a decrease of 42.9% and 19.5% in consultations respectively.DiscussionThis study highlights the persistent psychological burden during the COVID-19 pandemic, alongside reduced CL services due to lockdown measures. Integrating telemedicine into these types of services becomes imperative for meeting patient needs during restrictions. These findings can inform policies and practices to improve effective mental health care delivery during and beyond pandemics. Future research should explore the impact of pandemic-related restrictions on mental healthcare across settings and clinical factors affecting service accessibility.

Multi‐Objective Federated Averaging Algorithm

ABSTRACTThe recent global trend is the convergence of information and communications technology (ICT). By applying ICT in various fields such as the humanities, new types of products and services are created, and new values that help people's lives can be created. AI can be selected as a representative technology in such convergence ICT. However, applying AI technology to actual production requires ensuring data security. Federated learning (FL) can achieve secure sharing of data, where all parties participate in model training locally and upload it to the server for aggregation. The data never leaves the parties involved, thus solving the problems of data privacy and data silos. However, FL faces issues such as high communication cost, imbalanced performance distribution among participants, and low privacy protection. To achieve a balance between model accuracy, communication cost, fairness, and privacy, this paper proposes a multi‐objective optimization‐based FL algorithm (M‐FedAvg). The multi‐objective optimization problem of maximising the accuracy of the global model, minimising the communication cost, minimising the variance of the accuracy, and minimising the privacy budget is solved by NSGA‐III. The experimental results show that the algorithm proposed can effectively reduce the communication cost of FL and achieve privacy protection for participants without affecting the accuracy of the global model.

АНАЛІЗ ЦІНОВИХ СТРАТЕГІЙ ТА СПОЖИВЧА ПОВЕДІНКА В КОНТЕКСТІ МАРКЕТИНГОВИХ ДОСЛІДЖЕНЬ

Abstract introduction. The article examines the views of scientists regarding the formation of price strategies. The main approaches to pricing are considered, with the help of which companies set optimal prices for their services and goods. Factors affecting the company's choice of pricing strategy and affecting consumer behavior are considered. It is conducted research in relation to behavior of consumers and built model of satisfaction of consumer necessities. The purpose of the article. Consideration of pricing strategies of companies and their impact on consumer behavior. Researching consumer behavior and building a model for satisfying consumer needs in goods or services. Methods. Carrying out research the methods of abstraction, analysis, logical, theoretical and historical generalization and comparison are used. For basis of research a dialectical method is taken. Results. The article examines the main approaches to pricing, with the help of which companies set optimal prices for their services and goods. The factors affecting the company's choice of price strategy are considered, and the factors influencing consumer behavior are highlighted. Conducted research on consumer behavior. The proposed model of meeting the needs of consumers in goods or services, which contains 8 sections: the consumer's awareness of the need for the need for a product or service; collection of information; selection of goods or services; decision-making; purchase (payment) of goods or services; evaluation of the choice made and enrichment of experience; the degree of satisfaction of the need for a product or service and consumption of the results. Conclusiоns. After researching and analyzing the available types of marketing price strategies, business entities choose their own price strategy, taking into account certain existing tools, taking into account: characteristics of the service or product, market segment, market competition, competitor analysis, level of market demand, marketing strategies, etc. .. The use of the correct price strategy and the concept of pricing contributes to the achievement of goals: ensuring the stable financial condition of the business entity, meeting the needs of consumers. The offered model in relation to satisfaction of necessities of consumers in commodities or services gives understanding to the process of making decision by consumers in relation to a purchase that is the basic factor of success of company in a competition environment. Companies, that is able to adapt oneself to the necessities of consumers and, to their requirements, that understand the customers, have more chances to retain and attract clients, promote a competitiveness and score a success at the market. The question of the method of determining prices for certain types of services and the behavioral reaction of consumers requires further research.

Effect of elevated temperature on the bond behaviour of adhesive shear joints between glass substrate and iron-based shape memory alloy strip

Glass has been increasingly used as structural elements, such as glass beams or fins. Previous feasibility studies have shown increased initial and post-fracture load-bearing capacity of laminated glass beams post-tensioned with adhesively bonded iron-based shape memory alloy (Fe-SMA) strips. However, the potential elevated service temperatures were not considered, which significantly degraded the material properties of the adhesive. This study experimentally investigated the mechanical behaviour of Fe-SMA-to-glass lap-shear joints with an epoxy adhesive at different temperatures of 23 °C, 50 °C, and 80 °C, representing room temperature and typical elevated service temperatures. The results showed that, compared with the one at room temperature, the load-carrying capacity remained nearly unchanged at 50 °C and decreased by approximately 20% at 80 °C. On the contrary, the effective bond length increased from approximately 116mm to 250-300mm. The failure modes, the tensile strain of the iron-based shape memory alloy, the bond-slip behaviour, and the fracture energy of the joints were also evaluated. The current study fills a significant research gap in the engineering application of strengthening glass structures by bonded pre-stressed Fe-SMA strips. Moreover, the results may also significantly contribute to the future application of the selected adhesive at elevated temperatures.

A two-echelon multi-trip vehicle routing problem with synchronization for an integrated water- and land-based transportation system

This study focuses on two-echelon synchronized logistics problems in the context of integrated water- and land-based transportation (IWLT) systems. The aim is to meet the increasing demand in city logistics as a result of the growth in transport activities, including parcel delivery, food delivery, and waste collection. We propose two models, a novel mixed integer linear joint model, and a logic-based Benders’ decomposition (LBBD) model, for a two-echelon problem under realistic settings such as multi-trips, time windows, and synchronization at the satellites with no storage and limited resource capacities. The objective is to optimize transfers and satellite assignments, thereby reducing overall logistics costs for street vehicles and vessels. Computational experiments demonstrate that the LBBD model is more robust in terms of solution quality and solution time on average while the added value of the LBBD is more evident when solving large-scale instances with 100 customers, reducing the overall costs by 10.6% on average and significantly reducing the fleet costs on both networks. Furthermore, we assess the effect of changing cost parameters and satellite locations in the proposed IWLT system–analyzing system behavior and suggesting potential improvements–and evaluate several system alternatives in city logistics–consisting of different transportation network designs (single- and two-echelon), vehicle types, and operational constraints. On average, the proposed two-echelon IWLT system reduces the number of kilometers traveled by vehicles at street level by ranging from 20% to 30% compared to a typical single-echelon service design that relies solely on trucks.

Universal Health Care Coverage for Aging Population

The term Universal Health Coverage (UHC) refers to a situation where “all people (both males and females, boys and girls) have access, without financial hardship, to the full range of type of quality health services when and where they need them, now and at times”. The UHC envisages coverage of the full range of essential health care services: from health promotion to (1) ‘Prevention’, (2) ‘Treatment’, (3) ‘Rehabilitation’, and (4) ‘Palliative care’ [aimed at improving quality of life of people (adults and children) and their families confronted with life-threatening illness]. It is pertinent to note that the UHC aligns with the SDG (Sustainable Development Goal) Target 3.8: achieve universal health coverage. The UHC is, thus, global commitment. However, in to deliver this promise, national governments need and inter-governmental organizations need to have health systems that are rooted in the locations communities they serve. Also, such health systems need to be • Need-based, • Efficient, and • Equitable. The author of this review paper argues that Primary Health Care (PHC) is the most effective and cost-efficient way to reach out to people with the UHC, with consideration of “need-based approach”. Further, it is due to this consideration of need-based theory that every country, with its own socio-economic and demographic profile, adopts a different strategy for the purpose of achieving the UHC. Furthermore, national governments decide what to cover, depending on the needs of their populations, including availability of health infrastructure (resources). Investment in the scientifically designed UHC programs has the potential to ensures that health needs of people are (a) ‘Identified’, (b) ‘Prioritized’, and (c) ‘Addressed’. The conceptual framework of the UHC is of increased relevance for aging population (individuals above the age of 65). The author of this work is of the considered research view that objective of achieving the SDG-3.8 target cannot be fully and adequately realized without transforming health care system that has significant impact on functional ability in older age people (or aging population). Objective of this evidence-based review paper is to investigate into significance and implications of the UHC for aging population. Also, it briefly outlines renewed strategies needed for the UHC for aging population. Secondary data (largely ‘qualitative’ in nature) have been used. The method of data analysis is ‘descriptive’, involving non-statistical (mathematical) techniques. The paper briefly concludes that scientifically-designed mechanism for offering the UHC for older people, without financial burden, is crucial. It is important that health financing systems of the national governments are designed to cater to health needs of older people, while protecting them from to access services when they are needed, but also to protect them from financial catastrophe (by abolishing “out of pocket spending”).

Retraction of "Home visiting impacts during the pandemic: Evidence from a randomized controlled trial of Child First" by Xia et al. (2023).

Reports the retraction of "Home visiting impacts during the pandemic: Evidence from a randomized controlled trial of child first" by Samantha Xia, Mervett Hefyan, Meghan P. McCormick, Maya Goldberg, Emily Swinth and Sharon Huang (Journal of Family Psychology, 2023[Aug], Vol 37[5], 569-580). This article is being retracted at the request of the publisher, and the editor and all authors of the original article consented. The MDRC study team identified two caregivers who were enrolled at baseline but were, themselves, minors. (The following abstract of the original article appeared in record 2023-81526-001.) Existing research has found that home visiting programs for families with young children can improve children's development and strengthen caregiver and family well-being. However, the pandemic created numerous challenges for home visiting programs, forcing them to deliver services online or in a hybrid format to respond to pandemic-related challenges. Questions remain about the impacts of these programs when delivered at-scale via a hybrid model, especially during this uniquely challenging time. The present study reports 12-month impacts from a randomized controlled trial of Child First-an evidence-based home visiting program that provides psychotherapeutic, parent-child intervention (children ages 0-5) embedded in a coordinated system of care-when implemented as a hybrid service. This study estimates impacts within four domains: families' receipt of services, caregiver psychological well-being and parenting, child behavior, and family economic well-being. After randomly assigning families (N = 226) to receive Child First or typical community services, the research team surveyed caregivers (N = 183) about a year after study enrollment. Results from regression models with site fixed effects revealed suggestive evidence that Child First reduced caregivers' job loss, residential mobility, and self-reported substance abuse, and increased receipt of virtual services during the pandemic. There were null impacts on caregivers' psychological well-being, families' involvement with the child welfare system, children's behaviors, and other indicators of economic well-being. Implications for future research and policy are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adolescent reproductive health care services: knowledge, perspectives, and challenges among service providers in Makurdi, Benue State Nigeria

Adolescence is a phase of life characterized by several reproductive health challenges that require support to navigate. However, access to adolescent and youth-friendly health service (AYFHS) centers to provide this support is limited. Perspective of healthcare workers (HCW) towards understanding the challenges to service provision has not been systematically documented. This study therefore documents the perspectives of HCWs on the types of services accessed by adolescents, and associated challenges in Makurdi, Benue State, Nigeria. The facility-based descriptive qualitative study used an in-depth interview guide among program officers in the 11 youth-friendly health centers. The interviews were recorded, transcribed, and analyzed thematically. The provision of HIV prevention services and AYFHS was appropriate while adolescents have preferences for facilities where their confidentiality is protected, and other needs are met. Reported challenges were lack of privacy, high cost of transportation to facilities, high staff attrition, poor awareness of the facilities and services, and parental consent. Suggestions for improvement included prolonged retention of youth-friendly trained staff, better client confidentiality, and economic empowerment of the adolescents to access services when needed. While the providers’ perspective on AYFHS for adolescents was positive, related challenges were also identified. Government and other stakeholders should collaborate to ensure the right environment for accessibility and utilization of AYFHS.

Vision rehabilitation workforce in Italy: a country-level analysis

BackgroundResearch and monitoring of human resources available for vision rehabilitation services has been a neglected area of work in the past. This study aims to offer an overview of the vision rehabilitation workforce available in Italy, in order to profile the distribution and number of human resources for vision rehabilitation.MethodsData on the available vision rehabilitation professionals were collected from the yearly report on the state of implementation of policies relating to the prevention of blindness, education and vision rehabilitation, according to a law which was passed by the Italian Ministry of Health, Department of Health Prevention. The report presents a review of all professional workers dealing with low vision rehabilitation centers in Italy between January 2005 and December 2019. Data on the distribution and type of services of government-supported low vision centers across the country were also obtained and examined.ResultsOf the 289 low vision rehabilitation workers in 2019, 28% were ophthalmologists, 31% orthoptists, 19% psychologists, 17% nurses and 5% social workers.The health workforce densities across the Italian regions ranged from 1.62 to 0.12 per 100.000. The density of vision rehabilitation workers showed a no growing trend from 2006 to 2015. During the study period, it was found a weak but statistically significant association of workforce density with the number of government-supported low vision centers across the Italian territory (r2 = 0.3, p < 0.05). The vision rehabilitation workforce was not associated with the number of low vision patients who accessed to a vision rehabilitation center (r2 = 0.05, p < 0.0001).DiscussionA critical review has identified the following national situation: need-based shortages of workers in the vision rehabilitation service sector, as well as deficiencies in data sources. Based on our results, we would recommend increasing the development of human resources trained and dedicated to vision rehabilitation and improve data collection and analysis; provide structural enhancements, across all service levels. These considerations may contribute to the enhancement of policy decisions in order to guarantee an adequate vision rehabilitation workforce and meet national rehabilitation needs. Furthermore, this analysis should be used as a lesson learned by other countries, as low-income ones, in order to develop vision rehabilitation services.

Service center in electricity distribution sector with variable peak electricity time: A two-stage queuing model approach with nested simulation

Customer service is essential for any business, significantly impacting customer satisfaction, brand reputation, and reducing associated costs. In the electricity industry, this importance is heightened due to the critical nature of electricity in daily life and growing usage rate of new technologies. Effective customer service in electric distribution companies involves handling a wide range of inquiries, from billing issues to technical support, requiring both remote and on-site assistance. The variability in customer calls, influenced by factors such as peak electricity hours, and different service and customer types, presents unique challenges in designing efficient service centers. This research develops a tailored model for the service center operations of a power distribution company, focusing on optimal staffing levels within budget constraints. A two-stage queuing model is proposed to address the needs of residential and non-residential customers. The study employs nested simulation techniques to account for variability in customer arrival times and peak hours. Key performance indicators (KPIs) are used to evaluate the effectiveness of staffing policies, considering both quantitative and qualitative costs. The study integrates stochastic optimization and ranking and selection methods to identify the best staffing configurations. The findings offer actionable insights for improving customer service efficiency and operational effectiveness in electricity customer service centers.

Identification of key areas for Territorial Ecological Restoration: focusing on ecological security and restoration potential

Implementing Territorial Ecological Restoration is a crucial approach to achieving ecological stability and regional sustainable development, and it also serves as an important measure for promoting the coordinated development of socioeconomic and ecological environments in the Yellow River Basin. However, effective identification of key areas for Territorial Ecological Restoration remains challenging in planning ecological restoration projects. This study focuses on ecological security and restoration potential, taking Linxia Prefecture in the ecologically fragile area of the upper Yellow River as an example. By evaluating six types of ecosystem services in this area, utilizing morphological spatial pattern analysis models and circuit theory, we identified the structural elements of ecological security patterns and assessed the potential for ecological restoration, identifying key areas for regional ecological restoration.The findings indicated that (1) 13 ecological patches were identified in total, predominantly distributed in the southwest and central regions of Linxia Prefecture. 25 ecological corridors were identified, demonstrating a high level of spatial coherence in terms of significance and connectivity, establishing a closely integrated ecological security network primarily in the southwest of Linxia Prefecture. (2) Thirteen ecological pinch points and seventeen ecological barrier points have been identified, concentrated in the central and southwestern regions of Linxia Prefecture. (3) Based on the characteristics and urgency of key areas for Territorial Ecological Restoration, they are classified and graded as “point-line-surface” and “primary-very important-important.” The primary restoration areas of the point type are mainly located in the central part of Linxia Prefecture, while the primary restoration areas of the line and plane types are mainly in the southwestern part of Linxia Prefecture. This paper emphasizing a holistic approach that prioritizes ecosystem integrity and social support to guide targeted restoration strategies across various ecological features, ultimately aiming for sustainable regional development and maximizing restoration benefits in ecologically fragile areas.

Managing Visitor Experience in Museums: Aiming Towards Satisfaction Through Edutainment and Perceived Authenticity in Arts and Culture

This paper demonstrates the value of edutainment and authenticity when managing the visitor experience and satisfaction with a service. The study concentrates on the specific type of services that are provided by museums. Drawing on the social cognitive theory, the paper explores the relationship between edutainment (defined as the combination of education and entertainment provided through interactive content) and the three components of the perceived authenticity of museum visitor experience, 1) the museum, 2) the visitor, 3) the materials. Including edutainment and hedonic expectations as antecedents, with satisfaction as an outcome, the paper proposes a new model of perceived authenticity of visitor experience. The model was tested on a sample of 313 museum visitors (in Croatia). The results revealed that edutainment (as a second-order construct) positively influences perceived authenticity. Also, hedonic expectations positively influence one out of three components of perceived authenticity of museum visitor experience, i.e. self-authenticity of the visitor, but there was no influence on the other two components – museum and materials. Finally, perceived authenticity positively influences visitor satisfaction. Our research provides useful insights to museum managers and service managers in general who should consider using edutainment as a strategic approach to managing the visitor experience and satisfaction.

Two-level integrated verification evaluation method based on comprehensive weighted assessment in multiple scenarios

The complexity and diversity brought by the distributed architecture of the new generation electric information collection system have deepened the difficulty of constructing evaluation verification index systems and quality evaluation models. Moreover, the presence of differentiated components has made fair and scientific verification challenging. Therefore, leveraging graph neural networks and siamese networks, a integrated construction quality evaluation system based on comprehensive weighted assessment in multiple scenarios was developed. Firstly, a graph neural network was constructed based on terminal data of the branches electricity usage information collection system and the link topology structure. Subsequently, this network was deployed on the headquarters side to directly acquire terminal data and generate mirror network input from the branches data, enabling real-time acquisition of various system operational indicators. Finally, the similarity between the headquarters and branches data was calculated using siamese networks to compute accuracy compensation weights for checking and evaluating various indicators, thereby obtaining comprehensive weighted quality evaluation indicators of the branches new generation electric information collection system. We use three types of services including electricity data collection, load forecasting, and task scheduling as experimental scenarios. The results showed that the multidimensional comprehensive weighted quality assessment combined with accuracy compensation obtained from the siamese network resulted in business construction quality assessment values of 97.92%, 95.95%, and 99.96% in branch. This value is approximately equal to the quality evaluation value of manual work, so the method can effectively verify the construction quality of new systems in the branch.

Adoption and Utilization of Telemedicine and Digital Health Services among Older Adults in Israel

Abstract Background As the population ages and the prevalence of long-term diseases rises, telecare is being used increasingly frequently to aid elderly people. Aims We aimed to explore the usage and adoption of 3 types of telehealth services among the senior population in Israel- prior, during, and after the COVID-19 pandemic rise in Israel. Methods We explored the usage characteristics of older adults (age 65 and above) belonging to ‘Clalit’, in the use of three types of telehealth services: digital services for administrative tasks, synchronous ‘online visits’ with the patient’s personal physician during clinic business hours, and ‘afterhours’ consultations during evenings, nights, and weekends. The data was collected and analyzed throughout three distinct time periods in Israel: before the COVID-19 pandemic, during the onset of the COVID-19 pandemic and following the COVID-19 ‘peak’. Results Data of 618850 patients who met the inclusion criteria was extracted. Telehealth services utilized for administrative purposes were the most popular. The older population significantly increased their use of all types of telehealth services during the COVID-19 period, and in the majority of types, this usage decreased after the COVID-19 peak, but to a level that was higher than the baseline level prior to the COVID-19 period. Prior to the COVID-19 period, 23.1% of the study population used ‘online visits’, and 2.2% used ‘afterhours’ consultations, at least once. The percentage of usage for these services increased during the COVID-19 period to 59.2% and 5.0%, and then decreased during the third period to 39.5% and 2.4%, respectively (P &amp;lt; 0.001). Multiple patient variables have been found to be associated with the use of the different telehealth services, in each time-period. Conclusions The senior population uses telehealth services, and can increase their consumption, when they are needed. Suitable and straightforward telehealth solutions tailored for this population should be created. Key messages • The senior population uses telehealth services, and can increase their consumption, when they are needed. • Suitable and straightforward telehealth solutions tailored for this population should be created.

Patients’ trust in health information sources as an antecedent of novel healthcare technology usage

Abstract Background As professional health information sources, healthcare maintenance organizations (HMOs) need to convince patients of the necessity, efficiency, and reliability of technology-based services to increase and optimize their usage. It raises the question of whether patients’ trust in health information sources shapes the use of technology-based services and, in return, increases their willingness to use novel healthcare services in the future. Methods Data were collected through an online close-ended survey among 668 adult Israeli citizens insured with Israeli health insurance (85% of them Jewish, 52.5% female, and in their early 40s, with half holding an academic degree). The survey explored actual use and willingness to use innovative healthcare technologies and the trust respondents attributed to various sources of health information. Data were analyzed by SPSS 28. Results Participants generally use healthcare technology primarily to schedule appointments, search for medical information, and make health-related requests. To quite an extent, they are willing to be treated with innovative healthcare technologies (e.g., for radiological purposes and personally tailored medication). Preliminary results suggest that trust in the measured formal health information sources (i.e., formal health providers, HMO, HMO online services) was positively associated with technology-based healthcare services usage (r=.14 - .20, p&amp;lt;.001). A positive association also emerged between the current use of healthcare technology and the willingness to use innovative medical technologies in the future (r=.23, p&amp;lt;.001). Conclusions HMOs, as key players, have the power to maximize the usage of advanced health services by establishing trusting relationships with their patients. This will increase the usage of healthcare technology-based services and generate positive patient experiences, which will result in the willingness to experience novel types of health services in the future. Key messages • Encouraging patients to use technology-based health services will maximize the potential inherent in the use of innovative health services and treatments in the future. • Nurturing trusting relationships with patients at any level in the health system will increase their compliance with health providers’ recommendations to use advanced health services.

Post-ROsc ecG pREdictS Survival after out-of hospital cardiac arrest: validation of the PROGRESS score

Abstract Background Prognostication is crucial for patients with an out-of-hospital cardiac arrest (OHCA) both during resuscitation and after return of spontaneous circulation (ROSC) and early prognostication is still a challenge. At this regard, we proposed the PROGRESS score: a post-ROSC 12-lead ECG features’-based score to predict 30-day survival. Purpose The aim of the present study is to validate the PROGRESS score on a larger population of post-OHCA patients and to test its performance even after correction for patients’ and events’ characteristics, contained in the UB-ROSC score, could increase its discrimination ability. Methods Cardiac arrest cases were retrieved from the Lombardy Cardiac Arrest Registry (LombardiaCARe) from January 2015 to December 2022. We considered only patients with a post-ROSC 12-lead ECG and all the variables for UB-ROSC calculation available. The PROGRESS score considers age, sex, number of segments with ST elevation, QRS width, and Brugada pattern and from 0 to 26 identifies three categories of risk of death at 30 days (low: 0-4; intermediate: 5-7; high: 8-26). The UB-ROSC score considers age, aetiology, location, witnessed OHCA, bystander cardiopulmonary resuscitation (CPR), emergency medical service (EMS) arrival time and type of presenting rhythm. The performance of the PROGRESS score, in terms of discriminatory power of calibration, was tested both alone and after correction for UB-ROSC score. Results We considered 940 OHCAs of whom 63.9% were males with a median age of 70 [59.5-79]. 30-day survival was 37.9%, 63.1% and 64.5% in high, intermediate, and low risk groups respectively. PROGRESS score was shown to discriminate high-risk patients from low-risk ones [HR 1.97 (95% CI 1.42-2.73), p-value &amp;lt;0.001], (Harrel-C= 0.58). After correction for UB-ROSC score both calibration and discrimination improved (Harrel-C = 0.70). Conclusions The PROGRESS score was confirmed to predict the risk of death at 30 days in patients resuscitated from an OHCA and its discriminatory power was increased by correction for the UB-ROSC score. The use of this two scores in the field allows risk stratification during resuscitation manoeuvres and in post-ROSC care, which is essential to guide resource allocation.

Digital strategies of public youth mental health services to raise awareness of their existence

Abstract Background Data from a survey of the first part of the eHealthLit4teen Project show that adolescents in the city of Barcelona (12-16 years old) are not aware of the public youth mental health services (YMHS) available in the city. Considering the intensive use that young people make of digital platforms, YMHS might leverage these channels to raise young people’s awareness of available resources, which would impact on the help-seeking behaviours. The aim of this work is to analyse the social media strategies for the dissemination of public YMHS and emotional well-being services (promoted by the city council and the regional government) in Barcelona. Methods Identification of public YMHS and emotional wellbeing services, and interview on the use of social networks for dissemination with those responsible for the services and communication (March-April 2024). Analysis of the use of persuasive design and behavioural design techniques by the social media profiles of these services and, by way of contrast, the influencers who publish mental health content identified by the adolescents in the previous survey of the Project (March 2023). Results Public YMHS mainly rely on outreach through face-to-face visits to high schools. This format makes it easier for reluctant young people to access formal support, but more difficult for them to seek support because of stigma. In general, public YMHS do not show a clear strategy to disseminate their service on social media, and the information provided confusion between the characteristics of the services offered. Likewise, there is no widespread use of behavioural design or persuasive design techniques in the publications of health services on social media, nor in those of influencers. Conclusions Public YMHS do not make efficient use of the digital platforms that young people use intensively to raise awareness of their existence and increase usage. Key messages • There is no clear digital strategy for communicating public youth mental health services (YMHS), although they recognise that digital platforms can be a good means of dissemination. • YMHS need to be accessible on digital platforms to young people’s adults of reference (especially for younger teens), as they are the ones who seek out online the existence of this type of services.

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.