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BACKGROUND: The pandemic rapidly expanded telemedicine, which has persisted as a widely available primary care modality. The uptake of telemedicine among people with dementia specifically in the primary care setting, who have more complex care needs but also benefit from more accessible primary care, is unknown. OBJECTIVE: Among people with dementia, assess uptake of telemedicine-based primary care in the post-pandemic period and determine associations with key socio-demographic characteristics. DESIGN: Retrospective observational study. SUBJECTS: People with dementia at UCSF and Kaiser Permanente Northern CA (KPNC) with at least one primary care encounter in pre- (3/1/2019-2/29/2020) or post-COVID (3/1/2021-2/28/2022) periods, post-COVID sample: N= 419 individuals (UCSF), N=18,037 (KPNC). MAIN MEASURES: Encounter modality: in-person, video telemedicine, or telephone telemedicine. Focal socio-demographic characteristics: age, limited English proficiency, socioeconomic status, driving distance to clinic, and caregiver at encounter. KEY RESULTS: There was a large increase in telemedicine among people with dementia in the post-pandemic period at both sites. At KPNC, those with only in-person primary care visits shrunk from 60.47% (pre) to 26.95% (post). At UCSF, the change was even greater: 98.99% to 35.08%. Across both sites, the only measure significantly associated with use of telemedicine was greater driving distance from home to clinic. At KPNC, those over age 90 were most likely to use telemedicine while patients with limited English proficiency and those with a caregiver at the encounter used telemedicine at lower levels. The relationships were similar at UCSF but not statistically significant. CONCLUSIONS: Telemedicine use is high for people with dementia in the primary care setting in the post-pandemic period. Those with longer drives to clinic and the oldest patients were most likely to use telemedicine, likely due to challenges traveling to appointments. Still, not all people with dementia used telemedicine equally-particularly those with limited English proficiency.

This study aimed to determine the teachers' utilization of the new trends of teaching strategies and their effects on pupils' academic performance, which will serve as inputs for a proposed framework of up-to-date teaching strategies during the school year 2023-2024. The perception of the teachers and pupils as regards the teachers' utilization of the new trends of teaching strategies. Regarding Gamification, the teacher-respondents got an average weighted mean of 3.69, while the pupil-respondents got 3.67, both verbally interpreted as Very Satisfactory. Regarding Convergent and Divergent Thinking, the teacher-respondents obtained an average weighted mean of 3.68, while the pupil-respondents obtained 3.59, both verbally interpreted as Very Satisfactory. Regarding Project-Based Learning, the teacherrespondents got an average weighted mean of 3.66, while the pupil-respondents got 3.69, both verbally interpreted as very satisfactory. Regarding Experiential Learning, the teacher-respondents achieved an average weighted mean of 3.67, while the pupil-respondents got 3.57, both verbally interpreted as very satisfactory. There is a significant difference between the perceptions of the two groups of respondents regarding the teachers' utilization of the new trends of teaching strategies concerning the variables above. There is no significant difference between the perceptions of the two groups of respondents regarding the teachers' utilization of the new trends of teaching strategies concerning Gamification, Convergent and Divergent Thinking, Project-Based Learning, and Experiential Learning. The academic performance of the pupils during the school year 2023-2024. The academic performance of the pupils during the school year 2023-2024 was Very Satisfactory. Significant correlation between the teachers' utilization of the new trends of teaching strategies and the pupils' academic performance. There is no significant correlation between the teachers' utilization of the new trends of teaching strategies and the pupils' academic performance. [ABSTRACT FROM AUTHOR]

The study assessed the utilization of RPMS classroom observation tool among MAPEH teachers in Tacloban City Division. The study utilized a descriptive-correlational research design, involving 73 public junior high school MAPEH teachers from Tacloban City Division as respondents. The findings revealed that most MAPEH teachers in Tacloban City Division are below middle-aged, female, with over 10 years of experience, possess a Baccalaureate Degree with Master's Units; and mostly proficient teachers. Moreover, the majority of trainings and seminars are local, with lower participation rates at higher seminar levels. Classroom observation tools are "Fully Utilized" for proficient and highly proficient teachers, regardless of school size. The study found no significant correlation between profile variables and utilization, and no significant differences in utilization across different school categories. It is advised that Junior High School MAPEH teachers seek professional development and post-graduate coursework, while DepEd Tacloban officials should promote collaboration, resource utilization, and feedback among teachers for enhanced teaching effectiveness. [ABSTRACT FROM AUTHOR]

Vitamins are essential components of enzyme systems involved in normal growth and function. The quantitative estimation of the proportion of dietary vitamins, that is in a form available for utilization by the human body, is limited and fragmentary. This review provides the current state of knowledge on the bioavailability of thirteen vitamins and choline, to evaluate whether there are differences in vitamin bioavailability when human foods are sourced from animals or plants. The bioavailability of naturally occurring choline, vitamin D, vitamin E, and vitamin K in food awaits further studies. Animal-sourced foods are the almost exclusive natural sources of dietary vitamin B-12 (65% bioavailable) and preformed vitamin A retinol (74% bioavailable), and contain highly bioavailable biotin (89%), folate (67%), niacin (67%), pantothenic acid (80%), riboflavin (61%), thiamin (82%), and vitamin B-6 (83%). Plant-based foods are the main natural sources of vitamin C (76% bioavailable), provitamin A carotenoid β-carotene (15.6% bioavailable), riboflavin (65% bioavailable), thiamin (81% bioavailable), and vitamin K (16.5% bioavailable). The overview of studies showed that in general, vitamins in foods originating from animals are more bioavailable than vitamins in foods sourced from plants. [ABSTRACT FROM AUTHOR]

Many countries are experiencing a post-pandemic surge in hospital utilization along with accelerating population aging. Maximal hospital efficiency is required, with utilization evidence essential for identifying appropriate hospital or broader health system reforms. We offer an investigation of the most recent pre-COVID year (2019–2020) of complete population-based hospital utilization data to describe and compare the use of hospitals by older (65+) and younger (0–64) people admitted for inpatient services in Canada. We found that 35.7% of all 1,888,133 admitted individuals and 39.8% of all 2,543,227 hospital episodes involved people aged 65+, representing 4,963,766 or 17.1% of the study population. This study, as do previous Canadian and other ones, found hospitals admit more younger people than older people. The admission and care patterns of both younger and older patients reveal a need for more community-based services to shorten older patient hospitalizations and prevent avoidable hospitalizations by both younger and older people. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence of non‐utilization of dental care in Lebanon and associated socioeconomic factors and self‐care behaviours. Methods: A nationwide, quantitative, survey‐based study was conducted by trained interviewers with Lebanese residents aged ≥18 years between July and September 2019. Univariate analyses were performed using Pearson Chi Square test or the Fisher's exact test followed by a binary logistic regression using the SPSS Version 25. Results: Of the 1070 participants, 247 (23.1%) did not utilise any type of healthcare and 144/247 (58.3%) did not utilise dental care. The prevalence of non‐utilization of dental care was estimated at 13.5%. Only 4.7% of the respondents consulted their dentist in the past year, among which 53% cited pain/emergencies as the reason for their consultation. Socioeconomic factors associated with the non‐utilization of dental care were lack of social medical insurance (OR, 0.49 [95% CI, 0.31 to 0.79]) and long waiting time/patient time restriction (OR, 2.05 [95% CI, 1.26 to 3.35]). On the other hand, facilitators for utilization of dental care included ethical standards/personal qualities of the dentist (OR, 0.53 [95% CI, 0.32 to 0.88]) and convenient cost with respect to the individual's economic status (OR, 0.28 [95% CI, 0.18 to 0.43]). Conclusion: This study suggests that dental care practices in Lebanon, including the non‐utilization of dental care, are suboptimal. Measures such as reducing sugar and tobacco consumption, providing information on oral hygiene, and using fluoride products are inexpensive; however, implementing these measures may take substantial time and input by multiple stakeholders. [ABSTRACT FROM AUTHOR]

The red swamp crayfish (Procambarus clarkii) was introduced from Japan to China in the 1920s. Crayfish are now widely distributed in almost all types of freshwater wetlands, including rice fields, ditches, swamps, lakes, and ponds in most provinces of China, owing to their multi-directional movement, rapid growth, adaptability to the environment, and relatively high fecundity. The delectable taste and high nutritional value of crayfish have made them popular among consumers, leading to the significant development of red swamp crayfish farming in the last two decades. Currently, it represents the largest proportion of commercially farmed freshwater crustaceans in China and has become an integral component of China's aquatic economy. Crayfish are highly valued for their edibility and for their by-products, which have various important uses. This review discusses nutrient composition, active ingredients, safety evaluation, processing and preservation, and comprehensive utilization of crayfish by-products to explore and organize the existing knowledge about crayfish and to promote the growth of the crayfish industry. This comprehensive review aims to provide a basis for the optimal utilization and sustainable development of crayfish resources worldwide. [ABSTRACT FROM AUTHOR]

We focus on two of the many sources of uncertainty in healthcare operations, mix uncertainty – the variation in the complexity of care required by the patient mix, and volume uncertainty – the variation in the volume of care demanded by the patient population. Using an interdisciplinary perspective, we study the impact of mix and volume uncertainties on two important healthcare outcomes, length of stay and number of procedures, along with the mitigation impacts of the operational concepts of related focus and utilization levels. Based on large dataset of 830,853 patient discharges in 26 clinical departments across 731 hospitals in five U.S. Midwest states, our results indicate that mix and volume uncertainties each have a significant impact on patient care. We also find that related focus and department utilization levels have a mitigating effect on uncertainty in healthcare settings. Lastly, we find considerable heterogeneity in the effects of uncertainty across hospital types and departments. We discuss key research and managerial implications of our findings. Highlights: Mix Uncertainty, the uncertainty in care delivery operations owing to the variation in the complexity of patient‐care needs, triggers more procedures as providers search for information.Volume Uncertainty, the uncertainty in care delivery operations owing to the variation in the volume of patients served, drives providers to reduce number of procedures and increases patients' length of stay.Related Focus, a department's breadth of expertise in relevant areas, may provide key information that reduces the need for additional procedures and can lower patients' length of stay. [ABSTRACT FROM AUTHOR]

In Germany, medical rehabilitation is provided to promote work ability and health in the case of chronic illness and to avoid early disability pensions. Studies have shown that employees with a history of migration are less likely to seek medical rehabilitation. The aim of this paper was to examine which factors influence the use of medical rehabilitation services in migrants with back pain. We used data from a German cohort study also including migrant employees aged 45 to 59 years. Participants reported back pain in the last 3 months and completed a baseline questionnaire in 2017. Data on rehabilitation utilization was extracted from administrative records covering the period until the end of 2018. Proportional hazard models were fitted to identify factors that were associated with utilized rehabilitation measures. Data of 552 participants were included, and 25 individuals utilized rehabilitation during follow-up. Sex (women: HR = 3.05; 95% CI: 1.10; 8.45), higher job insecurity (HR = 1.02; 95% CI: 1.00; 1.03), support from physicians and therapists (HR = 2.22; 95% CI: 1.52; 3.24), proportion of foreigners (HR = 3.27; 1.17; 9.15), and the self-reported need for rehabilitation (HR = 3.23; 95% CI: 1.12; 8.60) were associated with utilization. In summary, informational and practical support provided by physicians and therapists on medical rehabilitation services seems to be a key predictor of rehabilitation utilization. Our findings, therefore, support the call for transcultural competence to be more widely incorporated into the education of medical and health professionals to counteract health care disparities. [ABSTRACT FROM AUTHOR]

Background: The use of immediate postpartum intrauterine contraceptive devices during the postpartum period supports women's need for spacing births and prevents them from unplanned pregnancies. However, in developing countries, utilization of immediate postpartum contraceptives is low. This increases the risk of maternal morbidity, maternal mortality, preterm birth, child mortality, low birth weight, and small gestational age in subsequent pregnancy with interpregnancy interval. Objective: To assess immediate postpartum intrauterine contraceptive device utilization and the associated factors among women who gave birth in Hospitals in West Wolegga Zone in 2020. Methods and materials: An institutional-based cross-sectional study was conducted in public hospitals in the West Wolegga Zone from 1 April 2020 to 30 April 2020 among 290 postpartum women. The sample size was proportionally allocated to six hospitals by considering their monthly delivery. Study subjects were taken by systematic sampling technique (Kth=N/n =1025/290=3.53), thus every 4th woman who gave birth in the hospital was recruited in each hospital until the total sample size for this study was obtained. Bivariable and multivariable logistic regression was used to assess the association of independent variables with immediate postpartum intrauterine device utilization. A significance level of 0.05 was used to assess the statistical significance of the study's associations. Results: In this study, the magnitude of the Immediate postpartum intrauterine contraceptive device utilization was 19.3%.factors like Early initiation of antenatal care [AOR=4.46 95% CI:1.84-10.78], Planning of future pregnancy [AOR=3.7(95% CI: 1.43-9.54)], Ever heard of the immediate postpartum intrauterine contraceptive device [AOR=2.67(95% CI: 1.08-6.58)] and Counseling about postpartum intrauterine contraceptive device [AOR=5.15(95% interval: 2.00-13.28] were associated with immediate postpartum intrauterine device utilizations. Conclusion: The use of immediate postpartum intrauterine contraceptive devices is low compared to other studies conducted in Ethiopia. Age, early antenatal care initiation, pregnancy planning, hearing of the immediate postpartum intrauterine device immediately inserted after delivery, and counselling on the immediate postpartum intrauterine device were significantly associated with mothers' use of immediate postpartum intrauterine devices. Health Program directors should develop strategies to increase the use of immediate postpartum intrauterine contraceptive devices. [ABSTRACT FROM AUTHOR]

Introduction: Contraceptive methods are techniques used to prevent pregnancy during sexual intercourse. The primary goal of contraception is to inhibit the fertilization of an egg by sperm or to prevent the implantation of a fertilized egg in the uterus. Unwanted pregnancy is a major challenge for street beggar women. Due to limited use of modern contraception, unwanted pregnancy and STDs are key issues faced by this population. This study aims to assess modern contraceptive utilization and explore factors influencing contraceptive choices among street beggar women in the Sidama region, Ethiopia by using Bayesian logistic approaches. Methods: A cross-sectional quantitative study was conducted on reproductive-aged (15–49) street beggar women in the Sidama Region. Data was collected using a pre-tested, structured interview questionnaire in the local language from each town in the Sidama region. Descriptive and inferential statistics were used to analyze the data using STATA version 17. A Bayesian logistic approach, with Markov Chain Monte Carlo methods, was used to model the association between modern contraceptive utilization and independent variables, allowing for estimation of model parameters and credible intervals. Result: The study found that 38.9% of street women in the Sidama region used modern contraceptives, primarily implants and injections. Bayesian logistic regression identified key factors influencing contraceptive use including, women aged 25–34 (AOR: 2.69 (95% CI: 1.57, 4.26)), married women (AOR: 4.91 (95% CI: 2.67, 8.51)), Widowed women (AOR: 2.81 (95% CI: 1.49)) and educated women (AOR: 2.16 (95% CI: 1.48, 3.01)) were more likely to use contraceptives. In contrast, those living on the street (AOR: 0.12 (95% CI: 0.05, 0.27)), with no history of pregnancy (AOR: 0.07 (95% CI: 0.02, 0.16)), and no sexual activity in the last six months (AOR: 0.11 (95% CI: 0.01, 0.03)), had lower usage rates. Additionally, women whose only job was begging (AOR: 0.43 (95% CI: 0.13, 0.92)) and those lacking health advice (AOR: 0.25 (95% CI: 0.07, 0.59)) also showed reduced utilization. Lack of discussion about contraceptives with partners (AOR: 0.18 (95% CI: 0.08, 0.33)) and no women's approval (AOR: 0.18 (95% CI: 0.08, 0.33)) further contributed to lower usage. Conversely, good knowledge of modern contraceptives was positively associated with utilization (AOR: 2.33 (95% CI: 1.44, 3.64)). Conclusion: The findings of this study identified several factors significantly associated with modern contraceptive use among street beggar women in the Sidama region, including age, marital status, Education level, disability, Job in addition to begging, Current living situation, history of sexual assault/rape, History of pregnancy after street life, discussion of modern contraception with a sexual partner, Advice from a health professional, Sexual activity in the last six months, time taken to arrive at a health facility on foot, approval of modern contraception, and knowledge. The main barriers reported were fear of side effects and lack of knowledge about contraceptive methods. The study suggests that concerned stakeholders should intervene to address these factors and improve modern contraceptive uptake in this vulnerable population. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the level of technology utilization and its impact on learner engagement in the classrooms of Kinder-2nd Grade teachers for the school year 2023-2024. The study examined respondents' demographic profiles and the usage levels of various technologies in the classroom, including Educational Online Videos, Independent Online Programs, Gamified Online Programs, and Interactive Technology. Additionally, learner engagement was assessed in relation to these applied technologies. The study employed a descriptive-comparativedevelopmental design, integrating both quantitative and qualitative approaches. A purposive sampling method was used to select respondents, and data were collected through survey questionnaires and focus group discussions. Statistical analysis was conducted using frequency, percentage, mean, standard deviation, t-tests, and one-way Analysis of Variance, supported by PostHoc Analysis using Scheffe's method. Results revealed that educational online videos were the most frequently utilized technology, while interactive technology was the least utilized. Conversely, learners showed the highest engagement with interactive technology and the least engagement with independent online learning. The study found that age, sex, and years of teaching experience significantly impacted the level of technology utilization, whereas educational attainment did not. Additionally, the findings indicated that learners were more engaged when interactive technology was employed in the classroom, despite teachers' lower utilization levels of such technology. The study also highlighted challenges faced by teachers, including learners' proficiency in digital literacy and the need for an assessment tool to evaluate learner engagement. In conclusion, the study demonstrates that the level of technology utilization by teachers has a significant impact on learner engagement in the classroom. [ABSTRACT FROM AUTHOR]

Background: Abortion-related complications are the third leading cause of maternal mortality in Uganda, accounting for approximately one-fourth of all maternal deaths. Most are preventable through adequate use of the full package of postabortion care (PAC) services. Objective: We aimed to assess the level of utilization of PAC services and the associated sociodemographic, obstetric, gynecological, and system-related factors at a high-volume tertiary health facility in Northern Uganda. Design: A cross-sectional survey was conducted among women receiving PAC at the Gulu Regional Referral Hospital from March 2023 to June 2023. Participants were recruited consecutively and exit interviews were conducted using structured questionnaires. Methods: Utilization of PAC was defined as the use of four or more of the following: counseling, emergency treatment, family planning services, linkage to other sexual and reproductive health services, and community health service provider cooperation. Modified Poisson regression analysis was used to determine the independent predictors of PAC utilization. Results: A total of 364 participants were enrolled in the study. Overall, 21.1% (n = 77) of the participants had used four or more PAC services. Having a supportive partner (adjusted prevalence ratio (aPR): 1.9, 95% confidence interval (CI): 1.19–2.88, p = 0.006), knowledge on PAC services (aPR: 1.7, 95% CI: 1.19–2.48, p = 0.004), low parity (aPR: 2.2, 95% CI: 1.16–4.35, p = 0.016), nulliparity (aPR: 2.4 95% CI: 1.19–4.73, p = 0.014), and provision of privacy(physical privacy during prescription, counseling, procedures) (aPR: 2.3 95% CI: 1.14–4.47, p = 0.02), were significantly associated with utilization of PAC. Overall, only one in five participants utilized four or more PAC services. Use of four or more PAC services was significantly associated with women having a supportive partner, knowledge of PAC services, low parity, nulliparity, and provision of privacy while receiving PAC services. Conclusion: Approaches such as advocating male partner involvement, bridging the knowledge gap through health education, and promoting respectful care may improve the utilization of PAC services. [ABSTRACT FROM AUTHOR]

Background: Online learning is becoming increasingly essential for health professionals, and it is necessary to understand how this modality affects clinical nurses' learning of Evidence-Based Practice (EBP). For this reason, the present study sought to assess the effectiveness of an online training program in improving nurses' EBP competence. Methods: A quasi-experimental study with a pretest–posttest design was conducted with a control group and without randomization for a period of 6 months. The intervention was an online self-learning course based on Melnyk's seven steps of Evidence-Based Practice (EBP). The course was structured into sequential modules requiring 72 h of work, with task completions and tests necessary for progression. Participants had three months to complete the course. EBP competence was measured with the EBP-COQ Prof© questionnaire. Data analysis included percentages, means, standard deviations, chi-square tests, student's t-tests, and a two-way repeated measures analysis of covariance (ANCOVA). Results: The analysis of the changes observed in each dimension and the overall EBP competence between the intervention group (IG) and the control group (CG) showed a significant group*time interaction in three of the four dimensions of the questionnaire. The results indicated that the online Evidence-Based Practice (EBP) course significantly improved knowledge, skills, and utilization three months after its completion. In the IG, the mean score was 44.04 (standard deviation (SD) = 7), compared to 37.83 (SD = 8.5) in the CG (p < 0.001). Regarding skills, the IG had a mean score of 24.24 (SD = 3.8), while the CG scored 23.01 (SD = 3.1) (p = 0.008). For utilization, the mean score in the IG was 36.77 (SD = 6.8), and the CG was 33.12 (SD = 6.3) (p = 0.005). Overall competence also showed a statistically significant difference, with the IG achieving a mean score of 141.22 (SD = 20.0) compared to the CG with a mean score of 130.34 (SD = 16.7) (p < 0.001). Conclusions: Training through an online education platform for three months (72 h) is an effective tool for improving the competence in Evidence-Based Practice (EBP) of clinical nurses. A significant increase was observed in knowledge and moderate improvements in skills and the application of EBP. These online courses, adapted to the needs of professionals, can be an efficient way to prepare nurses and improve their application of EBP in a clinical setting. [ABSTRACT FROM AUTHOR]

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Background: The World Health Organization (WHO) advocates the use of insecticide-treated nets (ITNs) as a primary strategy for malaria control during pregnancy. Despite these recommendations, ITN utilization among pregnant women in endemic regions, particularly East Africa, remains lower and inconsistent. This systematic review and meta-analysis comprehensively examined individual studies to provide a more robust and reliable estimate of ITN utilization among pregnant women in the region. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of ITN utilization among pregnant women in East Africa. Methods: We conducted a comprehensive literature search to identify studies on insecticide-treated bed net utilization among pregnant women in East Africa. We searched the Medline/PubMed, Embase, Scopus, Science Direct, Epistemonikos, Google Scholar, and Google manual databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. We used predefined inclusion criteria to screen identified studies. Heterogeneity across the studies was evaluated via Cochrane Q test statistics and the I2 test. A random effects model was computed to estimate the pooled prevalence of ITN utilization among pregnant women in East Africa. Results: After a systematic review of 11,509 studies, 35 studies met the inclusion criteria and were included in the meta-analysis. The findings from the 35 studies revealed that the pooled prevalence of ITN utilization among pregnant women in East Africa was 51.6% (95% CI: 42, 61). Subgroup analysis revealed that the highest prevalence of ITN utilization was observed in South Sudan (89%), and the lowest was in Sudan (12%). Conclusions: This review revealed that a significant proportion of pregnant women in East Africa did not use ITNs. In addition, there was significant variation in ITN utilization among pregnant women across East African countries. These findings indicate a need for tailored interventions to address these disparities. [ABSTRACT FROM AUTHOR]

Resuscitation interventions are procedures for managing clinical deterioration in patients with life-threatening conditions by securing the airway, maintaining breathing, or supporting circulation. Little is known about differences in the use of resuscitation interventions and the characteristics of patients eligible for palliative care in the emergency department. The objectives of this study are to compare resuscitation interventions in the emergency department between patients with cancer and non-cancer palliative care eligibility. A retrospective cohort study was conducted by reviewing the medical records of the palliative care eligible patients who visited the emergency department of one university hospital between January and June 2019. Among the 956 visits (13.7%) by palliative care eligible patients of 7000 random visits, 480 were patients with cancer (50.2%), and 476 were non-cancer patients (49.8%). The overall median age was 72, and 54.1% were female. The mortality rates in the following year were 35.0% for patients with cancer and 18.7% for non-cancer illnesses. The patients with cancer and non-cancer received prior palliative care at 7.3% and 0.8% (p < 0.001) and initiated palliative care at the emergency department at 6.3% and 2.7%, respectively (p = 0.008). The non-cancer patients utilized overall resuscitation interventions 1.7 times more than the cancer patients (aOR = 1.7, 95% CI = 1.0–2.6, p = 0.030). For the palliative care eligible patients in the emergency department, patients with cancer and non-cancer significantly differed in their characteristics. Patients with non-cancer received more resuscitation interventions than patients with cancer. [ABSTRACT FROM AUTHOR]

AbstractIn this systematic review on the educational digital divide, we examined 77 studies for publication trends, context, research methods, digital divide factors, dimensions and interventions using a multidimensional approach. This review identified factors such as socioeconomic status, gender, geography, age, ethnicity, parent knowledge/educational level, school type and second language influencing digital divide and found gender, geography, and socio-economic status were the most studied. Among multidimensional digital divide dimensions, utilization and access dimensions were most studied compared to cognitive and affective dimensions. Among 17 digital divide sub-dimensions examined, student use, internet access, and hardware access were the most studied. Interventions recommended in research for digital inclusion include providing technology resources; training, instruction and support for teachers, students and parents; and organizational practices. [ABSTRACT FROM AUTHOR]

Soybean is a rapidly growing agricultural crop, fueled by the rising global demand for animal feed, plant‐based proteins and essential nutrients for human consumption. Soybeans contain a wide range of essential nutrients that are vital for health and may play a significant role in disease prevention. Their nutritious composition has led to a diverse range of soy‐based foods and derivatives available on the market. A substantial amount of soybeans is allocated to the animal feed sector, human consumption, nutraceuticals and other industrial applications. Soybean has superior protein quality and digestibility compared to other legumes. It also contains abundant amounts of isoflavones, phytosterols and minerals that augment its nutritional value as a constituent of the human diet. Many different by‐products are produced during the processing of soy. Due to a lack of sustainable food manufacturing practices, a sustainable amount of these by‐products is discarded as waste, posing environmental challenges. Developing an effective waste management system for soybean by‐products can help address public health concerns and provide a cost‐efficient way to repurpose valuable components of soy, such as soy meal, okara and soy whey. Such valorization can mitigate the environmental impact of waste and contribute to malnutrition. This study aims to evaluate the sustainable use of soy by‐products to help preserve biodiversity and reduce food insecurity. This article thoroughly examines the fundamental components of soybean use in the fields of health and soybean by‐product processing. It provides a summary of cost‐efficient, feasible and ideal processing technologies. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Background: Tele-assisted home-based palliative care (THPC) usually fulfills the desire of terminal patients to pass away at home. The overall costs of such a service deserve evaluation. Objectives: This study aims to determine health care utilization and costs for cancer patients at the end of life, stratified by THPC service. Design: Patients who received THPC were matched 1:1 based on age, gender, year of death, and propensity score with those who did not receive THPC. Setting/Subjects: A total of 773 cancer patients passed away in a regional hospital in Taiwan during the period of 2012–2020, of which 293 received THPC. Measurements: We measured the rates and costs of outpatient clinic visits, emergency department (ED) visits, hospitalizations, and intensive care unit (ICU) admissions during the last week, the last two weeks and the last month before death. In addition, we estimated the driving times and expenses required for transportation from each cancer patient's home to the hospital using Google Maps. National Health Insurance (NHI) reimbursements and out-of-pocket expenses were also calculated. Results: In comparison with patients without THPC, those who received THPC had a 50% lower likelihood of visiting the ED or being hospitalized, a more than 90% reduced chance of ICU admission, but were four times more likely to obtain their medicines from outpatient clinics. THPC patients had similar out-of-pocket expenditures, approximately half of the NHI costs, and lower rates and costs for ambulance transportation to the ED. Conclusions: THPC reduced health care costs for terminal cancer patients in the last week, the last two weeks, and the last month before death, while also increasing the likelihood of patients being able to rest and pass away at home. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to describe the use of digital health tools by people with spinal cord injury and associated factors. Design: Cross-sectional data from the 2022 Swiss Spinal Cord Injury Cohort Study (SwiSCI) were analyzed. Descriptive statistics summarized data regarding sociodemographic characteristics, self-management, health, and digital health usage. Multiple logistic regression analysis examined the association of digital health use with reasons of use, concerns, confidence, sociodemographic characteristics, self-management, and comorbidities. Results: Among 961 participants, 69% used digital health tools. Females were 1.79 timesmore likely to adopt them. People aged 60-70 had 3.84 times higher usage rates than 18-30 yrs old. Longer spinal cord injury duration increased usage by 0.98 times/year. Confidence using digital tools and positive health attitudes predicted usage. Comorbiditieswere positively correlated with usage. Concerns about digital health utilization had no significant impact. Conclusions: Our study provides one of the first comprehensive descriptions of digital health utilization in spinal cord injury. Its findings shed light on the intricate factors influencing digital health utilization, contribute to a deeper understanding of this patient population, and pave theway for more targeted and effective digital tools and strategies for their uptake. [ABSTRACT FROM AUTHOR]

State health departments' (SHD) role in infection prevention and control (IPC) includes robust educational and consultative services for various health care settings. During the COVID-19 pandemic, Washington-SHD (W-SHD) IPC staff conducted remote and on-site Infection Control Assessment and Response (ICAR) consultations for long-term care (LTC) and non-LTC health care facilities. ICAR consultations were classified as "reactive" in response to a COVID-19 outbreak or "proactive" to help facilities improve IPC protocols. Facility addresses were geocoded to census tracks, classifying urban or rural areas. Facility types and characteristics were analyzed, assessing the impacts of repeat visits. All descriptive statistics, Pearson's χ2 tests, and odds ratios were calculated. Between March 2020 and December 2022, W-SHD conducted 3,093 ICARs at 1,703 health care facilities in 94.9% (37/39) of Washington counties. Of the total visits, most were in LTC (90.5%) and 48.9% were reactive. Facilities with initial on-site ICARs had 1.5 times the odds of having a repeat visit than facilities with initial remote visit (95% CI: 1.21, 1.87). Maintaining strong connections with health care facilities can help bolster infection prevention practices and minimize loss of information at the facility level. Evidence-based findings on the sustainability of the W-SHD's ICAR services during the COVID-19 pandemic illustrated the value of public health IPC programs. • Public health infection control programs expanded during the COVID-19 pandemic. • From 2020 to 2022, 3,093 consultations were conducted at 1,703 health care facilities. • Facilities were more likely to have a repeat visit if they first had a reactive visit. • Facilities were more likely to have a repeat visit if they first had an on-site visit. • Public health infection control consultations build trust with health care facilities. [ABSTRACT FROM AUTHOR]

This study aims to determine whether there is an influence of the level of knowledge of JKN-KIS participants, the attitude of health workers, and the accessibility of health facilities simultaneously on the utilization of health services for JKN-KIS participants at Community Health Centers and their networks. The method used in this study is quantitative. A minimum of 99 samples from JKN-KIS participants in the work area of Pematang Panggang III.b Health Center, Mesuji Makmur District, Ogan Komering Ilir Regency. In this study, there were two hypothesis tests, namely the Partial Significance Test (T-Test) and the Simultaneous Test (F-Test). The data analysis technique used descriptive statistical analysis techniques; and multiple linear regression analysis. The results showed that the level of knowledge of JKN-KIS participants did not have a significant effect on the utilization of health services at the Pematang Panggang III.b Health Center, Mesuji Makmur District and its network. The accessibility of health facilities had a positive and significant effect on the utilization of health services for JKN-KIS participants at the Pematang Panggang III.b Health Center, Mesuji Makmur District. The level of knowledge of JKN-KIS participants, the attitude of health workers, and the accessibility of health facilities simultaneously had a positive and significant effect on the utilization of health services for JKN-KIS participants at the Pematang Panggang III.b Health Center, Mesuji Makmur District. Prosperous Mesuji. [ABSTRACT FROM AUTHOR]

Aim: As the government of India has been undertaking various initiatives since 2005 (launch year of National Rural Health Mission) to increase the utilization of public healthcare facilities, it is very important to investigate the factors governing their utilization. Therefore, the purpose of this study was to explore the determinants of utilization of public healthcare facilities in India. Subject and methods: The data for the study were collected using a comprehensive structured interview schedule. Data were collected from 399 outpatients of district hospitals of the erstwhile state of Jammu and Kashmir, India. A logit model was used to study the variables determining the use of public healthcare facilities. Results: The results showed that distance and waiting time are negatively related to utilization, whereas satisfaction with hospital services and provision of free medicines are positively related and significantly increase the odds in favour of utilization of public hospitals. It was found that more than 60% of outpatients belonged to groups below the poverty line (BPL) and Antodaya Anna Yojna (AAY) families, but most of them had to spend out of pocket for medicines and diagnostic tests. Conclusion: The findings suggest that service delivery and provision of free medicines significantly increase the odds in favour of utilization whereas delayed services and distance decrease the odds in favour of utilization. Implications: The outcomes of this study are significant to achieve universal health coverage. Our study indicates that user fees should be abolished at least for economically disadvantaged patients, and the availability of medicines should be improved significantly to increase the utilization of public helathcare facilities as envisaged in National Health Policy, 2017. [ABSTRACT FROM AUTHOR]

Coffee is one of the most consumed beverages worldwide. Its production generates a large amount of waste, and its use is of vital importance to prevent it from becoming a source of environmental pollution. Cuba is a country with a well-known coffee-growing tradition. Although coffee production has decreased, it is vitally important to use the waste generated in these productions to reduce environmental pollution. To know the possible use or application of coffee waste, it is necessary to know its composition. In this article, three Cuban Arabica coffee wastes (husk, parchment and spent coffee grounds) were characterized using chemical, physical and physicochemical methods. In the characterization of these wastes, SEM and EDX were used to determine their microscopic form and chemical composition. The Chesson–Datta method, ATR and TGA were used to determine whether these materials were lignocellulosic. Ash, pH and density of the waste were determined as characterization methods. The extractive content was determined and a phytochemical screening was performed to determine the groups of the secondary metabolites present. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective cohort analysis Objective: To characterize the impact of COVID-19 on utilization of the ten most common spine procedures and percentages of outpatient procedures. Methods: The PearlDiver national database was queried from January 2010 to April 2021 for short (<6 segments) and long segment posterior instrumented fusion (≥6 segments), posterior cervical fusion, anterior cervical decompression and fusion (ACDF), cervical laminectomy, laminoplasty, and disc arthroplasty, lumbar laminectomy, microdiscectomy, and interbody fusion. Annual procedure utilization between January 2010 through April 2021 was recorded and compared. Monthly trends were compared to January 2020. Outpatient trends were compared between 2010-2019 and 2019-2021 using segmented linear regression. Results: Overall, all ten procedures decreased 4.3% in 2020 compared to 2019 and increased 6.3% in 2021 compared to 2019. March and April of 2020 had the largest decreases, with March 2020 decreasing 18.2% and April 2020 decreasing 51.6% compared to January 2020. Despite increasing COVID cases in January 2021, overall procedure utilization decreased only 1.8% compared to January 2020, and increased later in 2021 with April 2021 case volumes increasing by 138% compared to January 2020. Outpatient utilization of short segment posterior lumbar fusion and lumbar interbody fusion significantly increased during this time (P <.001). Conclusion: The greatest impact on spine surgery volume from the COVID-19 pandemic occurred in March and April 2020. Spine procedure utilization was otherwise similar or increased compared to January 2020. Additionally, the volume of outpatient short segment posterior fusion and lumbar interbody fusions increased during this time period. [ABSTRACT FROM AUTHOR]

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While some see carbon capture, utilization, and storage (CCUS) as crucial for cost-effective decarbonization, it faces opposition based on air pollution and equity concerns. To understand this cost–air pollution trade-off, we simulate the potential impacts of allowing CCUS deployment in the US power sector under plausible climate policies. We show that the existence of this trade-off critically depends on the underlying policy, which affects the type of generation CCUS could displace: under a policy that incentivizes coal generation, CCUS might improve health outcomes and reduce costs. When we disaggregate our results, we find that the air pollution (PM2.5) effects of allowing CCUS, positive or negative, are largest for Black and low-income populations. We show that allowing CCUS can yield energy-cost savings, particularly benefiting lower-income communities. Our sensitivity analyses highlight the effects of uncertainties on costs and benefits. Overall, this study contributes to our understanding of broader distributional consequences of allowing CCUS. [ABSTRACT FROM AUTHOR]

Purpose: The article studies the utilization of ICT within healthcare at home in Sweden overlooking a perspective of 20 + years. Starting point are articles by the authors from 2002 and 2003. These outlined an already feasible ICT supported healthcare at home as a tool to address healthcare's identified challenges—a growing elderly population and general demand for more healthcare in combination with issues on financing and lack of human resources. Despite early signals the care transition has been unexpectedly slow. Why? Methods: With the articles as take-off the journey for ICT based healthcare at home up to today is discussed. In the articles five areas considered as critical for a successful transition were pinpointed and are now used to support the authors considerations, reasoning, and conclusions. Results: Results indicate that technology has never been a limiting factor. Nor has selected medical issues or expected benefits normally been a limitation. Instead limitations and hindrances are found in other areas and activities. Conclusions: Technology is not the main challenge when it comes to implementation, instead a focus on business models, deployment, and scaling issues is now advocated. Initiatives also must make more use of gained knowledge and experience. Not doing so delays utilization and deployment. The impact on healthcare effects and expected savings may be over-optimistic. A thorough analysis of all associated costs, consequences, investments, and benefits is recommended. Non-digital alternatives must continue to be offered to these who cannot go digital. In communication improved medical outcome and patient satisfaction must be emphasised. [ABSTRACT FROM AUTHOR]

Background: Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001–2010 and 2015–2018. Methods: We used national cross-sectional data from seven cycles of the Canadian Community Health Survey between 2001 and 2018. The survey included Canadians aged 12 years and older living in private dwellings in all provinces and territories. National annual weighted prevalence and age-standardized weighted prevalence (and 95% confidence intervals) of chiropractic utilization were calculated. We calculated prevalence of chiropractic utilization stratified by demographic, socioeconomic, lifestyle and health-related variables. Crude linear trends and change in prevalence from 2001 to 2010 were assessed using linear regression models. Results: The national annual prevalence of Canadians consulting a chiropractor in the previous 12 months slightly increased from 11.0% (95% CI 10.8, 11.3) in 2001 to 11.4% (95%CI 11.1, 11.7) in 2010, and in those reporting receiving regular health care from a chiropractor from 7.5% (95%CI 7.2, 7.7) in 2015 to 7.9% (95%CI 7.7, 8.2) in 2018. Prevalence of utilization varied by province, highest in the Western provinces but lowest in Atlantic provinces. The age-specific prevalence of chiropractic utilization was highest in those aged 35–49 years and remained stable over time, except for slight increase in those aged 65–79 years. A higher percentage of Canadians identifying as white, Canadian-born, in the highest quintile of household income, overweight, physically active and in excellent health reported seeking chiropractic services. The most common reported chronic conditions measured in the survey among Canadians consulting chiropractors were chronic back problems, arthritis, fibromyalgia and headaches. Conclusion: The national prevalence of utilization of chiropractic services among Canadians slightly increased over time but varied by province and respondents' socioeconomic and health characteristics. Chronic back problems were the most common reported chronic condition. This comprehensive population-based study on chiropractic utilization in Canada can be used to inform decisions concerning health human resources and access to rehabilitation care for MSD. [ABSTRACT FROM AUTHOR]

Background: Utilization of oral health services is a global public health challenge. Low- and middle-income countries are disproportionately affected. Uganda is one of the low- and middle-income countries where only 4% of the population has access to oral health services. Northern Uganda is one of the regions in the country with limited information about oral health utilization. Objective: To assess factors associated with utilization of oral health services among adults aged 18–70 years in Lira district, Northern Uganda. Methods: This was a quantitative cross-sectional study conducted in Lira District. Multistage sampling was used to select 576 respondents. Data was collected using a researcher-administered structured questionnaire that was adopted, modified, and pretested. Data was analyzed at three levels, including univariate, bivariate, and multivariate at 0.05 significance level. Results: Of the 634 respondents, 576 responded, giving a 90.9% response rate. Results show that utilization of oral health services was 20.5% (118) among adults aged 18–70 years in 6 months. Predictors of utilization of oral services among this age group are: having not attended any formal education (AOR = 0.2, 95%CI 0.06–0.62), having poor attitudes towards oral health services (AOR = 0.55, 95%CI 0.34–0.89), having cultural influence on the utilization of the oral health services (AOR = 4.84, 95% CI 2.77–8.43), accessing the services from private not-for-profit facilities (AOR = 4.67, 95% CI 1.79–12.16), being un sure of the availability of the equipment used (AOR = 0.42, 95% CI 0.18–0.9), and availability of friendly services (AOR = 2.53, 95% CI 1.12–5.50). Conclusions and recommendations: Utilization of oral health services is low in Lira district, with only 2 in 10 of the adults aged 18-70years of age utilizing oral health services in 6 months. To improve utilization, targeted health education campaigns should address cultural barriers and attitudes, while ensuring that public health facilities are better equipped and provide more user-friendly services. [ABSTRACT FROM AUTHOR]

A gene bank for farm animal genetic resources (FAGR) is an important facility for the diversity conservation of FAGR. The primary purpose of gene banks for FAGR is the reconstruction of those breeds. With the advent of the post-genomic era, gene banks for FAGR have increasingly become an infrastructure for the support of livestock research and animal breeding, and a platform for international research collaboration. China is one of the richest countries in the world in terms of FAGR. Chinese National Gene Banks for FAGR (CNGBFs) have an important legal status and play an important function in the Chinese FAGR protection system. In this paper, we reviewed the current situation of CNGBFs construction, and systematically collected and analyzed legal rules related to CNGBFs. As results, those legal rules were categorized into two types: (a) organization and management, (b) activities. We summarized problems existing in the current legal rules for CNGBFs from three levels: institution, practical operation, and digital development. Improvement directions of legal rules regarding CNGBFs are proposed. They include clarifying the utilization function of CNGBFs and the ownership of FAGR in CNGBFs. Moreover, improving the mechanism of administrative management, rules on domestic and international access and benefit-sharing, and the system of digital sequence information management are also suggested. The improvements in those legal rules will contribute to the appropriate utilization of Chinese FAGR and international collaborations. [ABSTRACT FROM AUTHOR]

Aim: Although sexual and reproductive health for adolescents is a recognized fundamental human right and a critical component of health policy, it is poorly addressed and seldom researched in pastoral communities. The study aimed to determine the status of sexual and reproductive health knowledge, attitudes, and practice among pastoral school adolescents in Ethiopia. Study design: An Institution-based comparative study was conducted from Nov. 2020 to Jan. 2021. Methods: We conducted a comparative cross-sectional study at four randomly selected high schools. Seven hundred seventy-three adolescent students participated, with 384 from Gorodola and 389 from Wadara districts, Guji zone Ethiopia. The data was collected using 34 self-administered questions and analyzed using descriptive, t-test, and linear regression models. Results: The study found that only 44.2% of all the participants had good knowledge, 46.1% had good attitudes and 35.4% had good utilization of Sexual and Reproductive Health Services. Respondents from Wadara High School had significantly higher mean knowledge scores (49.3% vs. 44.2%, p < 0.01) than those of Gorodola High School. There was no significant difference in mean utilization scores between case and compare (45.08% vs. 37%, p > 0.01). Adolescents who were not communicated on SRH matters, previously utilized FHS, and visited Friendly Health facilities were associated with poor utilization of sexual and reproductive health services. Conclusion and public health contributions: Wadera High School adolescents have better Sexual and reproductive health knowledge and utilization than Gorodola high schools. Community public health care providers in Wadara District explain the outcome through their contributions. Within the context of inherent disadvantage in the school environment setting, there is a need to improve sexual and reproductive health education with a greater emphasis on school girls. [ABSTRACT FROM AUTHOR]

The increasing challenge of freshwater scarcity amid rising demand and diminishing availability has led to a critical issue threatening sustainable development, especially in rural areas of developing countries like Nigeria. Despite the abundance of studies on rural water use, gaps remain in understanding the interplay between socio-economic factors, and agricultural practices in shaping these preferences and utilisation. Thus, the study investigates the preference for water sources and their utilisation in agricultural activities among rural households in the Akoko district of Ondo State, Nigeria. Cross-sectional data from randomly sampled 240 rural households were collected with the aid of a questionnaire, and employed for the data analysis. Descriptive statistics, logit, and multinomial regressions were used for the data analysis. The findings revealed a dominant preference for rainwater and well water. Factors such as access to safe water sources, time spent, extension service, technology adoption, soil type, experience, and proximity to water sources significantly influence the choice of water source utilization in the area using multinomial logit regression. Again, the results from logit regression revealed that water source, technology adoption, soil type, fish farming, crop farming, farming experience, and distance to water sources significantly affect the use of water for agricultural purposes. Therefore, the policy should enhance water access, consider soil characteristics in agricultural planning, and facilitate knowledge transfer among farmers for optimal water use, recognizing the symbiotic relationship between water access and agricultural sustainability. Article Highlights: Rainwater and well water are the most preferred sources for rural households in agricultural activities. Water source preference is influenced by access, soil type, farming experience, and proximity to water. Improved water access and tailored policies can enhance agricultural productivity and rural livelihoods. [ABSTRACT FROM AUTHOR]

Background: Among the many pressing concerns of the Somali-American community, and other similar immigrant and refugee communities as they grow in the United States, is the provision of care for older adults and adults with disabilities. The implications of effective caregiving range from the facilitation of community building and place-making to the delivery and management of healthcare on a systemic level. However, little is currently known about Somali-American family caregivers, including their duties and responsibilities, primary concerns, and the impacts of surrounding influences on their ability to fulfill their role. Methods: Semi-structured interviews were conducted with 10 Somali-American family caregivers in Somali language. The resulting transcripts were translated into English by a professional interpreter and analyzed using an inductive thematic analysis approach. A key informant from the community was additionally consulted for insights regarding cultural nuances and interpretations of idiomatic expressions and concepts. Results: Thematic analysis of the reports revealed the principal themes of visitation, patient accompaniment, and self-sacrifice through acceptance and God-consciousness as pervasive and salient concerns across participants. Furthermore, the heightened stresses of the COVID-19 pandemic revealed just how severe the consequences can be when access to culturally habituated navigational tools and coping mechanisms are restricted. Conclusions: In light of our findings, the growing concern for discrimination and sociocultural discord in the Somali-American community presents a particularly prescient threat to the well-being and sustainability of family caregivers. Their experiences must be understood and used to promote education and partnership between the healthcare system and the community in order to build trust and ensure a healthy future for this indispensable population. [ABSTRACT FROM AUTHOR]

With the ongoing advancement of human civilization, China is increasingly prioritizing the preservation and transmission of its architectural heritage. This study examines the historical development of the Longevity Pagoda in Jingzhou, synthesizing its architectural and artistic characteristics as well as its cultural heritage value. In light of contemporary challenges, the paper proposes strategies for the protection and preservation of the Longevity Pagoda. The aim is to ensure that the Longevity Pagoda continues to realize its distinctive historical, cultural, and social significance in the future. [ABSTRACT FROM AUTHOR]

This study aims to analyze the utilization of e-books and the challenges faced in their use at SMP Negeri Satu Atap 6 Menthobi Raya, Lamandau Regency, in the subject of Islamic Religious Education. This is a field study using a descriptive qualitative approach. Data collection techniques include observation, interviews, and documentation. Data analysis is conducted through data reduction, data display, and conclusions drawing/verifying, while data validation is done using triangulation techniques. The research findings are, 1) The utilization of e-books has had a positive impact, as teachers are able to use e-books effectively, such as through projector displays and digital distribution via WhatsApp groups, enhancing interactivity and flexibility in the learning process while creating a more enjoyable, modern, and conducive learning environment. From the students' perspective, the use of e-books has been able to increase learning motivation and make them more productive in using gadgets, thereby improving students' learning outcomes. 2) The challenges in utilizing e-books are due to internal factors, which include a lack of attention and active participation in discussions, low confidence in presenting discussion results in front of the class, and a lack of discipline in submitting assignments or uploading work. Meanwhile, external factors include limited internet access, slow internet connections, the absence of smartphones among some students, and teachers' discomfort in adopting new technology-based learning models. [ABSTRACT FROM AUTHOR]

In 2017, the Certified Community Behavioral Health Clinic (CCBHC) demonstration was implemented in New York State to redesign care delivery and financing for behavioral health services. Although CCBHC primarily targeted Medicaid patients, it was hypothesized that the clinic-level benefits of CCBHC were expected to impact even non-Medicaid patients treated in CCBHCs. To test this hypothesis, this study conducted a health insurance claims data analysis of non-Medicaid (ie, commercial and Medicare) patients with severe mental illnesses, comparing a cohort of CCBHC-treated patients with a propensity score-matched comparison cohort of patients treated by non-CCBHC clinics on rates of mental health service utilization, hospitalization, and emergency department (ED) visits. The data suggested CCBHC was associated with more than 10% increase in outpatient mental health service utilization by the patients' second year of CCBHC exposure, accompanied by similarly significant reductions in the rates of all-cause ED visits and non-psychiatric hospitalization. These findings suggest that for behavioral health clinics that serve a sufficiently large population of Medicaid, the impact of innovative clinical redesign attributable to CCBHC is likely to extend to all patients treated by them. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions This study aims to summarize the existing research literature examining Medicare‐skilled home health (HH) utilization and clinical outcomes for persons with dementia (PwD). We sought to answer the following questions: (1) How is dementia defined and classified in the HH literature? (2) What associations have been observed between dementia status and patterns of HH utilization? (3) What associations have been observed between dementia status and HH outcomes?Using Arksey and O'Malley's framework for scoping reviews, we searched PubMed, Google Scholar, and select relevant journals for quantitative studies conducted in the United States between 2000 and 2023 examining Medicare HH use and outcomes for PwD. We describe and compare approaches to classify dementia, identify findings related to HH utilization and outcomes supported by the preponderance of evidence, and comment on existing gaps and areas of ambiguity in the literature.Thirty‐two articles met the inclusion criteria. Most used claims‐based data to classify dementia, leveraged national data, and were limited to traditional Medicare beneficiaries. Studies found meaningful differences in HH utilization by dementia status; most notably, PwD were more likely to access HH without a preceding hospitalization, had longer lengths of stay, and incurred higher HH costs. Literature relating to clinical outcomes was more difficult to interpret, due to significant variation in study objectives, samples, and outcome measures which prompted more nuanced and even contradictory conclusions. There is a dearth of research identifying how specific HH care pathways (e.g., service types, visit frequency) impact outcomes for this patient population.This review supports the understanding that PwD are a unique subpopulation of HH patients who require special attention in policy development and evaluation. Critical research is needed to examine clinical outcomes in PwD further to inform practice and improve care quality. [ABSTRACT FROM AUTHOR]

Background: Time in healthcare facilities is associated with worse patient quality of life (QoL); however, impact on family caregiver QoL is unknown. We evaluate care recipient days not at home—days in the emergency department (ED), inpatient (IP) care, and post‐acute care (PAC)—to understand how care recipient days not at home correspond to family caregiver QoL. Methods: Secondary data were linked to care recipient utilization data. Elastic net machine learning models were used to evaluate the impact of a single day of utilization in each setting on binary QoL outcomes. We also compared composite weighted and unweighted "days not at home" variables. Two time periods, 6 and 18 months, were used to predict three caregiver QoL measures (self‐rated health, depressive symptoms, and subjective burden). Results: In the 6‐month timeframe, a single day of ED utilization was associated with increased likelihood of poor QoL for all three assessed outcomes (range: 1.4%–3.2%). A day of PAC was associated to a modest degree with increased likelihood of caregiver burden (0.2%) and depressive symptoms (0.1%), with a slight protective effect for self‐rated health (−0.1%). An IP day had a slight protective effect (−0.2 to −0.1%). At 18 months, ED and IP had similar, albeit more muted, relationships with caregiver burden and depressive symptoms. PAC had a slight protective effect for caregiver burden (−0.1%). Cumulative days in all settings combined generally was not associated with caregiver QoL. Conclusion: Whereas total care recipient time away from home had some negative spillovers to family caregivers, the countervailing effects of unique settings on caregiver QoL may mask net QoL effects. This finding limits the utility of a single care recipient home time measure as a valid caregiver‐centered measure. Considering cumulative care recipient time in individual settings separately may be needed to reveal the true net effects on caregiver QoL. [ABSTRACT FROM AUTHOR]

This account presents information on all aspects of the biology of Trapa natans L. (water caltrop and water chestnut) that are relevant to understanding its ecological characteristics and behaviour. The main topics are presented within the standard framework of the International Biological Flora: distribution, habitat, communities, responses to biotic factors, responses to environment, structure and physiology, phenology, floral and seed characters, herbivores and disease, history, conservation and global heterogeneity.The water caltrop is an annual herbaceous hydrophyte rooted in the sediment of water bodies, forming flexuous underwater stems that create a buoyant, light‐capturing leaf rosette at the water surface. The submerged stem nodes additionally bear linear leaves. These are replaced by photosynthetically active, pinnately branched structures and unbranched adventitious roots early on, which complement previously established roots on the hypocotyl, altogether facilitating anchorage, nutrient and water absorption, aeration and capture of subsurface irradiance. Solitary flowers pollinated primarily through autogamy and incidentally through entomophily give rise to a fully developed edible single‐seeded drupe with two to four barbed horns. Fruits are dispersed with the help of hydrochory, epizoochory and anthropochory.Throughout its lowland, global temperate, subtropical and tropical distribution in Eurasia and Africa, the thermophilic macrophyte is found in shallow, sun‐exposed, nutrient‐rich freshwater bodies with low‐velocity flows and steady water levels. These offer slightly acidic to mildly basic conditions. The accompanying soft substrate is usually characterized by a high organic matter content. Regularly co‐occurring with other macrophytes, some of which are also of conservation concern, such as those in rare stands of the association Trapetum natantis in Europe, the water caltrop has at times been outcompeted, though it may form monodominant stands, due to several competitive features.Formerly widespread in Europe, T. natans is today recognized as a rare, strictly protected macrophyte. It has been introduced to Australia and North America; on the latter continent, its naturalization, spread and aggressive overgrowth have led to extensive control efforts. Having been used as a crop since Neolithic times, it is still exploited in Asia for means of food production, phytoremediation, ornamental purposes, medication and alternative uses. [ABSTRACT FROM AUTHOR]

Owing to the widespread advancement of transformer‐based artificial neural networks, artificial intelligence (AI) processors are now required to perform matrix–vector multiplication in addition to the conventional matrix–matrix multiplication. However, current AI processor architectures are optimized for general matrix–matrix multiplications (GEMMs), which causes significant throughput degradation when processing general matrix–vector multiplications (GEMVs). In this study, we proposed a port‐folding GEMV (PF‐GEMV) scheme employing multiformat and low‐precision techniques while reusing an outer product‐based processor optimized for conventional GEMM operations. This approach achieves 93.7% utilization in GEMV operations with an 8‐bit format on an 8 × 8 processor, thus resulting in a 7.5 × increase in throughput compared with that of the original scheme. Furthermore, when applied to the matrix operation of the GPT‐2 large model, an increase in speed by 7 × is achieved in single‐batch inferences. [ABSTRACT FROM AUTHOR]

The objective of the study was to assess the determinants of the utilization of digital technologies by smallholder farmers in South Africa. A cross-sectional survey of 250 smallholder farmers was purposively sampled from Port St Johns and Ingquza Hill Local Municipalities. Binary and ordered logistic regression were used to analyse the data. The results show that 55% of the smallholder farmers were using digital technologies. Out of these, 40% were using smartphones and radio. Close to 47% of the smallholder farmers who were using digital technologies were using them to some extent and 65% had been using digital technologies for a period of 1–4 years. 89% of the smallholder farmers using digital technologies indicated that they are beneficial and 83% had opted to continue using digital technologies to increase their skills and knowledge. However, 44% of the smallholder farmers who had opted to discontinue the use of digital technologies indicated that these technologies were not beneficial for them. Overall, 85% of the smallholder farmers would recommend the use of digital technologies to other farmers. Factors such as age, educational level, marital status, full-time farming, and land size affected the utilization of digital technologies while age, marital status, educational level, full-time farming, household size, non-crop producing, and tenure affected the extent of digital technology utilization. The study concludes that the partial utilization of low-tech digital technologies is a socio-economic driver. Recommendations include the promotion of digital technologies, especially high-tech technologies, taking into account the socio-economic circumstances of smallholder farmers. [ABSTRACT FROM AUTHOR]

Introduction: Several studies have been done on the utilization of sexual and reproductive health services by high school students in Ethiopia, but they have yielded inconsistent results. This study aimed to evaluate the extent to which high school students in Ethiopia are using sexual and reproductive health services by conducting a systematic review and meta-analysis. Methods: Various electronic databases such as PubMed, Cochrane Library, AJOL, Google Scholar, and Grey Literature were used to search for relevant articles. Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines were followed for this review and meta-analysis. Heterogeneity was assessed using I² and Cochrane Q statistical tests, and data analysis was done with STATA 17 software. Random effect meta-analyses were used to determine the overall utilization rate of sexual and reproductive health services. Result: This review included 20 studies with 12, 215 study participants. The pooled magnitude of sexual and reproductive health service utilization among high school students in Ethiopia was 29.79% (95% CI: 25.14, 34.43). Students with grades 11--12 (AOR = 2.33, 95% CI: 1.39, 3.90), aged between 20 and 24 years (AOR = 2.61; 95% CI: 1.79--3.81), having higher level of knowledge towards sexual and reproductive health issues (AOR = 3.10; 95% CI: 1.67--5.77), previous history of sexual intercourse (AOR = 4.18; 95% CI: 2.59--6.75), previous history of sexually transmitted infection (AOR = 3.74; 95% CI: 2.22--6.31), presence of a reproductive health service facility in the school (AOR = 2.55; 95% CI: 1.72--3.77), and ever-discussed reproductive health issues (AOR = 4.04; 95% CI: 1.62--10.03) were more likely to utilize sexual and reproductive health services. Conclusions: The overall utilization of sexual and reproductive services among high school students in Ethiopia was found to be low as compared to SDG 3.7. Older individuals with higher education levels and knowledge about sexual and reproductive health services, as well as those who have had previous sexual experiences or discussions about sexual health, are more likely to utilize reproductive health services. To increase utilization, the Ministry of Health and the Ministry of Education should prioritize these factors. [ABSTRACT FROM AUTHOR]

This research aims to analyze the influence of the knowledge level of JKN-KIS participants, the attitudes of healthcare workers, and the accessibility of health facilities simultaneously on the utilization of health services by JKNKIS participants at community health centers and their networks. The method employed in this study is quantitative, with a minimum sample size of 99 JKN-KIS participants from the work area of Pematang Panggang III.b Health Center in Mesuji Makmur District, Ogan Komering Ilir Regency. This study involves two types of hypothesis testing: the Partial Significance Test (T-test) and the Simultaneous Test (F-test). The data analysis techniques used include descriptive statistical analysis and multiple linear regression analysis. The results indicate that the level of knowledge among JKN-KIS participants does not have a significant impact on the utilization of health services at Pematang Panggang III.b Health Center and its networks. In contrast, the accessibility of health facilities has a positive and significant effect on the health service utilization of JKN-KIS participants. Overall, the knowledge level, attitudes of healthcare workers, and accessibility of health facilities have a positive and significant impact on the utilization of health services at the health center. [ABSTRACT FROM AUTHOR]

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Abstract Introduction Contraceptive methods are techniques used to prevent pregnancy during sexual intercourse. The primary goal of contraception is to inhibit the fertilization of an egg by sperm or to prevent the implantation of a fertilized egg in the uterus. Unwanted pregnancy is a major challenge for street beggar women. Due to limited use of modern contraception, unwanted pregnancy and STDs are key issues faced by this population. This study aims to assess modern contraceptive utilization and explore factors influencing contraceptive choices among street beggar women in the Sidama region, Ethiopia by using Bayesian logistic approaches. Methods A cross-sectional quantitative study was conducted on reproductive-aged (15–49) street beggar women in the Sidama Region. Data was collected using a pre-tested, structured interview questionnaire in the local language from each town in the Sidama region. Descriptive and inferential statistics were used to analyze the data using STATA version 17. A Bayesian logistic approach, with Markov Chain Monte Carlo methods, was used to model the association between modern contraceptive utilization and independent variables, allowing for estimation of model parameters and credible intervals. Result The study found that 38.9% of street women in the Sidama region used modern contraceptives, primarily implants and injections. Bayesian logistic regression identified key factors influencing contraceptive use including, women aged 25–34 (AOR: 2.69 (95% CI: 1.57, 4.26)), married women (AOR: 4.91 (95% CI: 2.67, 8.51)), Widowed women (AOR: 2.81 (95% CI: 1.49)) and educated women (AOR: 2.16 (95% CI: 1.48, 3.01)) were more likely to use contraceptives. In contrast, those living on the street (AOR: 0.12 (95% CI: 0.05, 0.27)), with no history of pregnancy (AOR: 0.07 (95% CI: 0.02, 0.16)), and no sexual activity in the last six months (AOR: 0.11 (95% CI: 0.01, 0.03)), had lower usage rates. Additionally, women whose only job was begging (AOR: 0.43 (95% CI: 0.13, 0.92)) and those lacking health advice (AOR: 0.25 (95% CI: 0.07, 0.59)) also showed reduced utilization. Lack of discussion about contraceptives with partners (AOR: 0.18 (95% CI: 0.08, 0.33)) and no women's approval (AOR: 0.18 (95% CI: 0.08, 0.33)) further contributed to lower usage. Conversely, good knowledge of modern contraceptives was positively associated with utilization (AOR: 2.33 (95% CI: 1.44, 3.64)). Conclusion The findings of this study identified several factors significantly associated with modern contraceptive use among street beggar women in the Sidama region, including age, marital status, Education level, disability, Job in addition to begging, Current living situation, history of sexual assault/rape, History of pregnancy after street life, discussion of modern contraception with a sexual partner, Advice from a health professional, Sexual activity in the last six months, time taken to arrive at a health facility on foot, approval of modern contraception, and knowledge. The main barriers reported were fear of side effects and lack of knowledge about contraceptive methods. The study suggests that concerned stakeholders should intervene to address these factors and improve modern contraceptive uptake in this vulnerable population.

Abstract Background The use of immediate postpartum intrauterine contraceptive devices during the postpartum period supports women’s need for spacing births and prevents them from unplanned pregnancies. However, in developing countries, utilization of immediate postpartum contraceptives is low. This increases the risk of maternal morbidity, maternal mortality, preterm birth, child mortality, low birth weight, and small gestational age in subsequent pregnancy with interpregnancy interval. Objective To assess immediate postpartum intrauterine contraceptive device utilization and the associated factors among women who gave birth in Hospitals in West Wolegga Zone in 2020. Methods and materials An institutional-based cross-sectional study was conducted in public hospitals in the West Wolegga Zone from 1 April 2020 to 30 April 2020 among 290 postpartum women. The sample size was proportionally allocated to six hospitals by considering their monthly delivery. Study subjects were taken by systematic sampling technique (Kth=N/n =1025/290=3.53), thus every 4th woman who gave birth in the hospital was recruited in each hospital until the total sample size for this study was obtained. Bivariable and multivariable logistic regression was used to assess the association of independent variables with immediate postpartum intrauterine device utilization. A significance level of 0.05 was used to assess the statistical significance of the study’s associations. Results In this study, the magnitude of the Immediate postpartum intrauterine contraceptive device utilization was 19.3%.factors like Early initiation of antenatal care [AOR=4.46 95% CI:1.84-10.78], Planning of future pregnancy [AOR=3.7(95% CI: 1.43-9.54)], Ever heard of the immediate postpartum intrauterine contraceptive device [AOR=2.67(95% CI: 1.08-6.58)] and Counseling about postpartum intrauterine contraceptive device [AOR=5.15(95% interval: 2.00-13.28] were associated with immediate postpartum intrauterine device utilizations. Conclusion The use of immediate postpartum intrauterine contraceptive devices is low compared to other studies conducted in Ethiopia. Age, early antenatal care initiation, pregnancy planning, hearing of the immediate postpartum intrauterine device immediately inserted after delivery, and counselling on the immediate postpartum intrauterine device were significantly associated with mothers’ use of immediate postpartum intrauterine devices. Health Program directors should develop strategies to increase the use of immediate postpartum intrauterine contraceptive devices.

Introduction Although adolescents have access to sexual and reproductive health services, they encounter a variety of obstacles, including limited access to safe abortion and contraceptives, early pregnancy and parenthood, and a high occurrence of sexually transmitted infections. This research assessed the awareness and use of adolescent sexual reproductive health services in the Keta Sub-district of Ghana. Methods A cross-sectional study using a quantitative method of analysis and the administration of a structured questionnaire to 350 adolescents between the ages of 14 and 19 in the Keta Sub-district was conducted. Results Of the 10 services covering adolescent sexual and reproductive health, 75% of participants were aware only of comprehensive sex education. Only 27% were aware of sexually transmitted infection prevention and care services. Awareness was 13% or lower for the remaining eight services. Only 24% had used an adolescent sexual reproductive health service. Conclusion Awareness of adolescent sexual reproductive health services and their use is low in the Keta Sub-district. To improve access to sexual and reproductive health information, sub-district health services should create school-based satellite clinics for adolescents. Adolescents’ ambassadors should be created to educate peers on adolescent issues, especially sexual and reproductive health.

Abstract Resuscitation interventions are procedures for managing clinical deterioration in patients with life-threatening conditions by securing the airway, maintaining breathing, or supporting circulation. Little is known about differences in the use of resuscitation interventions and the characteristics of patients eligible for palliative care in the emergency department. The objectives of this study are to compare resuscitation interventions in the emergency department between patients with cancer and non-cancer palliative care eligibility. A retrospective cohort study was conducted by reviewing the medical records of the palliative care eligible patients who visited the emergency department of one university hospital between January and June 2019. Among the 956 visits (13.7%) by palliative care eligible patients of 7000 random visits, 480 were patients with cancer (50.2%), and 476 were non-cancer patients (49.8%). The overall median age was 72, and 54.1% were female. The mortality rates in the following year were 35.0% for patients with cancer and 18.7% for non-cancer illnesses. The patients with cancer and non-cancer received prior palliative care at 7.3% and 0.8% (p