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Case conceptualization is an important stage in the sport and performance psychology (SPP) consulting process. The conceptualization of a case can influence a consultant's understanding of the underpinning mechanisms contributing to a presenting concern, interventions selected to help a client, and the effectiveness of provided services. Guidelines for case conceptualization have been developed for SPP professionals, but little is known about how this activity is undertaken in practice. The purpose of this study was to investigate the case-conceptualization methods and approaches of certified SPP professionals. Fifty-two certified mental performance consultants completed an online qualitative survey exploring how they conceptualized cases. Our findings suggested that SPP consultants viewed case conceptualization as an ongoing process, something that helps a consultant understand a client's presenting concerns and guide any intervention plans, a collaboration between client and consultant, and a way to evaluate the effectiveness of their practice. [ABSTRACT FROM AUTHOR]

This study explored how speech-language pathologists (SLPs) in Jordan perceived and implemented telepractice at the beginning of the COVID-19 pandemic, from April to June 2020. Eighty-five SLPs who provided telepractice and 57 SLPs, who did not, completed an online survey sharing their perceptions related to the delivery and barriers of telepractice. The results showed a significant increase of telepractice use in response to the pandemic. However, the SLPs identified several barriers to telepractice, including environmental distractions at the client's end, limited computer knowledge, technological issues, internet connectivity problems, and platform availability. There was general agreement among the SLPs regarding the need for professional training and governmental guidelines to regulate the use of telepractice. The study's findings demonstrate how SLPs in Jordan adapted to the sudden shift toward telepractice, and identify potential implementation obstacles, which could assist in establishing telepractice as a reliable model for speech-language therapy services in the future. [ABSTRACT FROM AUTHOR]

Mpofana protests are characteristic of local protest actions occurring across South Africa. In 2014 Mpofana Municipality was placed under administration by the provincial authority and one of the reasons cited for this were high levels of protest. This paper focuses on Mpofana protests to examine demands for 'service delivery' and citizenship as well as political strategy with regards local level leadership. The paper also considers the narratives and strategies around protest in the context of the 'neoliberal citizen' and 'market' approaches to citizenship. It draws on a qualitative study comprising focus groups conducted across three Mpofana wards. The paper suggests that in Mpofana there are clear struggles for the attainment of social citizenship in the context of a divide between those who have no access to work and wages and those who have access to income and assets. Citizenship attainment struggles are interwoven with failed patronage networks, and processes of piercing the 'common sense' appear through protesters questioning local leadership and proposing solutions for change. There is also evidence in Mpofana though of the 'depoliticised subject' fostered by the neoliberal doctrine where the language of protest is cast in market terms. [ABSTRACT FROM AUTHOR]

By comparing respondent's perceptions of blame for the death of a prisoner and a non-prisoner, we explore whether the fundamental principle of equal protection under the law is possible. We examine reactions to a vignette experiment that varies whether a prison transport was conducted by a contractor or directly provided by the government, and whether the victim was another prisoner or a bystander. Drawing on literature regarding blame avoidance, citizens blame government less for contracted service failures. In contrast to social identity theory expectations, respondents place greater blame to the government and guards when the victim is a prisoner. [ABSTRACT FROM AUTHOR]

Although trauma-focused evidence-based psychotherapy (TF-EBP) is recommended for posttraumatic stress disorder (PTSD), rates of TF-EBP initiation among veterans is very low. Service delivery research has shown that other treatments are commonly provided to veterans diagnosed with PTSD, including stabilization treatments. As little is known about how veterans experience the transition to TF-EBP, we conducted a qualitative examination of veterans’ perspectives on transitions in PTSD treatment. We recruited a diverse sample of veterans (n = 30) who recently initiated TF-EBP to complete semi-structured qualitative interviews focusing on six domains (PTSD treatment options, cultural sensitivity of treatment, PTSD treatment selection, transition criteria, beliefs about stabilization treatment, treatment needs/preferences). Rapid qualitative analysis procedures were used to identify themes. Themes included: (1) wanting to learn about TF-EBP earlier; (2) perceived risks of transition; (3) relationships with non-TF-EBP providers as transition barriers; (4) high symptoms and poor interpersonal functioning as transition facilitators; (5) benefits of treatment planning and handoffs; (6) prior therapy best when aligned with TF-EBP; (7) socialization as a key benefit of prior therapy; and (8) medications supporting TF-EBP. Results highlight the importance of introducing TF-EBP early to veterans, establishing and communicating a comprehensive care plan, and anchoring stabilization treatment in TF-EBP concepts. [ABSTRACT FROM AUTHOR]

Forensic mental health, custodial and community forensic services provide care and treatment to individuals with complex histories and needs including the presence of trauma. With increased attention being paid to delivering trauma informed care, this paper presents a framework for supporting safe and effective service delivery. It details ways in which trauma informed organizational consultation and trauma informed staff supervision and reflective practice should be embedded within criminal justice and forensic mental health service delivery. Together these support reflection, learning, decision making and intentional action, helping to meet an organization's duty of care to both staff and clients. Trauma informed organizational consultation and trauma informed forensic staff supervision and reflective practice provide ways to anticipate and address possible iatrogenic impacts on staff (e.g. burnout, presenteeism and sickness) and on clients (e.g. dropping out of treatment). Together these can enable services to provide and sustain authentic approaches to delivering safe and effective care. [ABSTRACT FROM AUTHOR]

Background: Understanding community preferences for vaccination services is crucial for improving coverage and satisfaction. There are three main approaches for COVID-19 vaccination in Indonesia: health facility-based, community-based, and outreach approaches. This study aims to assess how the vaccination approaches impact user satisfaction levels. Methods: This study was part of a large household survey involving 12,120 respondents across nine districts in Bali Province. The study population comprised all residents aged ≥12 years who had received at least one dose of COVID-19 vaccination. Samples were selected through three stages of systematic random sampling. Data were collected through interviews using structured questionnaires, which included socio-demographic characteristics, vaccination services, and satisfaction levels. Analysis was performed using Chi Square test and logistic regression, with the entire process incorporating weighting factors. Results: A total of 12,120 respondents reported receiving their first dose of COVID-19 vaccination. The satisfaction level among vaccine recipients (partial, complete, and booster doses) was high (84.31%). Satisfaction within each SERVQUAL dimension was highest in tangibles (96.10%), followed by responsiveness (93.25%), empathy (92.48%), assurance (92.35%), and reliability (92.32%). There was no significant difference in the overall SERVQUAL score between the health facility and community-based approaches. However, the latter slightly improved user satisfaction across three dimensions: tangibles (adjusted odds ratio, AOR = 1.52, 95% confidence interval (CI) = 1.21–1.90), reliability (AOR = 1.67, 95%CI = 1.42–1.96), and assurance (AOR = 1.26, 95%CI = 1.07–1.48). Conclusion: During the pandemic, both health facility and community-based approaches resulted in a high satisfaction level. It is recommended that the government prioritise and optimise community-based programs and health facility-based delivery in future vaccination initiatives, especially during public health emergencies. Without effective treatments, with emerging variants and waning immunity, vaccination remains our primary defence against COVID-19. Maintaining high population immunity is crucial. Both health facility and community-based approaches to vaccination yielded high satisfaction during the pandemic. It is recommended that the government prioritise and optimise these programs for future vaccination initiatives, especially during public health emergencies. [ABSTRACT FROM AUTHOR]

The study sought to establish the moderating effect of information quality on the relationship between corporate IT strategy and service delivery of state corporations in Kenya. The unit of analysis was 178 state corporations in Kenya. Descriptive methods were used to collect and analyze data on the study variables. Structured questionnaire was used to collect primary data while secondary data was collected from annual performance reports of the state corporations. Out of 178targeted response only 120 positively responded making an adequate response rate of 67.4% for investigation. The analysis established that 68.2% of changes in service delivery were accounted for the changes in information quality, corporate IT strategy and interaction term. In conclusion this study found statistically significant effect of information quality on the relationship between corporate information Technology and service delivery of state corporations in Kenya. The findings of this study added to the body of knowledge in the area of service delivery of state corporations by emphasizing on information quality and corporate IT strategy. On the basis of these findings it is important that national government to develop appropriate policies to support corporate information quality that is embedded on new technologies to foster customized services for profitability and growth. [ABSTRACT FROM AUTHOR]

Quality healthcare service delivery has a significant influence on customer satisfaction, the burden of meeting health service costs, and the recovery of patients. Therefore, health facilities should make use of electronic health management systems to improve the quality of their service delivery in administration and patient care. The purpose of carrying out this study was to establish how Service Delivery can be improved through Electronic Communication in Public Hospitals in Kenya. A pragmatic research paradigm was employed coupled with Descriptive and correlational research design. The target population was all the 1207 professional staff working in Moi Teaching and Referral Hospital Eldoret and Kenyatta National Hospital Nairobi as well as 1841 outpatients treated in both hospitals between January and May 2020. To select the 341 respondents of the research, a stratified random sampling technique was used. The researcher used secondary and primary data. Semistructured questionnaires were distributed to the respondents to allow for the collection of primary data. Qualitative data was analyzed with the help of thematic analysis. Inferential and descriptive statistics were used in the analysis of quantitative data. Descriptive statistics that were used include mean, percentages, frequencies, and standard deviation. Inferential statistics that were used are multiple regression analysis, correlation analysis, and univariate regression analysis. From the findings, the utilization of electronic communication had a positive influence on service delivery in public hospitals in Kenya as indicated by the regression coefficient of 0.715 (p-value=0.000). This implies that a unit improvement in the utilization of electronic records management would lead to a 0.715 improvement in service delivery in public hospitals in Kenya. Since the p-value (0.000) is less than the significance level (0.05), the null hypothesis was rejected and hence utilization of electronic records management has a significant influence on service delivery in public hospitals in Kenya. It can be recommended that health facilities in Kenya should improve the utilization of personal digital assistants, social media platforms, and local area networks to improve service delivery through reduced queuing and turnaround time. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultConclusionSpeech-language pathologists (SLPs) work in Australian schools yet, little is documented about their service delivery practices. This study therefore explores Australian speech-language pathology service delivery in schools, inclusive of work activities, caseloads, and assessment and intervention practices.An online survey comprising multiple choice, constant sum, Likert scale, and open text questions was completed by 105 SLPs. Quantitative data was analysed using descriptive statistics while open-text responses were analysed using content analysis.Participants were predominantly government education department employees working in multiple schools, and caseloads ranged from 10 to 240 students for full-time SLPs. While responses varied considerably, some general trends emerged. Most time was spent on intervention, followed by non-contact tasks, and assessments, with differences across employment sectors. Language was the most common student need, followed by literacy and speech. Frequently reported factors contributing to client complexity and intervention frequency were co-occurring presentations, severity of student needs, caseload size, and impact on learning. Caseload manageability was a concern for participants who reported larger caseloads, spent more time in assessment or less time in therapy than others, and worked in education departments.Findings have implications for policy makers, professional bodies and employers, and provide direction for future systematic data collection. [ABSTRACT FROM AUTHOR]

Aims: This evaluation combines clinical and non-clinical collaborative breast referral triage to gain an understanding relating to the value of triage, by identifying 'suspected cancer' and 'cancer not suspected' populations, improve the patient pathway, and facilitate optimised resource availability. Method: An iterative service improvement method was used, with distinct phases of the process outlined to facilitate testing of ideas. The evaluation ran for 13 weeks in 2022. Regular team member meetings were arranged to discuss and agree improvement aims and outcomes. Findings: A triage flowchart was developed collaboratively, and subsequently adopted by the non-clinical booking team. Bespoke clinics were established, demonstrating no evidence of increased risk to patients, and meeting 28-day Faster Diagnosis Standard (FDS) requirements. Conclusion: breast referral triage of 'suspected cancer' and 'cancer not suspected' patients, using a clinical and non-clinical collaborative approach facilitates improved service visibility, prioritisation, management, and measurement. This also supports delivery of the 2019 NHS Long Term Plan to enhance earlier and faster cancer diagnosis by optimising access to diagnostic resources where required. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and response severely impacted people living with non-communicable diseases (PLWNCDs) globally. It exacerbated pre-existing health inequalities, severely disrupted access to care, and worsened clinical outcomes for PLWNCDs, who were at higher risk of morbidity and mortality from the virus. The pandemic's effects were likely magnified in humanitarian settings, where there were pre-existing gaps in continuity of care for non-communicable diseases (NCDs). We sought to explore factors affecting implementation of NCD care in crisis settings during the COVID-19 pandemic and the adaptations made to support implementation. Methods: Guided by the Consolidated Framework for Implementation Research, we undertook an online survey of 98 humanitarian actors from multiple regions and organization types (March-July 2021), followed by in-depth interviews with 13 purposively selected survey respondents (October-December 2021). Survey data were analysed using descriptive statistics, while interview data were analysed thematically, using both deductive and inductive approaches. Results: Initially, humanitarian actors faced challenges influenced by external actors' priorities, such as de-prioritisation of NCD care by governments, travel restrictions and supply chain interruptions. With each infection wave and lockdown, humanitarian actors were better able to adapt and maintain NCD services. The availability of COVID-19 vaccines was a positive turning point, especially for the risk management of people with NCDs and protection of health workers. Key findings include that, despite pre-existing challenges, humanitarian actors largely continued NCD services during the crisis. Enabling factors that supported continuity of NCD services included the ability to quickly pivot to remote means of communication with PLWNCDs, flexibility in medicine dispensing, and successful advocacy to prioritize NCD management within health systems. Key lessons learned included the importance of partnerships and cooperation with other health actors, and the mobilisation or repurposing of community health workers/volunteer networks. Conclusions: The COVID-19 experience should prompt national and global health stakeholders to strengthen inclusion of NCDs in emergency preparedness, response, and resilience planning. Key lessons were learned around remote care provision, including adapting to NCD severity, integrating community health workers, providing context-adapted patient information, combating misinformation, and strengthening cross-sectoral partnerships. [ABSTRACT FROM AUTHOR]

Objective: The study aims to explore the perceived outcomes of Medical Teaching Institution (MTI) reforms on autonomy and overall performance within tertiary healthcare institutions in Khyber Pakhtunkhwa (KP) province, Pakistan. Methodology: A cross-sectional study was carried out from September 2023 to March 2024, involving interviews with frontline staff, administrative personnel, and senior management within MTI-affiliated institutions. The methodology employed, using both qualitative and quantitative data analysis techniques. Results: The study showed that institutional staff members' knowledge and understanding of the MTI changes differed. Some observed very minor adjustments, while others saw advances in hospital operations and service delivery. Administrative complexity, political meddling, and resource allocation problems were noted as challenges. Positive results were also observed, though, and they included improved infrastructure, possibilities for staff training, and decision-making procedures. Conclusion: Despite significant improved, there are still challenges, such as inconsistent staff comprehension, mixed impacts on service delivery, resource allocation issues, and political meddling. Addressing these issues necessitates improved communication, continuous evaluation, and coordinated efforts to improve administrative systems and obtain consistent funding. [ABSTRACT FROM AUTHOR]

Background: Key populations (KP), including men who have sex with men (MSM), female sex workers (FSW), and transgender women (TGW), experience a disproportionate burden of HIV, even in generalized epidemics like South Africa. Given this disproportionate burden and unique barriers to accessing health services, sustained provision of care is particularly relevant. It is unclear how the COVID-19 pandemic and its associated restrictions may have impacted this delivery. In this study, we aimed to describe patterns of engagement in HIV prevention and treatment services among KP in South Africa and assess the impact of different COVID-19 restriction levels on service delivery. Methods: We leveraged programmatic data collected by the US President's Emergency Plan for AIDS Relief (PEPFAR)-supported KP partners in South Africa. We divided data into three discrete time periods based on national COVID-19 restriction periods: (i) Pre-restriction period, (ii) High-level restriction period, and (iii) After-high level restriction period. Primary outcomes included monthly total HIV tests, new HIV cases identified, new initiations of pre-exposure prophylaxis (PrEP), and new enrollments in antiretroviral therapy (ART). We conducted interrupted time series segmented regression analyses to estimate the impact of COVID-19 restrictions on HIV prevention and treatment service utilization. Results: Between January 2018 and June 2022, there were a total of 231,086 HIV tests, 27,051 HIV positive cases, 27,656 pre-exposure prophylaxis (PrEP) initiations, and 15,949 antiretroviral therapy initiations among MSM, FSW and TGW in PEPFAR-supported KP programs in South Africa. We recorded 90,457 total HIV tests during the 'pre-restriction' period, with 13,593 confirmed new HIV diagnoses; 26,134 total HIV tests with 2,771 new diagnoses during the 'high-level restriction' period; and 114,495 HIV tests with 10,687 new diagnoses during the after high-level restriction period. Our Poisson regression model estimates indicate an immediate and significant decrease in service engagement at the onset of COVID-19 restrictions, including declines in HIV testing, treatment, and PrEP use, which persisted. As programs adjusted to the new restrictions, there was a gradual rebound in service engagement, particularly among MSM and FSW. Towards the end of the high-level restriction period, with some aspects of daily life returning to normal but others still restricted, there was more variability. Some indicators continued to improve, while others stagnated or decreased. Conclusion: Service provision rebounded from the initial shock created by pandemic-related restrictions, and HIV services were largely maintained for KP in South Africa. These results suggest that HIV service delivery among programs designed for KP was able to be flexible and resilient to the evolving restrictions. The results of this study can inform plans for future pandemics and large-scale disruptions to the delivery of HIV services. [ABSTRACT FROM AUTHOR]

Background: Many older people are now living with co‐occurring physical and mental health disorders, but these often managed separately. The aim of this systematic review was to explore integrated physical‐mental health care services available internationally for older people living with mental health diagnoses, and whether these result in improved health outcomes. Methods: Medline, Embase, CINAHL, PsycINFO and Scopus were searched with a predefined search strategy (PROSPERO: CRD42022383824), generating 6210 articles. Studies were included where an integrated physical‐mental health care service model was utilised in a population of older people (aged >60 years) with a mental health diagnosis (including dementia or cognitive impairment) and at least one concomitant physical health condition requiring physical health care input. All studies were assessed for risk of bias (ROB 2.0, ROBINS‐I) and results were synthesised narratively. Results: Nine studies were included across inpatient (n = 6, 1262 patients) and community (n = 3, 466 patients) settings. Studies were rated as low‐moderate risk of bias. These covered joint physical‐mental health wards, liaison services, embedded physicians in mental health wards, and joint multidisciplinary teams. Services with greater integration (e.g., joint wards) had more benefits for patients and carers. There were few benefits to traditional outcomes (e.g., hospital admissions, mortality), but greater care quality, carer satisfaction, and improved mood and engagement were demonstrated. Conclusions: Multidisciplinary integrated care resulted in improvement of a range of health outcomes for older people with combined physical and mental health needs. Larger and more robust studies are needed to explore the development of these service models further, with cost‐effectiveness analyses. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Professionalism in local government is a critical aspect of effective governance and service delivery. This study investigates the promotion of professionalism within local government, focusing on a case study of the City of Johannesburg. A qualitative approach is followed using a case study strategy. The primary data was collected through semi-structured interviews and were analysed through a documentary and thematic analysis resulting in the triangulation of data obtained from interviews. In this case study the main findings from the passage indicate that The City of Johannesburg (CoJ) has established policies and a code of conduct to promote professionalism, although professional development and training opportunities are not consistently accessible across all departments. In addition, political interference and leadership changes; disrupt administrative processes and service delivery within the CoJ, underscoring the need for consistent governance frameworks. The final finding echoed that the CoJ has introduced e-services and e-recruitment systems to enhance accessibility, operational efficiency, and citizen engagement, aligning with principles of transparency and citizen-centric governance. In conclusion from this research article, it is apparent that the CoJ has all the correct mechanisms in place however it is not applied effectively enough to achieve its optimal standards set for professionalism. [ABSTRACT FROM AUTHOR]

This paper is a build-up to the investigation of the sustainability GNU, which will be the initial one to be established in South Africa in the experience of democracy. South Africa gained its democracy in the past thirty years. South Africa was under the apartheid government for as long as until 1984, in its exit to democracy there was a bit of Government of National Unity since the apartheid regime did not exit immediately as it was supposed to hand over to the democratic government. The typology of the Government of National Unity and Government of Coalition is very complex and mostly misunderstood in the academic community and public sector. The complexity of this understanding also builds up to the fact that the very same academics as well as the public administration are being build up by the politicians too. However, there seems to be a gap in theory and research that seeks to offer a mechanism to define and measure the differences between GNU and Coalition. Principal agencies and public value theories as an addition to the GNU and Coalition theoretical foundation were adopted to clarify improvement in such. This qualitative study meticulously examines scholarly journals, books reports, policies, and government programmes. The findings are that SA has been found as not the first country that will be in GNU and must try the notion to make it work. The study concludes that there is an urgency in the building as well as tolerating GNU to realise service delivery. Afterward, the study influences the successful policy making to improve service delivery through advanced ways to uphold public responsibility. [ABSTRACT FROM AUTHOR]

The scope for environmental management accounting (EMA) has perpetually received attention in recent years, and it has become a pillar of sustainability in addressing environmental and service delivery challenges. Most scholars focused on EMA in a corporate context, limited attention has been given to local governments in available scholarly articles except for various initiatives by the United Nations to guide local governments in adopting and implementing sustainable environmental management practices. This has continued to affect the uptake of EMA in local governments, particularly in developing economies, as the question concerning the role of EMA practices (EMAPs) in environmental and service delivery remains unexplored. A systematic literature review (SLR) through the use of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify EMAPs and their role in promoting environmental and service delivery performance (SDP) in local governments was employed. Articles from Google Scholar and Scopus published between 2000 and 2023 were considered. The researchers identified and evaluated energy accounting, material flow accounting, water management accounting, carbon management accounting and biodiversity management accounting as effective EMAPs to address local governments' environmental and service delivery challenges. Furthermore, a conceptual framework to integrate EMAPs with environmental improvement and service delivery plans was developed and has implications for policymakers, communities, government and environmental specialists. The lessons learned from the research are pertinent to developing sustainable cities in emerging economies and further expose the need for further research to consider accounting approaches from higher-income countries as benchmarks for future development of ecosystem accounting to assist local governments in managing environmental challenges. [ABSTRACT FROM AUTHOR]

IMPACT: 'Co-creation' is a major buzzword in contemporary governance. A range of public sector organizations nowadays declare co-creation as an overall strategy for their policies and actions. However, what co-creation should mean in operational terms often remains less clear. This article explores what co-creation could look like within three significantly different policy contexts: the exercise of authority, service delivery and regulation. To illustrate the argument, the article also explores the extent to which co-creation as a practice already exists in three Norwegian policy fields which resemble the three policy contexts. These three policy fields are child welfare and protection (authority), elderly care (service delivery) and climate policy (regulation). Although the illustrative examples are derived from a single country, they will be relevant to other countries as well. Co-creation is a broad concept that can potentially be applied to many significantly different policy contexts. However, the co-creation literature has paid less attention to questions like how policy content conditions co-creation, and how this generic idea can be translated into different policy fields. To address this gap, this article aims to explore what co-creation might mean in different policy contexts, and discusses co-creation in the context of legal authority, service provision and regulation. The arguments are illustrated using examples from three Norwegian policy sectors: child welfare, elderly care, and climate policy. [ABSTRACT FROM AUTHOR]

The rapid advancement of information technology has become a critical factor in supporting business processes, especially for startups operating 24/7. These businesses rely heavily on robust IT systems to ensure service availability. IT service assessment plays a vital role in evaluating and improving the quality of IT services within organizations. This study evaluates IT service management at PT Loyal.id using the ITIL (Information Technology Infrastructure Library) V3 framework, focusing on service management and service delivery. By implementing ITIL, the organization can enhance incident management, problem management, and service desk performance. The study uses a self-assessment tool in the form of a website for evaluation. The assessment revealed that IT services at PT Loyal.id are still inadequate, with service desk and incident management reaching only level 1.5, and problem management reaching level 2. The results indicate that the organization's IT services require significant improvements to meet ITIL standards and enhance service quality, ultimately aligning IT operations with business objectives. [ABSTRACT FROM AUTHOR]

Townships in South Africa were designed and established when apartheid was at its peak. The challenge facing the democratic government in the developmental local sphere of government, is inefficient service provision, due to the continuous increase of local inhabitants, caused by an increased rate of rural-urban migration patterns. Urban planning focuses on city and town design and how the municipality delivers services to communities dwelling within these designed urban spaces. Rural-urban migration is the movement of people from rural to urban areas, with the main reason the pursuit of better opportunities to improve their socioeconomic conditions. Therefore, the pull and push factors of rural to urban migration are clearly defined and explained in order to assist the municipal administration and academia to improve urban service delivery. The study adopts a quantitative approach with the sample comprising 350 respondents, purposively selected through non-probability sampling and required to complete a 5-point Likert scale questionnaire. The researcher assisted in terms of questionnaire administration. The completed questionnaire provided the quantitative data for statistical analysis, using SPSS version 28.0. Study findings indicate that, among other factors, a strong significance exists regarding increased crime levels in urban areas as a result of rural-urban migration patterns, with suggestions that include more money needs to be prioritised from government for policing and crime in cities such as eThekwini Municipality. Since there are more informal settlements because of rural-urban migration, it is also shown as necessary to create network infrastructure in rural areas to improve communication for those working from home. To identify and explain migration to enhance service delivery at eThekwini Municipality, the study investigated the pull and push factors in migration patterns and their influence on service delivery, as well as examining the extent to which rural-urban migration can be used to deal with the current state of service delivery. In addition, the study determined the role of rural-urban migration in the overpopulation of urban areas at eThekwini Municipality, to suggest and recommend a conceptual framework that should be employed to improve the current state of service delivery in the municipality. [ABSTRACT FROM AUTHOR]

Purpose: Facilities management (FM) as a strategic management tool has been an attractive research topic among scholars and practitioners alike for decades. The primary purpose of this paper is threefold: to assess the extent of use of FM roles (strategic, tactical and operational); to examine user satisfaction of service quality performance; and to analyse the influence of FM roles on service quality performance using data from Nigeria's banking sector. Design/methodology/approach: Relying on exploratory cross-sectional survey, 350 copies of a structured questionnaire were purposively distributed to senior management staff, bank staff, FM supervisors and bank customers in Lagos, Nigeria. One hundred and forty valid responses were returned to give a response rate of 40%. Data collected were analysed using descriptive, Spearman rank correlation and Kruskal–Wallis tests. Findings: It was discovered that strategic facilities planning, IT planning strategy and real estate decisions are the most important FM roles at the strategic level; resource management, data control and planning change at the tactical level; and implementations, building operations and emergencies at the operation level. Findings equally revealed that visual appealing of materials associated with services (tangibles), insisting on error-free records (reliability), willing to help (responsiveness), having the knowledge to answer questions (assurance) and giving individualised attention (empathy) were the most important service quality performance indicators. Furthermore, the study revealed that strategic FM roles significantly influenced tangibles, reliability and responsiveness of staff and the services. Besides, tactical FM roles significantly influenced all service quality indicators except assurance, while operational FM roles had significant influence on tangibles, responsiveness and empathy. Originality/value: To the best of the author's knowledge, this study has provided first ever insight into the extent of FM strategic roles in the banking sector and influence of FM roles on service quality performance. [ABSTRACT FROM AUTHOR]

This paper examines the challenges encountered during the implementation of the Service Delivery and Budget Implementation Plan (SDBIP) within the uPhongolo Local Municipality. The paper adopted New Public Management (NPM) theory as the theoretical framework that offers insights into organisational capabilities and resources relevant to this study. The paper utilises a qualitative methodology, which combines an extensive evaluation of existing literature with primary research methods such as interviews conducted with municipal personnel. The study sample was 9 participants. The present study aims to expand the existing knowledge on the obstacles encountered in municipal government and offers practical strategies to improve the execution of the Service Delivery and Budget Implementation Plan (SDBIP). These findings have the potential to be relevant to other municipalities experiencing similar concerns. The primary obstacles that have been highlighted include limitations in resources, hurdles to effective communication, and the resulting consequences on the provision of services and public perception. The paper's findings indicate that the issues result in project execution delays, which have a detrimental impact on the municipality's capacity to achieve its strategic goals and undermine public confidence. Moreover, the research emphasises the significance of community involvement in local government administration and the potential advantages of using digital technologies to improve operational effectiveness. The report presents a series of practical suggestions based on the aforementioned results. The recommendations include enhancing resource management practices, using digital project management tools, and establishing periodic community involvement forums.

Abstract Objective The study aims to explore the perceived outcomes of Medical Teaching Institution (MTI) reforms on autonomy and overall performance within tertiary healthcare institutions in Khyber Pakhtunkhwa (KP) province, Pakistan. Methodology A cross-sectional study was carried out from September 2023 to March 2024, involving interviews with frontline staff, administrative personnel, and senior management within MTI-affiliated institutions. The methodology employed, using both qualitative and quantitative data analysis techniques. Results The study showed that institutional staff members’ knowledge and understanding of the MTI changes differed. Some observed very minor adjustments, while others saw advances in hospital operations and service delivery. Administrative complexity, political meddling, and resource allocation problems were noted as challenges. Positive results were also observed, though, and they included improved infrastructure, possibilities for staff training, and decision-making procedures. Conclusion Despite significant improved, there are still challenges, such as inconsistent staff comprehension, mixed impacts on service delivery, resource allocation issues, and political meddling. Addressing these issues necessitates improved communication, continuous evaluation, and coordinated efforts to improve administrative systems and obtain consistent funding.

Digitalization brought about by the Covid-19 pandemic has revolutionized many aspects of businesses, magnifying their opportunities and challenges in the market. The global retail sector is no exception. Several changes have transpired in the sector, such as increased preference for online shopping and changes in supply chains and logistics. The purpose of this study is to examine how digital advancement has taken place in the retail sector of Dubai and how it has affected service delivery. To this end, a survey of 94 retailers from around Dubai was conducted using a structured, close-ended questionnaire. The data analysed on SPSS software showed that disruptive technologies like internet of things, artificial intelligence, automation, and big data analytics have a role in changing business functioning. With the implementation of practices like on-demand delivery, tracking product location, personalized services, controlled delivery system, and reduction in transmissible disease exposure the retail industry can improve its service delivery and build healthier relationships with consumers.

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Purpose: To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers. Methods: We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal–Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders. Results: A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70–0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84–0.99). Associations were no longer significant when confounders were controlled for. Conclusion: RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format. [ABSTRACT FROM AUTHOR]

Service delivery is an integral part of the activities that must be regularly performed by the personnel of any library, especially in academic libraries. This review paper focused on the analytical factors that could boost the service delivery among staff in academic libraries. These include quality of library services, user satisfaction, user engagement, staff performance, access to information, library usage, and the academic performance of students. The paper reviewed relevant literature on each of the outlined factors to enable library staff to know how each factor would boost their service delivery job in their various libraries where they are saddled with the task of providing relevant educational resources in meeting the information needs of readers. To this end, it is expedient for the library management to seek and put in place those motivating factors that would improve the service delivery of its staff in the academic community. Also, the library management should engage their staff on the necessity of meeting the information needs of readers as they look up to the library as their last hope in getting relevant information for their academic and research activities. Besides, the institution’s management should give adequate support and provision for training and retraining of its workforce especially the library staff to enhance their productivity.

Municipalities in South Africa face numerous challenges that hinder efficient service delivery. One of these challenges is the lack of implementation of required services, leading to citizen dissatisfaction and protest actions. This study aims to investigate methods for improving service delivery in public institutions in South Africa through the implementation of work-integrated learning (WIL) programmes. Data for this study was collected from the uMzimkhulu local municipality in KwaZulu-Natal, specifically from the Harry Gwala District. A total of 56 participants took part in the study, including 28 WIL students and 28 mentors. This ensured representation from all departments within the municipality. Two separate sets of questionnaires were used to collect data from these two groups. Data analysis was performed using the Statistics Packaging for Social Sciences (SPSS) version 27. The study identified several challenges that currently hinder the effective implementation of WIL programmes within the municipality. As a result, it is recommended that the municipality provide training for WIL students and establish efficient monitoring and evaluation processes for the WIL programmes. Additionally, the municipality should involve students in WIL programmes in matters related to progressive initiatives and provide further support to enhance their ability to handle client services. It is also advised that the municipality prioritise the development of facilities and resources for WIL students to fully engage them in their work.

The article focusses on the question of whether Zimbabwe’s local units of public management are substitutable. The question is asked considering Zimbabwe’s present heightened national government emasculation of lawfully designated local authorities’ powers and tasks. Water supply and sanitation, solid waste management, road construction and maintenance, healthcare, motor vehicle registration and licensing are just a few of the examples of local functions the national level has allocated to national agencies it directly controls over the past few years. Given this background, the article sought to explore through structured documentary analysis acceptability of the national level’s substitution of the local units of public governance in service delivery. Crucially, the engagement revolves around the fundamental policy issue of protecting the autonomy of the local units. Among others, the article finds that the local sphere of government is rooted in rich philosophies, theories and legal protections that make it indispensable in the country’s governmental system even as it is constantly encountering brutal assault seemingly designed to bring it into the orbit of national government; tamed, subdued and emasculated.

Introduction: The Hub-and-Spoke stroke system seeks to enhance the efficiency of stroke care by establishing a cohesive network between healthcare facilities providing quality stroke care to patients. This study endeavors to evaluate the effectiveness and characterize the outcomes of acute ischemic stroke patients treated within the Hub-and-Spoke hospital system over 2 years. The assessment focused on thrombolysis rates, mortality, and disability at 3-month follow-up. Methods: We conducted a retrospective single-center review to assess the service delivery and outcomes of acute ischemic stroke patients within the Hub-and-Spoke framework which was implemented in Q3 2021. The Hub-and-Spoke model aimed to provide appropriate neurological care for stroke patients, growing from four to eight spoke hospitals in 2 years. Results: The study consisted of 132 stroke patients transferred to the hub hospital, and 42 (31.8%) of them had acute ischemic stroke. Among these 42 ischemic stroke patients, 76% of them were candidates for thrombolysis with a mean NIHSS of 12 (6–22). Among the subset of 32 patients eligible for intervention within the specified time window, a total of 23 individuals, constituting 72% received r-TPA. Regarding patients administered r-TPA, 91.2% demonstrated favorable functional outcomes with an mRS score of 0–1, while 8.7% exhibited a score of 2–3. Among those not given r-TPA, the mean NIHSS was 17 (ranging from 2 to 32). Their functional outcomes after 3 months revealed 52.5% with an mRS score of 0–1, 16% with a score of 2–3, 21.2% with a score of 4–5, and 10.5% with an mRS score of 6. Conclusion: Hub-and-Spoke networks represent a crucial advancement in stroke treatment, particularly for facilities lacking the capacity to manage strokes effectively. By leveraging added expertise and reducing the time from onset to diagnosis to treatment, these networks have significantly enhanced patient care. This enhancement is particularly evident in the increased rate of thrombolysis, resulting in reduced morbidity and prevention of mortality.

Abstract Background Libya has experienced decades of violent conflict that have severely disrupted health service delivery. The Government of National Unity is committed to rebuilding a resilient health system built on a platform of strong primary care. Aim Commissioned by the government, we set out to perform a rapid assessment of the system as it stands and identify areas for improvement. Design and setting We used a rapid applied policy explanatory-sequential mixed-methods design, working with Libyan data and Libyan policymakers, with supporting interview data from other primary care policymakers working across the Middle East and North Africa region. Method We used the Primary Health Care Performance Initiative framework to structure our assessment. Review of policy documents and secondary analysis of WHO and World Bank survey data informed a series of targeted policymaker interviews. We used deductive framework analysis to synthesise our findings. Results We identified 11 key documents and six key policymakers to interview. Libya has strong policy commitments to providing good quality primary care, and a high number of health staff and facilities. Access to services and trust in providers is high. However, a third of facilities are non-operational; there is a marked skew towards axillary and administrative staff; and structural challenges with financing, logistics, and standards has led to highly variable provision of care. Conclusion In reforming the primary care system, the government should consolidate leadership, clarify governance structures and systems, and focus on setting national standards for human resources for health, facilities, stocks, and clinical care.

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThis review examines the availability of information on welfare technologies for people living with dementia in Sweden.A scoping review of 21 counties and 290 municipalities was conducted to assess the degree of information provided on welfare technologies.The findings of this review indicate that most Swedish municipalities offer limited information regarding these technologies. Additionally, we conducted a mapping survey to identify the various welfare technologies offered by each county based on the available online material.We argue that greater attention should be given not only to how information is provided but also to the extent to which it is provided to people with dementia and their relatives. Improving these aspects is crucial for making informed decisions. Finally, our review suggests that counties and municipalities should coordinate with local and national resources (e.g., Alzheimer Sweden) to deliver more accurate information through different media forms.The information presented about welfare technologies varies greatly between municipalities and counties, which ultimately affects the capacity of people with dementia and their relatives to make informed decisions surrounding the use of these technologies.The geographical location can influence the availability of options (welfare technologies). Hence, people with dementia and their relatives may not have the same number of options as others who reside in a different municipality or county.Searching for information online can prove to be cumbersome as the information is not clearly found in the right pathways.Greater collaboration is required by the counties, municipalities, and dementia organizations to provide accurate and easily accessible information about welfare technologies to people with dementia and their relatives.The information presented about welfare technologies varies greatly between municipalities and counties, which ultimately affects the capacity of people with dementia and their relatives to make informed decisions surrounding the use of these technologies.The geographical location can influence the availability of options (welfare technologies). Hence, people with dementia and their relatives may not have the same number of options as others who reside in a different municipality or county.Searching for information online can prove to be cumbersome as the information is not clearly found in the right pathways.Greater collaboration is required by the counties, municipalities, and dementia organizations to provide accurate and easily accessible information about welfare technologies to people with dementia and their relatives. [ABSTRACT FROM AUTHOR]

• Clinics varied greatly in their referral criteria, services, and data collection. • Most clinics reported challenges in meeting demand and maintaining funding. • Efforts to increase coordination might assist in improving access to care. Functional neurological symptom disorder (FND) is characterised by neurological symptoms that are incompatible with recognised neurological or medical conditions. The condition is common in neurology clinics and causes significant morbidity, though timely access to specialist care is difficult. We sought to characterise the availability and clinical practice of specialist FND clinics across Australia and New Zealand. Clinicians or coordinators involved in running specialist FND clinics were identified through clinical contacts with further recruitment by snowball sampling and contacting patient organisations. All clinics completed a survey about details of service delivery, including clinical model, referral sources, criteria, demand, staffing, interventions, clinical data collection, and funding. We identified 16 clinics across Australia and New Zealand. Of these, 12 were in capital cities and four were in regional centres. Three of these focused on paediatric patients and 13 focused on adults. Clinics varied in their clinical model, referral sources, criteria, staffing, interventions, data collection, and funding. Most clinics reported challenges related to coping with demand and obtaining adequate funding. FND clinics in Australia and New Zealand appear to be concentrated predominantly in metropolitan areas and vary considerably in their referral sources, clinical data collection, and models of care. Reported challenges in meeting demand indicate a need for greater resources. The heterogeneity across clinics suggests a need to harmonise clinical standards to facilitate access to evidence-based care. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Lancet Low Back Pain (LBP) Series highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs and (2) how that care is delivered. DESIGN: An online mixed-methods study. METHODS: A Consortium for LBP in LMICs (n = 65) was developed with an expert panel of leading LBP researchers (>2 publications on LBP) and multidisciplinary clinicians and patient partners with 5 years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using inductive and deductive coding and developed a thematic framework. RESULTS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women, 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and people with lived experience (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The thematic framework comprised 8 themes: (1) self-management is ubiquitous, (2) medicines are the cornerstone, (3) traditional therapies have a place, (4) society plays an important role, (5) imaging use is very common, (6) reliance on passive approaches, (7) social determinants influence LBP care pathway, and (8) health systems are ill-prepared to address LBP burden. CONCLUSION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines. [ABSTRACT FROM AUTHOR]

Objective: This study compared mental health treatment engagement among people with serious mental illness after release from jails that had either a for-profit (N=3 jails) or a nonprofit mental health provider (N=7 jails). Methods: Across the 10 jails, data were collected in 2019 for 1,238 individuals with serious mental illness. Data included demographic characteristics (age, race-ethnicity, gender, geography, and jail type) and behavioral health variables (previous mental health treatment, psychotropic medication use, substance use, and receipt of jail-based mental health services). Logistic regression was used to predict treatment engagement during the year after release, stratified by type of jail-based mental health provider, in analyses controlled for demographic and behavioral health variables. Results: Almost half (46%, N=573) of the individuals had stayed in jails with a for-profit mental health provider; the other half (54%, N=665) had stayed in jails with a nonprofit provider. In the year after release, 37% (N=458) of all individuals engaged in mental health treatment, and 63% (N=780) did not. Those who had stayed in a jail with a for-profit provider were significantly less likely to engage in mental health treatment during the year after release (AOR=0.59, 95% CI=0.42–0.83, p<0.01), compared with those in jails having a nonprofit provider. Conclusions: Staying in a jail with a for-profit mental health provider was associated with reduced postrelease engagement with community service providers. Less engagement with services during a pivotal time after release may increase behavioral health crises that erode individuals' well-being and may raise downstream costs due to further criminal legal involvement and emergency care use. [ABSTRACT FROM AUTHOR]

The article focuses on the difficulties in providing bulk water services in Dr. Ruth Segomotsi Mompati district municipality, North West Province, South Africa. Topics include operational inefficiencies, the need for strategic planning and dynamic master planning, and the exacerbation of challenges due to the COVID-19 pandemic.

The communities of the world need health insurance services during and after COVID-19. This study aims to evaluate the perspectives on the service quality of health insurance companies by expanding the service quality model based on the disconfirmation expectation theory. This proposed model adds various factors like sales agents, trust, and service delivery to the service quality model. The questionnaires were distributed to health insurance policyholders. The descriptive research study, structural equation modelling, was used to analyse the data. Four hundred and eighteen respondents' data were collected using a convenient sampling method from June 2021 to December 2021. The dimension of service quality was confirmed, except for reliability. Reliability has shown a negative impact on consumer satisfaction. Trust seems to be the most influential dimension for consumer satisfaction in the proposed model. Service delivery has a positive impact on customer satisfaction, but sales agents have a negative impact on customer satisfaction. Hence, health insurance companies must improve the service quality of their sales agents. The novelty of this research paper lies in the expansion of the service quality model, based on the disconfirmation expectation theory, to evaluate the service quality of health insurance companies. [ABSTRACT FROM AUTHOR]

This paper intricately examines Vhavenda indigenous governance systems in juxtaposition with the modern administrative systems in South Africa. Through a comparative analysis using qualitative research methods and secondary data analysis, the paper reveals nuanced strengths and weaknesses in each framework, suggesting avenues for collaborative synergy and improved service provision in rural areas. Purposive and snowball sampling, along with a focus group discussion, were employed for data collection. Textbooks, academic journals, papers, and online sources were analysed. The findings not only enrich the understanding of indigenous governance but also provide actionable insights for policymakers and practitioners to enhance governance efficacy and community well-being. This paper represents a vital step towards fostering inclusive and equitable governance practices in a rapidly evolving socio-political landscape, emphasising the importance of embracing the complexities of tradition and modernity for a system that meets the diverse needs of all community members. Thus, the findings and recommendations presented in this paper are at the heart of efforts to foster sustainable development and promote social cohesion -- a foundational aspect of effective nation-building endeavours. [ABSTRACT FROM AUTHOR]

AbstractDespite mitigating the severe impacts of poverty, synchronized, monthly government income assistance payments can negatively impact people who use drugs, including disrupting service utilization. This study evaluates whether changing payment timing and frequency impacts health and social service access. This secondary analysis of an exploratory, parallel, unblinded, randomized controlled trial assessed data collected between 2015–2019 from income assistance recipients who use drugs in British Columbia, Canada (n = 194). Participants were randomly assigned for six monthly payment cycles to: (a) synchronized government schedules (control); (b) desynchronized “staggered” single monthly payments; or (c) desynchronized “split & staggered” twice-monthly payments. Generalized linear mixed models assessed utilization of, and barriers to, acute/emergency healthcare, community healthcare, psychosocial services and material/legal services. Mixed results showed increases in access to psychosocial services and material/legal services, but also increases in the barriers to community healthcare and material/legal services. Changing payment schedules may alter access to services in complex ways implicating practice, organizational and interagency adaptations for marginalized populations. Results support the importance of social service agency involvement in income assistance policy reform discussions to ensure effective service delivery. Further research should include perspectives from service providers and utilize agency administration data to better understand payment schedules and service provision dynamics. [ABSTRACT FROM AUTHOR]

Emerging technologies such as artificial intelligence have become a dominant technological focus in the academic context that enables libraries to restructure their activities. AI enhances library operations and service delivery within the virtual workplace ecosystem, leading to seamless digital information flow that supports innovative services tailored to meet evolving user needs. The purpose of this study was to investigate how emerging technologies and skills can improve service delivery in digital libraries. The positivist quantitative approach research methodology was adopted in this study applying a survey data collection method coupled with literature review. Data were analysed through statistical instruments and visually presented. The study revealed that adopting a wide scale of technologies would require digital competencies and algorithmic literacy to influence broader access to knowledge and re-engineer library operations for efficiency in virtual and physical environment. The study recommended that artificial intelligence-driven technologies would better position libraries for future innovative changes through efficient systems integration to streamline services and foster greater accessibility to knowledge resources to enrich user experience. Adopting emerging technologies improved distribution and sharing of resources, leading to better service delivery, as cybrarians could devote valuable time to supporting users. [ABSTRACT FROM AUTHOR]

Background and aims: People who inject drugs (PWID) are at risk for adverse outcomes across multiple dimensions. While evidence‐based interventions are available, services are often fragmented and difficult to access. We measured the effectiveness of an integrated care van (ICV) that offered services for PWID. Design, setting and participants: This was a cluster‐randomized trial, which took place in Baltimore, MD, USA. Prior to randomization, we used a research van to recruit PWID cohorts from 12 Baltimore neighborhoods (sites), currently served by the city's mobile needle exchange program. Intervention and comparator: We randomized sites to receive weekly visits from the ICV (n = 6) or to usual services (n = 6) for 14 months. The ICV offered case management; buprenorphine/naloxone; screening for HIV, hepatitis C virus and sexually transmitted infections; HIV pre‐exposure prophylaxis; and wound care. Measurements: The primary outcome was a composite harm mitigation score that captured access to evidence‐based services, risk behaviors and adverse health events (range = 0−15, with higher numbers indicating worse status). We evaluated effectiveness by comparing changes in the composite score at 7 months versus baseline in the two study arms. Findings We enrolled 720 cohort participants across the study sites (60 per site) between June 2018 and August 2019: 38.3% women, 72.6% black and 85.1% urine drug test positive for fentanyl. Over a median of 10.4 months, the ICV provided services to 734 unique clients (who may or may not have been cohort participants) across the six intervention sites, including HIV/hepatitis C virus testing in 577 (78.6%) and buprenorphine/naloxone initiation in 540 (74%). However, only 52 (7.2%) of cohort participants received services on the ICV. The average composite score decreased at 7 months relative to baseline, with no significant difference in the change between ICV and usual services (difference in differences: −0.31; 95% confidence interval: −0.70, 0.08; P = 0.13). Conclusions: This cluster‐randomized trial in Baltimore, MD, USA, found no evidence that weekly neighborhood visits from a mobile health van providing injection‐drug‐focused services improved access to services and outcomes among people who injected drugs in the neighborhood, relative to usual services. The van successfully served large numbers of clients but unexpectedly low use of the van by cohort participants limited the ability to detect meaningful differences. [ABSTRACT FROM AUTHOR]

Background: Services from specialized professionals in childcare settings contribute to support early childhood development. Little is known, however, about how services are delivered in this context. The aims of this scoping review were to propose a framework to describe services delivered by specialized professionals in childcare contexts and synthesize knowledge about those services. Methods: Documents published between 2000 and 2022 in APA PsychINFO, ERIC, CINAHL and MEDLINE were included. These documents described services delivered by a range of specialized professionals (e.g., speech‐language pathologists, occupational therapists, physical therapists and early childhood special education teachers) in childcare contexts and whose aim was to support motor, cognitive, affective, language or social development of children. Deductive and inductive qualitative analyses and descriptive statistics were carried out. Results: The review included 47 documents. The Description of Services delivered by specialized Professionals in Early Childhood (D‐SPEC) Framework emerged from qualitative analyses. The D‐SPEC Framework included 11 dimensions: three actors and their context, specialized professionals involved, children served, purpose of service, type of service, service duration and intensity, mode of service delivery, mode of access to services and funding. Most services delivered by specialized professionals in childcare were provided by a single professional and targeted language. Two documents described multitiered service delivery models with a continuum of services ranging from general support for all children to individualized interventions for children with specific needs. In‐context services were preferred to pull‐out services in most documents reviewed. Conclusions: The D‐SPEC Framework may be a useful tool to assist researchers in documenting and comparing services delivered by specialized professionals. More importantly, this framework will facilitate the development of intersectoral and interdisciplinary services essential for supporting early childhood development. Multitiered service delivery models appeared to be a promising way to develop those services addressing the various needs encountered in childcare. [ABSTRACT FROM AUTHOR]

Despite huge investments in the educational sector, many countries in Africa have not fared well in the education indices. This study examined the effect of teaching equipment and teachers' effort on learning outcomes in 744 Nigerian primary schools using Stochastic Frontier and Ordinary Least Square regression. The mean technical efficiency was 0.43 which showed most of the surveyed schools were technically inefficient. Also, 42.8% of public primary schools operate below 20% efficiency level as against 12.3% in private primary schools. Factors influencing efficiency include school ownership type, visits from the Local Government Education Authority Student-Teacher ratio, and school hygiene. [ABSTRACT FROM AUTHOR]

Background and purpose: Women with acute ischemic stroke (AIS) are older and have greater preexisting handicap than men. Given that these factors do not fully explain their poorer long‐term outcomes, we sought to investigate potential sex differences in the delivery of acute stroke care in a large cohort of consecutive AIS patients. Methods: We analyzed all patients from ASTRAL (Acute Stroke Registry and Analysis of Lausanne) from March 2003 to December 2019. Multivariable analyses were performed on acute time metrics, revascularization therapies, ancillary examinations for stroke workup, subacute symptomatic carotid artery revascularization, frequency of change in goals of care (palliative care), and length of hospital stay. Results: Of the 5347 analyzed patients, 45% were biologically female and the median age was 74.6 years. After multiple adjustments, female sex was significantly associated with higher onset‐to‐door (adjusted hazard ratio [aHR] = 1.09, 95% confidence interval [CI] = 1.04–1.14) and door‐to‐endovascular‐puncture intervals (aHR = 1.15, 95% CI = 1.05–1.25). Women underwent numerically fewer diagnostic examinations (adjusted odds ratio [aOR] = 0.94, 95% CI = 0.85–1.04) and fewer subacute carotid revascularizations (aOR = 0.69, 95% CI = 0.33–1.18), and had longer hospital stays (aHR = 1.03, 95% CI = 0.99–1.07), but these differences were not statistically significant. We found no differences in the rates of acute revascularization treatments, or in the frequency of change of goals of treatments. Conclusions: This retrospective analysis of a large, consecutive AIS cohort suggests that female sex is associated with unfavorable pre‐ and in‐hospital time metrics, such as a longer onset‐to‐door and door‐to‐endovascular‐puncture intervals. Such indicators of less effective stroke care delivery may contribute to the poorer long‐term functional outcomes in female patients and require further attention. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the collaborative practice between speech-language pathologists (SLPs) and teachers in two Australian states with different policies and legislations affecting SLP services in schools. Methods: Teachers from New South Wales (NSW) and Queensland (QLD) completed an online survey (N = 117). A mixed-method approach was used to analyse teachers' responses in the survey. Results: QLD teachers were significantly more likely to work with SLPs in multiple models of collaborative practice. NSW teachers were more than twice as likely to work with SLPs in the pull-out model as the single means of collaborative practice. While NSW and QLD teachers accessed SLP services differently, they perceived funding and lack of time to be influencing collaborative practices. A clear need was highlighted for SLPs and teachers to develop a greater depth of shared understanding for successful collaborative practices. Conclusion: This study provided preliminary insight into SLP-teacher collaborative practices in two Australian states with different policies and legislations affecting SLP services in schools. There is a need for evidence-based and student-centred guidelines to facilitate SLP-teacher collaborative practices in schools. [ABSTRACT FROM AUTHOR]

Aim: To characterise experiences with telehealth for Medications for Opioid Use Disorder (MOUD) services among patients, prescribers, nurses and substance use counsellors to inform future best practices. Design: We engaged a qualitative descriptive study design. Methods: Semi‐structured interviews were conducted with prescribers (nurse practitioners and physicians, n = 20), nurses and substance use counsellors (n = 7), and patients (n = 20) between June and September 2021. Interviews were verbatim transcribed. Thematic analysis was conducted using a qualitative descriptive method. Results: Among both providers and patients, four themes were identified: (1) Difficulties with telehealth connection (2) Flexibility in follow‐up and retention, (3) Policy changes that enabled expanded care, (4) Path forward with telehealth. Two additional findings emerged from provider interviews: (1) Expansion of nurse‐managed office‐based opioid treatment, and (2) Novel methods to engage patients. Conclusions: Patients and providers continued to view telehealth as an acceptable means for delivery and management of MOUD, particularly when utilised in a hybrid manner between in‐person visits. Nurse‐managed care for this service was evident as nurses extended the breadth of services offered and utilised novel methods such as text messages and management of 'call‐in' lines to engage patients. Implications for the profession and/or patient care: Use of telehealth for MOUD should be incorporated into practice settings to reach patients in a flexible manner. Nurses in particular can use this medium to extend office‐based opioid treatment by conducting assessments and expanding capacity for other wrap‐around services. Impact: We identify recommendations for best practices in the use of telehealth for opioid use disorder management and highlight the value of nurse‐managed care. Reporting method: The consolidated criteria for reporting qualitative research. Patient or Public Contribution: Patients with opioid use disorder and prescribers with experience using telehealth were interviewed for this study. [ABSTRACT FROM AUTHOR]