Prevalence of anti-SARS-CoV-2 antibodies in people attending the two main Goma markets in the eastern Democratic Republic of the Congo.

The Democratic Republic of the Congo (DRC) officially reports low coronavirus disease 19 (COVID-19) prevalence. This cross-sectional study, conducted between September and November 2021, assessed the COVID-19 seroprevalence in people attending Goma's two largest markets, Kituku and Virunga. A similar study in a slum of Bukavu overlapped for 1 month using identical methods. COVID-19-unvaccinated participants (n = 796 including 454 vendors and 342 customers, 60% of whom were women) were surveyed. The median age of vendors and customers was 34.2 and 30.1 years, respectively. The crude and adjusted anti-SARS-CoV-2 antibody seroprevalence rates were 70.2% (95% CI 66.9-73.4%) and 98.8% (95% CI 94.1-100%), respectively, with no difference between vendors and customers. COVID-19 symptoms reported by survey participants in the previous 6 months were mild or absent in 58.9% and 41.1% of participants with anti-SARS-CoV-2 antibodies, respectively. No COVID-19-seropositive participants reported hospitalisation in the last 6 months. These findings are consistent with those reported in Bukavu. They confirm that SARS-CoV-2 spread without causing severe symptoms in densely populated settlements and markets and suggest that many COVID-19 cases went unreported. Based on these results, the relevance of an untargeted hypothetical vaccination programme in these communities should be questioned.

We used to get money to teach students, now we teach students to get money: medical education has become a market with credentials not knowledge the commodity!

Preclinical medical education has lost its way. In fact, it seems that preclinical medical education has forgotten its mission and has become focused on assembly line efficiency and profits. Administrators and students are increasingly considering preclinical medical education as a market with credentials (access to USMLE Step 1 or COMLEX Level 1) the commodity and students the consumers. Consider that, once banned, for-profit medical schools are on the rise in the United States. In response to these changes, medical schools are adopting corporate models, cutting costs, and seeking profit-making opportunities. One example is the broadcasting of content to multiple sites and satellite campuses. In addition, the customers need to feel satisfied with the educational experience bought for them at high tuition costs. However, providing students with what they want often happens at the expense of what they need, and administrators engage in subtle pandering to students. Furthermore, although the pursuit of credentials is understandable, a university is more than a factory that produces diplomas and careers. Universities exist to educate, discover, and impart knowledge while impacting our ways of living and thinking. In this context, universities exist for the greater good and betterment of societies. The "corporatization" of medical education and satisfying the customer creates an environment where a university is selling socioeconomic stability, professional status, and success, rather than a setting for the formation of character, intellect, and critical thinking. Our hope is that administrators, educators, and students will reconnect to the greater purpose and value of learning.NEW & NOTEWORTHY We should be preparing future physicians to deliver the care we want to receive as patients. This requires training in communication, collaboration, inquiry, discovery, and innovation while developing the habits of the mind and heart that advance the practice of medicine and the health of the public. However, the current "corporatization" of medical education is failing to accomplish this outcome. Specifically, medical schools are adopting corporate models, cutting costs, and seeking profit-making opportunities without improving what goes on in the classroom. Our hope is that we will reconnect to the greater purpose and value of learning.

Drivers of consumers' behavioral intention toward private umbilical cord blood banking: a review.

Immunitary bioeconomy encompasses a significant share of the bioeconomy that is accompanied by a high degree of complexity and various religious and ethical controversies for both customers and the service providers. Compared to blood banking, these complexities are more substantial for the new state-of-the-art technology of umbilical cord blood (UCB) banking, in which the viable therapeutically active substance of cord blood (i.e., cord blood stem cells (CBSCs)) is banked for much less likely future demand. It became even more complicated when we knew that the main three types of cord blood banking industry (i.e., private, public, or hybrid models) are not the same regarding economic, ethical, and even social considerations. The present paper aims to review and discuss the main drivers of behavioral intention among the customers of private UCB banking. We focused on private UCB banking because, although there is a low likelihood of childs' future need for their siblings' CBSCs, there is an unnecessary growing demand for using private UCB banking services. Based on the previously published pieces of research, we discussed five main influential factors (i.e., awareness, reference group, usability, disease history, and price) that can affect the customers' risk perception (and further their behavioral intention) to preserve their child UCB for private applications. Finally, we concluded that private UCB banking must not be considered a commercial activity, and ethically healthcare managers must be more actively involved in facilitating the proper flow of information among the customers.

Children's perceptions of their parent's parenting strategies and child influence on purchases in a supermarket.

This field study identified, through observation, child influence on food and beverage purchases within a supermarket, as well as the influence of the children's perceptions of their parents' parenting strategies related to eating behaviors on these purchases. Four supermarkets were recruited to participate and agreed to allow recruitment of parent-child dyads and implementation of data collection protocols within their stores. Parent-child (7-14 yo) dyads were recruited to wear eye-tracking glasses during the supermarket visit, complete separate individual interviews, and have their store receipts scanned. The receipt data provided evidence of what was purchased, including overall purchases, as well as purchases of energy-dense, nutrient-poor foods and beverages. The eye-tracking data, together with the receipt data, identified which items were requested by the child and purchased. The child interviews provided the child's perceptions of parenting strategies (i.e., parental monitoring, control). Seventy-six dyads agreed to participate and completed the study protocols. During most of the shopping trips, items were purchased as a result of child-initiated request interactions. Children's perceptions of their parent's use of monitoring was consistently associated with fewer purchases overall and of energy-dense, nutrient-poor items, and with reduced child influence on what was purchased.

A customer portfolio management model that relates company's marketing to its long-term survival.

A typical customer relationship management model is designed to increase the value of a company's existing customers in the next period. While useful in the short term, such a process, followed blindly period after period, would drive the company out of business when those existing customers all eventually died. In reality, no company would do this. Instead, these short-term models are nested within a long-term view of customer management, and it is long-term customer management that the proposed model addresses. The model assumes that a company has identified a set of customer types across which it needs balance in order to remain viable in the long-term (e.g., a company might wish to maintain a supply of "entry-level customers" in order to eventually replenish its collection of more profitable "loyal customers"). Though the model is applicable in any industry, we illustrate it for automobiles. Results reveal the strengths with which each marketing intervention causes General Motors to attract each of their desired customer types. The model is extended to also reveal differences in the ways that marketing interventions by Ford, Toyota, and Honda change the strengths with which those automakers attract customers. Supplementary Information: The online version contains supplementary material available at 10.1007/s11747-020-00765-9.

Occupational and non-occupational allergic contact dermatitis to hair dyes in Greece. A 10-year retrospective study.

BACKGROUND: Oxidative hair dyes are an important source of chemical exposure and a major risk factor for the development of occupational and non-occupational allergic contact dermatitis (ACD) worldwide. OBJECTIVE: To identify the frequency of common allergens associated with occupational and non-occupational ACD to hair dyes during the last 10 years, in Greece. METHODS: We retrospectively reviewed the medical records of patients with suspected ACD to hair dyes from 2010-2019. All patients with patch-test-confirmed ACD to hair dyes were evaluated. RESULTS: Out of 501 patients with suspected ACD to hair dyes, 362 had at least one positive reaction to hair dye allergens (62.4% were customers and 37.6% were hairdressers). The mean age of customers and hairdressers was 43.8 years and 30.8 years, respectively. Of the customers, 58.9% were exposed to dyes for >10 years and 61% of hairdressers for <5 years. The most common site of ACD among customers was the scalp (85%) and among hairdressers the hands (90%). p-Phenylenediamine (PPD) was the most common contact allergen (52.2%), followed by toluene-2,5-diamine, p-aminophenol, m-aminophenol, and ammonium persulfate. CONCLUSIONS: Sensitization prevalences for PPD and cross-reacting allergens have increased in Greece during the last decade, regardless of occupational or non-occupational exposure to hair dyes.

How Do Waterpipe Smoking Establishments Attract Smokers? Implications for Policy.

BACKGROUND: Given the unique social nature of waterpipe smoking, an important factor contributing to its popularity is the spread of waterpipe establishments. OBJECTIVES: With a focus on implications for regulations, we conducted a qualitative assessment of customers' online reviews on Yelp.com to gain insight into their positive and negative perceptions about waterpipe establishments and products, and identify features that are most important to them. METHODS: In June 2016, an online search of Yelp was conducted to identify waterpipe establishments in Miami, Florida. First, we collected information from the websites on establishments' characteristics and their marketing practices. Then we selected customers' waterpipe-related reviews and used an inductive qualitative method to code and identify key themes associated with positive and negative customers' experiences. Thematic analysis was completed upon reaching saturation. The final coding scheme consisted of 32 codes within eight themes. RESULTS: The homepage of the establishment was used to promote special discounts and events, while the online waterpipe menu was used to promote the waterpipe products. Our thematic analysis indicated that the variety of flavored tobacco was the most rated positive factor to customers, while the low-quality charcoal and high price were the most negative factors. Conclusions/Importance: Waterpipe online advertisements and promotions should be monitored and restricted. The availability of flavored tobacco, innovative device/accessories, affordable pricing, and charcoal quality are important domains for waterpipe establishments policy/regulation. Regulatory framework for waterpipe establishments should address the complex context of waterpipe including the venue (i.e., physical, website, menu), the tobacco, the device/accessories, and charcoal.

Application of the Health Belief Model to customers' use of menu labels in restaurants.

Some countries require the provision of menu labels on restaurant menus to fight the increasing prevalence of obesity and related chronic diseases. This study views customers' use of menu labels as a preventive health behavior and applies the Health Belief Model (HBM) with the aim of determining the health belief factors that influence customers' use of menu labels. A self-administered survey was distributed for data collection. Responses were collected from 335 restaurant customers who experienced menu labels in restaurants within three months prior to the survey. The results of a structural equation model showed that all the HBM variables (perceived threats, perceived benefits, and perceived barriers of using menu labels) positively affected the customers' use of menu labels. Perceived threats were influenced by cues to action and cues to action had an indirect influence on menu label use through perceived threats. In conclusion, health beliefs were good predictors of menu label use on restaurant menus. This study validated the application of the HBM to menu labeling in restaurants, and its findings could offer guidelines for the industry and government in developing strategies to expand the use of menu labels among the public.

Community pharmacy customer segmentation based on factors influencing their selection of pharmacy and over-the-counter medicines.

BACKGROUND: Within the competitive pharmacy market environment, community pharmacies are required to develop efficient marketing strategies based on contemporary information about consumer behavior in order to attract clients and develop customer loyalty. OBJECTIVES: This study aimed to investigate the consumers' preferences concerning the selection of pharmacy and over-the-counter (OTC) medicines, and to identify customer segments in relation to these preferences. METHODS: A cross-sectional study was conducted between February and March 2016 on a convenient quota sample of 300 participants recruited in the metropolitan area of Thessaloniki, Greece. The main instrument used for data collection was a structured questionnaire with close-ended, multiple choice questions. To identify customer segments, Two-Step cluster analysis was conducted. RESULTS: Three distinct pharmacy customer clusters emerged. Customers of the largest cluster (49%; 'convenience customers') were mostly younger consumers. They gave moderate to positive ratings to factors affecting the selection of pharmacy and OTCs; convenience, and previous experience and the pharmacist's opinion, received the highest ratings. Customers of the second cluster (35%; 'loyal customers') were mainly retired; most of them reported visiting a single pharmacy. They gave high ratings to all factors that influence pharmacy selection, especially the pharmacy's staff, and factors influencing the purchase of OTCs, particularly previous experience and the pharmacist's opinion. Customers of the smallest cluster (16%; 'convenience and price-sensitive customers') were mainly retired or unemployed with low to moderate education, and low personal income. They gave the lowest ratings to most of the examined factors; convenience among factors influencing pharmacy selection, whereas previous experience, the pharmacist's opinion and product price among those affecting the purchase of OTCs, received the highest ratings. CONCLUSIONS: The community pharmacy market comprised of distinct customer segments that varied in the consumer preferences concerning the selection of pharmacy and OTCs, the evaluation of pharmaceutical services and products, and demographic characteristics.

How much segmentation is needed in the health care marketplace? An exploratory study of HMO and non-HMO customers.

The health care landscape has changed dramatically. Consumers now seek plans whose benefits better fit their health care needs and desires for access to providers. This exploratory survey of more than 1,000 HMO and non-HMO customers found significant differences with respect to their selection processes for health plans and providers, and their expectations regarding access to and communication with health care providers. While there are some similarities in factors affecting choice, segmentation strategies are necessary to maximize the appeal of a plan, satisfy customers in the selection of physicians, and meet their expectations regarding access to those physicians.

How do prostitution customers value health and position health in their discussions? Qualitative analysis of online forums.

AIM: Information on the health values and positioning of health among prostitution customers is limited. The aim is to explore the positioning of health among prostitution customers using data from Internet forums in Finland. METHODS: Qualitative study using a purposive sample of public online forums among prostitution customers in 2002-2012. RESULTS: Health beliefs in relation to infections and risky sexual behavior were diverse, from correct to false. Although men were aware of health risks in prostitution, it was common to have multiple sexual partners and unprotected sex. Although there were men who warned others about possible health consequences when a condom is not used, typically men were proud not to use a condom with a prostitute and found different explanations for not using a condom. Condom breakage was not an issue discussed in forums. Unexpected findings were beliefs that one fifth of the Nordic population is resistant to HIV, that the possibility of HIV transmission is exaggerated by medical specialists, and that men should control their behavior in order not to degrade prostitutes. Discussions on health service use were few. CONCLUSIONS: Sexual satisfaction and entertainment were the main reasons to post in the analyzed forums health discussion was not common although condom use was reported, attention to health risks was selective information on health service use was limited, which may suggest this topic was not valued among men and should be a topic of future studies.

The Chinese customers and service staff interactive affective system (CCSIAS): introduction to a multimodal stimulus dataset.

To research the emotional interaction between customers and service staff, single-modal stimuli are being used to activate subjects' emotions while multimodal emotion stimuli with better efficiency are often neglected. This study aims to construct a multimodal emotion stimuli database (CCSIAS) with video records of real work status of 29 service staff and audio clips of interactions between customers and service staff by setting up wide-angle cameras and searching in company's Ocean Engine for 15 consecutive days. First, we developed a tool to assess the emotional statuses of customers and service staff in Study 1. Second, 40 Masters and PhD students were invited to assess the audio and video data to evaluate the emotional states of customers and service staff in Study 2, using the tools developed in Study 1. Third, 118 participants were recruited to test the results from Study 2 to ensure the stability of the derived data. The results showed that 139 sets of stable emotional audio & video data were constructed (26 sets were high, 59 sets were medium and 54 sets were low). The amount of emotional information is important for the effective activation of participants' emotional states, and the degree of emotional activation of video data is significantly higher than that of the audio data. Overall, it was shown that the study of emotional interaction phenomena requires a multimodal dataset. The CCSIAS (https://osf.io/muc86/) can extend the depth and breadth of emotional interaction research and can be applied to different emotional states between customers and service staff activation in the fields of organizational behavior and psychology.

Search Engines and Generative Artificial Intelligence Integration: Public Health Risks and Recommendations to Safeguard Consumers Online.

BACKGROUND: The online pharmacy market is growing, with legitimate online pharmacies offering advantages such as convenience and accessibility. However, this increased demand has attracted malicious actors into this space, leading to the proliferation of illegal vendors that use deceptive techniques to rank higher in search results and pose serious public health risks by dispensing substandard or falsified medicines. Search engine providers have started integrating generative artificial intelligence (AI) into search engine interfaces, which could revolutionize search by delivering more personalized results through a user-friendly experience. However, improper integration of these new technologies carries potential risks and could further exacerbate the risks posed by illicit online pharmacies by inadvertently directing users to illegal vendors. OBJECTIVE: The role of generative AI integration in reshaping search engine results, particularly related to online pharmacies, has not yet been studied. Our objective was to identify, determine the prevalence of, and characterize illegal online pharmacy recommendations within the AI-generated search results and recommendations. METHODS: We conducted a comparative assessment of AI-generated recommendations from Google's Search Generative Experience (SGE) and Microsoft Bing's Chat, focusing on popular and well-known medicines representing multiple therapeutic categories including controlled substances. Websites were individually examined to determine legitimacy, and known illegal vendors were identified by cross-referencing with the National Association of Boards of Pharmacy and LegitScript databases. RESULTS: Of the 262 websites recommended in the AI-generated search results, 47.33% (124/262) belonged to active online pharmacies, with 31.29% (82/262) leading to legitimate ones. However, 19.04% (24/126) of Bing Chat's and 13.23% (18/136) of Google SGE's recommendations directed users to illegal vendors, including for controlled substances. The proportion of illegal pharmacies varied by drug and search engine. A significant difference was observed in the distribution of illegal websites between search engines. The prevalence of links leading to illegal online pharmacies selling prescription medications was significantly higher (P=.001) in Bing Chat (21/86, 24%) compared to Google SGE (6/92, 6%). Regarding the suggestions for controlled substances, suggestions generated by Google led to a significantly higher number of rogue sellers (12/44, 27%; P=.02) compared to Bing (3/40, 7%). CONCLUSIONS: While the integration of generative AI into search engines offers promising potential, it also poses significant risks. This is the first study to shed light on the vulnerabilities within these platforms while highlighting the potential public health implications associated with their inadvertent promotion of illegal pharmacies. We found a concerning proportion of AI-generated recommendations that led to illegal online pharmacies, which could not only potentially increase their traffic but also further exacerbate existing public health risks. Rigorous oversight and proper safeguards are urgently needed in generative search to mitigate consumer risks, making sure to actively guide users to verified pharmacies and prioritize legitimate sources while excluding illegal vendors from recommendations.

Water conservation quantities vs customer opinion and satisfaction with water efficient appliances in Miami, Florida.

During 2006-2007, Miami-Dade County, Florida, USA, provided incentives for low income and senior residents in single family homes for retrofitting with high efficiency fixtures. The participating residences were retrofitted with high-efficiency toilets, showerheads, and aerators. In 2012, a telephone survey was conducted to evaluate the satisfaction of the participants and the associated effects on water conservation practices. This study evaluates the attitudes and opinions of the participants relative to water use efficiency measures and the actual reduction in water consumption characteristics of the participating households. The participant characteristics were analyzed to identify correlations between the socio-demographic factors, program satisfaction and actual water savings. Approximately 65.5% of the survey respondents reported changes in their water use habits and 76.6% reported noticeable reduction in their water bills. The analyses showed that the satisfaction levels of the participants were closely correlated with the actual water savings. The results also showed that satisfaction level along with water saving potential (i.e., implementation of water efficiency devices) or change of water use habits has provided positive synergistic effect on actual water savings. The majority of the participants surveyed (81.3-89.1%) reported positive attitudes for water conservation incentive program and the benefits of the high efficiency fixtures.

Customers' Perception Towards Accountability of Diagnostic Centres: Evidence from India.

Introduction: A deeper comprehension of accountability is beneficial for identifying and fostering tactics to boost accountability and raise the standard of healthcare. The main objective of the present paper is to measure the level of customers' perception of accountability of healthcare diagnostic service providers and to identify the factors that influence the perception of accountability of healthcare diagnostic service customers. Methods: A questionnaire survey was used to collect data from 393 customers of various diagnostic centers in the city of Guwahati from the state of Assam in India. The reliability of the data was tested using Cronbach's Alpha. Statistical tests were used for the mean, percentage, standard deviation, etc. Factor analysis was performed to find out the factors affecting customers' perception of accountability. Results: It was found that the overall level of perception of the customers with respect to the accountability of diagnostic centers in Guwahati is of high level. The study reveals four variables that affect how customers perceive the accountability of diagnostic service providers. These are Competency, Responsiveness, Compliance with protocol, and Problem-solving approach. Discussion: Significant contributions have been made by the present study in terms of the development of a scale to measure customers' perception of accountability of diagnostic centre, and the development of a theoretical model to explain this accountability.

Examining the key determinants of the jordanian customer's adoption of genetically modified food.

Genetically modified food (GMF) is one of the most debated issues in the food market. There has been considerable interest from both academic researchers and policy makers regarding the antecedents and consequences of the commercial adoption of GMF applications. Conceptually, GMF can be defined as "Genetically modified (hereafter GM) foods are produced from genetically modified seeds or ingredients derived from plants or animals whose DNA has been manipulated using genetic engineering methods" [1, p. 2861]. However, only a limited number of studies have tested the related issues of GMF products from a customer perspective. Thus, this project intends to discover and examine the main drivers and hindrances in predicting customers' intention and buying decision behaviour in developing Arabian countries (i.e., Jordan). A diffusion of innovations (DOIs) model was selected as the theoretical basis for the current study project. A field survey study was conducted to collect the requested quantitative data from a convenience sample of Jordanian customers. Statistical results largely supported the role of relative advantage, compatibility, trialability, social approval, awareness, perceived risk and price value on the behavioural intention to adopt GMF products, which in turn significantly predicted actual adoption behaviour. The results of the current project will hopefully expand the current academic understanding of the main factors that predict Jordanian customers' perception and adoption of GMF products.

The nexus between quality of customer relationship management systems and customers' satisfaction: Evidence from online customers' reviews.

Customer Relationship Management (CRM) is a method of management that aims to establish, develop, and improve relationships with targeted customers in order to maximize corporate profitability and customer value. There have been many CRM systems in the market. These systems are developed based on the combination of business requirements, customer needs, and industry best practices. The impact of CRM systems on the customers' satisfaction and competitive advantages as well as tangible and intangible benefits are widely investigated in the previous studies. However, there is a lack of studies to assess the quality dimensions of these systems to meet an organization's CRM strategy. This study aims to investigate customers' satisfaction with CRM systems through online reviews. We collected 5172 online customers' reviews from 8 CRM systems in the Google play store platform. The satisfaction factors were extracted using Latent Dirichlet Allocation (LDA) and grouped into three dimensions; information quality, system quality, and service quality. Data segmentation is performed using Learning Vector Quantization (LVQ). In addition, feature selection is performed by the entropy-weight approach. We then used the Adaptive Neuro Fuzzy Inference System (ANFIS), the hybrid of fuzzy logic and neural networks, to assess the relationship between these dimensions and customer satisfaction. The results are discussed and research implications are provided.

Using science as a differentiator in a crowded digital mental health market.

The digital mental health industry has seen remarkable growth in recent years. However, within this crowded landscape, many companies overlook a critical factor for gaining a competitive edge: the integration of science. In this context, "science" refers to the strategic collection and analysis of information (i.e., data) at digital mental health companies, aimed at guiding business decisions and achieving business objectives. This paper demonstrates that science is integral, yet underutilized in the digital mental health industry, with common misconceptions about its role. When science is integrated within a company, it enables them to (1) innovate, (2) understand customers, (3) make informed decisions, and (4) drive revenue. Digital mental health companies recognizing the multifaceted value of science may be better equipped for sustainable growth and success amid the crowded digital health market.

The role of customers' awareness towards the sustainable development goals (SDGs) of banks on their behavior.

Banks and sustainable development have lately gone hand in hand. Of late, banks have focused on sustainable management in order to improve their environmental footprint, to eliminate financial risks, to promote social issues, and to exploit new opportunities. The sustainable development management of organizations attracts new customers over and above conventional institutions thus leading to greater market share and increased revenues. This paper aims to examine if and how sustainable development goals (SDGs) adopted by banking institutions play a role in customers' decisions and behavior. The way that banks, SDGs, and sustainable image affect customer behavior, attitudes, trust, loyalty, satisfaction, and perceived fair pricing policy is assessed. To this end, 1084 questionnaires were collected and the PLS-SEM method was utilized. The findings show a positive relationship between the stance of banks relating to SDGs and customer trust, loyalty, and perceived fair pricing policy. Finally, the SDGs adopted by banks are an important strategic tool which strengthens relationship with their customers.

Dataset for a Norwegian medium and low voltage power distribution system with industrial loads.

This article presents a dataset for a Norwegian industrial medium voltage (MV) and low voltage (LV) electric power distribution grid with load time series. The raw dataset was collected in collaboration with the Norwegian distribution grid company (DSO) Norgesnett as part of a pilot project in the Norwegian research centre CINELDI and was later anonymized and simplified into a secondary dataset, presented here. The load dataset comprises over three years of measurements of hourly load demand from 45 grid customers in the time period 2019-03-01 to 2022-03-16, collected from smart meters installed with the customers. The grid data comprises 2 radials of the distribution grid, collected from the network information system of the DSO. The data was anonymized and simplified. The dataset can be used for stochastic load modelling, analysing the grid's need for flexibility and power flow analyses for grid planning purposes.