Dimensions Of Access Research Articles

Barriers to financial access of disabled people to health services in rural areas: A case study of Iran.

People with disabilities (PWDs) account for a significant percentage of the world's population, with a higher prevalence in less developed countries. Access to healthcare services is the main component of health systems performance, with lower access for PWDs living in rural areas. The current study aimed to investigate PWD's access to healthcare services in rural areas of Iran and, secondly, factors that contribute to this issue. Following a cross-sectional design, the current descriptive-analytical study is performed in the north of Iran. Using the quota sampling technique, 471 PWDs were recruited. Data were collected using a valid and reliable questionnaire, covering three dimensions of access, by face-to-face interview. Data analysis was administered using central tendency indicators and multiple regression by SPSS version 17. Statistical significance was considered when the P value <0.05. The mean score of PWD's access to healthcare services for dimensions of utilization, availability, and affordability was 8.91 (±6.86), 14.54 (±2.3), and 51.91 (±8.78), indicating very low, low, and moderate levels of access. All three regression models were significant (P < 0.05), and variables of gender, age, marital status, education level, residence status, the income of the household head, receiving financial aid, and house area showed a significant effect (P < 0.05). This study demonstrated the seriousness of paying attention to PWD's financial access to healthcare services, particularly in rural areas of Iran. Hence, policymakers should better focus on this problem, mainly regarding accessibility and utilization and factors that result in inequalities.

Policy-reality gaps in Africa’s walking cities: Contextualizing institutional perspectives and residents’ lived experiences in Accra

ABSTRACT This paper confronts the current policy landscape and lived experiences of walking in African cities through the lens of policies, plans, institutional, and residents’ narratives. The paper builds on qualitative evidence drawn from content analysis and semi-structured interviews with local-level stakeholders across policy sectors concerned directly or indirectly with walking and walkability in the city. Perspectives from local government institutions are first reviewed to ascertain considerations for accessibility, safety, and pleasurability dimensions of walking and, second, contrasted with the lived walking experiences of residents of low-income settlements in Accra. Results indicate limited attention to pleasurability dimensions in both policy and municipal plans and significant incongruities with residents’ lived realities of walking. This parallel between the frameworks and plans underpinning the construction of the walking environment and the lived experiences of those affected by such decisions seeks to nuance debates about policy-reality (dis)junctures in African urbanism.

THE EXPANDED DIGITAL MEDIA EMPOWERMENT ON SECONDARY EDUCATIONAL SETTING

Background: Digital media empowerment by ensuring equitable access to digital technologies and safeguarding against digital divide issues. Legal measures also ensure that digital platforms are not misused for spreading misinformation or engaging in unlawful activities. This study expanded the digital media empowerment construct for Jakarta's senior high school students to eight dimensions, blending awareness, motivation, technical access, empowerment, and gratification dimension with three dimensions of social contract utilitarianism, egalitarianism, and real equality of opportunity.&#x0D; &#x0D; Method: This study applied an explanatory quantitative approach and conducted a survey. Six hundred respondents were online surveyed and analyzed to confirm the integration of eight dimensions of digital media empowerment. Eight dimensions were validated by Person’s correlation of validity and assessed by Cronbach’s Alpha of reliability. The integrated dimension was tested as a hypothesis by Confirmatory Factor Analysis by showing the value of Kaiser-Meyer-Olkin Measure of Sampling and Barlett’s Test of Sphericity.&#x0D; &#x0D; Results: The result of validity, reliability, and confirmatory factor analysis proved the integration of eight dimensions of digital media empowerment. The results highlighted a significant correlation among all eight dimensions with the digital media empowerment construct. The gratifications dimension is the most dominant dimension of digital media empowerment from students’ perspectives on digital technology usage.&#x0D; &#x0D; Conclusion: The integration offers a more holistic understanding of justice distribution in the secondary educational setting. It underscores the importance of considering both technological and ethical-social factors in shaping students' digital experiences and competencies, paving the way for more targeted and sustainable educational development in the digital era.

Strategies for Accessible Breast Screening for People With Intellectual Disability.

People with intellectual disability are less likely to participate in breast screening than people without intellectual disability. They experience a range of barriers to accessing breast screening, however, there is no consensus on strategies to overcome these barriers. Our objective was to reach consensus on the strategies required for accessible breast screening for people with intellectual disability. Fourteen experts participated in a modified on-line Delphi that used Levesque's model of health care access as the theoretical framework. At the end of each round descriptive and thematic analyses were completed. Data was then triangulated to determine if consensus was reached. After 3 rounds, 9 strategies were modified, 24 strategies were added and consensus was reached for 52 strategies across the 5 dimensions of access. Key areas of action related to (i) decision making and consent, (ii) accessible information, (iii) engagement of peer mentors, (iv) service navigators, and (v) equipping key stakeholders. The resulting strategies are the first to articulate how to make breast screening accessible and can be used to inform health policy and quality improvement practices.

Measuring public transport accessibility to fixed activities and discretionary opportunities: a space–time approach

The Space–Time Accessibility (STA) model is broadly used to measure person-based accessibility based on the space, time, and transport constraints experienced at the individual level in connection to the actual modal choices of observed individuals. In this paper, we propose to adjust the STA model (by introducing a so-called PT-STA model) with three core purposes: (1) focusing on public transport accessibility specifically, (2) measuring accessibility to both fixed activities and discretionary opportunities, and (3) integrating travel-time thresholds in the accessibility measurement. These three elements aim to make the PT-STA model a suitable tool to evaluate the impacts of public transport interventions on person-based accessibility and extend the evaluation of public transport accessibility to its fixed and discretionary dimensions. The PT-STA model is tested with a sample of 118 residents of the rural municipality of Mühlwald (South Tyrol, Italy). Results show that the accessibility to fixed activities and discretionary opportunities are limitedly correlated. It is possible to identify people with high accessibility to fixed activities and poor access to discretionary opportunities (typically pensioners and homemakers living in remote locations) and vice versa (e.g. people with articulated rural–urban commutes but daily visiting locations with several amenities). These results preliminarily confirm the importance of combining both accessibility dimensions in the PT-STA model since they tell complementary and not overlapped stories that are relevant for policymakers to evaluate the pros and cons of alternative public transport interventions.

Dimensions of Accessibility and Use of Information Communication Technology Among Cocoa Farmers in Atwima Mponua District, Ghana

This research examined the drivers of accessibility and use of information communication technologies (ICTs) by cocoa farmers. A sample size of four hundred (400) cocoa farmers was selected using a multi-stage random sampling procedure. Data were analysed using percentage, means, standard deviation, Kendall’s coefficient of concordance and multiple linear regression model. The study revealed that mobile phones, radio and television are the most available (=4.99, 4.95 and 4.85 respectively), accessible (=4.97, 4.83 and 4.40 respectively) and utilised (=4.97, 4.81 and 4.30 respectively) ICT tools by cocoa farmers. There is a relatively high level of availability of ICT (=3.57), a moderate level of accessibility (=2.90) and low use (=2.19) of ICT tools. Cocoa farmers mainly used ICT tools to acquire information on their cocoa farm activities (=4.82). Gender, age, education and farmer-based organisation participation affected farmers' accessibility of ICT tools. Age, education and farm experience significantly affected farmers’ use of ICT tools. The greatest challenge faced by cocoa farmers in accessing and using ICT tools is a lack of skills in operating the tools ( rank=2.24). Training on ICT use should be intensified by all relevant stakeholders to enable cocoa farmers to increase their use of ICT tools.&#x0D;

Food Access After Disasters

Problem, research strategy, and findings Access after disasters to resources such as food poses planning problems that affect millions of people each year. Understanding how disasters disrupt and alter food access during the initial steps of the recovery process provides new evidence to inform both food system and disaster planning. Our research took a supply-side focus and explored the results from a survey of food retailers after Hurricane Harvey in three Texas counties. The survey collected information on how the disaster affected a store’s property, people, and products and the length of time a store was closed, had reduced hours, and stopped selling fresh food items. We found that a focus only on store closures and property damage would underestimate the number of days residents had limited fresh food access by nearly 2 weeks. Further, stores in lower-income communities with chronically low access to supermarkets (food deserts) were closed longer than other stores, potentially compounding pre-existing inequalities. To plan for a more equitable food supply after a disaster, planners should embrace more dimensions of access, encourage retailer mitigation, and assess the types of retailers and their distribution within their communities. Takeaway for practice Practicing planners aspire to ensure equitable access to resources (e.g., food, education, and health care). In the context of food access, planners should consider that a) common proximity-based measures of accessibility (e.g., food deserts) may underestimate inequality and that the inclusion of multiple dimensions of access may provide a more accurate picture, b) efforts to encourage business resilience can complement food systems planning, and c) targeted engagement with local food retailers, food suppliers, and food aid agencies is important for both day-to-day community needs and for disaster planning.

Women's status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling.

Skilled birth attendants (SBA) facilitate identifying and overcoming labor problems and saving lives. With one of the highest maternal death rates in the Asia-Pacific area, SBA utilization during childbirth among Papua New Guinea (PNG) women remains low. Women's status and empowerment are important factors in maternal and child health services and critical to maternal and child health development. This study is intended to apply structural equation modeling based on data from the Demographic and Health Survey (DHS) to evaluate the causal relationship between women's status, empowerment, and SBA utilization in PNG and the mechanisms of their influence. This study employed data from the 2016-2018 Papua New Guinea Demographic Health Survey (PNG DHS), which recruited 18,175 women aged 15-49 years. A multi-stage sample and a structured questionnaire were used to collect information on maternal health, women's empowerment, and related topics. STATA 17.0 was used to describe the data, while MPLUS 8.2 was employed for structural equation modeling and pathway analysis. The two empowerment dimensions of household decision-making (standardized path coefficient, β = 0.049, p < 0.05) and access to health services (β = 0.069, p < 0.01) were positively associated with SBA utilization, while the association between attitudes toward partner violence and SBA utilization was not statistically significant. In addition, mediation analysis revealed that education indirectly influenced SBA utilization through access to health services (β = 0.011, 95% CI: 0.002, 0.022). The findings confirmed the direct and indirect effects of women's status and empowerment on SBA utilization in PNG. Therefore, a call for further evidence-based interventions in PNG and possibly Pacific Small Island Developing States (PSIDS) is needed to improve women's educational attainment, household decision-making, and access to health services to enhance maternal and newborn health and well-being.

Negotiating dignity and social justice in community food access spaces

PurposeThis study aims to explore how key stakeholders and recipients of local food access programs operate strategically to meet individual and community food needs, enhance experiences of dignity and promote social justice. The study of a fragmented community food system highlights the connections between micro and meso dimensions of food access, illustrating how people work around food system limitations to access food.Design/methodology/approachUsing qualitative in-depth interviews with food assistance managers, workers, volunteers and recipients, this study examines the period before the implementation of a centralized community-based food access initiative in a mid-sized, rural Oklahoma college town with a high rate of food insecurity. This study asks: What are community members’ experiences in a fragmented food assistance system? In what ways do individuals use everyday resistance and workarounds to actively promote experiences of dignity and social justice in food access spaces?FindingsThose involved in sites of community food access build important networks to share information and engage in negotiation and trade to gain access to useful food resources. As forms of everyday resistance, such practices encourage co-construction of dignity and social justice in stigmatized spaces.Originality/valueThis research contributes to literature examining micro- and meso-level community dynamics that inform agency, dignity and social justice in community food access approaches.

An investigation of data from the first year of the interim Canada Dental Benefit for children

In 2022, the federal government announced a commitment of $5.3B to provide dental care for the uninsured, beginning with children <12 years of age. Now referred to as the Interim Canada Dental Benefit (CDB), the program targets those <12 years of age from families with annual incomes <$90,000 without private dental insurance. The purpose of this study was to review federal data from the Government of Canada on public uptake and applications made to the Canada Revenue Agency (CRA) during the first year of the Interim CDB. Data for the first year of the Interim CDB (up to June 30, 2023) were accessed from the Government of Canada Open Data Portal through Open Government Licence-Canada. Rates of children receiving the Interim CDB per 1,000 were calculated by dividing the number of beneficiaries by the total number of children 0-11 years by province or territory, available from Statistics Canada for the year 2021. During the first year of the program, a total of 204,270 applications were approved, which were made by 188,510 unique applicants for 321,000 children <12 years of age. Over $197M was distributed by the CRA. Overall, the national rate for receiving the Interim CDB was 67.8/1,000 children. Ontario (82.5/1,000), Manitoba (77.1/1,000), Nova Scotia (73.4/1,000), and Saskatchewan (72.3%), all had rates of children with the Interim CDB above the national rate. Data from the first year of the Interim CDB suggests that this federal funding is increasing access to care for children <12 years by addressing the affordability of dental care. Governments and the oral health professions need to address other dimensions of access to care including accessibility, availability, accommodation, awareness, and acceptability of oral health care.

Supporting Inuit food sovereignty through collaborative research of an at-risk caribou herd

IntroductionClimate change is increasing vulnerability to food insecurity and biodiversity loss for many Indigenous Peoples globally. For Inuit, food sovereignty is one expression of Indigenous self-determination, and it includes the right of all Inuit to define their own conservation policies. Caribou conservation is particularly pertinent because of the central role caribou play in Inuit food systems. The “Dolphin and Union” (DU) caribou herd is a critical component of Inuit food systems in the Canadian Arctic and has declined by 89% in 2020 (3,815) from the peak measured by aerial survey in 1997 (34,558).MethodsOur first objective was to identify insights about this herd from and with Inuit Qaujimajatuqangit (knowledge). Using thematic analysis, we created a collective account on the DU caribou herd through a research partnership among Indigenous knowledge keepers, government, and academia. Our second objective was to put our findings into the broader literature on the DU caribou herd and connect isolated data on their abundance and distribution.ResultsWe found understanding Inuit knowledge of caribou meant situating harvesters’ knowledge within their family history, harvesting methods, conservation ethics, and in relation to other harvesters. Through this framework, we conceptualized Inuit-described metrics of caribou status, resulting in three sub-themes of caribou trends over time – their abundance, distribution, and health, − and ending with conservation concerns and potential actions. The synthesized data indicated that the overall population size increased since ~1990s and then decreased after ~2000s alongside a range contraction. Our results add value to co-management literature by (1) articulating Inuit-described metrics of a population decline that inform continued monitoring and incorporation of these metrics into management planning and (2) synthesizing data from various studies on the DU caribou herd abundance and distribution that assists management to make informed conservation decisions based on Inuit and Western knowledge.DiscussionResults from this research contribute to understanding the six dimensions of environmental health, i.e., availability, stability, accessibility, health and wellness, Inuit culture, and decision-making power and management relating to caribou. The results contribute information that is used by to support environmental health, i.e., knowledge systems, policy, and co-management relating to caribou. Thus, this collaborative research study supports the expression of Inuit food sovereignty through caribou conservation.

Psychosocial dimensions of access and their association with contraceptive use and intention to use.

Several studies suggest that psychosocial accessibility appears to be the key remaining hurdle to contraceptive use when issues of geographic and financial accessibility have been resolved. To date, the literature has considered various dimensions of psychosocial accessibility, which are not well measured by the two main sources of contraceptive data (DHS and PMA2020). In a previous paper, we have designed a framework that outlines four subdimensions of cognitive and psychosocial access and their theoretical relationship to contraceptive use and intention to use. This paper aims to study the associations between the four dimensions of access to contraception with the contraceptive use and intention to use. It also aims to explore the mediation effect of these four dimensions of access in the relationships between classical individual characteristics and contraceptive use and intention to use. The data we used came from the 6th round of the PMA2020 survey in Burkina Faso in 2018-19. This survey included 2,763 households (98.4% response rate) and 3329 women (97.7% response rate). In addition to PMA's core questions, this survey collected data on psychosocial accessibility. Each group of questions was added to address one dimension. We use a multilevel generalized structural equation and mediation modeling to test the associations between psychosocial accessibility and contraceptive use while controlling for some individual and contextual characteristics. Approval, contraceptive knowledge, and agency were associated with contraceptive use, while fears of side effects were not. Approval and agency explain part of the effects of education and parity on contraceptive use. Exposure to family planning messages had a positive impact on women's contraceptive agency. FP messages can help enhance women's contraceptive agency, and then, contraceptive use, regardless of age and parity. The analysis highlights the mediator effects of contraceptive approval and agency on the association between parity and education with contraceptive use.

Clinical comprehensive evaluation of Houyanqing Oral Liquid in treatment of acute pharyngitis

This study systematically combed the existing evidence of Houyanqing Oral Liquid in the treatment of acute pharyngitis from the &quot;6+1&quot; dimensions of safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine(TCM) and carried out qualitative and quantitative analysis of the data from each dimension. The multi-criteria decision analysis(MCDA) model and CSC v2.0 were used to evaluate the clinical value of this drug, so as to provide evidence for the selection of essential drugs in the department of otolaryngology and for medical and health decision-making. The dimensions are graded A, B, C, or D. The adverse reactions of Houyanqing Oral Liquid in the treatment of acute pharyngitis were mainly manifested as abdominal pain, diarrhea, rash, etc., which were relieved after drug withdrawal. In terms of safety, it was considered that Houyanqing Oral Liquid had controllable risk and high safety, which was rated as grade B. Compared with ribavirin aerosol alone, Houyanqing Oral Liquid combined with ribavirin aerosol can significantly improve the total response rate, shorten the time to abatement of fever and di-sappearance of throat pain and mucosal congestion, and alleviate mucosal congestion and cough with sputum. With medium-quality evidence, the effectiveness was rated as grade B. Compared with ribavirin aerosol alone, Houyanqing Oral Liquid combined with ribavirin aerosol had cost-effectiveness advantages in the treatment of acute pharyngitis, and its economy was rated as grade C with the evidence of general quality. For acute pharyngitis, Houyanqing Oral Liquid can shorten the disease course and obviously relieve sore throat. Moreover, it can be used for the treatment of radioactive pharyngitis and oral ulcer, and thus its innovation was rated as grade B. With convenient and simple administration and standard and complete drug information, the suitability of this drug was rated as grade B. Houyanqing Oral Liquid is derived from the folk prescription in Hunan province and has been subjected to real-world studies, and thus the TCM characteristics was rated as grade B. According to the ratings of all the dimensions, the comprehensive value of Houyanqing Oral Liquid in the clinical treatment of acute pharyngitis was determined as grade B, with sufficient evidence and clear results. It is suggested that the results should be conditionally converted into relevant policy of clinical basic drug management according to procedures.

Analysis of the effect of climate-smart agricultural practices (CSAPs) on food security of maize production in Southeast, Nigeria

This study examines the effect of Climate-Smart Agricultural Practices (CSAPs) on the food security dimensions of availability, accessibility, affordability, stability, and usability of maize production in Southeast Nigeria. A multi-stage random sampling method was adopted to select 375 farmers. Censored and OLS regression analyses were conducted using R software to analyze the data. Results indicate that certain CSAPs significantly influence the availability and accessibility dimensions of food security. Water management, residue management, mulching, crop rotation, adopting early planting, and obtaining credit were associated with higher levels of availability and accessibility, while practices like minimum tillage and improving access to information were associated with lower levels. Practices such as water management, minimum tillage, and adopting early planting positively influence affordability and stability. Furthermore, the study explores the influence of constraints on the practice of CSA in Southeast Nigeria. Farmers’ illiteracy (50.6)***, high production costs (4.00)***, lack of equipment and inputs, limited awareness of CSA practices (5.24)***, and resistance to change (13.70)*** were identified as key constraints. However, the study recommends that promoting awareness and incentivizing sustainable agricultural practices can encourage farmers to overcome resistance to change and embrace CSA initiatives, thus enhancing food security and economic development in Southeast Nigeria.

SDG-16 and Access to Justice for Marginalized Dalit: A Study of Patepur Village of Ghazipur District of Uttar Pradesh

SDG-16, one of the 17 Sustainable Development Goals set by the United Nations in 2015, aims to promote peaceful and inclusive societies, ensure access to justice for everyone, and establish effective, accountable, and inclusive institutions at all levels. Within SDG-16, the third target specifically addresses the importance of equal access to justice. Access to justice is an important legal right in any democratic society. It ensures that everyone is treated fairly and equally under the law. This essential entitlement plays a crucial role in upholding justice principles and creating an environment where legal solutions are fair for all. It’s a cornerstone in protecting individual freedom and rights, emphasizing that legal protections should be available to everyone, regardless of their background or status in society. However, this right remains elusive for a significant portion of the population – the Dalit communities, often characterized by untouchables, socially marginalized and downtrodden. This study delves into the nuanced dimensions of justice accessibility for marginalized Dalit communities, with a specific focus on Patepur village situated in Ghazipur district of Uttar Pradesh. This research paper aims to evaluate the current state of justice accessibility for Dalit individuals and pinpoints the major barriers impeding their access to justice. One of the most fundamental challenges is the limited awareness of legal rights. They are often unaware of their rights and the available legal remedies, leaving them at a significant disadvantage when faced with legal issues. This lack of awareness further exacerbates their vulnerability and perpetuates a cycle of injustice. Socioeconomic barriers are equally daunting. Economic constraints and the associated difficulties in affording legal representation often leave these communities without recourse when confronted with legal problems. These barriers effectively deny them access to the justice they are entitled to. Furthermore, the inadequacy of legal infrastructure in marginalized areas compounds the issue. Often, individuals from Dalit communities are forced to travel long distances to access legal services, incurring additional expenses and hardships. Disparities in legal representation are yet another major obstacle. The study employs a mixed-methods approach, incorporating semi-structured interviews, and secondary resources such as Government reports, media reports, and relevant legal and research documents. By applying these sources, the research seeks to provide a comprehensive understanding of the multifaceted challenges that marginalized Dalits of this area face in their pursuit of justice. The key findings of this study are expected to highlight several critical aspects, including the limited awareness of legal rights among Dalit communities, the influence of socio-economic barriers, inadequate infrastructure, and disparities in legal representation.

Comprehensive evaluation of multi-scale elderly care service facilities under the orientation of urban renewal: A case study of Qingdao downtown area

As Qingdao entered into the stage of aging society, the issue of spatial configuration’s mismatch and imbalance between supply and demand of elderly care service facilities is becoming more outstanding at this stage. This study takes urban renewal as the guide, obtains Point of Interest (POI) data through the Gaode Map, and constructs a multi-scale (district and street scales) comprehensive evaluation model of institutional elderly care service facilities and home-based community elderly care service facilities in Qingdao’s downtown area based on the three dimensions of efficiency, equity, and accessibility. Based on the district scale, the spatial configuration shows good status in Shibei District and Shinan District, average status in Laoshan District and Licang District, and bad status in Chengyang District and Huangdao District. Based on the street scale, 54.69% of streets have achieved a high comprehensive evaluation of institutional elderly care service facilities, 21.87% have reached the average, and 23.44% have had a low. Some institutional elderly care service facilities are in strong need of being newly constructed or reconstructed. Similarly, the comprehensive evaluation of home-based community elderly care service facilities also varies among all counted streets. In some streets, there are even no home-based community elderly care service facilities. Finally, according to the comprehensive evaluation results, the streets are respectively classified as the areas of quality optimization, the areas of quality improvement, and the areas of inadequate supplement, aiming to provide some references on the balanced configuration and the planning of elderly care service facilities

Assessing performance and satisfaction of micro-mobility in smart cities for sustainable clean energy transportation using novel APPRESAL method

South Korea signed the Global Methane Pledge to reduce methane emissions by 30% by 2030, updated its Nationally Determined Contribution (NDC) to target a 40% reduction in GHGs (Green House Gas) from 2018 levels by 2030. In addition, South Korea submitted its Long-Term Strategy (LTS) to achieve carbon neutrality by 2050. Nowadays, to mitigate the GHG emission every country explicitly planning to reduce non-renewable energy resource vehicles. The electric vehicle (EV) markets growing rapidly with various technologies, strategies and innovations to support decarbonization. In 2022, by the transportation CO2 (Carbon dioxide) emission report of International Energy Agency (IEA), the cars and vans contributes 48% in the over all CO2 emissions. Increasing the electric micro-mobility service would be one of the best effective approach in accordance to reduce CO2 emission. This research study support to reduce the GHG emission by increasing the clean energy vehicle. A case study conducted to analyze firm-wise e-scooter sharing service performance and its satisfaction in smart cities of South Korea. Lacking in the consistent good quality and performance affects the number of electric vehicle users. Hence, electric vehicle firm should focus into their product better performance and quality. This research supports to analyze the e-scooter based on the various criteria from the user’s perspective. This research study helps to firms to identify their lacking criteria and improve their quality and performance. We considered the performance, accessibility, tangibility, reliability and responsiveness factors which affects user’s perspective in e-scooter sharing services. A survey was conducted over sixty user’s for different e-scooter services with twenty four factors. Generally, MCDM (Multi-Criteria Decision-Making) techniques holds two phases to determine the weight of the criteria and another phase to ranking the alternatives. The existing MCDM techniques lacks to handle the user’ satisfaction index analysis and not considering the influence grade of each factors in the analysis. To overcome this draw back and analyze the micro-mobility services based over the user’s point of view, we introduced a novel fuzzy based MCDM method name as Approach for Preference, Performance and Ranking Evaluation with SAtisfaction Level (APPRESAL) approach. The findings show that Lime, a micro-mobility firm, outperformed other firms with high-quality service and user satisfaction, followed by Wind, XingXing, Alpaca, and Beam. The influences of defected factors from the accessibility, reliability, responsiveness, and assurance dimensions had an adverse effect on quality of firm’s micro-mobility service with unsatisfactory performance.

The potential of accessible tourism for sustainable development of local communities in northern Pakistan

PURPOSE: Accessible tourism holds significant importance for local communities as it is a cornerstone for fostering inclusivity and equal participation in the tourism industry. Recognizing the growing global emphasis on inclusivity, especially for individuals with diverse needs, this research aims to explore the multifaceted impacts of accessible tourism on the sustainable development of local communities in the northern areas of Pakistan. Additionally, the study assesses the moderating role of destination image between accessible tourism dimensions and the sustainable development of local communities. Given that destinations heavily rely on tourism to fulfill their socio-economic needs, it becomes imperative to evaluate the potential transformative impact of accessible tourism on their sustainable development. METHODOLOGY: A self-administered survey was completed using a two-stage sampling approach with 321 tourists and 321 local residents from five tourist destinations in northern Pakistan. Subsequently, the collected data were analyzed using Structural Equation Modeling (SEM) to test the proposed hypotheses. FINDINGS: The results show the significance of all four dimensions of accessible tourism (accessible core resources and attractors, accessible supporting factors and resources, accessible qualifying and amplifying determinants, and destination planning and management) in the sustainable development of local communities. The moderation assessment further confirms that destination image strengthens the relationship between accessible core resources and attractors, contributing to the sustainable development of local communities. However, destination image was found to have a negative moderating effect between accessible qualifying and amplifying determinants and the sustainable development of local communities. IMPLICATIONS: Empirical findings offer fresh insights for destination planners and policymakers in the tourism industry. These insights pertain to the effective utilization of accessible tourism practices, which can significantly contribute to the sustainable development of destinations. Additionally, tourism businesses can leverage the research to attract a broader segment of tourists, increase profitability, and enhance tourist satisfaction by implementing accessible practices and services. Understanding the moderating role of destination image can further guide them in crafting responsible tourism narratives that resonate with diverse travelers. ORIGINALITY AND VALUE: The study marks an initial attempt to explain how destinations, particularly those heavily reliant on tourism, can strategically leverage accessible tourism as a crucial factor in fostering sustainable community development.

Provider Perspectives of Facilitators and Barriers to Reaching and Utilizing Chronic Pain Healthcare for Persons With Traumatic Brain Injury: A Qualitative NIDILRR and VA TBI Model Systems Collaborative Project.

To identify facilitators and barriers to reaching and utilizing chronic pain treatments for persons with traumatic brain injury (TBI) organized around an Access to Care framework, which includes dimensions of access to healthcare as a function of supply (ie, provider/system) and demand (ie, patient) factors for a specified patient population. Community. Clinicians (n = 63) with experience treating persons with TBI were interviewed between October 2020 and November 2021. Descriptive, qualitative study. Semistructured open-ended interview of chronic pain management for persons with TBI. Informed by the Access to Care framework, responses were coded by and categorized within the core domains (reaching care, utilizing care) and relevant subdimensions from the supply (affordability of providing care, quality, coordination/continuity, adequacy) and demand (ability to pay, adherence, empowerment, caregiver support) perspective. Themes from provider interviews focused on healthcare reaching and healthcare utilization resulted in 19 facilitators and 9 barriers reaching saturation. The most themes fell under the utilization core domain, with themes identified that impact the technical and interpersonal quality of care and care coordination/continuity. Accessibility and availability of specialty care and use of interdisciplinary team that permitted matching patients to treatments were leading thematic facilitators. The leading thematic barrier identified primarily by medical providers was cognitive disability, which is likely directly linked with other leading barriers including high rates of noncompliance and poor follow-up in health care. Medical and behavioral health complexity was also a leading barrier to care and potentially interrelated to other themes identified. This is the first evidence-based study to inform policy and planning for this complex population to improve access to high-quality chronic pain treatment. Further research is needed to gain a better understanding of the perspectives of individuals with TBI/caregivers to inform interventions to improve access to chronic pain treatment for persons with TBI.

Evaluating Urban Transportation Accessibility: A Systematic Review of Access Dimensions and Indicators

Evaluating Urban Transportation Accessibility: A Systematic Review of Access Dimensions and Indicators