Access Communication Research Articles

Enhancing Patient Satisfaction by Healthcare Service Providers: A Systematic Literature Review

Aims: The aim of this study is to identify the primary determinants and emerging trends that influence patient experiences patient experiences. Study Design: Through a systematic review of scholarly literature, an investigation examines the pivotal elements that drive patient satisfaction outcomes in innovative healthcare service delivery contexts. Place and Duration of Study: The study was conducted in healthcare service innovation. The duration of the study around six months by analyzing articles published between 2019 and 2023 in Scopus-indexed academic journals. Methodology: Following the PRISMA guidelines, this study analyzed 54 peer-reviewed articles to examine the relationship between service quality, communication, digital transformation, physical environment, waiting time, and healthcare accessibility on patient satisfaction. Results: The findings emphasize the increasing trend toward patient-centered care and the integration of technology to improve service delivery. These results underscore the importance of continuous service improvement and innovation in healthcare to meet patient expectations and enhance satisfaction. The study concludes that addressing these key factors is essential for healthcare providers to achieve higher patient loyalty, better health outcomes, and a competitive advantage. Future study should focus on further integrating digital solutions and patient-centered approaches to drive improvements in customer satisfaction in healthcare settings. Conclusion: The review indicates that service quality, characterized by reliability, responsiveness, and empathy, is the most significant determinant of customer satisfaction. Communication between healthcare providers and patients is also identified as a critical factor, with clear and empathetic interactions significantly enhancing patient trust and satisfaction. Digital transformation, including telemedicine and electronic health records, emerges as a key innovation in improving service efficiency, reducing waiting times, and expanding access to care. The physical environment and waiting times are also noted as important contributors to patient satisfaction, influencing their overall experience in healthcare facilities.

‘So much for the prattling of sages’: D&D gaming paratexts, Fan(nish) distribution of knowledge, and Drow

This article investigates gaming paratexts related to the popular tabletop roleplaying game Dungeons & Dragons (D&D) as heuristics. Gaming paratexts are accessible communication and media artifacts that influence what new players learn about games as cultural and ludic texts. In this work we examine ‘official' and ‘unofficial' gaming paratexts about drow, D&D’s dark elves. We highlight authorship, circulation, and accessibility as key impact factors, then identify common themes such as insider knowledge, transmission of expertise, and knowledge acquisition. This analysis reveals how – beyond information about the game itself – gaming paratexts can lead players to receive biased or incomplete impressions of issues with D&D, such as racism within the game system. We find that this specific form of online discourse about TTRPGs influences popular conceptions about D&D and often parallels forms of fannish practise through its affective connections, citational politics, and modal variety.

Supporting Human and Machine Co-Learning in Citizen Science: Lessons From Gravity Spy

We explore the bi-directional relationship between human and machine learning in citizen science. Theoretically, the study draws on the zone of proximal development (ZPD) concept, which allows us to describe AI augmentation of human learning, human augmentation of machine learning, and how tasks can be designed to facilitate co-learning. The study takes a design-science approach to explore the design, deployment, and evaluations of the Gravity Spy citizen science project. The findings highlight the challenges and opportunities of co-learning, where both humans and machines contribute to each other’s learning and capabilities. The study takes its point of departure in the literature on co-learning and develops a framework for designing projects where humans and machines mutually enhance each other’s learning. The research contributes to the existing literature by developing a dynamic approach to human-AI augmentation, by emphasizing that the ZPD supports ongoing learning for volunteers and keeps machine learning aligned with evolving data. The approach offers potential benefits for project scalability, participant engagement, and automation considerations while acknowledging the importance of tutorials, community access, and expert involvement in supporting learning.

Inovasi Pelayanan Publik Bupati Ngantor Di Desa (BUNG DESA) Kabupaten Labuhanbatu Utara

Difficult road access and long travel distances in several areas of Labuhanbatu Utara Regency have become the main obstacles for the community in obtaining public services. In response to this issue, the Head of the Labuhanbatu Utara District launched an integrated service innovation through the "Bupati Ngantor di Desa" program. (Bung Desa). This program focuses on providing public services in one location for one day to improve community accessibility to government services. This article aims to analyze the effectiveness of the Bung Desa program as an innovation in improving the quality of public services in Labuhan Batu Utara Regency. This research uses a literature study method that includes searching for scientific references through Google Scholar and news sources related to the Bung Desa program. Relevant articles are classified based on publication year, keywords, and journal content, while news is categorized according to source, relevance, and publication time. The research results show that the Bung Desa program adopts the principles of New Public Management (NPM) and has had a positive impact. This innovation not only improves service accessibility even to remote villages but also encourages community participation in development. The success of this program is influenced by several factors, such as the awareness and capability of the apparatus, implementation regulations, and the availability of facilities and infrastructure. However, improving road infrastructure remains a priority to support smooth accessibility. In addition, the publication of schedules and activities of the Bung Desa program through official media, such as the local government website, needs to be improved to expand the reach of information to the public

The Virtual Rural Generalist Service: a hybrid virtual model of care designed to improve health access and outcomes in rural and remote communities.

The Virtual Rural Generalist Service: a hybrid virtual model of care designed to improve health access and outcomes in rural and remote communities.

The quest for social justice through ICT access and inclusion for rural schools and communities: The South African case of Urglobal

Mobile technology has been recognized as a tool in reducing the inequality gap, especially for those in developing communities. With a Gini score of 63 in 2014, South Africa is regarded as one of the most unequal countries in the world. Furthermore, 86% of total wealth is controlled by 10% of the population with 7% of the wealth shared by 60% of the citizens. In 2017 Urglobal initiated a concept of driving technology training for rural schools and communities using mobility. In this paper we contribute to the debate by exploring the question of how providing access to technology for rural communities can lead to inclusion and social justice. Pre- and post-training surveys together with dialogue sessions were held with the pertinent respondents to explore this question. Empirical findings reflect that driving technology training on a mobile basis can be an entry point for rural communities in achieving social justice. The study is significant in that it provides a citizen-centred design for technology training and substantiates that mobility does ensure societal access regardless of geography. The study contributes to the body of knowledge by providing proof of concept that can be used for the integration of technology into rural schools and communities.

Digital Divide Factors for User Engagement

This study examines the digital divide in older adults in a minority-majority urban community. Grounded in resources and appropriation theory, this study predicts that categorical disparities in society produce an unequal distribution of resources and that an unequal distribution of resources leads to unequal Internet use. To investigate the relationships in an older adult sample, personal (ethnicity and gender), positional factors (income, education, employment, and retirement), and appropriation factors (attitude, access, skills, and usage) were included in analyzing data from a community where minority ethnic groups are the majority. Data was collected from older adults in an urban area in the Southern United States. Hispanics' Internet skill levels were higher than the other ethnicities. More positive attitudes, access, skills, and usage were found in wealthier residential locations, higher income, and higher education. The results also underscored the crucial role of attitudinal factors in improving material access, Internet skills, and usage in the minority-majority community.

ACCESSIBLE TRANSPORTATION – UNIVERSAL OR INCLUSIVE DESIGN?

The accessibility of public utility buildings, including transportation infrastructure, especially railways, is a prerequisite for the independent functioning of individuals with diverse needs. Despite the enactment of the law in 2019 and its enforcement since September 2021, both architectural and digital accessibility, as well as information and communication accessibility, often fail to meet its requirements. Ensuring accessibility is undoubtedly a long-term process. It is easiest to achieve by designing new facilities in accordance with universal design principles, and somewhat more challenging when modernizing existing ones. Transportation, and therefore railway infrastructure, such as stations, terminals, and platforms, plays a crucial role in social life. This article presents various design strategies, with a particular emphasis on universal and inclusive design. It highlights the differences and similarities and demonstrates the validity of their application to ensure transport accessibility. General requirements for railway infrastructure accessibility are formulated, while detailed requirements specific to these types of facilities are incorporated into the developed accessibility assessment method, which has been implemented in a selected example of existing infrastructure. The article also presents the results of surveys on the accessibility of railway transportation for people with disabilities, confirming the need for auditing railway infrastructure. The results obtained allowed for the identification of the most common barriers that hinder individuals with diverse needs from using railway transportation freely.

Strategi Inovasi Produk Keuangan Syariah untuk Meningkatkan Inklusi Finansial

This study aims to analyze strategies for product innovation in Islamic finance to enhance financial inclusion, a significant challenge in countries with large Muslim populations such as Indonesia. The research employs a qualitative approach, utilizing data from various literature sources, including academic journal articles, reports from Islamic financial institutions, and government regulations. The findings reveal that Islamic financial product innovation can be categorized into new product development, digital technology adoption, improvement of Islamic financial literacy, and cross-sectoral collaboration. Products such as microfinance based on Sharia contracts, digital waqf savings, and technology-driven Takaful insurance exemplify innovations aligned with modern societal needs. Additionally, Islamic fintech platforms have expanded financial access for remote communities, despite challenges such as low digital literacy and limited infrastructure. Islamic financial literacy emerges as a crucial element influencing public trust and participation in formal financial systems. In practice, cross-sector collaboration among Islamic financial institutions, governments, and the technology sector serves as a strategic approach to address regulatory barriers, competition with conventional sectors, and inconsistent global standards. This study recommends strengthening regulations, enhancing financial literacy, developing inclusive digital technologies, and fostering international cooperation to support the sustainable growth of the Islamic finance sector. With integrated strategies, Islamic finance holds significant potential not only to improve financial inclusion but also to create a fairer, more inclusive financial system that aligns with Islamic values in the modern era.

Advancements in Arabic Sign Language Recognition: A Method based on Deep Learning to Improve Communication Access

This research anticipates the issue of real-time sign language recognition as a means of facilitating the daily communication of the hearing-impaired persons. Improvement in the rate of real time sign language recognition will help in boosting interaction in the society and access to services for the hearing-impaired persons. This paper outlines a step-by-step guide on fine tuning an object detection model for the AASL using the SSD architecture. The AASL dataset which includes total of 7,857 samples of more than 200 patients are first preprocessed where the images are scaled, normalized, and augmented. In SSD model, the base of the network is the VGG16 network and few extra layers for feature extraction and for auxiliary and prediction of objects are added. Particularly in object detection, Intersection over Union (IoU), and mean Average Precision (mAP) are used in addition to the confusion matrix metrics comprising accuracy, precision, recall, and F1-score. The proposed model provides good recognition accuracy of 98 percent. This feature checks its capability of real-time identification of sign languages and shows 25% efficiency. The efficiency of the proposed method is explained when comparing the results of the modified VGG16-based SSD with other methodologies. As for the improvement of communication for the hearing-impaired individuals, the present work demonstrates that the deep learning methods can be significantly effective; however, suggesting that more research efforts should be directed to real-time solutions and that the datasets should be expanded.

Sign Speak

The project is to enable people who are not versedin sign language or people from the deaf or hard- of-hearing community to communicate by using a system that translates their American Sign Language (ASL) gestures into text, which could then be converted into speech. Computer vision and machine learning algorithms allow the system to “read” the sign language as accurately as possible, and then translate into a native text. Text is transcribed to speech using Text-to-Speech (TTS) capabilities The proposed calibration can be applied to real-time applications serving purpose for accessible and decent spoken communication among different individuals with hearing loss which applies the natural co-articulation constraints in various social or professional environments.

Unlocking the potential of social media on food additives for effective science communication

Ultra-processed foods dominate modern diets, often containing numerous additives to enhance flavor, texture, and shelf life. Concerns about the potential health risks of daily or excessive consumption have sparked online discussions. This study analyzed perceptions of food additives on Zhihu, a popular Chinese social platform. The findings revealed no significant difference in attitudes between experts and non-experts (p > 0.05), with experts relying on statistical data and non-experts drawing from personal experiences. An independent t-test indicated no significance in comment engagement (p > 0.05) among them. However, a chi-square test showed that experts were significantly more interactive, frequently replying directly to original posts and commenters (p < 0.05). This suggests that experts actively facilitate discussions, moving away from reliance on influencers and instead prioritizing high-quality, accessible scientific communication. The findings highlight the crucial role of interactive online platforms in bridging the gap between science and the public.

Mapping urban health policies: A scoping review of environmental, behavioural and socioeconomic determinants of health

Researchers have consistently shown that determinants of health—factors beyond healthcare, including the built environment and socioeconomic conditions— significantly impact health outcomes. This understanding has led to a growing trend in recent decades towards policy discourse that links determinants of health with health outcomes. However, the scientific community's access to these policies in a structured and systematised manner remains limited. The importance of this gap cannot be overstated, as information about which determinants of health are discussed and prioritised in policy agendas is spread across various documents from different organisations, making it difficult to address relevant policy questions promptly. A scoping review of urban health policies was conducted following JBI guidelines to bridge this gap. The aim was to create a structured framework that outlines the environmental, behavioural, and socioeconomic determinants of health included in policy agendas, as well as how they are understood and prioritised, their relationships with each other and with health outcomes, and how they vary across different geographic and governance levels. Using content analysis methods, 128 policy documents from intergovernmental, national, regional, and local governance levels were analysed, covering the World and European region and the cities of London, Lisbon, and Copenhagen from 2010 to 2022. The review identified 83 determinants of health employed in policy discourse, categorising them into nine priority themes: healthy diet; drug, alcohol, and tobacco; social cohesion; physical activity; safety; active travel; natural and open spaces; environmental exposures; and basic services. These determinants of health were organised in a structured framework to illustrate their perceived relationships with each other, the priority themes, and health outcomes, as well as their prioritisation in policy discourse based on their frequency of use in urban health policy. This review represents the first comprehensive scope of how determinants of health are employed in policy discourse. The resulting conceptual framework offers a remarkably comprehensive mapping of the systemic relations between determinants of health and health outcomes, which forms a valuable tool for guiding research and practice on the policy-suggested complex multivariate causal pathways between variables. This framework provides a foundation for systematically exploring previously challenging questions, such as how research evidence is being translated into policy discourse and which aspects of this discourse are being implemented into action. Moreover, the scoping review and content analysis protocol can be replicated in other geographic regions, providing insights into potential outcome variations.

Delay reduction and interference mitigation by resource management for IAB networks

To overcome the increasing demand for high-throughput data services, the 3rd Generation Partnership Project (3GPP) has proposed Integrated Access and Backhaul (IAB) in Release 16 as a scalable and cost-effective alternative to traditional fiber backhaul for 5 G systems. A key feature of IAB is the shared use of the same spectrum band for both access and backhaul communications, which introduces challenges related to interference, delays, capacity sharing, and additional complexity due to the half-duplex constraint. In this paper, we provide an overview of the 3GPP guidelines for IAB resource management and introduce a semi-centralized, heuristic-based resource management policy aimed at jointly enhancing end-to-end delay and minimizing interference in IAB networks, in compliance with 3GPP standards. We conduct a comparative study of our proposed policy against several policies, including the baseline proposed by 3GPP. The evaluation is performed through discrete-event simulations under two types of traffic and varying network loads. The simulation results underline that our semi-centralized resource management policy effectively controls interference, leading to improved network Key Performance indicators (KPIs) like system throughput and end-to-end delay. Specifically, our solution achieves up to an 11% increase in system throughput and a 30% reduction in end-to-end delay compared to the baseline for constant traffic, while for variable traffic, it results in a 16% increase in system throughput and a 26% reduction in end-to-end delay.

Customer Relationship Practices through Processes Automation and Customer Satisfaction. Service Industry Experience

Purpose: The Purpose of this study was to establish the effect of Customer Relationship Management practices through Process Automation and customer satisfaction at Koitaleel Samoei University College. Specifically, this study was anchored on the CRM practices through processes automation and how they influence customer satisfaction. The study was based on symbolic interaction theory which insisted on the codependence of individuals and ideologies and how customer satisfaction depends on the CRM practices. Customer relationship management theory, an accepted philosophy that is concerned with identifying, satisfying, retaining, partnering and maximizing the value of customers by effectively managing the relationship between parties. Methodology: Descriptive design was used in this study. Data was collected by use of questionnaires and interview schedule. Data was presented by use of charts and tables. The target population was 150 individuals within KSUC. Strata of fifty (50) individuals was sampled compromising of suppliers, management and staff. The tools of data collection helped in ensuring the validity and reliability of the data that was collected. Ethical standards were considered where seeking permission before data collection from individuals was sought and the respondent’s privacy was granted. Findings: The study found out that CRM is a critical component in customer satisfaction and therefore can be highly applied. Unique Contribution to Theory, Practice and Policy: The study recommended provision of platforms for customers to leave reviews or even complaints and suggestions from their experience, Enhancement of Communication Channels and Implementation of clear and accessible communication channels for stakeholders to interact with the procurement department.

From fetchers to decision-makers: exploring the gender dynamics of water access and governance in resource-poor communities of Mbala, Zambia

ABSTRACT Research on African women often emphasizes their traditional roles as water fetchers and caregivers, but their potential role in water governance is frequently overlooked. Here, this research gap is explored with a focus on the sustainability of water access points (WAPs). The latest mWater tool version 3.0. was used to conduct household surveys concerning gender roles in water access in rural Mbala of northern Zambia. Purposive sampling, a non-probability methodological approach, was used to choose respondents. The Empowerment in water, sanitation, and hygiene (WASH) Index (EWI) was adopted to quantify empowerment levels. The analysis revealed significant contributors to disempowerment, such as group membership, control over household goods, work balance, and leadership in WAP implementation. The study also highlighted the critical role of Water Point Committees (WPCs) in sustaining WAPs. An unexpected finding emerges as the data contests the prevalent notion that women, who are primarily responsible for water fetching, are marginalized from decision-making processes. Instead, the results suggest that women's disempowerment is not the primary factor contributing to the lack of sustainability of WAPs. Rather, a general lack of financial commitment within communities is at play. The study highlights the critical, yet previously overlooked, role of community meetings in ensuring the sustainability of WAPs.

Perspectives of Greek Adults Who are Deaf or Hard-of-Hearing About Their Educational Experiences

Abstract Fifteen Greek adults who are deaf or hard-of-hearing (DHH) were interviewed as part of a qualitative study examining their perspectives as students during primary, secondary, or postsecondary education. Research on the perspectives of adults who are DHH involving all three levels of education is limited in Greece. This study focuses on four primary questions addressing the following topics: academic and social experiences in elementary and secondary school; preparation for postsecondary education; academic and social experiences in postsecondary education; and suggestions to improve the education of students who are DHH. To explore these questions in depth, an interview guide was developed consisting of 31 items, nine demographic and 22 yes/no or open-ended questions. Responses to a subset of the yes/no or open-ended questions are highlighted in this article. Several themes emerged from the data including deficiencies in vocabulary, language, and literacy skills; concerns about general education classrooms; limited communication access; insufficient educational supports; difficulty developing friendships; shortcomings in teacher preparation, and a lack of variety in teaching methods. Based on these themes, the article concludes by suggesting areas Greece needs to address to improve the educational experiences and outcomes of students who are DHH.

Patterns of eConsult use: A retrospective analysis of usage comparing two models deployed at an academic medical center.

Electronic consultations (eConsults) have been implemented by numerous academic medical centers (AMCs) to improve communication and address access to specialty care. As these models proliferate, we must understand their comparative benefit and use in various settings. This retrospective, descriptive analysis compares eConsult utilization trends at an AMC that has deployed an internal effort and an external pivot. Relevant metrics are presented using counts and proportions or median and range where appropriate. The internal AMC program demonstrated sustained growth from years 1 through 6, while the external pivot demonstrated considerable growth in year 1, followed by a steady decline in subsequent years. Endocrinology generated the highest number of eConsult orders in both programs (AMC 21%, external pivot 16%). Conversion rates to in-person visits were higher in the external pivot (22%) than in the internal AMC program (14%). Median response time across all specialties was faster (17 hours) for the AMC program than the external pivot (23 hours). The median number of eConsults ordered by any single primary care provider was 3 in both programs. The percentage of providers using the eConsult ordering system only once was approximately 30% in both programs. eConsults were primarily ordered by physicians (68%) at the AMC and physician assistants (40%) in the external pivot. The current study highlights similarities and differences between internal and external eConsult programs that can inform future "right-sizing" of care according to patient needs while promoting local care delivery and improving efficiencies at the AMC.

THE INFLUENCE OF EMOTIONAL INTELLIGENCE, CULTURAL DIVERSITY IN ORGANIZATION, AND COMMUNICATION STRATEGIES ON LEADERSHIP EFFECTIVENESS IN DIVERSE WORKPLACES IN FUZHOU CITY, FUJIAN PROVINCE, CHINA

In today’s rapidly evolving business landscape, characterized by heightened complexity and relentless change, the demand for adept management is more pronounced than ever. As organizations grapple with the challenges presented by an increasingly interconnected and technologically advanced world, the need to adapt and evolve management practices becomes a paramount concern (Drejer et al., 2014; BAGU et al., 2011). The aims of this study were to investigate the factors influencing Leadership Effectiveness based on 4 aspects, namely, the Demographic Factors, the Emotional Intelligence, the Cultural Diversity in Organization, and the Communication Strategies. The quantitative method was applied. Descriptive statistics such as frequency, percent frequency, mean, and standard deviation are introduced. Various inferential statistical methods are used to test the hypothesis, particularly the Independent samples t-test, the One-way ANOVA, and the Multiple linear regression analysis. The results obtained from the study indicate that differences in Marital Status, Age, Educational Level, and Monthly Income generate differences in Leadership Effectiveness. Based on the Multiple Linear Regression analysis, all aspects of Emotional Intelligence (Self-awareness, Self-regulation, Motivation, Empathy, and Social Skills), Cultural Diversity in Organization (Diversity, Equity, Inclusion, and Belonging) and Communication Strategies (Awareness and Understanding, Communication Quality, Accessibility, and Employee Engagement) had a positive impact on Leadership Effectiveness.

Using School-Based Teleconsultation Services to Make Community Health Services Accessible in Semirural Settings of Pakistan: Sequential Explanatory Mixed Methods Study.

In Pakistan's remote areas, quality health care and experienced professionals are scarce. Telehealth can bridge this gap by offering innovative services like teleconsultations. Schools can serve as effective platforms for introducing these services, significantly improving health service access in semirural communities. This study aims to explore the feasibility of introducing school-based teleconsultation services (TCS) to strengthen community health in a semirural area of Karachi, Pakistan. This study used a mixed methods design. A total of 393 students were enrolled for the quantitative component, while 35 parents, teachers, and community stakeholders participated in the qualitative arm (focused group discussion). Proportional computation for the quantitative data was done using SPSS (version 24; IBM Corp), while qualitative data underwent thematic analysis. A total of 1046 successful teleconsultations were provided for 393 students over 28 months. The demographic data showed that the mean age of the students availing TCS was 9.24 (SD 3.25) years, with the majority being males (59.3%, 233/393). Only 1.24% (13/1046) of cases required referrals. The qualitative analysis yielded three themes: (1) transformation of the health care experience, (2) escalating demands for teleconsultation, and (3) the psychological aspect of care. This study demonstrated the efficacy of integrating TCS in a semiurban school in Karachi to address health care accessibility gaps. Implementing TCS through the school platform improved the overall health status of school children while reducing school absences and financial burdens on families. The study highlighted TCS's cost-effectiveness, time efficiency, and quality, with community support for 24/7 availability, expansion to adults, and a reimbursement model. School health nurse-led TCS offers a scalable solution to health care challenges, enhancing health outcomes for school-going children in Pakistan and globally, particularly in low- and middle-income countries, where accessibility is a major issue.