People Access Research Articles

Children and young people's access to food, education, play and leisure in times of crisis: An international, integrative review of policy responses, impacts and adaptations during the COVID‐19 pandemic

AbstractThe COVID‐19 pandemic led to an unprecedented global moment when the core needs of children and young people (rights for education, food, play and leisure) were not adequately addressed, recognised from a policy perspective and to varying extents, ignored. This paper, by bringing scholarship and grey literature together, provides an integrative, international, comprehensive review and analysis of how the pandemic affected children's core needs (and rights) simultaneously. It also reviews and compares adaptations—often local, informal and/or community‐led—that attempted to respond to the shortcomings and negative impacts of more formal policy measures, including lockdowns themselves. By doing so, it engages with the question of resilience and calls for children and young people's needs and voices to be heard in the future, particularly considering future forms of crisis‐preparedness that can better account for children and young people's needs.

Accessibility services needs of visually impaired patrons in public libraries: a grounded theory study of China

PurposePublic libraries are strong advocates of the development of accessibility for people with disabilities. Understanding the accessibility services needs of visually impaired patrons is highly beneficial for increasing satisfaction with public library services. The purpose of this research is to assess the service capabilities of visually impaired patrons in public libraries and to improve the accessibility of services provided by public libraries for visually impaired patrons.Design/methodology/approachThis research adopts a mixed methods approach. Qualitative data collection involves interviews and surveys with 34 visually impaired individuals in China, applying grounded theory and expectancy theory. Quantitative analysis is then carried out using the Kano model.FindingsThe research reveals four types of accessibility service needs, with visually impaired patrons prioritizing value-added information services and self-service options. In addition, visually impaired patrons are also highly interested in the integration of assistive and innovative technologies within libraries.Originality/valueBy emphasizing a patron-centered approach, this research provides insights into innovative service approaches in public libraries that address the specific needs of visually impaired patrons and contribute essential strategies for bridging the digital divide.

“A Little More Gravitas”: Why Correctional Health Care Workers Value Third-Party Certifications

ABSTRACT Some people who work in correctional health care (CHC) choose to obtain third-party professional certifications. Prior research indicates that, in the aggregate, rates of certification correspond to rates of litigation; that is, increases in states’ numbers of CHC certifications tend to follow from increases in the number of lawsuits incarcerated people file against them. These statistical patterns, however, do not reveal what perceived value certification offers to the individuals who pursue it. To address this open question, we conducted interviews with 33 certified CHC workers. These interviews revealed two major themes in individuals’ ideas about the value of certification. First, certification constitutes a source of external legitimacy, helping people counteract the stigma associated with working in corrections and claim professional validity and social esteem. Second, certification provides workplace credibility, helping people assert expertise and access career opportunities in their working lives. These findings add new depth to social scientific understanding of how people manage working in stigmatized occupational settings and navigate the conflicting imperatives of care and punishment that characterize correctional environments.

'Better than Google': Information Activism for LGBTQ+ Young Adults in a Rural Community

For young lesbian, gay, bisexual, transgender, and queer people, and those belonging to other marginalized sexual and gender identities (LGBTQ+), accessing information to develop one's identity and community is essential. Yet information and resource access is a particularly complex process for LGBTQ+ youth living in rural areas and small towns without dense, visible LGBTQ+ networks. While efforts to remove LGBTQ+ resources and demonize LGBTQ+ people intensify, this study asks a group of young LGBTQ+ adults living in and around a college town in the rural Midwestern United States to document their experiences with navigating information landscapes in low-resource settings. Despite the remarkable everyday creativity required to craft their information practices, participants' current efforts produce several vulnerabilities that make local queer information networks precarious and often inaccessible. We lay out several patterns in this data, including experiences of both connectedness and disconnectedness, the role of organizations in information sharing, and the existence of both active and passive information search. Building on prior research that found increasing demand for multi-modal access to relevant information that is digitally enabled, but deeply embedded in localized social geography and LGBTQ+ community, we use this data and complementary interviews to identify problem areas and potential interventions to strengthen rural LGBTQ+ young people's information access. In response to the informational needs and desires of LGBTQ+ youth in this community, we propose a series of imaginative designs. These speculative artifacts are embedded in local communities to strengthen grassroots webs of knowledge. We focus on contributing solutions that fall under three problem areas in participants' information ecosystem: increasing information stumbling, building expert capacity and support, and bridging the disconnected to the connected. We propose speculative conceptual designs that address core challenges in LGBTQ+ information networks, working in the tradition of ''information activism'' to create and maintain access to otherwise precarious and ephemeral resources and spark social change.

The Regional Scale of Landscape Planning: the Possibilities for Measuring the Effectiveness of Nature-Based Solutions

Aim: The aim of this study is to investigate the measurement of landscape integrity based on ecological support processes in the Federal District, with the aim of defining a multi-scalar and multi-functional Regional Green Infrastructure Network (IVR) based on Nature-Based Solutions (NBS). Theoretical Framework: This topic presents the main concepts and theories that underpin the research. Landscape Ecology, Restoration Ecology, Green Infrastructure and Geodesign stand out, providing a solid basis for understanding the research context. Method: The methodology adopted for this research comprises the analysis of ecological support processes in the landscape, using the multispectral “CO2flux” index, related to the photosynthetic efficiency of vegetation and a proxy for energy, carbon and biomass inputs, which, together with the “Topographic Wetness Index”, related to the flow and accumulation of water and sediment in the landscape, provided the basis for the elaboration of a Geodesign process. Data was collected using multispectral satellite scenes - “Landsat 8”, collected during the dry season. Results and Discussion: The results obtained revealed the design of a mosaic of “hotspots”, corridors and patches that consolidates and intensifies carbon flows in the Federal District's landscape, with positive impacts on territorial resilience. In the discussion section, these results are contextualized in the light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The practical and theoretical implications of this research are discussed, providing “insights” into how the results can be applied, or how to influence practices in the field of landscape planning. These implications can cover the design of Nature-Based Solutions at a regional scale, climate mitigation and adaptation actions for territories, and people's access to ecosystem services. Originality/Value: This study contributes to the literature by proposing the design of a regional network of green infrastructures based on the analysis of the flow of ecological support processes in the landscape, considering different demands and goals for environmental recovery. The relevance and value of this research is evidenced by the possibility of planning and designing mosaics in the landscape based on the identification of networks with greater potential for the provision of ecosystem services and, consequently, for the adaptation and mitigation of territories to climate impacts and those resulting from human occupation.

Library Accessibility for People on the Autism Spectrum

Library Accessibility for People on the Autism Spectrum

What Counts as Global Health?

Safe abortion access is an essential aspect of reproductive justice and key to reducing global rates of maternal mortality, yet within the global heath enterprise, the rhetoric of sexual and reproductive health and rights has not yet been realised in practice. Access to safe legal abortion remains inequitable globally and within nations and deaths due to unsafe abortion take their highest toll in the Global South in jurisdictions with restrictive laws. Clandestine abortion access activist networks have been filling this gap offering life, dignity and futures to the people who seek their services. What should we make of clandestine activist networks around the world that help people access medication abortion? Such groups have been important players in women’s reproductive health in many jurisdictions for decades – but have typically, by necessity and design, flown under the radar. If visibility, accountability and humanitarian appeal are essential characteristic of global health work, how do we acknowledge and understand the work of clandestine abortion access activist networks? Does it count as global health? In this essay I offer the notion of ‘critique in action’ to further our understanding of such networks and also consider the idea of abortion access activist networks as an anti-regime of global health.

“Us versus Them”: is the voice of the community heard when planning communication screening programmes for preschoolers?

ObjectivesCommunity consultation is necessary to ensure the uptake and use of community-based screening intervention to detect early childhood disabilities, as its absence can result in poor service acceptance and usage. To document stakeholders' perspectives regarding planning a community-based communication disorder (an impairment in the ability to receive, send, process and comprehend concepts or verbal, non-verbal and graphic symbol systems) screening programmes for pre-schoolers. Study designThis qualitative research design used purposive and random sampling to recruit 46 participants from eThekwini Municipality, South Africa. These stakeholders consisted of caregivers/parents of children who underwent screening for communication disorders, People who are Deaf, their parents, early childhood development practitioners, health professionals and government officials involved with children with disabilities. All participants were adults aged between 19 and 79 years, with an average age of 39.7 years. MethodsData was collected through focus group discussions and individual interviews, which were thematically analysed. ResultsThe four emergent themes were screening approaches, methods, location and personnel. Service users expected greater access to screening and reliable tests to identify problems by trained personnel at sites within the community. Service providers preferred a targeted approach to screening with parental input. Task shifting and sharing were seen as a solution to address staff shortages and provide services at health facilities, as resource constraints made it challenging to provide outreach services. ConclusionStakeholder engagement revealed diverging views between service users and providers, with implications for programme provision and uptake. There is a need for ongoing, inclusive discussion to ensure consensus during the planning stage, in order to render services that address issues of equity and accessibility for people with disabilities in marginalised communities.

Automatic Gesture-Based Arabic Sign Language Recognition: A Federated Learning Approach

Featuring machine learning algorithms for recognizing hand gesture patterns adjusted for individuals with disabilities is an expanding trend in assisted living. This paper addresses the challenge of interpreting the semantics of image-based hand gestures by introducing a federated deep learning architecture for Arabic sign language recognition. The proposed model manages distributed learning through a client-server paradigm, wherein several edge nodes collaborate to jointly learn the discriminative features of confidential data without breaching its privacy. This model will enable more accessibility for people with deafness or impairment using image gestures. The federated learning procedure is primarily based on the ResNet32 deep backbone and federated averaging mechanism. The experimental results show the effectiveness of the proposed FL model, achieving an accuracy of 98.30% with 33 seconds on average for each client in a single training round. This demonstrates its high capabilities in recognizing Arabic sign language and improving the communication experience for people with disabilities.

The use of artificial intelligence in the education of people with visual impairment

Over the past decades, technological advances have led to the development of assistive technologies in the field of education. Specifically, in special education, access for people with a disability may require adaptations to educational programs and technological applications to enhance their independence and participation in society. One of these innovative educational technologies is artificial intelligence. Research has shown that the effective application of artificial intelligence is an important aid in the education of students with special educational needs, such as those with visual impairments. This article presents a brief review of recent studies on the application of AI in the education of people with visual impairments and whether it can contribute to improving their quality of life and their equal access to all levels of education. It also provides a case study, the "PeopleLens" system, for an in-depth analysis of the use of AI as an assistive technology.

Effects of the Hukou system on the geographies of young people in contemporary urban China

ABSTRACT The Chinese institution for population registration is called the hukou system. It divides residents into local and non-local hukou holders concerning geographical mobility. Within Chinese society, young people often move away from their birthplace and subsequently become non-local hukou holders in the destinations. The hukou system has become a barrier to the access of young people to urban rights, placing them in a peripheral position in society. To understand the often-overlooked geographies of young people in China, the article examines how the hukou system undermines young people’s right to the city. Subsequently, the invisible politics of young people in China is discussed, based on a scoping review that approaches the issue through three themes: young people’s tactics in their mobilities; housing inequality and residential segregation; and young people’s aspirations for the future. Combining authoritarianism and neoliberalism, the hukou system controls the distribution of city rights, and thus regulates the flows of young people. Such regulation constitutes a transitional regime that shapes the life trajectories of Chinese youths. Therefore, the article recommends hearing the voices of Chinese young people in the field of Children’s Geographies, and thus enabling their voices to influence future reforms of hukou policies.

Media Events in the Digital Age: Analysis of the Treatment of Elizabeth II and Juan Carlos I During the State Funeral

Digitalisation has redefined both media events and monarchical communication by enabling the diverse and critical participation of journalists and citizens. Media events that were once dominated by official narratives are now subject to multiple real-time transformations, with competing storylines emerging. This study examines the treatment of two monarchical figures (Queen Elizabeth II and King Juan Carlos I) during “the first major state funeral in the digital age” when the official invitation to Juan Carlos I generated a debate about his status and sparked curiosity about a potential photo. From an initial collection of 100,000 tweets and 1520 news articles, 187 pieces simultaneously mentioning both monarchs were selected and analysed to compare their treatment. In contrast to the British portrayal linked to professionalism and tradition, the Spanish media—and especially the social networks—immerse Juan Carlos I in controversy. A planned event in which strategic institutional messages were launched serves as an excuse for criticism and polarisation around the monarchy. This confirms that digitalisation has not only altered the way people access and participate but has also redefined the narratives of even the most traditional events. These transformations pose significant challenges to the image management of institutions such as the monarchy.

Improving physical healthcare for people experiencing mental illness: The COMITMENT project

Abstract Background People experiencing mental illness (PMI) face significant challenges in accessing and using somatic healthcare services, reducing their overall life expectancy by up to 20 years. The COMITMENT project aimed to identify barriers and facilitators in accessing and using somatic healthcare services for PMI and co-design strategies that could address existing challenges. Methods This study employed a qualitative participatory approach, involving a “trialogic” steering group composed of a person with lived experience of mental illness, a family member and caregiver of PMI, as well as a health professional. Two co-design workshops were conducted with members of each trialogic group, based on “World Café” methodology, facilitating open discussion between and among the three perspectives. Data was gathered through participant observations and systematically collecting participants’ workshop contributions, and analyzed thematically. Results Overall, 52 people participated in the two workshops. Findings identified six overarching themes regarding challenges in somatic healthcare access/use for PMI: (1) accessibility and facility design, (2) support and bureaucracy, (3) awareness among healthcare professionals, (4) societal awareness, (5) structural diversity of services, and (6) lack of networking abilities. Notable insights include inclusivity design requirements for healthcare facilities and the importance of integrating lived experiences of PMI into the training of healthcare professionals to reduce stigma. Conclusions This study underscores the critical need for systemic changes to improve somatic care for PMI. It suggests that greater awareness among healthcare professionals, coupled with more inclusive service design and enhanced networking abilities, could substantially improve the quality of healthcare for PMI. The COMITMENT project provides robust and co-designed results for social, systemic, and political reforms aimed at reducing healthcare inequity. Key messages • This study shows how direct involvement of relevant stakeholders improves the design of interventions that truly meet the needs of people with mental illness regarding somatic healthcare services. • To improve healthcare access and treatment for people experiencing mental illness, systemic social, design, educational, and political changes and adaptations are required.

Study on access to social protection policies by homeless people during the COVID-19 pandemic

Abstract The study analyzed the access of homeless people (HP) to health and social protection policies, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of the state of Minas Gerais, Brazil. Its main objective was to provide data on the profile of HP in the municipality, in addition to evaluating existing public policies focused on HP, based on the time frame of the health emergency. Study with mixed methods design with triangulation of quantitative and qualitative data. It used official databases in parallel with document analysis, interviews and focus groups. As a result, the cartography showed that in the first months of the pandemic the municipality had difficulty reorganizing the health system, which underwent constant protocol updates, consolidating, however, over the months. Important emergency interventions in the municipality of BH involved activities that facilitated HP’s access to the provision of services, including intersectorality between health services, social assistance and the third sector. The temporary offer of various intersectoral services, simultaneously with the offer of daytime shelters by organized civil society, was considered a key factor for the expansion and intensification of care networks for HP during the emergency phase. Itinerant services were among those with the greatest positive evidence of service to HP, with emphasis on the ‘Consultório na Rua’. The study concluded that understanding the profile of homeless people in BH and the intersectoral variables that impact HP contributes to better directing investments in interventions for these individuals and increasing the effectiveness of health and social protection systems, in line with with the work carried out by the third sector. Key messages • Understanding the inter-sector variables that impact Homeless People contributes to better targeting of investments in interventions in protection social. • Knowing the profile of the homeless population makes it possible to organize more effective health care and social assistance.

Mindful Transportation: A Conceptual Framework for Enhancing Accessibility for People with Disabilities in Malaysia

This conceptual paper explores the integration of mindfulness principles into the development of transportation services for people with disabilities (PWDs) in Malaysia. Transportation plays a critical role in promoting inclusivity and enhancing the quality of life for PWDs, yet accessibility remains a significant challenge due to infrastructural barriers, lack of awareness, and limited empathy from service providers. Drawing on the concepts of mindfulness, which are rooted in awareness, empathy, and responsiveness, this paper proposes a framework that emphasizes inclusivity, respect, and collaboration among key stakeholders. The proposed framework emphasizes the need for a holistic approach that incorporates physical accessibility, staff training, and policy reforms. Inclusivity involves modifying infrastructure to meet universal design standards, while empathy requires transport providers to understand the unique challenges faced by PWDs and offer compassionate, tailored services. Responsiveness, a key element of mindfulness, calls for flexible and adaptive transport services that cater to the real-time needs of PWDs, ensuring that they can access public transportation with ease and dignity. By applying this mindful approach, the transportation system can become more accommodating and respectful toward PWDs, thereby reducing social exclusion and improving their mobility. This paper contributes to the growing body of literature on disability inclusion and provides actionable strategies for policymakers, transport providers, and disability organizations to work together in creating a more accessible public transportation system. Future research should investigate the practical application of this framework and its potential to drive policy changes that benefit PWDs across Malaysia.

Healthcare access for people with disabilities: a scoping review of COVID-19 policies in Europe

Abstract Introduction The COVID-19 pandemic raised healthcare inequalities, affecting the most vulnerable groups. There is limited evidence of whether the COVID-19 measures and the health system’s preparedness for outbreaks among European countries were sufficient to cover the health access needs of PWDs. Aim To provide a structured overview of the COVID-19 measures and policies addressing access to primary and specialist health services for PWDs during the COVID-19 pandemic in the European Members States (MS) and the United Kingdom (UK), using ten dimensions of healthcare access by Levesque et al. (2013) and the PoliMap taxonomy. Methods This study followed the PRISMA guidelines for Scoping Reviews. A search strategy was employed on PubMed, Embase, Scopus, and Web of Science databases from January 2020 to January 2023. Studies published in peer-reviewed journals in English, Portuguese, and Spanish were included, informing a COVID-19 measure or policy and assessing or providing a rationale with access to primary or special healthcare services. Results The final search strategy yielded 2.076 results, 188 studies were reviewed for full-text analysis, and 74 were included in the final analysis. One hundred twenty-one policies or measures addressing primary or specialist care access were identified. Only thirteen target PWDs, focussing on intellectual or mental disability and addressing mental healthcare services. Results revealed that COVID-19 measures for PWDs were oriented to increase health system response capacity and reduce virus transmission, describing a predominantly negative effect on healthcare access for PWDs. Conclusions The needs of PWDs in access to primary and specialist care were not fully covered by the policies and measures placed during the COVID-19 pandemic among the MS and the UK. One-size approaches focussing on the attendance of COVID-19 infection with stigmatizing measures overlook the specific health necessities of this population. Key messages • Adopting disabled-inclusive measures in the daily healthcare provision and engaging PWDs in the policy cycle is paramount to preparing for the next outbreak and public health crises. • Additional research focusing on primary and specialized healthcare access during outbreaks for PWDs, especially with sensory and physical disabilities, is crucial to furthering health equity.

Self-help groups for people with migration experience

Abstract Background Self-help groups as voluntary associations of people to jointly cope with illnesses or psychological problems are sometimes regarded as the fourth pillar of the health care system. Still, so far people with migration experience do not resp. less participate in self-help groups in Austria. The project aimed therefore on identifying related obstacles and solutions. Methods A mixed-methods approach was chosen: a systematic literature search; interviews, focus groups and workshops; including people with migration experience and experts. A concept for self-help groups was delevoped in a participatory way, piloted in Vienna and evaluated. Results The study confirmed, that the concept of self-help groups as they are usually implemented in Austria is not known among people with migration experience. But there is a great need for exchange among those with a chronic illness or their relatives. Success factors and obstacles are mainly related to the access to people with a migration experience and the way how such self-help groups are set up. Much time needs to be invested in developing a common understanding of the concept of a self-help group and in maintaining contacts. However, despite the of the personal benefit, the often stressful life situation of people with migration experience is an obstacle for continuous participation or even initiating a self-help group oneself. Conclusions The project showed, that, although the concept of self-help groups is often not known, people with a migration experience can benefit from it. But more support is needed than is usually provided by the established self-help organisations. A change in the understanding of self-help groups on the one hand and integrating such activities in services/associations working with migrants on the other hand could improve the access for people with migration experience to this important pillar of the health care system. Key messages • Several obstacles hinder people with migration experience in participating in self-help groups in Austria, e.g. the concept itself is unknown to them. • Implementing a specific concept for self-help groups with support by professionals can facilitate the access of this population group to an important part of the health care system.

Perspectives of care providers on obstacles to healthcare access for people with disabilities in Ethiopia: a qualitative investigation

BackgroundDespite having similar healthcare needs to non-disabled individuals, people with disabilities in Ethiopia face significant challenges accessing healthcare services due to existing barriers. This study aimed to explore these barriers from the perspectives of care providers in primary healthcare facilities.MethodsQualitative research was conducted with care providers in Dire Dawa to identify barriers to healthcare access for people with disabilities. Thematic analysis was used to categorize data into themes.ResultsEight healthcare providers from four service departments participated in eight in-depth interviews and two focus groups. Six themes emerged: physical barriers, financial difficulties, non-accommodating diagnostic facilities, care providers’ attitudes and capacity, communication barriers, and lack of access to health information. Non-confidential and non-dignified care was also identified as a barrier.ConclusionThe study highlights important barriers that prevent people with disabilities from accessing primary healthcare services. Addressing these barriers is crucial for achieving disability-inclusive healthcare services. This research can serve as a starting point for further work in this area to promote equitable healthcare for people with disabilities.

Analysis of the Influence of Infrastructure Development, Poverty, and Education on Economic Growth in Mataram City 2014 – 2023

Economic growth is strongly influenced by infrastructure, poverty, and education. Good infrastructure accelerates the distribution of goods, services, and labor, which increases productivity and encourages investment. High poverty hinders economic growth because it limits people's access to essential resources such as education and health, thereby reducing productive participation. Quality education improves workforce skills, encourages innovation, and strengthens competitiveness, all of which contribute to sustainable and inclusive economic growth. The goal of this study is to evaluate how infrastructural development, poverty, and education affect economic growth in Mataram City. This study employed quantitative research. The data utilized in this study are secondary data acquired from BPS, and the analysis technique employed is multiple regression analysis to assess the association between variables, with data processed using the SPSS program. The results of the study show that infrastructure development, poverty and education have a positive effect on economic growth in Mataram City in 2014 – 2023.

Demographic, Clinical, Psychosocial, and Behavioral Predictors of Continuous Glucose Monitor Use in Adults with Type 2 Diabetes.

Continuous glucose monitor (CGM) use is increasing rapidly among people with type 2 diabetes, although little is known about predictors of CGM use beyond clinical and demographic information available in electronic medical records. Behavioral and psychosocial characteristics may also predict CGM use. We examined clinical, psychosocial, and behavioral characteristics that may predict CGM use in adults with type 2 diabetes. This longitudinal observational study comprised a secondary analysis of data collected in a larger trial. Enrollment included HbA1c tests and surveys assessing demographic, clinical, psychosocial, and behavioral characteristics. We queried participants regarding their CGM use during the study on their final self-report surveys, 15months post-enrollment. Participants were 245 community-dwelling adults with type 2 diabetes recruited from primary care. We used logistic regression to predict CGM use during the 15-month trial period from baseline characteristics. Around one-third of participants (37.1%; 91/245) started CGM. Predictors of starting CGM in bivariate models included younger age, higher socioeconomic status, insulin use, higher HbA1c, and more diabetes distress. When including all potential predictors in a single multivariable model, only younger age (aOR = 0.95, p = 0.001), insulin use (aOR = 2.33, p = 0.006), and higher socioeconomic status (aOR = 0.44, p = 0.037) were significant predictors. Despite the association between higher HbA1c and CGM use, neither diabetes self-care behaviors nor diabetes self-efficacy significantly predicted CGM use. Of participants who tried a CGM, 14.3% (13/91) had stopped, with cost being the most-cited reason. Even when including behavioral and psychological characteristics, younger age, using insulin, and higher socioeconomic status remain key predictors of CGM use. These findings emphasize the importance of access and affordability for people who may benefit from CGM. Providers should not bias their introduction of CGM towards those with (perceived or actual) optimal or sub-optimal self-care behaviors.