Bridging Gaps Research Articles

Island Health Crisis: Bridging Gaps in Indonesia's Healthcare Deserts

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in the Diffusion of Innovations and Health Belief Model frameworks, the study proposes evidence-based strategies to enhance healthcare accessibility and quality in these underserved regions. The Health Belief Model is employed to understand health behaviors within island communities, addressing perceived susceptibility, severity, benefits, and barriers. Strategies include increasing awareness of health risks, highlighting the benefits of telemedicine and improved infrastructure, and reducing access barriers through incentives and infrastructural enhancements. In contrast to, The Diffusion of Innovations Theory guides the dissemination of new healthcare practices and technologies. Emphasizing innovation attributes such as relative advantage, simplicity, trialability, and observability, and utilizing effective communication channels and local social systems. The study aims to promote the adoption of telemedicine and other innovations. By engaging community leaders and health workers, and considering the time needed for adoption, the proposed recommendations aim to accelerate the diffusion process, ultimately improving healthcare accessibility and outcomes in Indonesia's island communities.

Translating Identity in Leila Abouzeid’s Return to Childhood

This paper delves into the intricate process of translating migrant literature, using Leila Abouzeid’s autobiography Return to Childhood as its case study. Beyond merely examining the multifaceted mechanics of translation, it uncovers the profound significance embedded within this process. By navigating linguistic disparities and cultural nuances, translators, it avers, play a pivotal role in bridging gaps between cultures. By employing a detailed analytical framework, the study elucidates how translation serves as a dynamic catalyst for cultural transformation. In so doing, it seeks to catch the delicate balance between preserving cultural identity and catering to the expectations of diverse audiences. Additionally, the paper underscores the pivotal role of migrant authors as agents of cultural hybridization. Through their translated works, they challenge dominant cultural narratives and dismantle stereotypes, enriching the cultural landscape with diverse perspectives. Moreover, the discussion delves into the inherent power dynamics of translation, emphasizing its primordial role in fostering cross-cultural understanding and disrupting monolithic cultural identities. In fine, this study illuminates the transformative potential of translation in shaping cultural discourse and promoting inclusivity on a global scale.

Temporary Urbanism as a Catalyst for Social Resilience: Insights from an Urban Living Lab Practice-Based Research

This research paper investigates the impact of Urban Living Labs (ULLs) on social resilience within urban communities, with a specific focus on the Multicultural City ChatterBox project in Portsmouth, the UK. Drawing on a rich body of literature and empirical data collected through ethnographic research methods, including interviews, focus groups, and participant observations, this study explores how participatory placemaking and co-creation activities foster community resilience. The ChatterBox project, a collaborative effort between the local community and researchers, led to the construction of a temporary timber pavilion in an underutilized urban space, serving as a vibrant hub for social interaction and engagement among diverse community groups. Our findings reveal that ULLs significantly contribute to enhancing social resilience by empowering communities, fostering a sense of belonging, and facilitating the development of social networks. Through the process of co-design and co-creation, participants not only gained a deeper understanding and ownership of their urban environment but also developed valuable skills and knowledge, thus strengthening their capacity to adapt to societal challenges. Furthermore, this study highlights the role of ULLs in bridging gaps between different community groups, thereby promoting inclusivity and social cohesion. The Multicultural City ChatterBox project exemplifies how ULL interventions can serve as catalysts for social innovation, offering flexible and adaptive solutions to urban challenges while simultaneously enriching the social fabric of cities. This paper contributes to the growing discourse on urban resilience, placemaking, and community-led urban development, providing valuable insights for policymakers, urban planners, and community organizers seeking to foster resilient and vibrant urban communities.

Enhancing hydrogen sulphide removal efficiency: A DFT study on selected functionalized graphene-based materials

In response to the escalating demand for cleaner energy sources, this study investigates the potential of carefully selected functionalized graphene-based materials for enhancing hydrogen sulphide (H2S) removal in fuel streams, utilizing semi-empirical and density functional theory (DFT) calculations for molecular-level insights. A particular focus is placed on aliphatic methyl (-CH), alcohol (-COH), carboxylate (-COO), carbonyl (-CO), and acid (-COOH) -functionalized graphene, aiming to bridge gaps between desulphurization methods and graphene applications, specifically targeting H2S removal. Through extensive computational analyses, the research unravels the intricate interactions between chosen functionalized graphene materials and sulfur compounds like H2S, emphasizing mechanisms contributing to improved desulphurization efficiency. Our study's analysis highlights the superior performance of carboxylate (-COO)-functionalized graphene, mainly through dissociative adsorption mechanisms. The study systematically evaluates the influence of selected functional groups on adsorption activity, emphasizing the significance of dissociation. Overall, this research advances desulphurization strategies and underscores the potential of functionalized graphene in sustainable energy solutions.

Digital Competence to Bridge Transactional Distance in Distance Education

Utilising primary data and a stratified random sampling method, this study explores the proficiency of Open and Distance Learning (ODL) students in navigating digital resources and their intrinsic motivation for academic growth. Data collected from 390 IGNOU students, via stratified random sampling, includes undergraduates enrolled from 2016 to 2021 and postgraduates from 2018 to 2021. The study emphasies the crucial importance of fostering an interactive and engaging learning environment for the development of affective skills, countering transactional distance. It underscores the pivotal role of ICT in bridging gaps and promoting meaningful social interactions in distance education programs, thus enhancing holistic growth and employability.

Redefining the Role of Medical Affairs Professionals as Innovators and Leaders in Industry-Led Medical Education.

Medical affairs professionals are pivotal players at the intersection of medical innovation and practice in the pharmaceutical industry. They are uniquely positioned to translate complex medical knowledge into actionable insights for internal and external stakeholders. Industry-led continuing medical education (CME) programs, guided by these professionals, hold the potential to markedly improve clinicians' application of evidence-based medicine (EBM) in clinical settings, thereby elevating patient care outcomes. However, current CME techniques often overlook the integration of diverse disciplines such as educational theories, cognitive psychology, information mastery, and implementation science, which are important for effective real-time decision-making in patient care. This gap in integrating implementation science is vital, as it is key in ensuring that medical innovations are not just developed but also effectively implemented and efficiently utilized in clinical settings. In this opinion article, we aim to highlight the crucial yet often underrecognized role of medical affairs professionals in shaping robust and practical CME programs within the industry. We explore emerging trends and approaches in medical education and CME based on the principles of adult education. Additionally, we explore how medical affairs professionals can effectively drive the adoption of EBM in clinical practice. This exploration aims to provide insights into enhancing CME programs, with medical affairs professionals at the forefront of innovation and leadership in bridging gaps in clinical practice.

Telehealth Utilization for Opioid Use Disorder: A Nationwide Analysis Before and After the COVID-19 Public Health Emergency Declaration.

Introduction: The COVID-19 pandemic has led to the rapid and widespread adoption of telehealth services. Telehealth may aid in bridging gaps in access to care. The specific impact of telehealth on opioid use disorder (OUD) and its treatment remains uncertain. Methods: A retrospective review of commercial insurance claim records within the United States was conducted to investigate the association between the COVID-19 pandemic and changes in the rates of(a) OUD treatments with and without telehealth support and (b) prescriptions for medications for opioid use disorder (MOUD) with and without telehealth support among individuals diagnosed with OUD. Results: In a study population of 1,340,506 individuals, OUD diagnosis rates were 5 per 1,000 in-person and 1 per 1,000 via telehealth. COVID-19 decreased in-person OUD diagnoses by 0.89 per 1,000, while telehealth diagnoses increased by 0.83 per 1,000. In-person MOUD treatment rates increased by 0.07 per 1,000 during COVID-19, while telehealth rates remained low. The onset of COVID-19 saw a 1.13 per 1,000 higher increase in telehealth-supported MOUD treatment compared to solely in-person treatment. Conclusions: A retrospective review of commercial insurance claim records within the United States was conducted to investigate the association between the COVID-19 pandemic and changes in the rates of (a) OUD treatments with and without telehealth support and (b) prescriptions for MOUD with and without telehealth support among individuals diagnosed with OUD.

Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review.

The increased interest in sensing tattoos reflects a shift in wearable technology, emphasizing their flexible, skin-adherent nature. These devices, driven by advancements in nanotechnology and materials science, offer highly sensitive and customizable sensors. The growing body of research in this area indicates a rising curiosity in their design and applications, with potential uses ranging from vital sign monitoring to biomarker detection. Sensing tattoos present a promising avenue in wearable healthcare technology, attracting attention from researchers, clinicians, and technology enthusiasts. The objective of this study is to analyze the development, application, and integration of the sensing tattoos in the health domain. A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome reported 37 studies. Sensing tattoos hold transformative potential in health monitoring and physiological sensing, driven by their focus on affordability, user-friendly design, and versatile sensorization solutions. Despite their promise, ongoing refinement is essential, addressing limitations in adhesion, signal quality, biocompatibility, and regulatory complexities. Identified opportunities, including non-invasive health monitoring, multiplexed detection, and cost-effective fabrication methods, open avenues for personalized healthcare applications. However, bridging gaps in medical device standards, cybersecurity, and regulatory compliance is imperative for seamless integration. A key theme calls for a holistic, user-centric approach, emphasizing interdisciplinary collaboration. Balancing innovation with practicality, prioritizing ethics, and fostering collaboration are crucial for the evolution of these technologies. The dynamic state of the field is evident, with active exploration of new frontiers. This overview also provides a roadmap, urging scholars, industry players, and regulators to collectively contribute to the responsible integration of sensing tattoos into daily life.

Adolescents' views on oral health care and promotion in Norway: everyday practices, recommendations, and future visions.

In this study, we aimed to understand adolescents' perspectives on oral health care and promotion. Our research was conducted in the context of Norway's oral health care system, where societal factors like income and education influence health disparities. Despite free public dental care for all residents younger than 19 years, challenges persist in promoting oral health among adolescents, a group whose oral health behavior and literacy remain largely unexplored. A thematic analysis of an anonymized dataset from 80 adolescents aged 12-20 years was conducted. Five central themes were recognized: (1) Feeling fresh vs. feeling indifferent: A broad spectrum of attitudes; (2) Bridging gaps, building habits: Collaborative efforts in oral care; (3) "Create good experiences at the dentist so people come back again"; (4) Requested qualities in oral health promoting solutions; (5) Reminder tools for everyday use. Taken together, these themes highlight adolescents' oral health practices and resources, recommendations for dental clinics, and visions for future oral health promotion. Based on the results, the discussion highlights a need for tailored oral health promotion and ideas to reach adolescents in meaningful and effective ways. Reflections on the theme of social inequalities are provided.

Digital Literacy Initiatives in India: Bridging the Gap for Online Education

Abstract As technology continues to change, educational change is inevitable. A lot of research is being done to understand the pros and cons of online education as compared to face-to-face education. In India, there are many challenges and opportunities for online education. In this paper, we have identified key factors that will drive online education in India through a comprehensive literature review. We have identified internet penetration, low cost of online education, ease of doing course, government initiative, employer recognition and bridging gap as the key factors for the growth of online education. There are certain factors that are hindering the growth which include inadequate digital infrastructure, credibility and language used in online education. The paper also looks at the future opportunities in the education sector with the increasing number of internet users in India.

A Comprehensive Social Impact Analysis of Technological Advancements in Education: Bridging or Broadening Gaps

This study explores the social impact of technology integration in education through Social Impact Assessment (SIA). SIA originated in the 1970s and has evolved to include various social and economic aspects, particularly education. Interpretivist methodology and SWOT analysis highlight technology's positive and negative effects in the educational sector. Positively, technology enhances learning outcomes, ensures equitable access, promotes social cohesion, and facilitates lifelong learning. It also supports teacher development and makes learning materials more accessible. On the other hand, challenges include increased academic misconduct, ethical dilemmas involving AI, digital divides in socio-economic sectors, and the vast nature of digital content. This paper highlights the need for specific educational policies and interventions by recognizing the diverse impacts of technological advancements in different academic environments.

Investigating Practical Content Delivery Perspectives among Engineering Students: Insights from Tertiary Institutions in South-West Nigeria

The lack of enthusiasm among students for practical classes is alarming. This prompted the need for an investigation into the issues of engineering education, with a focus on practical content delivery perspectives. An online questionnaire was completed by 325 respondents from tertiary institutions in southwest Nigeria, resulting in responses. This ensured diversity in age, gender, field of study, and academic level, providing detailed insights into the composition of the respondent pool. Notably, the majority of participants (295) are male, with only 30 females, highlighting a gender disparity that is common in most tertiary institutions. The distribution across fields and academic levels illustrates the diversity of engineering disciplines and academic advancement. For instance, electrical/electronics engineering received 153 responses, with ND 1 students being the most represented. A comprehensive evaluation of practical session challenges revealed widespread consensus on issues such as time constraints, insufficient equipment, and overcrowded classes. The mean values revealed the relative importance of each criterion, providing a more comprehensive understanding of respondents' viewpoints. The study concludes with innovative strategies for improving hands-on education while addressing identified shortcomings. The recommendations include improved access to resources, increased industry participation, modernization of equipment, standardized content delivery, technology-enabled learning, faculty development, structured coaching, adaptive assessments, and regular curriculum evaluations. These programs aim to promote continuous improvement and create a positive and productive learning environment for engineering students. This study provides valuable insights and practical solutions for enhancing the delivery of content, bridging gaps, and improving the quality of engineering education.

Whispers of Consciousness: the Interplay of Surgery, Internal Medicine, and Anesthesia

Introduction: the interplay between surgery, internal medicine, and anesthesia is fundamental to the comprehensive care of patients, particularly in complex clinical scenarios. Understanding the dynamics of these interactions is crucial for improving patient outcomes and advancing healthcare practices.Objective: to review the existing literature on the collaboration between surgery, internal medicine, and anesthesia, identifying key areas of synergy, challenges, technological impacts, and future directions for research and practice.Methods: An extensive literature search was conducted across multiple databases, including PubMed and Google Scholar, using a combination of keywords related to surgery, internal medicine, anesthesia, patient care, and interdisciplinary collaboration. 22 relevant articles were selected based on predefined inclusion and exclusion criteria, with a focus on those that explored the integration and outcomes of these medical disciplines. Data were synthesized through thematic analysis.Results: the review highlights the significance of interdisciplinary collaboration in optimizing patient care, the role of technological advancements in bridging gaps between disciplines, and the ethical and patient-centered considerations that underpin successful integration. Education and training emerge as critical components for fostering effective collaboration.Conclusions: effective interdisciplinary collaboration between surgery, internal medicine, and anesthesia is pivotal for enhancing patient outcomes. Future research should focus on addressing identified gaps, particularly in the integration of technology and the development of ethical guidelines for complex patient care

Early Exposure to Orthopaedic Surgery.

Disparities in early orthopaedic experiences among medical students prompt a critical examination of factors influencing the availability and nature of these exposures. While the current body of literature underscores the significance of early surgical exposure and mentorship in medical education, a notable gap exists in investigating early orthopaedic exposure and its specific impact on students from diverse backgrounds. A 16-item questionnaire, approved by our institutional review board, was administered to fourth-year medical students (MS4) and first-year orthopaedic residents (PGY-1) across U.S. orthopaedic surgery programs during the 2022-2023 application cycle. The questionnaire assessed participants' initial orthopaedic exposures and factors influencing interest in the field. Two-proportion Z-test analyses were conducted to analyze the data, and thematic analysis was used to assess qualitative data involving free-response questions. Out of 72 total respondents, the study revealed that 83% of respondents encountered orthopaedics before medical school, with initial exposures stemming from various sources such as familial connections (28%), athletics(17%), and high school or college exposures (15%), including shadowing, athletics participation, and occupation-related exposure. Disparities were observed in the availability of orthopaedic mentors and early exposure opportunities between demographic groups. Statistical analyses highlighted significant differences in access to mentors who reflected students' identities between male and non-male participants (70% vs. 39%, p=0.02) and between white and non-white participants (69% vs. 36%, p=0.02). White participants were also more likely to first interact with a surgeon who treated them or their family members than non-white participants (35% vs 7%, p=0.04). Non-white participants were more likely than white participants to come by their first orthopaedic opportunity by searching for it independently (21% vs. 4%, p=0.03). Family and friend connections in orthopaedics were found to be influential in motivating students to pursue orthopaedics, with 40% of respondents indicating personal connections in medicine and 12% reporting family members who are orthopaedic surgeons. Research experiences were identified as important contributors to students' initial interest and motivation to ultimately pursue orthopaedics, especially those with diverse backgrounds. The findings underscore the importance of early orthopaedic exposures in shaping students' interest in the field, highlighting the need for more immersive pre-clinical year opportunities and enhanced mentorship programs. Addressing disparities in mentorship access and early exposure opportunities requires systemic changes and increased support for underrepresented minorities in orthopaedics. Initiatives like mentorship programs and research opportunities can help bridge gaps in access to early orthopaedic experiences. Medical schools should prioritise targeted early access to orthopaedic exposures for all students, regardless of background. This initiative aims to promote inclusivity and cultivate a more diverse orthopaedic workforce capable of meeting the evolving healthcare needs of society.

293 The MEND Initiative: Meaningfully Empowering the NeuroDiverse

OBJECTIVES/GOALS: This project’s objective is to empower verbally-communicating autistic adults to express their mental health needs to mental health professionals, regardless of their training or experience in autism. By enhancing empowerment in this area, we aim to enhance their self-awareness and confidence in navigating and accessing mental health support. METHODS/STUDY POPULATION: Following the Toronto Translational Framework (TTF), our approach involves co-designing and testing an intervention directly with the autistic population through three phases. Phase I will review published literature on autism, mental health, and patient empowerment, validate our identified need through informal meetings with stakeholders, and assemble an autistic advisory committee (AAC) of 5-8 members who are able to provide informed conset without assistant, are fluent in English, and 18 years of age or older. Phase II will involve participatory design sessions with our AAC to develop a low-fidelity prototype to address the identified need. Phase III will evaluate our prototype’s effectiveness through a separate series of focus groups, which will consist of members from our target population. RESULTS/ANTICIPATED RESULTS: We are anticipating that by the end of our research, we have successfully co-designed an intervention that effectievly empowers autistic adults in their mental health journey through increasing their self-awareness and confidence in navigating and receiving mental health support. At a larger scale, results may include the empowerment of autistic adults to seek and receive mental health care from mental health professionals, regardless of professionals’ prior autism expertise. DISCUSSION/SIGNIFICANCE: By enhancing self-awareness of their mental healthcare needs and boosting self-reported confidence in communicating with mental health professionals, we aim to take the first step in creating timely, patient-centered solutions, and bridging gaps in the evolving neuro-affirmative healthcare system.

DEVELOPING CRITICAL THINKING SKILLS IN ENGLISH CLASSROOMS AT THE SECONDARY LEVEL: TEACHERS’ PERSPECTIVE

This quantitative, descriptive research study investigated English teachers' perspective of critical thinking at secondary level. Sample of 100 participant (50 male, 50 female) was selected through random sampling. The data was collected using self-developed, 5-point Likert scale questionnaire. The data was analyzed using SPSS-20 software, with frequencies calculated for each response option. The results indicated that majority of respondents (92.4%) had knowledge about critical thinking, viewed it as important for teaching English (92%), and considered it crucial for 21st-century learning (91%). Most of teachers (90%) reported using different techniques, particularly questioning (95%), to develop the students' critical thinking skills. However, only 14% believed students were good at the critical thinking, while 44.7% disagreed with this notion. This highlighted a perceived gap between their efforts & students' abilities. It is concluded that English teachers have strong theoretical understanding of critical thinking and recognize its significance. Still, concerns exist about use of the current practices in fostering students' critical thinking skills. Addressing these areas could help bridge gap amid teachers' aspirations for critical thinking development & observed outcomes in their students

Process Modeling of Aerosol‐Cloud Interaction in Summertime Precipitating Shallow Cumulus Over the Western North Atlantic

AbstractProcess modeling of Aerosol‐cloud interaction (ACI) is essential to bridging gaps between observational analysis and climate modeling of aerosol effects in the Earth system and eventually reducing climate projection uncertainties. In this study, we examine ACI in summertime precipitating shallow cumuli observed during the Aerosol Cloud meTeorology Interactions oVer the western ATlantic Experiment (ACTIVATE). Aerosols and precipitating shallow cumuli were extensively observed with in‐situ and remote‐sensing instruments during two research flight cases on 02 June and 07 June, respectively, during the ACTIVATE summer 2021 deployment phase. We perform observational analysis and large‐eddy simulation (LES) of aerosol effect on precipitating cumulus in these two cases. Given the measured aerosol size distributions and meteorological conditions, LES is able to reproduce the observed cloud properties by aircraft such as liquid water content (LWC), cloud droplet number concentration (Nc) and effective radius reff. However, it produces smaller liquid water path (LWP) and larger Nc compared to the satellite retrievals. Both 02 and 07 June cases are over warm waters of the Gulf Stream and have a cloud top height over 3 km, but the 07 June case is more polluted and has larger LWC. We find that the Na‐induced LWP adjustment is dominated by precipitation feedback for the 2 June precipitating case and there is no clear entrainment feedback in both cases. An increase of cloud fraction due to a decrease of aerosol number concentration is also shown in the simulations for the 02 June case.

Building multiscalar sustainable ocean governance: How do global perspectives interact with the Portuguese national approach?

UNESCO's Intergovernmental Oceanographic Commission launched the United Nations Decade of Ocean Science for Sustainable Development in 2021 to boost global and sustainable Ocean governance. The initiative resulted from historical and political dynamics at the global and lower political scales, with maritime environmental and economic concerns becoming more prominent in 2010. The Ocean Decade's pillars include science and research, sustainability, conservation, and bridging gaps for a global Ocean-Climate-Biodiversity nexus. The Sustainable Development Goals recognized the importance of oceans and marine resources, and the Ocean was officially perceived as a determining factor of Climate Change at CoP 21 in 2015. Portugal has built integrated and far-reaching policies for ocean governance, including significant involvement with an international perspective since the Lisbon World Exhibition in 1998. In addition, the national government established a Ministry of the Sea in 2015 to re-develop relations with its maritime space. This article analyzes and compares the discourse of the United Nations' Sustainable Development Goals reports and the Portuguese government programs (2005–2022) to explore the prominent trends in Portuguese Ocean governance discourse and how global and national perspectives interact. Through this case study, the research aims to develop insights into the multiscalar impacts of promoting global and sustainable Ocean governance and its interaction with national perspectives.

Boosting Learner Independence: Adaptive Technology for Students with Cerebral Palsy in Primary Schools Across Busia District, Uganda

This study aims to identify the factors influencing the utilization of adaptive technology (AT) to promote independence among learners with cerebral palsy in primary schools within Busia District, Uganda. The specific objectives include assessing attitudes, determining training levels, evaluating proficiency in AT use, and scrutinizing environmental adaptations. Using a descriptive survey design, data was collected from a sample of 297 participants, including parents, children with cerebral palsy, teachers, and rehabilitation officers. The findings highlight positive attitudes toward AT, inadequate training levels, varying proficiency in AT use, and the need for environmental adaptations. Recommendations include comprehensive caregiver training, targeted interventions for specific challenges, and collaboration between stakeholders to create supportive environments for learners with cerebral palsy using AT. This study contributes to bridging gaps in existing research, aligning with Uganda's commitment to inclusive education and lifelong learning.

Determinants of investment decisions: The mediating role of financial technology

This research aimed to examine and assess the mediating function of financial technology in shaping the connection between financial literacy and investment choices. The research's participants were selected from Generation Z individuals who had invested in the capital or the money market in Cirebon. The data collection method employed accidental sampling, with 160 respondents receiving an online and offline questionnaire. For this research, the researchers utilized inner and outer models with the assistance of the SmartPLS 4.0 software program. The findings from the research indicate that financial literacy has no impact on investment choices, financial literacy also affects financial technology, financial technology affects investment decisions, and financial technology can function as a mediator in the association between financial literacy and investment choices. The results indicate that both the utilization of financial technology and an enhanced comprehension of financial literacy contribute to the effectiveness of the investment decision-making process. A future research agenda is put forward to investigate additional variables that may help bridge gaps in prior research, such as financial inclusion and income, which impact investment decisions.