Close Gaps Research Articles

Knowledge and awareness about colorectal cancer and barriers to its screening among a sample of general public in Saudi Arabia.

The present study investigated knowledge, awareness, and barriers to colorectal cancer (CRC) screening from a sample of the general population in Saudi Arabia. This cross-sectional study was conducted between August 2022 and January 2023 among a sample of the general population in Jeddah, Saudi Arabia. The questionnaire consisted of demographics, knowledge and awareness, and questions about CRC screening barriers. A total of 1105 adults belonged to the general public [505 females (45.7%) and 600 males (54.3%)] recruited in this survey. The mean age of the respondents was 39.79±12.49. The internet was the primary source of CC information for most participants, 661(59.8%). Gender-wise comparison of general public responses regarding CRC knowledge and awareness and barriers to screening showed a mixed response. Analysis of participants' knowledge regarding CRC and its risk factors and warning signs showed that 356(32.2%) people believed that the best age for the CRC test is 41-50 years, and 285(25.8%) responded they don't know. Almost half of the participants, 539(48.8%), were not interested in attending awareness seminars about CRC, while 371(33.6%) were interested in attending awareness seminars about CRC. Only one-third of the respondents, 368(33.3%), knew of any tests or examinations used to detect CRC. Participants' perceptions about colonoscopy-related and FOBT-related barriers to CRC screening disclosed that these are time-consuming, expensive, painful, embarrassing, etc. Insufficient information, poor awareness, and several assumed barriers to CRC screening were found among study participants. There is a need to close knowledge gaps and offer them comprehensive information regarding CRC, as well as the availability and benefits of screening. In this aspect, social media can be extremely beneficial.

News “Attraction” and Digital Inequalities: Incidental News Exposure and the Equalization or Stratification of Political Information

Understanding the impact of digital media on news inequalities is critical for democracy. The literature on incidental exposure challenges the idea that major platforms shrink information gaps, and research has turned to the identification of variables that explain how those gaps widen or persist. We use Latent Class Analysis to operationalize the metaphor of “attracting the news” and investigate incidental exposure as both an individual trait and temporal state. We link the top stories on Facebook during an election cycle with incidental exposure measures to explore news attraction, incidental exposure, and news engagement. We find some evidence incidental exposure may close information gaps, but that it does not close engagement gaps. Results contribute to theory about how digital media shape inequalities in news consumption and engagement.

Development and Cognitive Testing of Occupational Safety and Health Questions for a Youth Survey: Addressing the Research Needs for a Vulnerable Working Population.

While more than 2.5 million U.S. high students worked in 2020, data to assess how work affects this group are sparse. To facilitate such research, a set of occupational safety and health questions for inclusion on the Youth Risk Behavior Surveillance System (YRBSS) and other youth-focused surveys was developed. Survey questions about occupational experiences of young workers were adapted from other surveys or created de novo. Key audiences were engaged to define priority topic areas and develop draft questions, which were further refined through cognitive interviews with working youth. Twenty-one resulting questions spanned multiple work-related topics: employment status; health outcomes; psychosocial exposures; and safety climate. Cognitive testing revealed that youth (aged 14-19) had difficulty with temporal concepts. Some difficulties reflected the propensity of youth to engage in multiple, online, and informal jobs. During 3 rounds of interviews, questions were adjusted to better reflect youth employment circumstances and language. Four states added at least 1 work-related question to their 2023 Youth Risk Behavior Survey questionnaire, and the full set of questions has been disseminated to federal agencies and partners. Including tailored questions about employment in surveys of youth will facilitate occupational health surveillance for this group. Analysis of resulting data can help to close knowledge gaps, provide current prevalence data, inform policy, and allow development of focused prevention and intervention strategies to reduce adverse outcomes among young workers.

Trends and local perceptions of human-crocodile conflicts in Kariba town, northern Zimbabwe

ABSTRACT This study assessed the nature and local people’s perceptions of human-crocodile (Crocodylus niloticus) conflicts (HCCs) for the period 2007 to 2016 in Kariba town, northern Zimbabwe. A mixed-method approach was used with 150 local fish folks interviewed between July and October 2017 through face-to-face interviews and secondary data on HCC were retrieved from the wildlife authority’s records. In contrast to the general perception from fish folks that there was an increase in HCC, secondary data analysis showed no significant trends of crocodile attacks on people for the period under study. HCC was mainly driven by fishing activities which exposed people to crocodile attacks. The study concludes that despite the recorded non-increasing trend in HCCs, HCC is a major conservation issue in Kariba town given enhanced human–wildlife interactions due to the economic needs for local livelihoods. Community educational programs are recommended as a way to manage HCC and close gaps between the conventional scientific and local knowledge.

Toward a Roadmap for Best Practices in Pediatric Preventive Cardiology: A Science Advisory From the American Heart Association.

Cardiovascular disease risk factors are highly prevalent among youth in the United States and Canada. Pediatric preventive cardiology programs have independently developed and proliferated to address cardiovascular risk factors in youth, but there is a general lack of clarity on best practices to optimize and sustain desired outcomes. We conducted surveys of pediatric cardiology division directors and pediatric preventive cardiology clinicians across the United States and Canada to describe the current landscape and perspectives on future directions for the field. We summarize the data and conclude with a call to action for various audiences who seek to improve cardiovascular health in youth, reduce the burden of premature cardiovascular disease, and increase healthy longevity. We call on heart centers, hospitals, payers, and policymakers to invest resources in the important work of pediatric preventive cardiology programs. We urge professional societies to advocate for pediatric preventive cardiology and provide opportunities for training and cross-pollination across programs. We encourage researchers to close evidence gaps. Last, we invite pediatric preventive cardiology clinicians to collaborate and innovate to advance the practice of pediatric preventive cardiology.

Closing capability gaps for procuring infrastructure public-private partnerships: A case study in China

This paper explores how public sector owners (PSOs) close capability gaps between existing capabilities and required capabilities when first entering into infrastructure Public-Private Partnerships (PPPs). Drawing on the dynamic capabilities view and research on owner project capabilities, the paper presents an exploratory in-depth case study of a state-owned enterprise in China, as it was in the process of initiating PPP metro line projects for the first time. The findings show that PSOs closed capability gaps by obtaining owner strategic, commercial and governance capabilities at the initial phase of PPP procurement. This process was undertaken through a combination of acquiring capabilities externally and developing capabilities internally. The study contributes to the literesture on capability development and sheds light on the conditions when and where internal capability development and external capability acquisition are integrated to close capability gaps for procuring infrastructure PPPs.

A Salt Tolerant Native plants as a Solution for Mobile Sand and Dust in Kuwait

In this study, a coastal research site north of Kuwait Bay faces sand encroachment, floods, and wave erosion. The plantation project’s infrastructure was improved by fencing 1.2 km2 with barbed wire. The heavily deteriorated environment has coppice dunes of Nitraria retusa and Lycium shawii around single, double, or triple plants. To manage mobile sand and dust and protect the research centre, 21,500 Nitraria and Lycium were planted and irrigated with brackish water (around 7000 TDS). In order to aerodynamically shift and/or trap mobile aeolian sediments, the vegetation was planted in a V-shape facing the north-westerly wind. A closer gap (about 1m between plants) on the side facing the primary wind and widened toward the inner edges of the gated area controls mobile sand and dust. This projected design stabilizes the soil, protects against floods and wave erosion, enhances flora and animals, and controls aeolian activity. Mobile sand and dust yearly rates in the downwind traps were reduced by 94% and 64.5%, respectively. Native vegetation can control mobile sand and dust, according to this. Such systems can be more efficient with proper design and plant spacing.

The International Criminal Court: Whether the Crime of Aggression in Ukraine

Summary Since the establishment of the International Criminal Court (ICC) almost two decades ago, the crime of aggression has not been tested. The Russian invasion of Ukraine seems to provide a fitting opportunity. However, the ICC lacks jurisdiction over the crime of aggression in the current Russian/Ukrainian war. Nevertheless, 24 February 2022 marked the beginning of a renewed attack, as Ukraine witnessed unimaginable proportions of human rights violations, deaths, sufferings, and displacements due to the Russian invasion. While it is incontrovertible that the crime of aggression has been committed by President Vladimir Putin of Russia against Ukraine, and the ICC has begun the investigation of crimes against humanity and war crimes, jurisdictional questions looms. The ICC is empowered to investigate, prosecute, and punish individuals for international crimes, close impunity gaps, and ensure accountability for the ongoing heinous crimes being committed in Ukraine. How can justice be served specifically to Ukrainian victims and generally to the international community for the atrocities being committed and for the crime of aggression? Since the ICC lacks jurisdiction, would the setting up of a special tribunal or hybrid court be better to deal with the situation? How would such special tribunal deal with the issues of immunity and the practicality of investigations and prosecution? This paper discusses these questions and argues that beyond the referrals to the ICC made by over forty states, it may be imperative for the referring states to utilise the universal jurisdiction principle to investigate and prosecute the crime of aggression.

Use of drugs in pregnant dogs and puppies - what should be considered from a pharmacological point of view?

The administration of drugs to pregnant bitches may not only pose a potential danger to the bitch but also to the fetuses. In this context, the extent of the risk also depends on the stage of gestation. Although a number of agents are known to have a fetotoxic and/or teratogenic potential, insufficient knowledge concerning their potential risk to the embryo/fetus is available for the majority of drugs.Arranged in groups of active substances, a selection of drugs that are assumed to be safe according to the current state of knowledge is provided. Drugs for which there is insufficient knowledge or which are clearly contraindicated are also mentioned.The second part of this overview covers the use of medicines in puppies. The physiology of a puppy does not simply correspond to that of a small dog. Only very few drugs posess valid pharmacological data for use in puppies. However, a subset of restrictions on the use of pharmacologic agents may be derived from the specifics of puppy physiology.The recommendations made do not claim to be complete and no guarantee for accuracy is provided, as these have been compiled from a literature review. In certain cases, the recommendations are even contradictory.Veterinarians are therefore encouraged to report all adverse events associated with treatments of pregnant bitches and puppies within the framework of pharmacovigilance. This is the only way to close gaps in knowledge about the treatment of these special patients.

Defining operational research priorities to improve malaria control and elimination in sub-Saharan Africa: results from a country-driven research prioritization setting process

BackgroundIn order to reignite gains and accelerate progress toward improved malaria control and elimination, policy, strategy, and operational decisions should be derived from high-quality evidence. The U.S. President’s Malaria Initiative (PMI) Insights project together with the Université Cheikh Anta Diop of Dakar, Senegal, conducted a broad stakeholder consultation process to identify pressing evidence gaps in malaria control and elimination across sub-Saharan Africa (SSA), and developed a priority list of country-driven malaria operational research (OR) and programme evaluation (PE) topics to address these gaps.MethodsFive key stakeholder groups were engaged in the process: national malaria programmes (NMPs), research institutions in SSA, World Health Organization (WHO) representatives in SSA, international funding agencies, and global technical partners who support malaria programme implementation and research. Stakeholders were engaged through individual or small group interviews and an online survey, and asked about key operational challenges faced by NMPs, pressing evidence gaps in current strategy and implementation guidance, and priority OR and PE questions to address the challenges and gaps.ResultsAltogether, 47 interviews were conducted with 82 individuals, and through the online survey, input was provided by 46 global technical partners. A total of 33 emergent OR and PE topics were identified through the consultation process and were subsequently evaluated and prioritized by an external evaluation committee of experts from NMPs, research institutions, and the WHO. The resulting prioritized OR and PE topics predominantly focused on generating evidence needed to close gaps in intervention coverage, address persistent challenges faced by NMPs in the implementation of core strategic interventions, and inform the effective deployment of new tools.ConclusionThe prioritized research list is intended to serve as a key resource for informing OR and PE investments, thereby ensuring future investments focus on generating the evidence needed to strengthen national strategies and programme implementation and facilitating a more coordinated and impactful approach to malaria operational research.

Mooring in the green room. Sailors’ preferences and willingness to pay for green policies in marinas

‘Going green’ is still challenging in the yachting industry partly due to the lack of consumer-centric approaches. This study assesses sailors' preferences and willingness to pay for green policies in marinas, in the context of other measures to increase health security and digital transformation. To do so, a choice experiment was designed through the lens of stakeholders and supported by the Delphi technique. The study is based on the marinas of the Canary Islands in the Atlantic crossing and involved European sailors as potential users. Data confirm that sailors' utility and intention to visit marinas increase the most when ambitious green programs are in place, thereby confirming a high environmental sensitivity among them. More specifically, solar energy use, single-use plastic eradication, and waste recycling are the programs with the greatest positive impact on sailors' willingness to pay. This indicates a potential profitability and market opportunities derived from more environmental friendly practices in marinas. The study opens a new perspective to improve incentive and funding schemes and close implementation gaps in recreational ports.

Getting the basics right on soil enzyme activities: A comment on Sainju et al. (2022)

AbstractSoil enzyme activities have been measured since the mid‐20th century to help understand how agricultural management practices impact nutrient cycling, and are now considered biological indicators of soil health. However, misconceptions persist about what soil enzyme activities represent and how activities can or cannot be interpreted. The publication by Sainju et al. in Agrosystems, Geosciences & Environment that seeks to evaluate how soil enzyme activities relate to crop yields exemplifies many of these issues. We therefore provide a constructive diagnosis and critique of five common misunderstandings and even errors exemplified by this work. Our ultimate goal in this critique is to catalyze a better understanding of soil enzyme activities and identify where research is needed to close knowledge gaps.

Does Decision Making for Others Close the Gender Gap in Competition?

We examine whether the gender gap in competitiveness in stereotypically male tasks persists when the decision to compete is made by someone else. In a within-subject laboratory experiment, decision makers make competition entry decisions for both themselves and a randomly selected other. Although we replicate the standard gender gap in decisions for oneself, we do not find a gender gap when the decision to compete is made by someone else. This is driven by men being significantly more willing to enter themselves than others into competitions. Men’s and women’s willingness to enter others into competitions is statistically indistinguishable from women’s willingness to enter themselves into competitions. Subgroup analyses reveal that competitive preferences are significantly greater for Asian than non-Asian subjects. Our results have implications for the effectiveness of nominations and mentorship to close gender gaps in labor market outcomes that are affected by competitive preferences. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Funding: This work was supported by the Russell Sage Foundation [Grant G-5602]. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4861 .

Exploring the Transformative Potential of Technology in Overcoming Educational Disparities

The function of technology in fostering fair access to high-quality education and closing educational gaps. The main objective is to give a thorough overview of the role that educational technology plays in establishing inclusive and productive learning settings, as well as the difficulties it faces. The essay is broken up into a number of sections that explore various facets of technology integration in education. The relevance of technology as a driver for fair educational possibilities is emphasized in the first section, which explores the idea of bridging educational differences. It emphasizes the necessity of using technology-driven solutions to address inequalities in access, resources, and learning outcomes. The sections that follow examine various facets of technology integration. Personalized learning, connecting students from around the world via virtual platforms, overcoming resource limitations, equipping instructors with technology, gauging the success of technological interventions, and exploring future views in educational technology are some of these themes. Using pertinent research, examples, and case studies, each part offers a thorough treatment of the subject. The paper addresses how technology-enabled individualized learning techniques can meet a range of learning demands and improve educational experiences for all students. It also emphasizes how virtual learning environments could link students from all around the world, promoting collaboration and intercultural understanding. The report also looks at how technology may assist digital assessment and feedback, improve access to educational resources, and offer cost-effective ways to address resource limitations. It also looks at how technology integration strengthens teachers' pedagogies, supports professional growth, and streamlines administrative work. The article also underlines how crucial it is to evaluate how technology might be used to bridge gaps in educational attainment. The discussion centers on issues including accessibility, equity, bridging the achievement gap, teacher professional development, and long-term sustainability as it addresses the evaluation of technology interventions using quantitative and qualitative assessment approaches. The article examines promising developments in educational technology, such as gamification, data analytics, social and emotional learning, artificial intelligence, virtual and augmented reality, mobile learning, and block chain technology. It talks about how they could influence how education develops in the future, create inclusive classrooms, and get kids ready for success in the digital era. Overall, this essay offers a thorough examination of how technology might help close gaps in educational attainment. It draws attention to the transformative impact of technology in fostering fair access, improving learning opportunities, and empowering students and educators. Policymakers, educators, and stakeholders can cooperate to create an educational environment that is more inclusive and fair by utilizing the opportunities provided by technology.

Gender and competitive performance: Closing gaps with smaller competitions

AbstractWe examine whether gender gaps in competitive performance are moderated by the size of the competition. We hypothesize that women underperform in large, relative to small, competitions and that smaller competitions close gender performance gaps by enhancing women's performance. Study 1 demonstrates this effect using behavioral data from real marathon competitions. Study 2 experimentally replicates the effect with real behavior. Study 3 provides further experimental support that gender performance gaps are exacerbated under competition and that, in these situations, small groups help bring women's performance up to par with men's. We conclude with a discussion about how making simple structural changes can reduce gender equity gaps in organizations.

Stroke Characteristics in a Cohort of Hmong American Patients.

Background Prior studies have indicated high rates of vascular risk factors, but little is known about stroke in Hmong. Methods and Results The institutional Get With The Guidelines (GWTG) database was used to identify patients discharged with acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage between 2010 and 2019. Hmong patients were identified using clan names and primary language. Univariate analysis was used to compare Hmong and White patients. A subarachnoid hemorrhage comparison was not conducted because of the small sample size. We identified 128 Hmong patients and 3084 White patients. Hmong patients had more prevalent hemorrhagic stroke (31% versus 15%; P<0.0016). In the acute ischemic stroke cohort, compared with White patients, Hmong patients were younger (60±13 versus 71±15 years; P<0.0001), presented to the emergency department almost 4 hours later; and had a lower thrombolysis usage rate (6% versus 14%; P=0.03496), worse lipid profile, higher hemoglobin A1C, similar stroke severity, and less frequent discharge to rehabilitation facilities. The most common ischemic stroke mechanism for Hmong patients was small-vessel disease. In the intracerebral hemorrhage cohort, Hmong patients were younger (55±13 versus 70±15 years; P<0.0001), had higher blood pressure, and had a lower rate of independent ambulation on discharge (9% versus 30%; P=0.0041). Conclusions Hmong patients with stroke were younger and had poorer risk factor control compared with White patients. There was a significant delay in emergency department arrival and low use of acute therapies among the Hmong acute ischemic stroke cohort. Larger studies are needed to confirm these observations, but action is urgently needed to close gaps in primary care and stroke health literacy.

LA IMPORTANCIA DEL GENOTIPADO PROFUNDO EN EL MEJORAMIENTO GENÉTICO

One of the greatest challenges facing humanity is the development of sustainable strategies to ensure food availability in response to population growth and climate change. One approach that can contribute to increase food security is to close yield gaps and enhancing genetic gain; to such end, what is known as “molecular breeding” plays a fundamental role. Since a crop breeding program is mainly based on the quality of the germplasm, its detailed genetic characterization is mandatory to ensure the efficient use of genetic resources and accelerating development of superior varieties. Deep genotyping is an essential tool for a comprehensive characterization of the germplasm of interest and, fortunately, the technology is now accessible at a reasonable cost. What must be ensured is the correct interpretation of the genotypic information and on that basis develop efficient practical molecular crop breeding strategies that respond to the real needs of the breeding program. Key words: breeding population, genetic resources, marker assisted selection, Single Nucleotide Polymorphism (SNP)

Payer reimbursement practices and incentives for improving interpretation of germline genetic testing.

Germline genetic testing for inherited cancer risk has shifted to multi-gene panel tests (MGPTs). While MGPTs detect more pathogenic variants, they also detect more variants of uncertain significance (VUSs) that increase the possibility of harms such as unnecessary surgery. Data sharing by laboratories is critical to addressing the VUS problem. However, barriers to sharing and an absence of incentives have limited laboratory contributions to the ClinVar database. Payers can play a crucial role in the expansion of knowledge and effectiveness of genetic testing. Current policies affecting MGPT reimbursement are complex and create perverse incentives. Trends in utilization and coverage for private payers and Medicare illustrate opportunities and challenges for data sharing to close knowledge gaps and improve clinical utility. Policy options include making data sharing (i) a condition of payment, and (ii) a metric of laboratory quality in payment contracts, yielding preferred coverage or enhanced reimbursement. Mandating data sharing sufficient to verify interpretations and resolve discordance among labs under Medicare and federal health programs is an option for the US Congress. Such policies can reduce the current waste of valuable data needed for precision oncology and improved patient outcomes, enabling a learning health system.

The quality of prison primary care: cross-sectional analyses of prison healthcare data in Northern England.

Prisoners have considerable health needs, are relatively high users of health care and often die prematurely. Prison healthcare research has typically focused on specific problems such as substance misuse, but 'routine' primary care has received less attention. Strong primary care systems are associated with better population outcomes. Identifying inappropriate variations in care will inform strategies to close gaps in health care and reduce preventable deaths. To explore variations in the quality of primary care for prisoners. We assessed achievement against 30 quality indicators examining different aspects of care in 13 prisons. We conducted repeated cross-sectional analyses of routinely recorded data from electronic health records across 2017-2020. Multi-level logistic regression models explored associations between indicator achievement and prison and prisoner characteristics. We found marked variations in achievement between different indicators and different prisons. Achievement ranged from 0·2% of people with epilepsy coded as seizure-free, to 93·8% of people with diabetes having blood pressure checks, in the preceding year. Achievement improved over three years for 11 indicators and worsened for six, including declining antipsychotic monitoring and rising opioid prescribing. Achievement varied between prisons, from 1·93-fold for prescribing of gabapentinoids with no coded diagnosis of neuropathic pain (Odds Ratio (OR) range 0·67 to 1·29) to 21,610-fold for medicine reconciliation (OR range 0·45 to 9724·5). Shorter lengths of stay were frequently associated with lower achievement. Some associations between ethnicity and achievement were identified. We found substantial scope for improvement and marked variations in quality which were largely unaltered after adjustment for prison and prisoner characteristics.

Community-Based Approaches to Increase COVID-19 Vaccine Uptake and Demand: Lessons Learned from Four UNICEF-Supported Interventions.

Vaccination is critical to minimize serious illness and death from COVID-19. Yet uptake of COVID-19 vaccines remains highly variable, particularly among marginalized communities. This article shares lessons learned from four UNICEF interventions that supported Governments to generate acceptance and demand for COVID-19 vaccines in Zambia, Iraq, Ghana, and India. In Zambia, community rapid assessment provided invaluable real-time insights around COVID-19 vaccination and allowed the identification of population segments that share beliefs and motivations regarding COVID-19 vaccination. Findings were subsequently used to develop recommendations tailored to the different personas. In Iraq, a new outreach approach (3iS: Intensification of Integrated Immunization) utilized direct community engagement to deliver health messages and encourage service uptake, resulting in over 4.4 million doses of COVID-19 and routine immunization vaccines delivered in just 8 months. In Ghana, a human-centered design initiative was applied to co-develop community-informed strategies to improve COVID-19 vaccination rates. In India, a risk communication and community engagement initiative reached half a million people over six months, translating into a 25% increase in vaccination rates. These shared approaches can be leveraged to improve COVID-19 vaccination coverage and close gaps in routine immunization across diverse and marginalized communities.