Gaps In Access Research Articles

Synopsis: Filling the gap in language access: Voluntary sector translation of public health guidance in England during the Covid-19 pandemic

Synopsis: Filling the gap in language access: Voluntary sector translation of public health guidance in England during the Covid-19 pandemic

Filling the gap in language access: Voluntary sector translation of public health guidance in England during the Covid-19 pandemic

The right to health is a fundamental human right, making the timely and accurate communication of essential public health information crucial, particularly in emergency situations, and in all necessary languages and formats. Increasingly, such information is translated by unpaid volunteers and/or non-professional translators both in public health and emergencies. This situation came to a head worldwide during the Covid-19 pandemic. The inadequate response of the public authorities in the United Kingdom resulted in the voluntary or third sector stepping in to fill the gap. This paper focuses on the unique and sustained work by medical charity Doctors of the World UK (DoTW) and its partners to translate official pandemic health guidance at the national level in England. Using Taibi’s community translation quality assurance model (2018a), the paper examines the strategy adopted by DoTW and analyzes its approach in order to identify good practices for successful public risk communication through translation. In view of the growing use of voluntary sector initiatives in the public sector, it also considers the sustainability of voluntary sector intervention at the national level to fill the gaps in public service translation. A longer abstract of this article in this language can be found here: synopsis.

An electronic patient-reported outcomes (ePRO)-directed virtual model for addressing oncology supportive care needs.

e13886 Background: Virtual oncology care models using electronic patient-reported outcomes (ePRO)-based interventions improve outcomes, but limited access leaves gaps in care for symptom management, psychosocial support, and malnutrition. 1-16 This study aims to identify the percentage of participants who completed ePRO surveys as part of the Iris by OncoHealth virtual supportive care program and were referred to oncology specialists for virtual care based on survey results. We also assessed patients' perceptions of the care they received. Methods: A retrospective review of electronic medical records from June 2022 to May 2025 evaluated the effectiveness of ePRO screening and its role in referring patients to oncology-certified nurses (OCNs), oncology social workers (OSWs), and oncology-specialized dietitians (RDs) in the Iris program. The study population included cancer patients ≥18 years old who were members of participating health plans. Enrolled patients completed ePRO surveys, including the Patient Health Questionnaire-4 (PHQ-4), NCCN Distress Thermometer and Problem List, Malnutrition Screening Tool (MST), symptom questionnaire, and a survey evaluating resource needs. OCNs utilized ePROs to develop care plans and navigate patients to the appropriate services based on results. Patient perceptions were assessed through surveys after virtual interactions. Results: During the study period,976 patients enrolled and 507 (51.9%) engaged with the program. Table 1 summarizes ePRO results and clinical care. A total of 177 patients (34.9%) completed the patient perceptions survey, providing 441 responses. Of these, 92.2% were 5-star ratings, and 99.3% indicated needs were addressed. The program achieved a Net Promoter Score of 91 (93% promoters, 6% passives, and 2% detractors). Conclusions: The study results show high ePRO screening completion for distress, anxiety and depression, malnutrition, and symptom management within the oncology population, with a significant proportion of positive cases establishing care with OSW, RDN, or ONN. These results demonstrate how ePRO-directed virtual supportive care can address the needs of people with cancer and help close system-wide gaps in access to services. Patient satisfaction was exceptionally high, reflecting both the program's effectiveness and strong patient approval. Summarizes ePRO results and clinical care. Category Completed Screening (N, %) Screened Positive (N, %) Established Care (N, %) (Clinician) Distress 260 (51.3%) 169 (65.0%) 113 (66.9%) (OSW) Anxiety and Depression 156 (30.8%) 92 (59.0%) 77 (83.7%) (OSW) Malnutrition 155 (30.6%) 51 (34.9%) 36 (70.6%) (RDN) Symptom Questionnaire 341 (67.3%) 277 (81.2%) 98 (35.4%) (ONN)

Migration and Women's Health Research (2000-2023): A bibliometric analysis of trends and gaps.

This bibliometric study examines the scholarly landscape of migration and women's health, analyzing 1314 Scopus-indexed articles from 462 journals published between 2000 and 2023. Findings indicate a consistent increase in research output, reflecting growing global interest in this interdisciplinary field. Geographically, high-income countries (HICs), including the United States, Canada, the United Kingdom, and Australia, dominate contributions, while low- and middle-income countries (LMICs) remain underrepresented despite hosting significant migrant populations. International collaborations play a crucial role, with key institutions such as the University of California and the London School of Hygiene and Tropical Medicine shaping research efforts. The keyword co-occurrence analysis highlights migration, gender dynamics, mental health, and reproductive health as dominant themes. Persistent gaps in mental and reproductive healthcare access for migrant women emphasize the need for trauma-informed care (TIC), mobile bilingual healthcare services, and inclusive health policies. Disparities in research funding further exacerbate global health inequities, underscoring the necessity of equitable redistribution of resources, including redirecting at least 10% of HIC research grants to LMIC-led studies. The COVID-19 pandemic magnified pre-existing vulnerabilities, stressing the importance of multilateral collaborations and sustainable policy interventions to enhance migrant healthcare access. This study provides valuable insights into research trends, collaboration networks, and thematic focus areas, offering a foundation for future interdisciplinary research and evidence-based policymaking aimed at promoting health equity for migrant women globally.

Trends in female breast cancer among adolescent and young adults in Southeast Asia.

1597 Background: Breast cancer is the leading cancer among women globally and poses a growing public health challenge, particularly in adolescents and young adults (AYAs), defined as individuals aged 15–39 years. In Southeast Asia (SEA), rising breast cancer rates among AYAs are compounded by unique biological, socioeconomic, and healthcare barriers, including late-stage diagnosis and limited access to screening and treatment. However, regional data on incidence and mortality trends remain scarce. This study aims to analyze temporal trends in AYA breast cancer incidence and mortality across 11 SEA countries from 1990 to 2021 using data from the Global Burden of Disease (GBD) database. Methods: We extracted breast cancer incidence and mortality data for AYAs in SEA from the GBD database (1990–2021) for Brunei, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, the Philippines, Singapore, Thailand, Timor-Leste, and Vietnam. Age-standardized rates (ASRs) were calculated, and temporal trends were evaluated using Estimated Annual Percent Change (EAPC) based on log-linear regression. Results: Breast cancer incidence among AYAs increased significantly across SEA from 1990 to 2021. Thailand reported the highest ASR in 2021 (11.78 per 100,000) and the most pronounced rise in incidence (EAPC 4.06). Significant increases were also observed in Vietnam (EAPC 2.92), Cambodia (2.63), and Laos (2.57). Mortality trends were heterogeneous: Singapore achieved a significant decline (EAPC -2.00), attributed to advancements in early detection and treatment, while Thailand, Indonesia, Vietnam, and Cambodia experienced rising mortality rates. In 2021, the highest mortality rates were recorded in Myanmar (2.54 per 100,000), Thailand (2.36 per 100,000), and the Philippines (2.17 per 100,000). Conclusions: The growing burden of AYA breast cancer in SEA reflects a combination of epidemiologic transitions, socio-economic shifts, and regional healthcare disparities. Rising incidence is linked to changes in reproductive behavior, lifestyle factors, and urbanization, while increased mortality highlights gaps in healthcare access and screening infrastructure. Urgent public health interventions tailored to AYA populations are needed to enhance early detection, improve treatment accessibility, and address disparities across SEA. Regional collaboration and investments in healthcare systems are critical to mitigating the growing burden of breast cancer among AYAs in this dynamic region.

Analysis of the Impact of Computer Technology Development on the Education System

The development of computer technology from time to time has brought significant changes in various aspects of life, including the education system. This study aims to analyze the impact of the evolution of computer technology on the education system, especially in terms of learning methods, access to information, and efficiency of educational administration. The problems raised in this study are the extent to which computer developments affect the education system and how the integration of these technologies can improve the quality of learning. This study uses a qualitative descriptive method with a literature study approach and field observations in several universities. Data were collected through interviews with lecturers and education staff, as well as documentation related to the use of computer technology in the education process. The results of the study show that the development of computer technology has a positive impact on the education system, including through bold learning, the use of the Learning Management System (LMS), and the digitalization of campus administration. However, the study also identified challenges in its implementation, including gaps in access and technological skills. Thus, adaptation to computer developments must be accompanied by training and infrastructure improvements so that the benefits can be felt evenly.

Comparing Learning Modalities: How Motivation and Learning Approaches Shape Academic Achievement

The hurried shift to online learning during the COVID-19 pandemic significantly disrupted traditional learning paradigms for students, methods of instruction for faculty, and measurement of student success for administrators. The adaptability of existing online learning approaches did not withstand the significant pressures of the pandemic-forced transition. Despite a growing interest and literature base in online learning before the pandemic, additional challenges were uncovered in the quick transition to online learning, reflecting gaps in equitable access to learning across modalities. This commentary serves two purposes: First, it describes the psychological underpinnings of effective learning, including motivational factors and cognitive factors underlying strategies employed by students for self-regulated learning. Second, this article provides examples of practical applications from the existing educational and psychological scholarship concerning the role of student motivation and student learning behaviors that promote learning achievement across modalities.

Еvaluation of environmental research infrastructures services to address impacts on forest health and biodiversity

The potential of environmental research infrastructures (RIs) to fully implement the FAIR (Findable, Accessible, Interoperable, and Reusable) principles remains underutilised in addressing diverse challenges on global forest health and biodiversity. This study aims to characterise environmental RIs and their data services in tackling the effects of extreme climatic conditions on global forests. It examines the primary drivers of forest challenges across tropical, temperate, and boreal forest types, identifies the critical data required to understand these challenges, and explores the role and potential of environmental RIs in providing such data. A systematic literature search and review spanning 2013–2023 was conducted using sources such as Google, Google Scholar, and Scopus to identify documented key drivers of forest impacts, along with the relevant data types and sources utilised in the selected articles. The result has been organised in these four categories of drivers: biophysical, biological, human-induced, and socioeconomic. Furthermore, the numerous forest impacts identified are grouped into ecological, physiological, socioeconomic, and climate-related impacts. Different data types were considered in this study, ranging from carbon flux data to other various forms of experimental and field observation data. Data sources ranged from local and national forest inventories to specialized monitoring networks and research infrastructures. Four terrestrial biosphere RIs—ICOS, AnaEE, LifeWatch, and eLTER—were assessed through their websites, annual reports, and impact assessments to evaluate their data services and potential contributions to climate change on global forests. The analysis explored the frequency and significance of integrating cross-RI multidisciplinary services. The study ultimately highlights existing gaps in RI data availability, accessibility, integration, and interoperability to address interconnected and overlapping global forest challenges.

Continuing medical education in epileptology: The Level 1-2-3 experience of the ILAE academy.

The International League Against Epilepsy (ILAE) Academy is the world's eminent e-learning campus for epileptology. Its modular teaching content was developed to cover all competencies and learning objectives specified in the ILAE's curriculum for epileptology. The tutorless and self-paced entry Level 1 program for beginners offers an interactive case-based e-learning approach. A blended e-learning format was developed for the proficiency Level 2 with various learning domains and formats. They comprise a series of interactive, self-paced and case-based e-learning modules covering common, but also rare or complex epilepsy conditions, through state-of-the-art diagnosis and rational treatment decisions. Interactive EEG and MRI readers were integrated to support a tutorless online teaching format. An innovative adaptive e-learning format was applied for specific learning domains to reflect not only the proficiency level of the learner but also their self-confidence and perceived and unperceived knowledge of the topic. Our analysis of the completed adaptive e-learning courses revealed that 21% of the learning objectives had been answered incorrectly despite the learner indicating that they know the answer. This so-called "unconscious incompetence" should be regarded as a key motivation for building continuing medical education (CME) programs in epileptology. Level 2 utilizes a blended learning approach requiring 200 CME or equivalent ILAE credit points, earned through a mix of online learning with in-person participation in ILAE schools and congressional teaching activities. Level 3 is the subsequent step in the ILAE's structured learning path towards advanced proficiency and includes skill-based training in epileptology. Registered learners can apply for training visits in internationally renowned epilepsy centers around the world. Limited financial support is made available for selected applicants, e.g., to support candidates from resource limited settings. Designed to bridge the gap in knowledge and access to continuing education in epileptology, this unique structured learning path is open to all healthcare professionals.

Breaking the Cycle: Addressing Menstrual Health Inequities to Enhance Women's Workplace Productivity and Empowerment in India

Menstruation is a pivotal component of women's overall well-being and workplace productivity, yet it remains largely neglected in public health and workplace discussions. Despite a significant influence, menstrual health remains an under-researched condition in various policy frameworks in India. This study explains the conjuncture of menstrual health management (MHM) and participation rate of women in workforce that emphasizes the global inequalities in access to menstrual products and sanitation facilities. Considering the latest data from the National Family Health Survey (NFHS-5), the urban, educated and privileged women are more likely to make use of safe and hygienic methods in comparison to women hailing from rural and lower socio-economic status who depend on unhygienic traditional practices, thereby amplifying health risks and absenteeism. By underlining these divergences, the paper focuses on the urgent need for interventions that address the gap in menstrual health access. Highlighting the menstrual health inequities, not only aids in the improvement of women’s well-being but also enhances their productivity, gender equity and achievement of multiple Sustainable Development Goals (SDGs). Hence, this research contributes to the literature calling for an integrated approach to menstrual health as a key factor in women's empowerment and national economic progress.

Educational leadership for socioeconomic equity: University leaders’ perceptions on their role in reducing the access gap in higher education in China

This article investigates how university leaders in China perceive their role in reducing the socioeconomic access gap in higher education (HE), using the capability approach as a conceptual framework. Focusing on three educational capabilities, the study examines leaders’ perceptions of factors enabling or constraining access for low-socioeconomic-status students. The findings – based on interviews with six university leaders – reveal that while leaders recognise the socioeconomic access gap in HE, there is a lack of consensus regarding their responsibility to address it. Nonetheless, they are well-positioned to actively promote the capabilities of low-socioeconomic-status students, particularly respect and recognition, aspiration, and voice. The article concludes by speculating on the potential application of distributed leadership theories in the Chinese context to reduce this access gap. It highlights the important roles of informal leaders in ensuring that policies – aimed at facilitating access for low-socioeconomic-status students – are enacted in ways relevant to the local context.

The Role of Social Media in Driving Community Innovation: A Mixed-Methods Study on Challenges and Opportunities in the Digital Age

Social media has increasingly become a driving force for community innovation in cyberspace. Platforms such as Facebook, WhatsApp, Instagram, and TikTok have empowered individuals and groups worldwide to collaborate, share ideas, and innovate collectively. However, despite these opportunities, social media also presents significant challenges, including misinformation, algorithmic bias, and issues surrounding trust and privacy. Utilizing a mixed- methods research approach, this study combines quantitative surveys and qualitative interviews to assess the impact of social media on community innovation. Data will be analyzed using descriptive statistics and thematic analysis to understand engagement, collaboration patterns, and the challenges faced by users. The study aims to contribute to existing research by providing insights into how social media platforms can be optimized for innovation and what strategies can be employed to overcome the digital divide and algorithmic biases. This study finds social media significantly enhances community innovation, with surveys indicating 95% faster collaboration, 100% idea generation efficiency, and 90% solution implementation post- adoption. Persistent challenges include misinformation (84% agreement), algorithmic bias limiting diversity (90%), and access gaps excluding marginalized groups (87%). Mixed- methods data reveal a paradox: platforms democratize innovation yet perpetuate inequities. Opportunities emerge in algorithmic transparency (80% agreement) and policy-driven digital inclusion (78%). Reforms prioritizing ethical governance, transparent AI, and inclusive infrastructure are critical to equitably harness social media’s potential as a global innovation catalyst.

Navigating Marginalization: A field study on the livelihood struggles of Tribal women in Kerala

This paper examines the lived realities of tribal women in Wayanad, Kerala, against the backdrop of systemic socio-economic exclusion. Despite progressive legislation and welfare schemes intended to uplift tribal communities, the implementation often falls short at the grassroots level. Through field-based qualitative research involving 150 tribal women, this study captures the intersectional challenges faced by communities such as the Paniyas, Adiyans, and Kurichyas. It highlights critical issues such as land dispossession, declining forest access, inadequate healthcare, poor financial inclusion, and persistent gender-based vulnerabilities. Importantly, the study foregrounds women’s agency and their role in sustaining families through forest-based livelihoods, despite institutional apathy. The analysis of existing government schemes like MGNREGS and AMSY reveals significant gaps in awareness, accessibility, and impact. However, the research also presents hopeful examples of community-led resilience through self-help groups and informal cooperative networks. The paper aims to provoke a discussion around rights-based, gender-sensitive, and participatory policy reforms that can ensure more equitable development outcomes for marginalized indigenous populations.

Role of digital health technologies in improving health financing and universal health coverage in Sub-Saharan Africa: a comprehensive narrative review

Digital technologies play a key role in developing a comprehensive and resilient healthcare delivery system in many low and middle-income countries in Sub-Saharan Africa. These technologies aim not only to address the financial accessibility gap for health needs but also to enhance innovation, partnerships, data management, and performance across healthcare stakeholders. By bridging gaps in access and reducing inequities, digital health technologies have the potential to mitigate socioeconomic disparities in healthcare delivery, particularly in resource-limited settings. This paper explores existing data on health challenges, financing, and universal health coverage in sub-Saharan Africa, along with examining digital health technologies, their adoption, and implementation. Case studies from initiatives such as M-TIBA in Kenya, JAMII in Tanzania, and L'UNION TECHNIQUE DE LA MUTUALITÉ MALIENNE in Mali are presented, along with recommendations for scale-up, policy enhancement, collaboration, support, and identification of research gaps and areas for further exploration.

Increasing Financial Inclusion for Coffee Farmers through Fintech Education and Implementation in Lembang

Financial inclusion plays a crucial role in improving the economic resilience of smallholder farmers, particularly in rural areas with limited access to formal financial services. This community engagement program aimed to enhance financial literacy and promote fintech adoption among coffee farmers in Lembang. The initiative included structured training sessions, fintech demonstrations, and collaboration with agricultural cooperatives to ensure sustainable financial education. The results indicated a significant improvement in farmers’ understanding of financial management, budgeting, and digital financial tools. Many participants successfully adopted mobile banking, digital payments, and fintech-based lending solutions, reducing their reliance on informal credit sources. The involvement of cooperatives facilitated the dissemination of financial knowledge beyond the initial participants, contributing to long-term sustainability. However, challenges such as digital literacy gaps among older farmers and limited internet infrastructure in remote areas were identified as barriers to widespread fintech adoption. To address these issues, continuous financial literacy programs, mentorship initiatives, and infrastructure improvements are recommended. This study highlights the potential of fintech solutions in bridging financial access gaps and empowering rural farmers with better financial decision-making capabilities. Future initiatives should focus on expanding fintech services to include agricultural insurance and investment options, ensuring a more comprehensive approach to financial inclusion in the agricultural sector.

MedRent (Renting of Medical Equipment)

The high cost and limited availability of medical equipment pose significant barriers to patients in need of home-based care, particularly in underserved regions. MedRent introduces a peer-to-peer medical equipment rental platform designed to bridge this accessibility gap by connecting equipment owners—including individuals and healthcare institutions—with those in need. The platform ensures secure rentals through integrated features such as identity verification, real-time availability, review systems, and support for logistics and maintenance. This paper outlines the MedRent model, system architecture, and operational workflow, and explores its potential to promote affordability, sustainability, and equitable healthcare delivery. By optimizing underutilized medical resources, MedRent fosters a community-driven approach to healthcare support.

Bridging the United States population diversity gaps in clinical research: roadmap to precision health and reducing health disparities.

Precision medicine promises improved health outcomes by tailoring treatments to individual genetic and environmental factors. However, achieving this potential is hindered by persistent health disparities and the underrepresentation of racially and ethnically diverse populations in clinical trials. Limited diversity in research exacerbates health inequities, reducing the generalizability of findings and widening gaps in access to effective treatments. This review outlines a multi-faceted strategy to bridge diversity gaps in clinical trials, focusing on community engagement, clinical pharmacology, and regulatory science. Key approaches include decentralized trials, targeted recruitment, advanced data modeling, and comprehensive integration of genetic and social determinants of health data. Regulatory frameworks, such as diversity action plans, play a crucial role in ensuring equitable access to precision health innovations. Increasing representation in research enhances the reliability of clinical data and fosters health equity by addressing differences in disease prevalence, treatment responses, and healthcare access. By leveraging technological advancements and inclusive research methodologies, this framework aims to transform clinical trials into a roadmap for equitable healthcare. Ensuring diverse participation in research is essential for the successful implementation of precision medicine and realizing the full potential of precision health, ultimately reducing health disparities and promoting fair access to medical advancements across all populations.

Integration of Artificial Intelligence and Machine Learning in Education: A Systematic Review

This PRISMA-based systematic review analyzes how artificial intelligence (AI) and Machine Learning (ML) are integrated into educational institutions, examining the challenges and opportunities associated with their adoption. Through a structured selection process, 27 relevant studies published between 2019 and 2023 were analyzed. The results indicate that AI adoption in education remains uneven, with significant barriers such as limited teacher training, technological accessibility gaps, and ethical concerns. However, findings also highlight promising applications, including AI-driven adaptive learning systems, intelligent tutoring, and automated assessment tools that enhance personalized education. The geographical analysis reveals that most research on AI in education originates from North America, Europe, and East Asia, while developing regions remain underrepresented. Without strategic integration, the uneven implementation of AI in education may widen social inequalities, limiting access to innovative learning opportunities for disadvantaged populations. Consequently, this study underscores the urgent need for policies and teacher training programs to ensure equitable AI adoption in education, fostering an inclusive and technologically prepared learning environment.

Enhancing CNC Machine Operator Accessibility through a Multimodal Chatbot

Modern CNC machining presents significant operational complexities and data interaction challenges, often creating accessibility barriers for a diverse operator workforce. This paper details the design, development, and accessibility-focused evaluation of a Flutter-based mobile conversational assistant tailored for CNC machine operators. Developed with industry collaboration, the system aims to bridge the accessibility gap by translating complex, real-time telemetry data (spindle speed, feed rate, alarms) into easily understandable, actionable insights. The architecture leverages IoT data streams, structured storage, efficient querying, and automated data processing. Crucially, it employs a multimodal interface (text and voice), multilingual support, and a conversational interaction model powered by a Large Language Model (LLM) with Retrieval-Augmented Generation (RAG). Specific features like hands-free continuous conversation mode and visual adjustments directly target physical, cognitive, and linguistic accessibility needs. By providing intuitive, context-aware guidance through natural language, the assistant empowers operators with varying technical literacy and language backgrounds, reduces cognitive load, facilitates hands-free information access, and aims to foster a more inclusive and efficient shop floor environment. Initial findings suggest significant potential in reducing task completion times and improving usability compared to traditional interfaces.

Gambaran Surveilans Kesehatan Ibu dan Anak (KIA) sebagai Upaya Mengurangi Angka Kematian Ibu dan Anak di Kota Palembang

Maternal and Child Health (MCH) surveillance plays a critical role in reducing maternal and infant mortality rates in Palembang City. This study aims to provide a comprehensive overview of the implementation of MCH surveillance at the Padang Selasa Health Center in Palembang, focusing on the health conditions of mothers and children from 2022 to 2024. Using secondary data from annual and monthly reports, the study found that anemia and Chronic Energy Deficiency (KEK) in pregnant women remain significant health concerns. Furthermore, while the exclusive breastfeeding program and Vitamin A distribution showed positive outcomes, immunization coverage has declined in 2024, highlighting potential gaps in access and outreach. The study emphasizes the need for improved healthcare access, more effective nutritional education for pregnant women, and enhancements in the distribution and awareness of immunization programs to reduce maternal and child health risks.