People Access Research Articles

Unmet health-care needs among older adults living alone in Thailand

The present study examined unmet health-care needs (UHN) among older adults living alone in Thailand. This study had two specific objectives: (i) to analyze the effect of living alone on UHN using a matched sample obtained from a propensity score matching method and (ii) to analyze the sociodemographic determinants of UHN using the entire sample of data. Descriptive analysis and logistic regression were employed, along with Thailand’s 2019 Health and Welfare Survey dataset. The findings indicated that older people living alone experienced 1.613 (confidence interval [CI]: 1.066 – 2.440) times more UHN than those living with others (Objective 1). Moreover, older people with low incomes and chronic diseases experienced 1.391 (CI: 1.015 – 1.923) and 5.629 (CI: 4.375 – 7.243) times more UHN than their counterparts (Objective 2). Non-medical costs and a lack of social support facilitating access to health care (e.g., a lack of caretakers to bring older people to health-care providers and a lack of affordable transportation options) may have been the primary causes of the high UHN rate for these groups, as indicated in previous studies. Thus, the government should continue its efforts to alleviate these issues. Specifically, the existing community health volunteer program should prioritize older people living alone who need caretakers during illness. Local health authorities should support the program by offering health emergency vehicles, especially to those living outside major cities with limited transportation options to access health-care providers. The government should also increase the old-age allowance to enhance the financial independence of older people and extend the current telemedicine services to district hospitals and community health centers. Such measures have significantly improved health-care access for low-income older people who do not have extra resources to travel to health-care providers and chronically ill older people who need regular health care in Thailand.

Centering context when characterizing food environments: the potential of participatory mapping to inform food environment research.

Food environments are a critical place within the food system to implement interventions aimed at enabling sustainable diets. In this perspective article, we argue for the need for food environment research to more comprehensively examine the different types of food environments that people access within their communities to ensure that interventions and programs are better aligned with people's lived experiences. We highlight the potential ways in which participatory mapping (PM) can be leveraged to better design food environment research by: (1) identifying the different food environment types that are accessed within a given community; (2) providing insight into the timing for data collection; (3) informing the prioritization of where to conduct food environment assessments; and (4) highlighting the dynamism of food environments over time (e.g., across a given day or across seasons). We provide a case study example of the application of PM and the lessons learned from it in Cambodia. By conceptualizing food environments in a more comprehensive way, from the perspective of the people living within a given community, we will be able to measure food environments in a way that more closely aligns with people's lived experiences.

Adrijo: A Digital Platform for Adriatic Port Heritage—Good Practices for Virtual Museums and Touristic Experiences

Over the past decade, virtual museums have rapidly evolved due to technological advancements, and after the COVID-19 disruption grew in importance, this sustained the innovation of storytelling and the digital transformation of touristic practices. This paper presents the outcomes of a cooperation project: a virtual museum for eight ports in the Adriatic area, constituting notable examples of widespread heritage. The platform Adrijo is a multi-scalar, multilayer virtual museum that leverages the concept of geo-storytelling and e-tourism, also applying two augmented reality technologies for site-specific installations. In addition to the project results, an assessment of the different levels and experiences is provided, based on qualitative and qualitative analysis. As a re-usable resource, the technical tender specification from the methodological work package is presented, encompassing details of the technology, structure, functionalities, costs, timing for realization, and accessibility for disabled people. This paper proposes, through the critical analysis of the VM, a methodology that can be reused in other contexts, also providing toolkits for both its implementation and user satisfaction surveys, as well as for analyzing the strengths and weaknesses of some specific examples. The goal of the present research is thus to establish a consolidated methodological framework for designing, developing, implementing, and assessing a virtual museum, fully featured with 3D models and augmented reality technologies.

Aksesibilitas Pemustaka Penyandang Disabilitas Di Dinas Kearsipan Dan Perpustakaan Provinsi Sumatera Barat Berdasarkan Standar IFLA Checklist

This research aims to analyze the accessibility of library and archives services for people with disabilities in the West Sumatra Provincial Archives and Library Service, the accessibility of users with disabilities in the West Sumatra Province Archives and Library Service based on IFLA Checklist standards, and the obstacles faced in fulfilling accessibility for people with disabilities at the Provincial Archives and Library Service West Sumatra. This research uses qualitative research with descriptive methods. Data collection techniques use observation, interviews and documentation studies. The data validation technique uses triangulation, namely triangulation of data sources. The data validation technique uses the Miles and Hubermen model which consists of data reduction, data presentation, drawing conclusions and verification. The results of this research are as follows. Firstly, accessibility at the West Sumatra Provincial Archives and Library Service has not yet been fully realized because there are still many shortcomings found in the implementation of accessibility services for people with disabilities, such as the ease of library users in meeting their needs has not been fully realized and the only library material collections available are books with braille printing. Second, accessibility at the West Sumatra Archives and Library Service based on the IFLA Checklist Standard reached 40.54%. Thus, it can be said that accessibility for users with disabilities in the Archives and Library Service is still not in accordance with the IFLA Checklist standards. The research results from the IFLA Checklist standard amounted to 111 items which were 45 items which were appropriate while which were 66 items which were not appropriate. Third, the obstacles faced by the West Sumatra Province Archives and Library Service in fulfilling accessibility for disabled users from various aspects such as the lack of available funding, lack of technical knowledge of implementation, and limited human resources who are competent in providing services for users with special needs or disabilities.

Too costly to make a difference: An examination on the relationship between online financing and economic growth

AbstractWhile facilitating people's access to finance and promoting financial coverage, online financing activities involve high capital costs that suppress economic growth. Using 282 Chinese cities during 2011–2020 as the sample, we examine the relationship between online financing and economic growth. Exploiting a variety of models, we find that online financing activities do not have significant effects on economic growth. Further evidence shows that the insignificant relationship between online financing and economic growth also exists in cities with less developed formal financial systems. Our analysis based on the context where borrowers and lenders do not know each other offline implies that the technology intended to promote financial coverage, if not reducing information asymmetry and hence the cost incurred in financial transactions, does not necessarily lead to desirable economic and social outcomes.

Implementation of Chatbot Technology in Health Care: Protocol for a Bibliometric Analysis.

Chatbots have the potential to increase people's access to quality health care. However, the implementation of chatbot technology in the health care system is unclear due to the scarce analysis of publications on the adoption of chatbot in health and medical settings. This paper presents a protocol of a bibliometric analysis aimed at offering the public insights into the current state and emerging trends in research related to the use of chatbot technology for promoting health. In this bibliometric analysis, we will select published papers from the databases of CINAHL, IEEE Xplore, PubMed, Scopus, and Web of Science that pertain to chatbot technology and its applications in health care. Our search strategy includes keywords such as "chatbot," "virtual agent," "virtual assistant," "conversational agent," "conversational AI," "interactive agent," "health," and "healthcare." Five researchers who are AI engineers and clinicians will independently review the titles and abstracts of selected papers to determine their eligibility for a full-text review. The corresponding author (ZN) will serve as a mediator to address any discrepancies and disputes among the 5 reviewers. Our analysis will encompass various publication patterns of chatbot research, including the number of annual publications, their geographic or institutional distribution, and the number of annual grants supporting chatbot research, and further summarize the methodologies used in the development of health-related chatbots, along with their features and applications in health care settings. Software tool VOSViewer (version 1.6.19; Leiden University) will be used to construct and visualize bibliometric networks. The preparation for the bibliometric analysis began on December 3, 2021, when the research team started the process of familiarizing themselves with the software tools that may be used in this analysis, VOSViewer and CiteSpace, during which they consulted 3 librarians at the Yale University regarding search terms and tentative results. Tentative searches on the aforementioned databases yielded a total of 2340 papers. The official search phase started on July 27, 2023. Our goal is to complete the screening of papers and the analysis by February 15, 2024. Artificial intelligence chatbots, such as ChatGPT (OpenAI Inc), have sparked numerous discussions within the health care industry regarding their impact on human health. Chatbot technology holds substantial promise for advancing health care systems worldwide. However, developing a sophisticated chatbot capable of precise interaction with health care consumers, delivering personalized care, and providing accurate health-related information and knowledge remain considerable challenges. This bibliometric analysis seeks to fill the knowledge gap in the existing literature on health-related chatbots, entailing their applications, the software used in their development, and their preferred functionalities among users. PRR1-10.2196/54349.

Thinking Across Capability Model for Accessibility of People's Business Credit (KUR) Capital for Micro Business Actors

This research examines the central government's facilitation to foster the resilience of MSME actors through capital financing, namely the People's Business Credit (KUR) program. The implementation of capital assistance through KUR remains problematic, especially the accessibility. The main objective is to analyse the problem situations and dynamics of micro-business capital and provide recommendations in the form of an adaptive and innovative policy construction model to the government. This research utilises the Soft Systems Methodology (SSM) perspective, which can transform a complex, unstructured problem into a more structured problem situation and build a conceptual model that fits the context of the existing problem. The results indicate that the primary problem is the dominance of the KUR program’s policy control by the central government, which complicates capital accessibility, especially for micro businesses, and limits the authority of local governments. The proposed conceptual model focuses on thinking across capabilities, which allows the adoption of thoughts, opinions, and ideas outside the inherent cultural framework to create innovative and adaptive policy outcomes. The two main dimensions of the model application are delegated task and authority, which is the power to delegate and provide insight or the ability to produce innovative and adaptive thinking. This resulted in two recommendations for the mandate mechanism to local governments, namely (1) authorising local governments to make recommendations for business status based on mapping to provide a guarantee for micro-businesses (2) the authority of local governments to work with banks to facilitate the distribution and bureaucratic management of KUR financing to micro businesses.

Both frequency and diversity of childhood nature experiences are associated with self‐reported pro‐biodiversity behaviours in adulthood

Abstract The ongoing degradation of Earth's ecosystems through human activities poses a severe threat to biodiversity. To mitigate this crisis, substantial changes in human behaviour are required. The frequency of nature experiences, particularly during childhood, has been established as a key predictor of actions that support biodiversity (hereafter, pro‐biodiversity behaviours). However, the significance of the quality of these experiences remains poorly understood. In this study, we analysed a large sample of Japanese adults and observed positive associations between both the frequency and diversity of nature experiences during childhood and increased pro‐biodiversity behaviours. These associations held true across a range of behaviours, including the purchase of eco‐friendly products, reduced use of pesticides in domestic gardens and contributions to conservation organisations. Our findings indicate that the association between pro‐biodiversity behaviours and the diversity of childhood nature experiences is comparable to that of the frequency of such experiences. These findings suggest that expanding people's access to diverse and frequent nature experiences can play a crucial role in promoting positive behavioural changes to prevent biodiversity loss. Read the free Plain Language Summary for this article on the Journal blog.

The Association of Rheumatologist Supply and Multidisciplinary Care With Timely Patient Access to Rheumatologists: Evidence From British Columbia, Canada.

The objective was to understand how the expansion of rheumatology supply and the introduction of multidisciplinary care was associated with access to rheumatology services. We accessed Population Data BC, a longitudinal database with de-identified individual-level health data on all residents of British Columbia, Canada, to analyze physician visits and prescribing from 2010-2011 to 2019-2020. We calculated access as the time from referral to first rheumatologist visit and, for people with rheumatoid arthritis (RA), time to first disease-modifying antirheumatic drug (DMARD). Associations between lag time, patient characteristics, and system variables were explored using quantile regression. Over the study period, there were 149,902 new rheumatologist visits, with 31% more visits in 2019-2020 than in 2010-2011. The proportion of first visits for patients with inflammatory arthritis increased from 28% to 51%. The median time from referral to first visit decreased by 22 days (35%) from 63 days (interquartile range 21-120 days) in 2010-2011. For people with RA, time from referral to DMARD decreased by 4 days (6%) to 62 days. Male sex, living in metropolitan areas, and having a rheumatologist who used a multidisciplinary care assessment code were associated with shorter times from referral to first DMARD. Access to rheumatology care improved, and the increased proportion of patients with IA in the first visits case-mix indicates that rheumatologist supply and incentives for multidisciplinary care may have improved referral patterns. However, time to DMARDs for people with RA remained long, and we found signals of unequal access for female patients and people living outside of metropolitan areas.

Navigating Challenges and Prospects in Off-Season Vegetable Production

The demand for vegetables in India is substantial, driven by widespread vegetarian dietary preferences. However, the supply often falls short due to the inability to grow all types of vegetables throughout the year. This emphasizes the significance of off-season vegetable cultivation, offering a solution for year-round production, controlling price fluctuations during off-seasons, and ensuring accessibility for people across different economic classes. Off-season cultivation plays a pivotal role in addressing nutritional deficiencies and providing economic returns to farmers, especially during periods of market surplus and falling prices. Consequently, there has been a notable increase in off-season cultivation practices, where crops are grown outside the regular cropping calendar to counter supply shortages and capitalize on high market prices. Various methods are employed for cultivating off-season vegetables, including leveraging a country’s agro-climatic diversity, using different varieties, cultivating in diara lands/riverbeds, and employing protected cultivation. However, this review specifically focuses on diara/riverbed and protected cultivation of vegetables for their off-season production. While these practices have shown promise, ensuring consistent technical support, training, and a reliable supply of inputs like seeds and fertilizers, along with market information, is crucial for sustaining the adoption of agricultural technologies. Long-term success depends on accessible extension services, and the combined impact of various technologies contributes to improved off-season agricultural practices. This underscores the importance of farmer-centric policies in guiding enduring technology adoption. Factors such as education, experience in vegetable production, access to extension services, and training significantly influence farmers’ decisions regarding technology adoption.

Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review.

This scoping review aimed to explore three research questions: 1. What is the dental care access for children and young people (CYP) in care and care leavers? 2. What factors influence CYP in care and care leavers' access to dental care? 3. What pathways have been developed to improve access to oral health care for CYP in care and care leavers? Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, SocINDEX and Dentistry and Oral Sciences Source) and grey literature sources were systematically searched. Articles relating to CYP in care or care leavers aged 0-25 years old, published up to January 2023 were included. Abstracts, posters and publications not in the English language were excluded. The data relating to dental care access were analysed using thematic analysis. The search identified 942 articles, of which 247 were excluded as duplicates. A review of the titles and abstracts yielded 149 studies. Thirty-eight were eligible for inclusion in the review: thirty-three peer-reviewed articles, one PhD thesis and four grey literature sources. All papers were published from very high or medium Human Development Index countries. The studies indicate that despite having higher treatment needs, CYP in care and care leavers experience greater difficulty in accessing dental services than those not care-experienced. Organisational, psycho-social and logistical factors influence their access to dental care. Their experience of dental care may be impacted by adverse childhood events. Pathways to dental care have been developed, but little is known of their impact on access. There are very few studies that include care leavers. The voices of care-experienced CYP are missing from dental access research. care-experienced CYP are disadvantaged in their access to dental care, and there are significant barriers to their treatment needs being met.

Life Story Research with People Aging with Intellectual Disabilities: An Adaptation of the Lifeline Interview Method

A key feature of inclusive research is the accessibility of research procedures to meaningfully engage people with intellectual disabilities in research processes. Creating accessible research procedures requires innovations in methods traditionally used in research. This paper describes how the Lifeline Interview Method by Assink and Schroots was adapted and implemented in a study using life story research to better understand the experiences of older adults with intellectual disabilities. Twelve adults with intellectual disabilities over the age of 50 participated between two and seven times in interviews about their life histories. The interviewer assisted in the construction of timelines of key events in the participants’ individual life stories, and the participants decorated their lifelines throughout the course of the interviews. The lifeline process was an effective tool to engage the participants in the research process, support participation, and provide access for people with intellectual disabilities to retrieve their life experiences. Challenges in the lifeline process included barriers to gathering sufficient information to construct timelines and gatekeepers withholding access to information.

Analysis of Good Governance Implementation on Village Financial Management

The principle of good governance also controls the village government to carry out good governance and avoid fraud during the village financial management process. This type of research is a quantitative descriptive study using primary data and data collection techniques using questionnaires. This study uses the analysis of the validity test, reliability test, simple linear regression test, coefficient of determination, and hypothesis test. The study concluded that implementing good governance positively and significantly affected village financial management. In this study, it is hoped that the village government will be able to provide the community with correct information about village financial management and easy access for people who need information.

Accessibility for People with Disabilities in Public Services at UPTD LIPONSOS Kalijudan Surabaya City Social Service

In fulfilling human rights, there must be no provisions that exclude and align one person with another regardless of the shortcomings and advantages of each person, including no difference in treatment for normal people and people with disabilities. Persons with disabilities have the right to obtain justice for the availability of public services. For mankind, the principle of justice is an important principle that humans crave as the highest ideal of mankind. The existence of 4 aspects that have been explained in the Surabaya City regional regulations, namely Convenience, Usability, Safety and Independence, are expected to be able to improve accessibility for people with disabilities. The research method used is descriptive qualitative method with literature study and observation in the form of interviews. The results showed that in the aspect of convenience, it is quite good even though there are still some things that have not shown maximum results such as the absence of handrail facilities leading to the bathroom and handrails for wheelchair users, then for aspects of usability, convenience and independence have shown very good results.

Accessibility of Library Building for People With Disabilities in Jakarta Library

The lack of accessibility for people with disabilities in public facilities makes it difficult for people with disabilities to carry out activities and mobility easily, safely, comfortably, and independently, especially in terms of meeting information needs and accessing information needed in libraries. This study aims to find out the implementation of accessibility of library buildings for people with disabilities in the Jakarta-Cikini Library. The research method used is a qualitative approach with a type of case study research. Data collection through observation, interviews, and documentation. The selection of informants in this study used purposive sampling. The results showed that the implementation of accessibility of library buildings for people with disabilities in the Jakarta-Cikini Library can be said to be quite good based on IFLA standard guidelines. There are only a few accessibility that have not been implemented thoroughly such as disability-only parking lots far from the entrance and symbol colors in parking lots that have faded, doors and walls that use glass there are no stickers or warning signs to watch out for glass, the unavailability of an induction loop system at the circulation and information desk, the unavailability of handles to help disabled people standing on the toilet and the absence of the application of guiding blocks Inside the library.

Met and unmet need for medical gender affirmation in the Australian non-binary community

Background: There is a widely held assumption that non-binary people do not, or rarely, pursue gender-affirming hormone therapy (GAHT) or gender-affirming surgery (GAS), however, little is known about the medical gender affirmation needs of non-binary people in Australia. Aim: This study aimed to assess the rates of met and unmet need for GAHT and GAS amongst a community sample of non-binary people in Australia. Methods: This online, cross-sectional survey was open to non-binary people, living in Australia and aged ≥16 years between 11 June 2021 and 21 April 2022. Survey questions assessed history of and desire for GAHT and GAS. Outcomes: The main outcome measures were rates and types of GAHT and GAS that were desired and accessed. Results: Of 271 non-binary respondents, 80.4% were presumed female at birth (PFAB) and 19.6% were presumed male at birth (PMAB). Respondents ranged from 16–68 years of age, with a median age of 28 years (IQR 23, 34). In respondents PFAB, there was 63.1% total need for GAHT, and in those respondents who reported need for GAHT, the rate of unmet need was 8.8%. Over half of respondents PFAB reported need for GAS (52.8%) and in those respondents, the rate of unmet need was 43.4%. In respondents PMAB, there was 77.3% total need for GAHT, and in those respondents who reported need for GAHT, the rate of unmet need was 14.6%. One third of respondents PMAB (32.1%) reported need for GAS, and in those respondents, the rate of unmet need was 82.4%. Conclusion: Given the frequency with which non-binary people desire and access medical gender-affirmation, healthcare professionals urgently require additional training, to increase awareness about the variety of medical affirmation options and how to provide good quality, patient-centred care to improve psychological functioning and quality of life for non-binary people.

Preparing occupational therapy students for practice in rural areas: a scoping review protocol

IntroductionDespite greater needs in rural areas, occupational therapists are maldistributed to urban spaces which limits service access and health outcomes for rural people and communities. Preparation of students for rural...

Has the fall of Roe changed contraceptive access and use? New research from four US states offers critical insights.

The overturning of Roe v. Wade in the 2022 Dobbs v. Jackson Women's Health Organization decision has had vast impacts on abortion access across the United States, but less is known about the wider impacts on people's contraceptive access. We draw on cross-sectional survey data representative of reproductive-aged women in Arizona, Iowa, New Jersey, and Wisconsin at two time points-one prior to and one following the Dobbs decision. We examined changes between these two time points in key sexual and reproductive health metrics and, at the post-Dobbs time point, differences in these metrics across age, sexual and gender minority status, nativity, and income status. Between these two time points, we found statistically significant evidence that sexual activity declined, barriers to accessing contraception increased, reports of receiving high-quality contraceptive care decreased, and condom use increased. As continued fallouts of the Dobbs decision on access to abortion occur, this research makes clear that access to broader contraceptive care is worsening. Policies that promote meaningful access to all forms of sexual and reproductive health care must be advanced to support all individuals' right to reproductive autonomy while mitigating inequity and inequality.

Breaking Barriers and Building Confidence: Interprofessional Education's Impact on Allied Health Students' Competence and Self-Efficacy in Addressing Exercise Accessibility for People with Disabilities

Breaking Barriers and Building Confidence: Interprofessional Education's Impact on Allied Health Students' Competence and Self-Efficacy in Addressing Exercise Accessibility for People with Disabilities

Транспортная инфраструктура столичного мегаполиса: доступность для инвалидов

The article scrutinizes the problem of accessibility of transportation infrastructure in the Moscow region for peo-ple with disabilities. Today, knowledge about the social problems of people with disabilities, about projects to create an accessible urban environment, is scattered across the fields of industrial sociology, sections of urban studies and social medicine. The city’s transport infrastructure and its comfort, accessibility and safety for the most demanding category of citizens are the subject of a separate analysis. According to the article, the results of an empirical study of young Muscovites with low mobility disabilities are presented. The most sensitive is-sues for them related to the use of urban transportation and public spaces are highlighted. The results of the author’s empirical research presented in this work made it possible to discuss pressing social issues and out-line guidelines for further research. Obtained empirical data suggest practical application in the field of social policy, management of transport and urban infrastructure development in general.