Poor Access Research Articles

Using polymerase chain reaction cycle threshold (PCR Ct) values for predicting and managing cholera outbreaks: potential, challenges, and future directions

Abstract Background Cholera continues to be a major public health threat, especially in regions with poor sanitation and limited access to clean water. Accurate prediction and management of cholera outbreaks are essential to reduce mortality and morbidity. This review focuses on the potential of polymerase chain reaction (PCR) cycle threshold (Ct) values as an innovative tool for early detection and control of cholera outbreaks, specifically highlighting its utility in predicting outbreaks and guiding public health responses. Main body of abstract PCR Ct values offer a significant advantage in the early detection of Vibrio cholerae, the pathogen responsible for cholera, in both clinical and environmental samples. By providing quantitative data on bacterial load, lower Ct values indicate a higher concentration of the pathogen, signaling the potential for increased disease transmission. These values allow for more precise, real-time monitoring of cholera outbreaks and aid in targeting intervention strategies such as water sanitation improvements, vaccination campaigns, and antibiotic treatments. Moreover, the application of Ct values in environmental surveillance, particularly in monitoring water sources, offers a proactive approach to prevent the spread of cholera by identifying contamination risks before human cases arise. However, the implementation of PCR in low-resource settings faces significant challenges, including high costs, the need for advanced laboratory infrastructure, and a lack of technical expertise. Addressing these barriers through cost-effective innovations and capacity building initiatives is crucial for optimizing the use of PCR Ct values in cholera management. Conclusion PCR Ct values hold great promise for improving cholera outbreak prediction and control. Despite challenges in adopting this technology in resource-limited settings, the integration of Ct value monitoring into public health frameworks can enhance early detection efforts and contribute to more effective cholera management strategies.

Nutrition, hydration and supplementation considerations for mountaineers in high-altitude conditions: a narrative review

Staying and climbing in high mountains (>2,500 m) involves changes in diet due to poor access to fresh food, lack of appetite, food poisoning, environmental conditions and physiological changes. The purpose of this review is to summarize the current knowledge on the principles of nutrition, hydration and supplementation in high-altitude conditions and to propose practical recommendations/solutions based on scientific literature data. Databases such as Pubmed, Scopus, ScienceDirect and Google Scholar were searched to find studies published from 2000 to 2023 considering articles that were randomized, double-blind, placebo-controlled trials, narrative review articles, systematic reviews and meta-analyses. The manuscript provides recommendations for energy supply, dietary macronutrients and micronutrients, hydration, as well as supplementation recommendations and practical tips for mountaineers. In view of the difficulties of being in high mountains and practicing alpine climbing, as described in the review, it is important to increase athletes’ awareness of nutrition and supplementation in order to improve well-being, physical performance and increase the chance of achieving a mountain goal, and to provide the appropriate dietary care necessary to educate mountaineers and personalize recommendations to the needs of the individual.

INCIDÊNCIA DE SÍFILIS NA POPULAÇÃO CARCERÁRIA MASCULINA ENTRE OS ANOS DE 2000 À 2024: UM ESTUDO DE REVISÃO INTEGRATIVA DA LITERATURA

This study analyzed the incidence of syphilis among the male prison population in Brazil from 2000 to 2024. It emphasizes that syphilis, caused by Treponema pallidum, is a Sexually Transmitted Infection (STI) with high prevalence in this vulnerable group, primarily due to poor hygiene conditions and limited access to healthcare services. An integrative literature review was conducted, including eight articles that met the inclusion criteria of studies published between 2000 and 2024 specifically addressing syphilis in the male prison population. Articles focusing on other STIs without direct relevance and studies with inadequate methodologies were excluded. The search was performed in the databases PubMed, BVS, MedLine, and Scielo, using descriptors such as “syphilis,” “prison population,” and “Sexually Transmitted Infections (STIs).” The findings indicate a high incidence of syphilis, exacerbated by risk practices such as unprotected sex and the sharing of syringes, along with the absence of adequate health policies. The study highlights the urgent need for effective interventions, including systematic screening and health education, to control the spread of the disease and improve the quality of life for inmates. These measures are essential not only for the health of prisoners but also for preventing the transmission of syphilis to the broader population.

Landslide Studies in the Context of Disaster Management in Bangladesh—A Systematic Literature Review

Landslides and their resulting impacts on property and human life have become an ongoing challenge in the hilly regions of Bangladesh. This study aims to systematically review diverse landslide studies in Bangladesh, particularly focusing on landslide disaster management (LDM) from 2008 to 2023, encompassing the pre-disaster, syn-disaster, and post-disaster phases. Several key attributes of landslide studies were considered, including general trends, data types, study scales, contributing factors, methodologies, results, and validation approaches, to investigate challenges and subsequently identify research gaps. This study evaluated 51 research articles on LDM using a systematic literature review (SLR) technique that adhered to the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) framework. Our finding revealed that articles on LDM were dominated by the pre-disaster (76%) and the syn-disaster phases (12%), with the post-disaster phase (12%) receiving equal attention. The SLR revealed a growing number of studies since 2020 that used data-driven methods and secondary spatial data, often focused on medium-scale analyses (district level) that, however, often lacked field-based validation. From the factors examined in various landslide studies, topographical and hydrological factors were found to be the most significant attributes in assessment. This study identified key challenges, such as insufficient landslide inventories including poor site accessibility and a lack of high-resolution geological, soil, and rainfall data. It also highlighted critical research gaps, including the need for advanced technologies in susceptibility mapping for national hazard atlas, the investigation of underexplored causative factors, effective early warning systems, detailed post-event characterization, health impact assessment, risk-sensitive land use planning, and interactive web portals for landslide prone areas. This study would thus aid researchers in understanding the depth of existing knowledge and provide insights into how landslides fit into broader disaster management frameworks, facilitating interdisciplinary approaches.

The Prohibition of Forestation on Cultivated Land in China: A Difference-in-Differences Model Analysis of the Effects of Cutting Down Trees on Farmland Transfer

The implementation of China’s stringent farmland protection policy has resulted in the compulsory removal of trees from farmland, which has significantly impacted farmers’ willingness to transfer their land. To explain the impact of cutting trees on farmers’ land transfer, this study conducted a two-way fixed-effect difference-in-differences (DID) model based on a survey of 163 households in Daxiapo Village in China during 2020–2023. The results show that cutting trees significantly promotes farmland transfer among farmers. Moreover, the promotion effect of cutting trees is more pronounced when transferring land in than it is when transferring land out. For land plots with poor accessibility and fertility, the effects of transferring land out are more significant than for plots that are fertile and conveniently located. As a result, the prohibition of forestation on farmland has increased the contiguity of some land plots and improved the spatial configuration of farmland, but land fragmentation is still prominent on land owned by large-scale farmers. Therefore, this paper proposes two optimization scenarios to address the issue of farmland fragmentation and compares the feasibility of these plans in the short and long term. This paper suggests that short-term policies prohibiting forestation can trigger abrupt changes in farmland transfer patterns and drive further changes in the spatial configuration of farmland. Though some large-scale farming households were established through land transfer, the problem of plot fragmentation must be solved. This article presents several possible scenarios to aid in the design of more systematic policy systems to balance the protection of cultivated land, farmers’ willingness, and the spatial contiguity of cultivated land.

Multi-energy CT and iodinated contrast

Spectral CT acquires images with the emission or detection of two separate energy spectra. This enables material decomposition due to the photoelectric effect (prevalent in low-energy photons) and Compton scattering (prevalent in high-energy photons).Iodine and other materials with high atomic numbers appear more hyperdense on low-energy monoenergetic images because of the direct relation between the photoelectric effect and the Z value.Given the way iodine behaves on spectral maps, radiologists can optimise the use of contrast media in these CTs, thus allowing lower doses of radiation and lower volumes of contrast media while achieving the same CT values and even enabling lower contrast flow rates, which is especially helpful in patients with poor vascular access. Moreover, in suboptimal diagnostic cases caused by poor contrast opacification, the resolution can be improved, thus avoiding the need to repeat the study.

Incorporating Evidence of Migrant Women with Schizophrenia into a Women’s Clinic

Many gender differences in mental and physical health, along with accompanying social needs have been reported by those suffering with schizophrenia. The goal of this review is to explore the literature on migrant and culturally diverse women suffering with schizophrenia to develop and implement effective strategies in specialized clinics. In general, we found higher rates of mental health symptoms among migrant and refugee women when compared to men. Several factors contribute to this vulnerability, suggesting that women may experience more pre- and post-migration-related trauma. In clinical populations, migrant status, region of origin, age at the time of migration, migration with family or alone, and migration to join family determine the risk of schizophrenia and the clinical course of the illness. Refugee migrant women have a higher risk of schizophrenia than non-refugee migrants and native-born populations. Migration is associated with poor access to mental health services; low social support, lack of awareness of services, and language barriers may mediate this association. These findings call for specific assessments on migrant women, interventions (e.g., focus groups), and improvement in current programs. In our clinics, we have recently incorporated assessment and intervention strategies that may be effective in our programming.

Tele-collaborative outreach to rural patients with chronic pain: pragmatic effectiveness trial protocol for the CORPs study

Abstract Background Despite the increased availability of evidence-based treatments for chronic pain, many patients in rural areas experience poor access to services. Patients receiving care through the VA may also need to navigate multiple systems of care. Objective To examine the effectiveness of a remotely delivered collaborative care intervention for improving pain interference among veterans with high-impact chronic pain living in rural areas. Design We will conduct a four-site pragmatic effectiveness trial of remotely delivered collaborative care for high-impact chronic pain. Participants (n = 608) will be randomized to the Tele-Collaborative Outreach to Rural Patients (CORPs) intervention or to minimally enhanced usual care (MEUC). Participants randomized to CORPs will complete a biopsychosocial assessment and five follow-up sessions with a nurse care manager (NCM), who will collaborate with a consulting clinician to provide personalized recommendations and care management. CORP participants will also be invited to a virtual 6-session pain education group class. Participants randomized to MEUC will receive a one-time education session with the NCM to review available pain services. All participants will complete quarterly research assessments for one year. The primary study outcome is pain interference. This trial will oversample veterans of female birth sex and minoritized race or ethnicity to test heterogeneity of treatment effects across these patient characteristics. We will conduct an implementation process evaluation and incremental cost-effectiveness analysis. Discussion This pragmatic trial will test the real-world effectiveness of a remotely delivered collaborative care intervention for chronic pain. Study findings will inform future implementation efforts to support potential uptake of the intervention.

E-Learning Modules for the Care of Caregivers of Older Filipinos

As the population ages, so does the challenge to the care of older people with mental health problems. Geriatric syndromes such as delirium, dementia, and depression are amenable to medical management. Beyond care of the patient, however, is care for the caregiver. Behavioral and Psychological symptoms of Dementia (BPSD) such as agitation, aggression, and delusions increase the risk of caregiver stress. This may lead to strain of individual carers and household members, increasing the patient’s risk for poor care, abuse, or institutionalization. Caregiver education and skills training help reduce the level of caregiver stress. These are usually delivered face to face during clinic visits or training modules by dementia care professionals. However, remote alternatives for education, learning and counselling became essential during the COVID-19 pandemic. E-workbooks and online learning modules on dementia, delirium, and depression written by professionals in the Philippines and Asia Pacific are available. An example is the Dementia Community Toolkit in English and its Filipino adaptation. The latter was developed by the Institute on Aging, National Institutes of Health, University of the Philippines Manila, with support from the Mental Health Unit of WHO WPRO. Patient support groups such as the Alzheimer’s Disease Association of the Philippines likewise developed online learning materials. These were and are still freely available via their websites and the webinars have been uploaded in internet and social media sites. The efficacy and acceptability of remote education to reduce informal caregiver burden, negative mood, and quality of life was published in a Cochrane meta-analysis. The authors analyzed experimental trials on information, training, or support compared to usual treatment, waitlist, or attention controls. Following several eligibility criteria, they identified 26 studies with 2367 participants in their review. Although most studies were of low quality and had uncertain risks of bias, there was small evidence that training plus support modules resulted in an improvement of caregiver knowledge. Training alone had no benefit on knowledge. Furthermore, there was no significant effect on patient institutionalization, caregiver burden depression, or quality of life. The article on E-Learning on knowledge on the 3Ds of Geriatric Psychiatry is a good start in understanding the capacity of well-educated Filipino caregivers to improve their knowledge on the subject. Beyond individual knowledge, E-learning modules have the capacity to guide families and communities in reducing ageism and improve patient care for older people with dementia, depression, and delirium. Further experimental studies are needed using locally developed modules. The bigger challenge is accessibility and acceptability of remote learning materials for the greater majority of informal caregivers with lower levels of education and poor access to online resources.

Mapping Rosenwald Schools for African Americans in South Carolina: A Geographic Analysis of Spatial Patterns

In early twentieth-century America, many Blacks in the south had poor access to schooling. Philanthropist Julius Rosenwald and educator Booker T. Washington collaborated to help build schools in the south for Blacks in the 1920s and 1930s. This paper analyzes the geographic patterns of the schools that were built using funds donated by Rosenwald in the state of South Carolina. Some 446 of the 500 Rosenwald schools were located and mapped using a multi-step process, and then data related to these schools were analyzed in four state subregions. Rosenwald schools were built around the state, with relatively more schools built in the northern part of the state compared with the south, where a larger Black population in the south potentially points to less access to schools for Blacks at that time. Rosenwald funds required contributions from other sources, and the state, Blacks, and Whites all contributed. Interestingly, in the south, where there was a higher percentage of Blacks, Whites contributed a larger share towards the building of these schools in comparison with other state regions. The paper thus shows both the process and value of mapping these Rosenwald schools and analyzing this important historical time in South Carolina within a spatial construct.

<b>Diagnóstico Comunitario de Finca Tanagra y Gandoca: Resultados de Proyecto de</b> <b>Extensión de la Universidad de Iberoamérica (UNIBE)</b>

During November 2023, the communities of Gandoca and Finca Tanagra were visited with the objective of generating a communitary diagnosis. The data obtained is mixed, interviews were conducted to community leaders and other citizens (N=94) for a total of 27 families. Data analysis was made using JASP 19 for descriptive information, and grounded theory for qualitative data. Results suggest that Gandoca is in a more advantageous situation in terms of access to health, education and infrastructure compared to Finca Tanagra. Nonetheless, it is observed that most people in both communities find themselves at a socioeconomic disadvantage due to poor access to health, education, work and road infrastructure.

Effectiveness of paediatric asthma hubs: a clinical pilot study

BackgroundChildren and young people (CYP) with asthma in the UK are at higher risk of poor outcomes compared with other high-income European countries due to factors including poor access to high-quality asthma reviews, diagnostic testing and inconsistent postattack reviews. The Leicester Integrated Care Board funded the first UK pilot asthma hub for CYP, to investigate the feasibility and effectiveness of hubs, in providing postattack reviews along with providing asthma education, the opportunity to carry out diagnostic lung function tests and optimise treatment.MethodsClinical pilot study including CYP aged 4–17 years referred to the hub with uncontrolled asthma or postattack from November 2021 to April 2022. CYP received a structured clinical assessment including National Institute for Health and Care Excellence (NICE) first-line diagnostic investigations for asthma including spirometry, bronchodilator reversibility (BDR) and fraction of exhaled nitric oxide (FeNO).ResultsOf 312 CYP referred (mean age 8.6±3.2 years; 42% women), 266 (85.3%) attended their appointment. Median time from referral to review was 2 days (IQR 1–3). Three CYP (1.1%) were severely unwell at review and required further hospital treatment. In the 231 CYP who completed first-line tests, asthma was confirmed for 73 (31.6%) based on NICE diagnostic criteria for CYP. Twenty-two per cent of children with normal baseline spirometry had ≥12% BDR.ConclusionPaediatric asthma hubs are a feasible model of care to deliver CYP postasthma attack reviews and identify high-risk patients requiring further treatment. Spirometry, BDR and FeNO testing allowed diagnostic confirmation in a significant proportion of CYP.

Association of Workplace Toilet Access with Urinary Tract Symptoms and Productivity Loss among Female

Abstract Purpose Lower urinary tract symptoms (LUTS) are prevalent among women, affecting not only their physical well-being but also their quality of working life. We investigate workplace toilet access related to LUTS among women in the Korean workforce. Materials and methods An online survey was conducted to determine the demographic characteristics, occupational risk factors, and urinary tract symptoms among employed Korean women. Occupational risk factors included three survey questions on access to toilets at work: A) enduring urinary symptoms at work; B) capability to use the toilet at will during work, and C) needing to use the toilet during work but were unable to. The LUTS were assessed using the overactive bladder symptom score (OABSS) and international consultation on incontinence questionnaire-urinary incontinence short form (ICIQ-SF). Health-related productivity losses (HRPL) were estimated using the work productivity and activity impairment (WPAI) questionnaire for urinary symptoms. Multiple logistic regression was used to determined the association between workplace toilet access and LUTS. In addition, generalised linear regression analysis was performed to assess HRPL according to workplace toilet access. Results Of the 1057 participants, 260 (24.6%) and 294 (27.81%) had overactive bladder and urinary incontinence, respectively. More than 50% reported poor access to toilet. Multiple logistic regression analysis showed that the lower the access to toilets in the workplace, the higher the incidence of LUTS and the higher HRPL. Conclusions Restricted access to toilets at work are associated with poor urinary health and loss of productivity. The results highlight the need for interventions to improve the workplace environment. Key messages • Restricted access to toilets at work are associated with poor urinary health and loss of productivity. • The results highlight the need for interventions to improve the workplace environment.

AN ASSESSMENT OF THE PATTERNS AND ISSUES WITH AI DEPLOYMENT IN UNIVERSITY LIBRARIES IN NIGERIA

With the hindsight of the enormous benefits of Artificial Intelligence to every sector of human development, this article explores how university libraries in Nigeria intentionally adopt and use AI-enabled tools and technologies for library operations and services. It also identifies the constraints to the deliberate use of the technologies in the libraries. The paper adopts a survey approach using a self-developed questionnaire to elicit information from the 174 members of the Association of University Librarians of Nigerian Universities about the status of AI use in their libraries. Google Forms application was used to administer the survey for eight weeks. Only 25 universities responded to the survey. Data analysis shows that AI use is infantile and inadvertent in Nigerian university libraries, and its use is constrained by paucity of funds, lack of requisite skills and poor infrastructure, especially epileptic power supply and poor internet access. The paper is among the few that investigate deliberate use of AI in Nigerian universities libraries, and it recommends the need for Nigerian university to review and restructure their strategic plan documents to include AI integration in academic activities and programmes, particularly, for providing innovative library services.

Use of Artificial Intelligence tools in supporting decision-making in hospital management

BackgroundThe use of Artificial Intelligence (AI) tools in hospital management holds potential for enhancing decision-making processes. This study investigates the current state of decision-making in hospital management, explores the potential benefits of AI integration, and examines hospital managers’ perceptions of AI as a decision-support tool.MethodsA descriptive and exploratory study was conducted using a qualitative approach. Data were collected through semi-structured interviews with 15 hospital managers from various departments and institutions. The interviews were transcribed, anonymized, and analyzed using thematic coding to identify key themes and patterns in the responses.ResultsHospital managers highlighted the current inefficiencies in decision-making processes, often characterized by poor communication, isolated decision-making, and limited data access. The use of traditional tools like spreadsheet applications and business intelligence systems remains prevalent, but there is a clear need for more advanced, integrated solutions. Managers expressed both optimism and skepticism about AI, acknowledging its potential to improve efficiency and decision-making while raising concerns about data privacy, ethical issues, and the loss of human empathy. The study identified key challenges, including the variability in technical skills, data fragmentation, and resistance to change. Managers emphasized the importance of robust data infrastructure and adequate training to ensure successful AI integration.ConclusionsThe study reveals a complex landscape where the potential benefits of AI in hospital management are balanced with significant challenges and concerns. Effective integration of AI requires addressing technical, ethical, and cultural issues, with a focus on maintaining human elements in decision-making. AI is seen as a powerful tool to support, not replace, human judgment in hospital management, promising improvements in efficiency, data accessibility, and analytical capacity. Preparing healthcare institutions with the necessary infrastructure and providing specialized training for managers are crucial for maximizing the benefits of AI while mitigating associated risks.

It takes a village: A pilot cross-randomized trial to enhance pregnancy care and support in northern Ghana.

Maternal mortality remains a challenge in Ghana, where 263 women per 100 000 live births die during pregnancy or childbirth. Barriers to reaching the recommended antenatal care (ANC) include poor access to quality health care, cultural factors, and lack of support for pregnant women. We piloted two cross-randomized interventions: durbars, or local community meetings that incorporated education about ANC and supporting pregnant women, and an enhanced ANC model that added phone calls and a home visit to standard care. The study took place in 30 villages in the Upper East Region of Ghana between August 2021 and November 2022. We tracked 277 women during pregnancy, with 120 women randomly assigned to the enhanced ANC intervention and 142 women living in villages randomized to the durbar intervention. Women who were randomized to the enhanced ANC intervention were 13.2 percentage points (pp) (95% confidence interval (CI) = 0.1, 24.3) more likely to have average or above average knowledge of pregnancy danger signs, 22.1 pp (95% CI = 9.1, 36.5) more likely to have a birth plan, 28.2 pp (95% CI = 13.0, 42.4) more likely to prepare the plan with their partners, and 16.4 pp (95% CI = 0.9, 29.3) more likely to pay for delivery with funds set aside in birth plan. They were also 35 pp (95% CI = 16.1, 48.1) more likely to make blood donor arrangements than control women who made birth plans. We found no impact of the durbar intervention on study outcomes. Evidence from this pilot suggests that interventions that increase interactions between health providers and pregnant women outside of the health facility may substantially improve women's experience during pregnancy and maternal health outcomes. Providing structured ways for men to get engaged in ANC increased their involvement. Although we found no evidence the community meetings improved study outcomes, larger studies with repeated meetings and community-wide surveys are needed to make causal conclusions. American Economic Association RCT Registry: 10360; ISCRNT: ISRCTN95961119.

Cholera outbreak in diyala province

Background: Vibrio cholerae is a primary cause of severe dehydrating diarrhea and remains a serious public health problem in low- and middle-income countries (LMICs) with insufficient water, sanitation, and hygiene. Cholera remains a public health threat the worldwide, mainly in countries with poor access to safe water and sanitation facilities. According to estimates, there are 21,000–143,000 deaths and 1.3–4 million cases of cholera annual. Objective: This study aims to carry out an analysis of the available information on cholera outbreaks in Diyala province, 2022. Patients and Methods: A descriptive study conducted in the department of public health using the data of cases reported from eight sectors in province. The data was collected from the surveillance unit, communicable control division of the public health department in Diyala province, IRAQ in 2022. Results: The total number of confirmed cases of cholera was (n = 139), female (72) 52 % and male (67) 48%, death reported for two of these cases. According to the date of onset, the registration of cases began from July 19 to October 25, 2022. However, the case fatality ratio (CFR) was 1.4%, while the attack rate in the governorate is 7.6 per 100,000 populations during 2022, the highest attack rate in Khanaqin district was (77 cases) 46, while the lowest attack rate in Baldruze, Al-Mansuria, and Al-Khalis districts was (1 case) 0.3,0.6, and 0.8 respectively. The age mean of patients was (38.7 ± 17.14 years) and the occurrence of the disease is more incidence in the age group 30-44 and females more than males. Conclusion: Occurrence Cholera outbreak during year 2022 without confirmed cases recorded since 2015 and the occurrence of cholera cases in governorate is greater during the months of August and September and most of the cases were from Khanaqin district.

Coping mechanisms and “homemaking” in the face of environmental challenges: exploring the experiences of adolescent refugees in Jordan

ABSTRACT “: Home” is both a physical location and a space of important emotional and social attachments. Often associated with safety and familiarity, homes are also places where power inequalities may be reinforced. Contrary to human rights treaties stipulating the right of refugees to live in shelters that meet their basic needs, adolescent refugees in Jordan often reside in poor-quality housing within built environments that do not foster their wellbeing. Yet despite a burgeoning literature on refugee “homemaking”, little is known about how young refugees in Jordan perceive and respond to challenges in the built environment. This article addresses this knowledge gap, focusing on how gender norms are configured within “homemaking” practices. It draws on qualitative interviews with 31 adolescents in diverse locations: Syrians living in a formal refugee camp (Azraq), host communities, and informal tented settlements, and Palestinians without citizenship living in Jerash camp. Our findings show that refugee adolescents in Jordan face intersecting challenges, including poor access to services, inadequate housing infrastructure and sanitation, and safety concerns. These challenges vary based on location and are shaped by gender norms that influence access to spaces both inside and outside the household. Although adaptation methods can make homes more livable in terms of safety, aesthetics and practicality, these adaptations often reinforce gender norms that restrict girls’ mobility. This article concludes by underscoring that although refugees can make small changes to address immediate needs, structural responses which address gender inequalities and improve social protection support are essential to improving young refugees’ lives.

The state of e-learning in radiology colleges during the COVID-19 pandemic and its future prospects

This study evaluates the existing electronic learning (e-learning) infrastructure in Sudanese academic institutions that offer radiology education during the COVID-19 pandemic with the aim of understanding the extent and effectiveness of e-learning. By employing a descriptive cross-sectional survey from April to August 2021, data was gathered from undergraduate and postgraduate students enrolled in both public and private radiology educational institutions across Sudan. The questionnaire, created in Google Forms and distributed via email, WhatsApp, and Facebook, captured insights into the students' experiences and challenges with e-learning. The findings revealed that power outages and poor internet access were significant barriers, affecting 50% and 27% of respondents, respectively. While 33% of participants were satisfied with e-learning as a pedagogical strategy, 29% believed it hindered the achievement of educational goals. Furthermore, 78% of the respondents felt that e-learning was not suited to all medical specializations, although 46.6% supported the idea of integrating e-learning with traditional classroom instruction. Despite the adoption of e-learning due to the pandemic, students exhibited a preference for the conventional classroom setting, primarily due to challenges related to internet accessibility and the availability of the necessary technological resources. Significant infrastructure improvements and strategic planning are required to maximize the benefits of e-learning in resource-constrained countries.

Bridging the education gap: A comprehensive analysis of travel distance and education quality based spatial accessibility of early childhood education in Metropolitan Melbourne

In Australia, Melbourne's population is growing rapidly and will soon overtake Sydney, fuelled by a COVID-19 baby boom that has increased demand for early childhood education (ECE). In response, the Victorian Government has announced transformational reforms to improve the accessibility and quality of ECE for the growing urban population. This study aims to addresses the evolution and effectiveness of ECE reforms in Melbourne from 2021 to 2036 by proposing an innovative approach that integrates spatial accessibility and educational quality into ECE evaluations. Using the distance decay function, the Floating Catchment Area (FCA) method and the Huff model, it extends traditional geographical analyses by highlighting the importance of educational quality in parental choice and providing a refined technique for simulating local demand based on educational quality and travel distance. Overall, inequalities in educational resources have been identified, with a concentration of ECE services near the CBD, despite high population density, while peripheral areas have significant service deficits. Furthermore, the projected poor accessibility scores for 2026, 2031 and 2036 highlight the urgent need for educational infrastructure development, even in areas rated as having better accessibility in 2021.