Significant Barriers Research Articles

Implementation of Telemedicine in Medical Practice: Opportunities and Barriers

The integration of telemedicine into medical practice represents a transformative shift in healthcare delivery, offering both unprecedented opportunities and encountering significant barriers. This journal article explores the implementation of telemedicine, examining the multifaceted landscape of benefits and challenges associated with its adoption in medical settings. The opportunities presented by telemedicine include enhanced accessibility to healthcare services, especially in remote or underserved areas, improved patient outcomes through timely interventions, and increased efficiency in healthcare delivery. Telemedicine also facilitates remote patient monitoring, teleconsultations, and the exchange of medical information, contributing to a more patient-centric and adaptable healthcare system. However, the implementation of telemedicine faces several barriers, including regulatory complexities, concerns about data security and privacy, technological infrastructure limitations, and the need for healthcare professionals to adapt to new modes of communication. Cultural and organizational resistance further complicates the seamless integration of telemedicine into established medical practices. The article critically analyzes case studies and global implementations of telemedicine, highlighting successful models and lessons learned. It emphasizes the importance of policy frameworks, standardization, and ongoing training for healthcare providers to optimize the benefits of telemedicine while mitigating potential risks.

From recession to pandemic: Displacement among workers with disabilities from 2007 through 2021

BACKGROUND: With at least one-quarter of the U.S. adult population reporting one or more disabilities in 2020, people with disabilities represent a large and diverse group of individuals who often face significant barriers in the labor market, especially job displacement - involuntary job loss due to external factors. OBJECTIVE: We examine how rates of job displacement varied for people with different types of disabilities from 2007–2021, a period that includes the 2008 Great Recession and the COVID-19 pandemic. METHODS: We use data from six waves of Current Population Study Displaced Worker Supplement (CPS DWS, N = 344,729) and a series of logistic regression models to examine differences in displacement by disability status and type. RESULTS: People with disabilities were approximately twice as likely as those without disabilities to experience job displacement, but more during times of economic turmoil. Although displacement disparities by disability status were decreasing from a high of 6.5 percentage points during the Great Recession, the pandemic increased the gap to 5.8 percentage points. CONCLUSION: Involuntary job loss among people with disabilities is exacerbated by exogenous shocks. We extend work on disability and displacement, incorporating the COVID-19 pandemic in our discussion of explanations of both labor market disadvantage and precarity.

Help-seeker satisfaction with diagnosis and treatment of tinnitus

Objective To examine help-seeker satisfaction with the first communication of a tinnitus diagnosis by a healthcare provider, whether help-seekers undertook treatment and how they rated this treatment. Design A survey design assessed tinnitus characteristics and distress, health status, help-seeking, diagnosis communication, treatment and patient satisfaction. Study sample A self-selected cohort and a population-based cohort. Results Satisfaction scores were examined against demographic, clinical factors, and type of healthcare provider. A total of 281 adults participated (median age 61.6, IQR = 10.8 years), 52.3% sought help for tinnitus and 22.4% received treatment. The most frequently seen healthcare providers were general practitioners (34.0%), audiologists (29.3%) and ear, nose and throat specialists (25.9%). About two-thirds (64.1%) of help-seekers were unsatisfied with the first communication of a tinnitus diagnosis they received, and 56.5% rated their first tinnitus treatment as poor. Help-seekers were significantly more satisfied with audiologists than other providers regarding the communication of the first tinnitus diagnosis. Higher tinnitus distress scores were significantly associated with lower patient satisfaction with communication of first tinnitus diagnosis. No other factors were associated with patient satisfaction. Conclusion There are significant communication barriers along the tinnitus clinical pathway. Identifying and addressing these barriers could improve patient satisfaction.

Assessment of the impact of the implemented learning spaces on science achievement: Building Resilience at General Tomas Mascardo National High School

General Tomas Mascardo National High School is currently facing a significant challenge of classroom shortages, posing a threat to the fundamental principle of "education for all." This study aims to evaluate the impact of makeshift classrooms on the academic performance of science subject to students during the school year 2023–2024, adopting a mixed-methods approach. The analysis reveals variations in mean percentage scores across sections and shifts, emphasizing the need to investigate specific factors influencing performance outcomes. Despite small attendance fluctuations, the overall trend suggests a high level of students’ presence, indicating a generally conducive learning environment. However, the study identifies significant disparities in academic performance, particularly in the Quarterly Assessment (Q.A) variable among makeshift classes. The negative impact on academic performance is evident, highlighted by a statistically significant deviation in Q.A scores, emphasizing a specific area of concern. Irregular attendance patterns during September and October further contribute to the negative effect on academic performance, emphasizing the need for targeted interventions to address attendance issues systematically. Themes emerging from student responses encompass environmental factors, comfort, focus, motivation, adaptation, preference for regular classrooms, teacher impact, external factors, and physical environment. Morning shift students highlight noise and discomfort as significant barriers, while afternoon shift students express mixed feelings, acknowledging spaciousness but preferring regular classrooms for comfort. Both shifts discuss motivation, with morning shift students suggesting adaptive measures and crediting supportive teachers. In contrast, afternoon shift students express various emotions, including decreased motivation due to negative thoughts and noise pollution affecting focus. External factors, distractions, and concerns related to the physical environment are prevalent in both shifts, underlining the complexity of challenges students face in makeshift classrooms. Recommendations include a comprehensive investigation into academic disparities, addressing the quality of answers, targeted interventions for attendance improvement, and a holistic approach to creating a conducive learning environment.

Optimizing dental screening protocols for children with special healthcare needs: Enhancing access and prevention

Children with special healthcare needs face significant barriers to accessing dental care, resulting in higher rates of untreated dental disease and poorer oral health outcomes compared to their peers. Optimizing dental screening protocols tailored to the unique needs of this population is crucial to enhancing access to care and preventing dental disease. This paper explores the challenges in accessing dental care for children with special healthcare needs, reviews current screening protocols, and proposes strategies for optimization. The literature review highlights the multifactorial nature of barriers to care, including socioeconomic factors, physical and cognitive limitations, and cultural considerations. Despite existing challenges, success stories and emerging technologies offer promising avenues for improvement. Multidisciplinary collaboration, tailored screening protocols, technology integration, community outreach, and policy advocacy are identified as key strategies for optimization. The proposed strategies are underpinned by the principles of equity, inclusivity, and person-centered care. Implementation plans include pilot programs, professional training, and integration with existing healthcare systems. Evaluation metrics will assess the effectiveness and sustainability of optimized screening protocols. Expected outcomes include increased access to dental care, reduced prevalence and severity of dental disease, improved oral health-related quality of life, and cost-effectiveness. The conclusion emphasizes the importance of ongoing evaluation and adaptation to meet the evolving needs of children with special healthcare needs. This paper calls for concerted efforts from stakeholders across healthcare, education, policy, and advocacy sectors to implement and support the proposed strategies. By optimizing dental screening protocols, we can make significant strides towards enhancing access to care and improving oral health outcomes for children with special healthcare needs.

Pharmacovigilance in Nigeria: Addressing challenges in ensuring drug safety and monitoring adverse effects

This paper examines the specific challenges faced by Nigeria in implementing pharmacovigilance measures to ensure drug safety and monitor adverse effects. Despite the critical importance of pharmacovigilance in safeguarding public health, Nigeria grapples with several obstacles in its implementation. Through a nuanced exploration of literature and regulatory frameworks, this study sheds light on the unique hurdles encountered in pharmacovigilance practices within the Nigerian context. Challenges in Nigeria's pharmacovigilance landscape include limited awareness and understanding of pharmacovigilance principles among healthcare professionals and consumers, resulting in underreporting of adverse drug reactions. Additionally, there is a lack of robust infrastructure and resources for pharmacovigilance activities, including inadequate funding, shortage of trained personnel, and deficient pharmacovigilance databases. Regulatory enforcement and oversight are also hindered by issues such as weak regulatory frameworks, fragmented reporting systems, and suboptimal collaboration among regulatory agencies. Furthermore, Nigeria's pharmacovigilance efforts are compounded by factors such as the proliferation of counterfeit and substandard medicines, informal drug markets, and cultural beliefs influencing healthcare-seeking behaviors. These challenges pose significant barriers to effective pharmacovigilance implementation and compromise patient safety and public health outcomes in Nigeria. Addressing these challenges requires a multifaceted approach encompassing regulatory reforms, capacity building initiatives, public awareness campaigns, and collaboration with international partners. Strengthening regulatory frameworks, enhancing healthcare professional training on pharmacovigilance, establishing robust reporting systems, and fostering partnerships between regulatory agencies, healthcare institutions, and pharmaceutical companies are essential steps toward improving pharmacovigilance practices in Nigeria. Through a thorough examination of the Nigerian context, this paper aims to raise awareness of the specific challenges hindering pharmacovigilance implementation in the country and stimulate dialogue on potential solutions to enhance drug safety and monitoring of adverse effects in Nigeria's healthcare system.

Abstract 1514: A novel workflow to assess the T-cell and patient-derived organoid interaction

Abstract Immunotherapy is increasingly popular as a type of cancer treatment. These therapies include the use of Chimeric Antigen Receptor-engineered T-cells (CAR T-cells), tumor-infiltrating lymphocytes (TIL), and other genetically modified T-cells to specifically target the cancer cells. Although much success has been achieved with immunotherapy for treatment of blood cancers, its efficacy remains limited in solid tumors. One of the reasons for the low success rate is attributed to the solid tumor microenvironment (TME) where suppressive cytokines limit the tumor killing ability of T-cells. Thus, understanding the role the TME plays in T-cell responses is essential for the development of effective cancer therapies. The benefits of using 3-dimensional (3D) PDOs lie in the physical and chemical cues present within the TME that cannot be mimicked in traditional 2D monolayer cultures. Studies show that PDOs show similar responses to drugs as original tumors, suggesting the value of using PDOs to improve therapeutic outcomes. Thus, PDOs can provide more relevant physiological and pathological cancer models that recapitulate the basic features of primary tumors and is more suited for assessing the effectiveness of T-cell killing than 2D cell models. Despite the benefits associated with the use of PDOs, there are significant barriers to widespread adoption of PDOs in drug discovery. Organoid production is a costly and highly labor-intensive process. Moreover, organoid culture is a skilled manual process, and thus there can be significant variability between operators. To address the challenges associated with the use of PDOs in large scale applications, a semi-automated bioprocess has been developed for the large-scale expansion of assay ready organoids. Here, we developed a method to assess the effectiveness of T-cell invasion in solid tumors using patient derive organoids (PDOs). Using bioreactor expanded patient-derived colorectal cancer organoids (CRCs), activated PBMCs (human peripheral blood mononuclear cells) stained with CellTracker were added to CRCs (stained with MitoTracker) in a 96well microtiter plate and monitored on every 4 hours for 3 days using high content imager. To quantify T-cell invasion, we developed an image analysis method to measure the distance of each T-cell to the nearest organoid (interaction distance). We find that stimulated T-cell resulted in smaller interaction distance than non-stimulated T-cells. The results demonstrate the utility of the bioreactor-expanded organoids in large scale T-cell based screens. Citation Format: Zhisong Tong, Angeline Lim, Oksana Sirenko. A novel workflow to assess the T-cell and patient-derived organoid interaction [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1514.

Improving Quality of ICD-10 (International Statistical Classification of Diseases, Tenth Revision) Coding Using AI: Protocol for a Crossover Randomized Controlled Trial.

Computer-assisted clinical coding (CAC) tools are designed to help clinical coders assign standardized codes, such as the ICD-10 (International Statistical Classification of Diseases, Tenth Revision), to clinical texts, such as discharge summaries. Maintaining the integrity of these standardized codes is important both for the functioning of health systems and for ensuring data used for secondary purposes are of high quality. Clinical coding is an error-prone cumbersome task, and the complexity of modern classification systems such as the ICD-11 (International Classification of Diseases, Eleventh Revision) presents significant barriers to implementation. To date, there have only been a few user studies; therefore, our understanding is still limited regarding the role CAC systems can play in reducing the burden of coding and improving the overall quality of coding. The objective of the user study is to generate both qualitative and quantitative data for measuring the usefulness of a CAC system, Easy-ICD, that was developed for recommending ICD-10 codes. Specifically, our goal is to assess whether our tool can reduce the burden on clinical coders and also improve coding quality. The user study is based on a crossover randomized controlled trial study design, where we measure the performance of clinical coders when they use our CAC tool versus when they do not. Performance is measured by the time it takes them to assign codes to both simple and complex clinical texts as well as the coding quality, that is, the accuracy of code assignment. We expect the study to provide us with a measurement of the effectiveness of the CAC system compared to manual coding processes, both in terms of time use and coding quality. Positive outcomes from this study will imply that CAC tools hold the potential to reduce the burden on health care staff and will have major implications for the adoption of artificial intelligence-based CAC innovations to improve coding practice. Expected results to be published summer 2024. The planned user study promises a greater understanding of the impact CAC systems might have on clinical coding in real-life settings, especially with regard to coding time and quality. Further, the study may add new insights on how to meaningfully exploit current clinical text mining capabilities, with a view to reducing the burden on clinical coders, thus lowering the barriers and paving a more sustainable path to the adoption of modern coding systems, such as the new ICD-11. clinicaltrials.gov NCT06286865; https://clinicaltrials.gov/study/NCT06286865. DERR1-10.2196/54593.

Near-infrared Light-Induced Polymerizations: Mechanisms and Applications.

Photopolymerizations have garnered significant attention in polymer science due to their low polymerization temperature, high production efficiency, environmental friendliness, and spatial controllability. Despite these merits, the poor penetration and severe chemical damage from ultraviolet/visible (UV/Vis) light resources pose significant barriers to their success in conventional photopolymerizations. A recent breakthrough involving the utilization of near-infrared (NIR) laser with long wavelength has been exploited for diverse applications. With the combination of a NIR photosensitizer (PS), NIR-induced photopolymerizations have been successfully developed to alleviate the challenges in conventional methods. The enhancement of penetration depth and safety of NIR-induced photopolymerizations can contribute significantly to improving the efficiency of polymerization for production of intricate structures across various scales. In this concept, the typical types of PSs and polymerization mechanisms (PMs) within the NIR-induced photopolymerization systems have been classified in detail. Additionally, the applications of various polymers achieved by NIR-induced photopolymerizations are summarized. Furthermore, research directions and future challenges of this field are also discussed comprehensively.

Barriers to Early Treatment Seeking among Patients with Sexually Transmitted Infections in a Rural Community Setting at Kaproron Health Centre IV

Our study aimed to establish barriers to early treatment seeking among patients with sexually transmitted infections at Kaproron Health Centre IV. This was a facility-based cross-sectional survey employing quantitative methods. The study enrolled a total of 122 randomly selected participants who had consented to participate in the study. Data was collected using a pretested interviewer-administered questionnaire and analysed using STATA software version 14. Descriptive statistics were used to present data as graphs and tables of frequencies while for inferential statistics odds ratios and P-value set at 0.05 corresponding to a 95% confidence interval were used. The study revealed that 56.86% of the participants sought their STI treatment late. Participants’ age, sex, symptom severity and cost of services at Kaproron Health Centre IV presented as significant barriers to early STI treatment seeking. Participants aged 36-45 (AOR-0.16, p-0.04, CI-0.03-0.88) and ≥46 years (AOR-0.17, p-0.05, CI-0.03-0.98) had lower odds of seeking treatment early which was similar for female participants (COR-0.38, p-0.02, CI-0.17— 0.86). Conversely, participants with severe STI symptoms (COR-2.8, p-0.02, CI-1.19-6.58) and those who reported STI services at Kaproron Health Centre IV as affordable (AOR-3.73, p-0.011, CI-1.35-10.25) were 3.73 times more likely to seek early treatment. A higher proportion sought STI treatment late. Age, gender, symptom severity and service costs presented significant barriers to seeking early treatment. Mass STI screening programs should target individuals aged 26 and above, females and impoverished communities. Keywords: STI treatment, Patients, Age, Gender, Symptom severity.

Factors affecting community ambulation post-stroke: a mapping review protocol

Background Most stroke survivors consider community ambulation an essential but unmet goal of their recovery. Historically, interventions to enhance community ambulation have focused on improving biomechanical impairments of gait; however, recent evidence suggests that biopsychosocial and environmental factors may impact community ambulation, even beyond more obvious physical impairments. The identification of factors that pose as significant facilitators or barriers to community ambulation may serve to guide stakeholders in designing relevant and evidence-based interventions for improving community ambulation post-stroke. Objective This review aims to map the type and extent of existing evidence on the physical, biopsychosocial, and environmental factors affecting community ambulation post-stroke. Additionally, this review will describe the various methods used to examine the extent to which stroke survivors are restricted to community ambulation. Methods Nine databases will be searched including CINAHL, PubMed, and Web of Science. We will include studies published in English during or after 2001. Studies that examine physical, biopsychosocial, and/or environmental factors affecting community ambulation in ambulatory adults at least six months post-stroke will be considered for inclusion. Studies that assess general physical activity or community mobility through transportation modes other than walking will be excluded. All identified records will be collated in citation management software, followed by steps of deduplication, title/abstract screening, and full-text reviews by at least two independent reviewers. The bibliographies of the extracted studies will also be reviewed for relevant articles. The extracted studies will be analyzed, critically appraised, and presented in tabular, narrative, and evidence map formats. Discussion The evidence gained will be used to build a framework for community ambulation, informing stakeholders to develop meaningful interventions to improve community ambulation. The mapped evidence will motivate future studies to develop holistic approaches that specifically focus on the most vital factors that influence post-stroke community ambulation.

Commentary on the senate select committee into the provision of and access to dental services in Australia: an opportunity for reform.

A recent Senate Select Committee has tabled its report into the provision of and access to dental care in Australia. The Senate Committee heard: There are significant barriers for many people accessing dental care, including high costs, trauma and fear, long waiting times and inaccessible services. There are service gaps, including a lack of special needs dentists, limited mobile services, very few Aboriginal dentists and sparse services in regional areas. There are significant impacts of poor oral health, including pain and suffering, shame and low self-esteem, poor nutrition and poorer general health. There are benefits to good oral health, including the ability to smile, eat and talk, improved confidence, increased productivity and being more employable. There were 35 recommendations for reform centred around the need to put the mouth back in the body and covered by five broad themes: More equitable access. Better integration. National data and coordination. Awareness and education. Culturally safe and accessible care. This paper provides an overview of the problem and focuses on the recommended funding reforms necessary to improve access to dental care.

Data Governance in AI - Enabled Healthcare Systems: A Case of the Project Nightingale

The study investigates data governance challenges within AI-enabled healthcare systems, focusing on Project Nightingale as a case study to elucidate the complexities of balancing technological advancements with patient privacy and trust. Utilizing a survey methodology, data were collected from 843 healthcare service users employing a structured questionnaire designed to measure perceptions of AI in healthcare, trust in healthcare providers, concerns about data privacy, and the impact of regulatory frameworks on the adoption of AI technologies. The reliability of the survey instrument was confirmed with a Cronbach's Alpha of 0.81, indicating high internal consistency. The multiple regression analysis revealed significant findings: a positive relationship between the awareness of technological projects and trust in healthcare providers, countered by a negative impact of privacy concerns on trust. Additionally, familiarity with and perceived effectiveness of regulatory frameworks were positively correlated with trust in data, while perceptions of regulatory constraints and data governance issues were identified as significant barriers to the effective adoption of AI technologies in healthcare. The study highlights the critical need for enhanced transparency, public awareness, and robust data governance frameworks to navigate the ethical and privacy concerns associated with AI in healthcare. The study recommends adopting flexible, principle-based regulatory approaches and fostering multi-stakeholder collaboration to ensure the ethical deployment of AI technologies that prioritize patient welfare and trust.

Experiences with health information among caregivers of people with cancer from culturally and linguistically diverse backgrounds: A qualitative study.

Although some research suggests that caregivers from culturally and linguistically diverse (CALD) communities have higher unmet information needs compared to their English-speaking counterparts, few studies have examined determinants of information needs among CALD cancer caregivers and their satisfaction with received information. This study aimed to explore experiences with cancer-related information among caregivers of people with cancer from CALD communities. Semi-structured interviews were conducted with 24 caregivers from Arabic and Chinese backgrounds (12 in each group). Thematic analysis was used to analyze data. Participants' mean age was 40.6 years, and most were female (83%). Six themes were identified: (a) lack of information to meet their needs; (b) challenges understanding cancer- and care-related information; (c) proactivity to make sense of, and understand information; (d) interpreting information: the role formal and informal services; and (e) engaging with health providers to access information. Caregivers identified significant language and communication barriers impacting their capacity to understand cancer-related information given by providers and they invested personal effort clarifying information. The importance of access to formal interpreter services, even when caregivers and care recipients seem proficient in English, was highlighted. Cultural sensitivity of providers when discussing a cancer diagnosis and treatment was also identified as an important consideration. Culturally tailored outreach programs designed to provide key cancer-related information which are accessible to CALD caregivers have the potential to improve the health outcomes of both caregivers and care recipients.

Critical lessons from a pragmatic randomized trial of home-based COVID-19 testing in rural Native American and Latino communities.

Native Americans and Latinos have higher COVID-19 infection and mortality rates and may have limited access to diagnostic testing. Home-based testing may improve access to care in rural and underserved populations. This study tests the effect of community health worker (CHW) support on accessibility, feasibility, and completion of COVID-19 home testing among Native American and Latino adults living on the Flathead Reservation in Montana and in Yakima Valley, Washington. A two-arm, multisite, pragmatic randomized controlled trial was conducted using block randomization stratified by site and participant age. Active arm participants received CHW assistance with online COVID-19 test kit registration and virtual swabbing support. The passive arm participants received standard-of-care support from the kit vendor. Logistic regression modeled the association between study arm and test completion (primary outcome) and between study arm and test completion with return of valid test results (secondary outcome). Responses to posttest surveys and interviews were summarized using deductive thematic analysis. Overall, 63% of participants (n=268) completed COVID-19 tests, and 50% completed tests yielding a valid result. Active arm participants had higher odds of test completion (odds ratio: 1.66, 95% confidence interval [1.01, 2.75]). Differences were most pronounced among adults ≥60years. Participants cited ease of use and not having to leave home as positive aspects, and transportation and mailing issues as negative aspects of home-based testing. CHW support led to higher COVID-19 test completion rates, particularly among older adults. Significant testing barriers included language, educational level, rurality, and test kit issues.

Effectiveness of an online intervention for parents/guardians of children aged 4–7 years who are concerned about their child’s emotional and behavioural development: protocol for an online randomised controlled trial (EMERGENT study)

IntroductionThe demand for resources to support emotional and behavioural development in early childhood is ever increasing. However, conventional interventions are lacking in resources and have significant barriers. The Embers the...

Exploring the barriers to mental health service utilization in the Bolgatanga Municipality: the perspectives of family caregivers, service providers, and mental health administrators

BackgroundMental health service utilization remains a challenge in developing countries, with numerous barriers affecting access to care. Albeit data suggest poor utilization of mental health services in the Bolgatanga Municipality in Ghana, no studies have explored the barriers to the utilization of mental health services. Therefore, this study explored the perspectives of family caregivers, service providers, and mental health service administrators on the barriers to mental health service utilization in the Bolgatanga Municipality, Ghana.MethodsA qualitative descriptive design was employed for the study. Nineteen participants were purposively sampled from two hospitals including fifteen family caregivers, two service providers, and two mental health administrators. Data were collected through individual in-depth interviews using a semi-structured interview guide. Audio-recorded interviews were transcribed verbatim and thematically analyzed using NVivo 12 pro software.ResultsFive main themes emerged including individual-level barriers, interpersonal barriers, community-level barriers, organizational-level barriers, and policy-level barriers. At the individual level, lack of insight, poor treatment compliance, and financial challenges were prominent barriers. Interpersonal barriers included family pressure influenced by cultural and spiritual beliefs. At the community level, stigma and mental health illiteracy were identified as significant barriers. At the organizational level, barriers encompassed inadequate staffing, limited space, and staff attitudes. Policy-level barriers included the neglect of mental health in policies and the non-inclusion of mental health services in the National Health Insurance Scheme.ConclusionThis study highlights the complexity of barriers to mental health service utilization and underscores the need for a comprehensive approach to address them. Collaborative efforts involving healthcare providers, policymakers, communities, and families are essential to mitigate these barriers. It is imperative to consider these barriers when developing strategies to improve the utilization of mental health services in Ghana.

The triple glass ceiling: FinTech gender inequalities

Abstract While FinTech gets promoted as an innovative and progressive solution to meeting financial needs globally, it is afflicted by pervasive gender inequalities, only recently noticed in research. To explore these gender inequalities at the core of FinTech, we use a mixed-methods approach, combining data on 100 leading FinTech firms and 15 interviews with FinTech professionals, collected in the latter half of 2021. We argue that women in FinTech face the ‘triple glass ceiling’ at the intersection of financial, technological, and entrepreneurial gender inequalities. Our sample shows that women account for only 7.69% of (co-)founders, 18.2% of executive committee members, and merely 4.04% of FinTech companies are led by a woman. Gendered stereotypes and a privileging of masculine performances produce significant barriers to women entering and progressing within FinTech. Discriminatory practices are overt and implicit, everyday and exceptional, micro and acute. Shattering the ‘triple glass ceiling’ in FinTech represents an immense challenge.

Better Late than Never: Promoting Cultural Consumption Among the Elderly

AbstractCultural activities are greatly beneficial to older individuals but, unfortunately, many still face significant barriers that limit their ability to enjoy the arts. To tackle this issue, we have analysed data from an Italian audience development and engagement program for seniors, which was implemented at local level. By using an agent-based model, we discuss the potential effectiveness of audience development policies before implementation. Our research shows that social policies aimed at promoting cohesion and creating personal relationships can significantly increase the success of such initiatives. Moreover, our findings underline the importance of implementing targeted policies and engaging key individuals to ensure that older people can access and enjoy cultural activities.

Advocacy in gender affirming care.

Healthcare advocacy is the duty and privilege of all healthcare providers, but especially for those who care for children. Intersex and gender diverse youth face significant barriers across many aspects of life, with access to competent gender affirming healthcare chief among them. Understanding the importance of both institutional and individual efforts in healthcare advocacy is paramount to improving healthcare access and outcomes for this population.