Unequal Access Research Articles

Unequal Access, Unequal Impact? The Role of Open Access Policies in Publishing and Citation Trends Across Three Countries

This bibliometric study investigates Open Access (OA) publication and citation trends in Austria, Israel, and Mexico from 2010 to 2020—three countries with comparable research output but differing OA infrastructures. (1) Background: The study examines how national OA policies, funding mechanisms, and transformative agreements (TAs) shape publication and citation patterns across disciplines. (2) Methods: Using Scopus data, the analysis focuses on four broad subject areas (health, physical, life, and social sciences), applying both three-way ANOVA and a Weighted OA Citation Impact index that adjusts citation shares based on the proportional representation of each subject area in national research output. An OA Engagement Score was also developed to assess each country’s policy and infrastructure support. (3) Results: OA publications consistently receive more citations than closed-access ones, confirming a robust OA citation advantage. Austria leads in both OA publication volume and weighted impact, reflecting its strong policy frameworks and TA coverage. Israel, while publishing fewer OA articles, achieves high citation visibility in specific disciplines. Mexico demonstrates strengths in repositories and Diamond OA journals but lags in transformative agreements. (4) Conclusions: National differences in OA policy maturity, infrastructure, and publishing models shape both visibility and citation impact. Structural limitations and indexing disparities may further affect how research from different regions and disciplines is represented globally, emphasizing the need for inclusive and context-sensitive frameworks for evaluating OA engagement.

Commentary: Artificial Intelligence and the Future of Higher Education—Towards Inclusive, Ethical, and Employability-Driven Learning Ecosystems

Artificial Intelligence (AI) is revolutionising higher education by generating novel opportunities for inclusive learning, skill enhancement, and equal access to information. This chapter analyses the influence of AI on higher education, emphasising its contribution to fostering diversity, improving employability skills, and mitigating gender inequities. AI-driven solutions, including adaptive learning platforms, automated feedback systems, and natural language processing technologies, provide the capability to customise the learning experience, assist students with varied needs, and enhance academic English proficiency. Moreover, AI-powered career development solutions are transforming employability training through real-time feedback, workplace simulations, and focused skill enhancement interventions. Nonetheless, whereas AI presents opportunity to bridge educational disparities, it simultaneously engenders worries about algorithmic bias, ethical dilemmas, and data privacy vulnerabilities. While reviewing literature, this chapter examines AI's capacity to enhance inclusive education while critically evaluating the dangers of unequal access and algorithmic bias. It promotes a balanced approach that emphasises human-centred education, gender equality, and preparedness for employment. The findings enhance the overarching dialogue regarding AI in education, impacting policy deliberations and institutional approaches to fostering equal learning environments in the digital era.

Mind the gap: examining policy and social media discourse on Long COVID in children and young people in the UK

BackgroundLong COVID in children and young people (CYP) has posed significant challenges for health systems worldwide. Despite its impact on well-being and development, policies addressing the needs of CYP remain underdeveloped. This study examines UK Long COVID policies using ethical frameworks, integrating policy and social media analyses to explore public and professional concerns.MethodsA mixed-methods approach was applied. Policy documents were reviewed using Thompson et al.'s pandemic preparedness framework and Campbell and Carnevale’s child-inclusive ethical model. Social media discourse (12,650 posts) was analysed using Brandwatch™ to identify key themes around CYP and Long COVID policies. Data was collected and triangulated through the LISTEN method, which integrates policy analysis with social media discourse to ensure a holistic understanding of systemic gaps and public perceptions.ResultsAnalysis highlighted gaps in accountability, inclusiveness, and transparency in policy development. Social media data reflected significant public dissatisfaction, primarily critiquing government accountability (90% of posts) and delayed policy responsiveness (29% of posts). Key ethical challenges included limited CYP representation and unequal access to services.ConclusionsRecommendations include improving transparency, incorporating CYP perspectives in policymaking, and ensuring equitable access to care. These findings provide a foundation for ethically sound and inclusive policies addressing Long COVID in CYP.

Implementasi Media Audio-Visual untuk Meningkatkan Minat Belajar Siswa pada Mata Pelajaran SKI di MAN 2 Malang

This research is motivated by the low student interest in learning Islamic Cultural History (SKI) at MAN 2 Malang, due to monotonous teaching methods and the dominance of textual materials. In response to technological advancement and the Merdeka Curriculum, this study explores the use of audio-visual media as a transformative approach in Islamic education. The aim is to evaluate its effectiveness in enhancing student engagement and learning outcomes. Employing a descriptive qualitative method, data were collected through participant observation, in-depth interviews, and documentation involving 2 SKI teachers and 30 twelfth-grade students. Data were analyzed using Miles and Huberman’s model—reduction, presentation, and conclusion drawing—supported by source triangulation. The findings indicate that audio-visual tools such as animated videos, digital slides, and interactive quizzes significantly improve student participation, motivation, and historical understanding through visual storytelling. This study offers a practical contribution by integrating technology into SKI learning, shifting it from passive to interactive. Despite positive outcomes, challenges such as infrastructure limitations, unequal digital access, and varying teacher digital literacy persist. The study suggests the need for structured training, equitable resource distribution, and curriculum alignment to ensure sustainable implementation. The novelty of this research lies in highlighting contextual application of media in faith-based education under the Merdeka Curriculum.

Intercontinental Multidisciplinary Oncology Videoconferencing between the South Pacific and the French mainland: Reasons for medical evacuation after more than 2000 cases of cancers discussed

Intercontinental Multidisciplinary Oncology Videoconferencing between the South Pacific and the French mainland: Reasons for medical evacuation after more than 2000 cases of cancers discussed

Which Students are Exposed to Teachers of Color?

ABSTRACT Research finds many benefits of exposure to teachers of Color, especially for students of Color. However, teachers of Color are underrepresented and unevenly distributed resulting in unequal access to these benefits. We descriptively examine the rate at which cohorts of 3rd to 8th grade students in Tennessee are assigned to teachers of different racial/ethnic identities. We also investigate how school-level factors predict exposure to teachers of Color and same-race teachers. We find a sizeable group of students never have a teacher of Color in a tested subject (i.e. English/language arts, math, science, and social studies) from 3rd to 8th grade and large variation in exposure across regions, districts, and schools. While essentially all White students and most Black students have at least one same-race teacher, very few Hispanic and Asian students do. We find evidence that the presence of Black administrators makes exposure to Black teachers more likely. We also find that schools may strategically assign students within schools to increase student matching to same-race teachers, a pattern even more pronounced for Black students in schools with Black administrators.

In danger: HIV vaccine research and development in Europe.

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has shrinked. This viewpoint emphasises that supporting HIV vaccine research and development at the European level remains crucial: it is not only necessary to control the epidemic, but it promotes innovation, strengthens health security, epidemic preparedness, and health sovereignty while contributing to the economies of European nations.

Determinants of transport exclusion among pregnant women in selected locations of southwestern Nigeria

Unequal access to transport is an outcome of several factors which play a significant role in access to maternal healthcare services. This study examines the factors contributing to transport exclusion among pregnant women in southwestern Nigeria, with the objective of ascertaining lived experience among the respondents. A survey was conducted among 357 registered pregnant women from 113 hospitals across three local government areas in Oyo State. The analysis employed both descriptive and inferential statistics. Results revealed that transport exclusion is prevalent among pregnant women in the study area, with factors such as lack of money (95.0%), transport cost (72.0%), and the affordability of transportation means (60.2%) being key determinants. The study concluded that factors contributing to transport exclusion among pregnant women may have far-reaching effects on their ability to meet daily social needs, particularly healthcare access, given their vulnerable status, which in turn impacts their overall well-being. Further research may be needed to explain the connection between the transport exclusion of pregnant women and the ease of accessing medical care, as well as their overall well-being.

Migration and Its Impact on Economic Inequality in Sending and Receiving Countries

Migration plays a dual role in shaping economic inequality in both sending and receiving countries. While remittances from migrants help reduce poverty and improve economic stability in their home countries, brain drain and unequal access to migration opportunities exacerbate disparities. In receiving countries, migration alleviates labor shortages but can also widen wage gaps and strain public services when not managed effectively. Case studies of the Philippines and Mexico illustrate the benefits and challenges of remittances and skilled labor migration, while Germany and the United States provide contrasting examples of migrations impact on labor market inequalities. Germany's structured integration policies have mitigated disparities by providing migrants with employment and training opportunities. Conversely, the U.S. lacks a cohesive immigration policy, resulting in a two-tier labor market that places undocumented workers in low-wage, exploitative conditions, affecting both migrant and native workers. Additionally, social inequalities are compounded by discrimination and limited access to welfare services. To address migration-driven inequalities, policies should focus on improving legal pathways, enhancing integration programs, and fostering economic development in sending countries. By adopting comprehensive migration policies, governments can maximize its benefits while minimizing its negative effects on economic inequality.

Challenges for Women Entrepreneurs in Times of Crisis and Tools for Overcoming Them

Crises like the COVID-19 pandemic have significantly impacted women entrepreneurs. Policies designed to support entrepreneurs have often followed a one-size-fits-all approach, overlooking men's and women's unique needs and unequal access to state support. Recognizing these gender disparities, our analysis centres on the perspectives of policy-makers (both during and beyond the pandemic) as well as on the experiences of those the policies aim to support. The study is based on 17 in-depth, semi-structured interviews with low-income women entrepreneurs in the Czech Republic, along with three group discussions with policy-makers during and after the pandemic. We explore the level of policy-making through the views of policy-makers and compare these with the perspectives of women entrepreneurs affected by these policies. The findings reveal notable differences in how problems and solutions for women’s entrepreneurship are viewed, not just between policy-makers and those impacted but also within these groups. Our paper highlights fundamental issues in policy-making, including the neglect of structural barriers affecting women entrepreneurs, the neglect of necessity-driven entrepreneurship, and non-systematic state support.

Trends in level of education and area of residence of users of a mobile app to support treatment of urinary incontinence

BackgroundBetween 25% and 45% of women experience urinary incontinence. The Tät® app is intended to treat stress urinary incontinence in women, and has been evaluated for efficacy and effectiveness. The level of usage of digital healthcare differs depending on demographics, and this might lead to unequal access to healthcare. This study aims to analyse the change in level of education and area of residence of users of the Tät app over time, and compare this with overall demographic data for Sweden.MethodsWhen the app was downloaded, the user was invited to respond anonymously to a questionnaire. We included women aged 18–89 years living in Sweden. We weighted the app data to reflect the age distribution of the general female population of Sweden. We then compared the users’ level of education and area of residence with data from Statistics Sweden.ResultsThe study encompassed 153,819 users between 2016 and 2021. The percentage of Tät users with university education decreased from 63.14% (95% CI 62.16–64.11) to 61.07% (95% CI 60.53–61.61), and the percentage of users with fewer than 7 years of education increased from 0.02% (95% CI 0.006–0.077) to 1.94% (95% CI 1.80–2.10). In contrast to this, the Statistics Sweden data comparing 2016 with 2020, showed an increase in the category “university or higher education institution” from 38.94 to 42.10% and a decrease in the other categories. Comparing Tät users’ area of residence between 2018 and 2021 showed an increase in the amount of users living in rural areas from 16.90% (95% CI 16.44–17.37) to 20.53% (95% CI 20.08–20.98). Data from Statistics Sweden did not show any significant change, and in 2020 6.23% of women in Sweden lived in rural areas.ConclusionsThe proportion of Tät users in both the highest and the lowest educational categories had changed to be more like the overall Swedish female population. The proportion of Tät users living in rural areas had increased and was considerably larger than for the population in general. We thus see positive trends in the distribution of users, although users with a university education are still over-represented.

The paper study (prescribing antidepressants in primary care: ethnic inequalities in treatment). A study protocol.

South Asians represent the largest minority ethnic group in the UK, but prior research has suggested unequal access to primary care and differences in antidepressant prescribing practices for these patients. This project aims to understand the treatment of depression in South Asian patients, with specific reference to factors affecting appropriate prescribing. The secondary aim is to understand the intersection between ethnicity, age and financial deprivation within this context. A mixed methods approach will be adopted, including primary and secondary analyses, to understand the ways in which inequalities may arise along the pathway from patient experience of symptoms to clinician decision to treat with antidepressants in UK primary care. Two scoping reviews will inform our approach. Quantitative data analysis of UK Biobank will allow us to examine prevalence and heterogeneity in depressive symptoms, and antidepressant prescribing over time, stratified by ethnicity. Qualitative data will be generated through interviews and focus group discussions with patients and healthcare professionals to understand experiences of depression and document the depression management decision-making process. Ethical approval was obtained from Wales 6 Research Ethics Committee (reference 24/WA/0087). The dissemination plan will be informed by patient and public involvement (PPI) group members and engagement with stakeholders and will aim to produce a toolkit of resources for use in primary care.

What do parents know and feel about mental health in young children? A mixed methods systematic review of global parental mental health literacy

Abstract Despite the global rise in child mental health difficulties, public understanding of young children’s mental health remains unclear. Parents play a pivotal role in supporting their children’s mental health and seeking professional help for concerns. Our mixed-methods systematic review sought to describe current levels of child mental health literacy (CMHL) among parents, examine variations across sociodemographic and clinical factors, and explore the relationship between CMHL and professional help-seeking. We searched six databases for English-language studies investigating any aspect of CMHL among parents of children aged 4–12 years in community settings, published in the last decade. From 26 studies across 12 countries (N = 5562), we found that parents generally had: (1) low to moderately low recognition, (2) diverse causal and other mental health beliefs (in Western and non-Western countries), (3) high levels of stigmatising beliefs and perceived stigma; (4) attitudes to professional help-seeking ranging from moderately positive to highly negative, and (5) low awareness of available help. Lower CMHL was associated with lower parental education level, being a father and less acculturated ethnic minorities, while higher CMHL was linked with previous service use. Help-seekers tended to have higher CMHL than non-help-seekers. Thus, disparities in parental CMHL may contribute to unequal access to mental health services. A more holistic, strengths-based and prevention-focused approach to CMHL in future research and measurement would inform intervention. Public health campaigns and targeted coproduced interventions to enhance the CMHL levels of parents with young children should form a key strategy for the promotion of child wellbeing.

The gendered politics of the 'local turn' in peacebuilding: Acholi traditional justice and gender in post-conflict Uganda.

Typically, advancing localised approaches to peacebuilding has evaded critical reflection on the power dynamics and harms that can arise. This paper considers the gender dynamics and gendered harms that can manifest themselves when adopting an uncritical approach to localisation in peacebuilding. To do so, it examines the use of mato oput (drinking the bitter root) in post-conflict northern Uganda, as an example of a localised approach to post-conflict transitional justice, to investigate these dynamics and harms. It draws from interviews and focus-group discussions that were conducted in northern Uganda between 2020 and 2022 and engages with critical international relations scholarship on the 'local turn' in peacebuilding and the gendered nature of conflict and peace. The paper argues that in patriarchal societies, advancing localisation may entail a return to the traditional or customary order that reaffirms and reifies oppressive gender power relations and helps to consolidate gender inequalities, including unequal access to both security and justice.

Catastrophic health expenditure during healthcare financing reform: Evidence from Kazakhstan.

Catastrophic health expenditure during healthcare financing reform: Evidence from Kazakhstan.

Racial and Gender Discrimination when Tailoring Medical Management to Hypertension Treatment in Latin America.

Discrimination in cardiovascular healthcare, particularly concerning hypertension treatment, is a significant and complex issue in Latin America, driven by biases related to gender, ethnicity, and economic status. Although cardiovascular disease (CVD) is the leading cause of death worldwide, disparities in healthcare delivery endure, especially impacting marginalized populations. Women, ethnic minorities, and economically disadvantaged groups encounter considerable barriers, including underrepresentation in clinical research, delayed diagnoses, and unequal access to guideline-recommended treatments. Economic disparities maintain a divided healthcare system in which the quality of treatment often directly correlates with socioeconomic status, reinforcing inequities and adversely affecting health outcomes in lower-income communities. Ethnic discrimination, stemming from deeply ingrained social biases, leads to inadequate care and limited access to advanced medical technologies, disproportionately impacting indigenous and Afro-descendant populations. Addressing these systemic inequities requires comprehensive strategies that ensure equitable participation in clinical trials, develop tailored public health policies sensitive to socioeconomic and cultural contexts, and implement targeted educational initiatives. Healthcare systems must actively dismantle entrenched biases, improve access for economically disadvantaged communities, and guarantee that ethnic minorities receive treatment of equal quality. The Inter-American Society of Hypertension emphasizes that removing these discriminatory barriers reduces the burden of cardiovascular disease and enhances overall health outcomes across Latin America. This document endorses consensus recommendations detailed in positions 1 through 4, which tackle specific challenges related to personalized care, racial biases in treatment algorithms, socioeconomic healthcare inequalities, and gender disparities in hypertension management.

A rapid facility-level assessment of oxygen systems in 39 low-income and middle-income countries: a cross-sectional study.

A rapid facility-level assessment of oxygen systems in 39 low-income and middle-income countries: a cross-sectional study.

Розвиток людського капіталу в умовах глобальної нестабільності.

In the conditions of globalization, increasing interaction and interdependence of countries lead to their mutual vulnerability, aggravate old problems and give rise to new threats, risks, contradictions and crises, thus generating global instability. These processes exert impact on the world economy, international relations and human development. Therefore, it is relevant to study the impact of these changes on human development under global instability. The research objective of this article is to analyse the influence of global processes, threats and risks on the development of human capital. The novelty of the research results consists in disclosing the influence of global threats and risks on human capital development, with focus on environmental problems, pandemics, economic crises, increasing unevenness of socio-economic development of countries and regions of the world. The research relies on the methods of system analysis, scientific generalizations, cross-country comparisons, and economic and statistical analysis. The article reveals that the development of human society is affected by the global environmental problem associated with the change of the natural environment produced by human economic activity, which leads to the disruption of the structure and functioning of natural systems, the depletion of resources, and pollution of territories, all of these negatively affecting human development. The Covid-19 pandemic was a significant challenge for human society worldwide, which had a notable impact on economic and social development, caused a reduction in production and employment, a drop in incomes, and affected the state of health, thus determining a decline of the global Human Development Index — for the first time in 30 years of its existence. Economic crises, which are accompanied by economic recession, rising unemployment and prices, falling incomes and well-being, have a significant impact on human development, which reveals itself in the negative HDI changes in most countries. The uneven socio-economic development of countries and regions of the world has a negative impact on human development. It is manifested in the uneven distribution of resources and wealth, unequal access to education and profession, as well as in significant gaps in such important basic rights and opportunities as the right to life, freedom of choice, employment, etc. The solution of existing global problems and ensuring stability and development at the international level are to be attained within the framework of the global governance system, the core of which represent the UN and its institutions. This makes vital the development and reformation of global institutions to regulate international political, economic and social relations in accordance with the new conditions of human society development. The study of these issues is necessary to identify new global trends in the development of an effective development policy at the national and global level.

СОЦІАЛЬНИЙ КОНФЛІКТ ЯК ІНДИКАТОР ЦИФРОВОЇ ТРАНСФОРМАЦІЇ СУСПІЛЬСТВА В КОНТЕКСТІ ПУБЛІЧНОГО УПРАВЛІННЯ

The purpose of the article is to substantiate the theoretical foundations and develop a methodological approach to analyzing social conflict as an indicator of societal digital development, as well as to determine its role in shaping sustainable digital development strategies within the public governance system. The study established that the digital transformation of society creates new conditions for the emergence and escalation of social conflicts, which encompass economic, political, informational, and cultural spheres. Social conflicts in the digital environment arise due to unequal access to digital resources, algorithmic opacity, cybersecurity threats, manipulation in the information space, and violations of citizens' digital rights. The key results of the study include identifying the specific features of digital social conflicts, their causes, forms of manifestation, and socio-economic consequences for societal development. It was found that social conflicts in the digital environment can perform both destructive and constructive functions – either increasing social tension and societal polarization or stimulating the adaptation of social institutions to digital changes, updating digital policies, and fostering a digital culture of dialogue. A methodological approach to monitoring social conflicts as indicators of societal digital development has been proposed, enabling the identification of digital stability threats, the prediction of potential risks, and the formation of effective mechanisms for their resolution based on the principles of inclusiveness, transparency, and digital ethics. It is concluded that social conflicts are a natural component of a digital society and serve as an indicator of the level of digital maturity, social equality, and the effectiveness of state regulation in the field of digital transformation.

Proportion of food insecurity and its sociodemographic correlates among Spanish adolescents: the EHDLA study.

Insufficient and unequal access to food (i.e. food insecurity [FI]) has a negative impact on health, especially in vulnerable groups such as adolescents. This study determined the prevalence of FI and its sociodemographic correlates among adolescents in the Valle de Ricote, Region of Murcia, Spain. A secondary analysis was conducted using data from the Eating Healthy and Daily Life Activities (EHDLA) study, which provides a sample of 882 adolescents (median = 14, interquartile range [IQR] = 2) collected during the 2021-2022 academic year. FI was measured using the Child Food Security Survey Module in Spanish (CFSSM-S). Findings showed a prevalence of FI of 16.2%, with significant sociodemographic disparities. Adolescents from immigrant (n: 67; %: 46.9; odds ratio [OR] = 2.41; 95% CI: 1.38 to 4.21) and diverse (n: 25; %: 17.5; OR=2.04; 95% CI: 1.10 to 3.79) families showed a higher susceptibility to FI. In addition, higher parental education was related to lower FI (university education: n: 13; %: 9.6; OR=0.36; 95% CI: 0.17 to 0.74). These findings highlight the need for targeted public health policies that improve access to nutritious food, enhance parental education, and address socioeconomic inequalities to effectively reduce FI among Spanish adolescents.