Unequal Access Research Articles

Artificial Intelligence (AI) is Not A Writing Gods, So Why Do Post-Graduate Students Believe It?

This study was aimed at understanding graduate students' preferences in applying AI when dealing with their class papers and projects in Indonesia. It also sought to understand how students who have used AI in previous writing feel about such experience. This study adopted a phenomenological research method in order to elicit in-depth insights into the concerns of the students. The participants included graduate students from four universities in Indonesia. These data were gathered using semi-structured interviews of 30 students who had experience using AI for their academic writing. Guided by understanding the decision-making process, perceived benefits, and drawbacks of AI, and overall experiences, interview questions were prepared. One-way thematic analysis was conducted with the interview data. Students seemed to view AI applications as only helping with formatting and editing tasks, as most of them would like to have the opportunity to do the major work by themselves for better learning. Another underlying strong theme emerging here is related to AI overdependency and unequal access to it. The results offer insights into the respective areas that can be used by educators and institutions to provide a balance between the rising AI in use and support for independent learning within academics.

Digital Divide as a Dynamic Challenge and a Leveraging Opportunity: A Phenomenological Study on Seasoned TLE/TVL Teachers' Adaptive Pedagogy

This study explores the perspectives and strategies of seasoned Teachers of Technology and Livelihood Education / Technical-Vocational Education and Training (TLE/TVL) in addressing the challenges posed by the Digital Divide in educational settings. The participants are four Master Teachers who have 10 or more teaching experience and currently teaching in the secondary school in the Province of Ilocos Sur. Two of them are from rural secondary schools while the other two are from secondary schools situated in urban areas. Through a phenomenology study and cool and warm analysis, the research investigates how these seasoned teachers view their teaching experience in using adaptive pedagogical approaches and perceive the impact of unequal access to technology and varying levels of digital literacy among learners on engagement and learning outcomes. Findings reveal that seasoned TLE/TVL teachers view the Digital Divide as both a dynamic challenge and a leveraging opportunity. They employ adaptive pedagogical approaches, including differentiated instruction, flexible grouping, and varied assessment methods, to cater to diverse learner needs. Continuous assessment of individual learner digital competencies and promotion of collaborative learning emerge as effective strategies to bridge digital gaps and enhance student engagement. The study underscores the importance of ongoing professional development in digital competencies and the need for institutions to prioritize access to technology and support flexibility in teaching practices. However, the study also identifies limitations, including potential sampling bias and the subjectivity of self-reported teacher experiences. Despite these constraints, the findings contribute valuable insights into effective strategies for fostering inclusive learning environments in vocational education amidst technological disparities.

Inequality in the shadow: The role of private tutoring in SES achievement gaps

Despite the rapid growth of private tutoring, previous studies have not systematically addressed its implications for socioeconomic status (SES) disparities in education, as they have only separately examined differential access to and the effects of private tutoring. This study directly estimates the causal contribution of private tutoring to SES disparities in educational achievement and cognitive ability among Chinese middle school students. Using nationally representative longitudinal data and a novel gap-closing approach, we find that unequal access to private tutoring does not uniformally result in significant learning gaps between high- and low-SES students. When comparing disadvantaged students with their most socioeconomically advantaged peers, we find that the proportions of SES disparities attributed to differences in participation in and intensity of private tutoring increase with these differences. These findings have important policy implications for reducing SES disparities in learning outcomes.

Unequal Access to Primary Care Providers at the Intersection of Race/Ethnicity, Sexual Orientation, and Gender

Unequal Access to Primary Care Providers at the Intersection of Race/Ethnicity, Sexual Orientation, and Gender

The Use of Artificial Intelligence in Medical Diagnostics: Opportunities, Prospects and Risks

Rapid advancements in AI (artificial intelligence) technologies, including machine learning, natural language processing, and computer vision, have developed sophisticated tools capable of performing complex medical tasks. The AI integration in healthcare can revolutionise the industry by improving patient outcomes, optimising resource allocation, and reducing operational costs. However, the AI use in medicine carries certain risks related to ethics and data privacy, shortcomings in the quality of data for training algorithms, and importance of protecting against cyberthreats. There is also a threat of rising medical costs due to the need for a large number of tests and validations of new technologies. This study focuses on the AI application in the diagnostic field, as it is revolutionising the medical industry by offering new opportunities for accurate disease detection, classification, and prediction of treatment outcomes. The diagnostic field specificity is that any changes in it affect both those medical professionals who directly perform diagnostic procedures and those medical specialists who use the results of diagnostic examinations in their work. The research consists of two stages. Stage 1 is a survey of 119 respondents (medical professionals in Ukraine) about their attitude to the integration of AI technologies in diagnostics. Stage 2 is a study of opinions by 10 experts (medical professionals in Ukraine) about their own assessment of AI risk parameters in medical diagnostics. The survey showed the vast majority of Ukrainian doctors (over 84%) had no experience with AI-based diagnostic systems. Simultaneously, 74% of respondents believe AI can be effective in reducing diagnostic errors, and the future of medical diagnostics is associated with AI. They consider its main advantages to be speed, accuracy, objectivity, and ability to detect diseases at early stages. Respondents argue that AI is the most appropriate for diagnosing cancer, genetic research, and chronic conditions with atypical symptoms. Regarding the risks and barriers to AI introduction in medical diagnostics, at the first study stage, respondents named the high cost of implementation, the need for specialised training, and the possible lack of personal interaction between doctor and patient as the main ones. This opinion was clarified at the second study stage. In particular, 10 experts ranked these risks and potential problems in the following order (from the most to least important): unequal access; dependence on technology; ethical issues; legislative and regulatory challenges; lack of personal contact; bias and inequality; data privacy and security; errors in diagnosis and treatment. To mitigate each of these risks, the article develops a set of recommendations.

From alert to action: earthquake early warning and deaf communities

AbstractEarthquake early warning (EEW) alerts may give people valuable seconds to take protective action, such as drop, cover and hold on, before earthquake shaking starts. In order for individuals to take protective action, they need to receive the alert, understand the alert message, and have enough contextual knowledge to take appropriate protective action. Deaf and hard of hearing (DHH+) persons do not have equitable access to earthquake information, warning systems, training, and participation in disaster decision-making at all levels. Despite international policies for emergency alerts to be accessible to people with disabilities, there are no research publications that specifically address the effectiveness of EEW alerts for DHH+ communities. Missed notifications and misunderstandings about elements of the EEW alert message can delay the response time of DHH+ persons. Furthermore, unequal access to earthquake drills and preparedness information can leave DHH+ persons with insufficient context to take protective action when receiving alerts. The existing gaps in effectiveness of the EEW alerts stem from language inequities for DHH+ persons in our schools, workplaces and families, which we analyze by applying linguistic anthropological and sociolinguistic frameworks to examine the nexus of DHH+ communities’ languages and EEW messaging. To advance language equity in EEW alerting, inclusion of DHH+ communities can improve messaging and reduce misunderstandings so that DHH+ persons can quickly take protective action when they receive an alert.

Assessing the Benefits and Harms of Pharmacotherapy in Older Adults with Frailty: Insights from Pharmacoepidemiologic Studies of Routine Health Care Data.

The objective of this review is to summarize and appraise the research methodology, emerging findings, and future directions in pharmacoepidemiologic studies assessing the benefits and harms of pharmacotherapies in older adults with different levels of frailty. Older adults living with frailty are at elevated risk for poor health outcomes and adverse effects from pharmacotherapy. However, current evidence is limited due to the under-enrollment of frail older adults and the lack of validated frailty assessments in clinical trials. Recent advancements in measuring frailty in administrative claims and electronic health records (database-derived frailty scores) have enabled researchers to identify patients with frailty and to evaluate the heterogeneity of treatment effects by patients' frailty levels using routine health care data. When selecting a database-derived frailty score, researchers must consider the type of data (e.g., different coding systems), the length of the predictor assessment period, the extent of validation against clinically validated frailty measures, and the possibility of surveillance bias arising from unequal access to care. We reviewed 13 pharmacoepidemiologic studies published on PubMed from 2013 to 2023 that evaluated the benefits and harms of cardiovascular medications, diabetes medications, anti-neoplastic agents, antipsychotic medications, and vaccines by frailty levels. These studies suggest that, while greater frailty is positively associated with adverse treatment outcomes, older adults with frailty can still benefit from pharmacotherapy. Therefore, we recommend routine frailty subgroup analyses in pharmacoepidemiologic studies. Despite data and design limitations, the findings from such studies may be informative to tailor pharmacotherapy for older adults across the frailty spectrum.

PRACTICAL ASPECTS OF THE DEVELOPMENT OF STEM EDUCATION IN KAZAKHSTAN

The article discusses the importance of STEM education for workforce preparation in the context of Kazakhstan's economic development. The main issue addressed is the need to prove the integration of new technologies into educational programs, as this is crucial for preparing skilled specialists in a rapidly changing world. The aim of the study is to describe new methods of implementing STEM education and to identify successful practices. Research methods include analyzing current educational programs, studying examples of successful STEM methodology implementation, and conducting professional development courses for teachers. The article describes problem-based learning (PBL) methods that contribute to deeper student engagement and the development of critical thinking skills. The research results show that, despite significant progress in integrating STEM into educational programs and successful examples of applying innovative methods, challenges remain, such as unequal access to resources and a shortage of qualified specialists. However, successful initiatives, such as «STEM for All» programs, demonstrate a positive impact on the accessibility and quality of STEM education. The conclusions emphasize that for effective implementation of STEM education, it is necessary to focus on innovative teaching methods, address gender and socio-economic barriers, and adapt education to future technological trends. In this way, Kazakhstan can develop a STEM education system that prepares students for the demands of a rapidly changing world. The future of the country's economy depends on the ability to cultivate a new generation of scientists, engineers, and innovators who will contribute to sustainable development and economic growth.

Innovative Educational Broadcasting: UGTV's Influence on Gunadarma Students and the Wider Community

Television remains a medium for delivering information and entertainment, to communities, particularly in areas with unequal access to the internet, so television becomes their primary source. This study aimed to explore how UGTV is utilized to deliver educational content to students of Gunadarma University and the wider community. Using a qualitative method with a constructivist paradigm, this study was grounded in the Media Ecology Theory. Data were collected through observation, in-depth interviews, documentation, and literature studies. The findings revealed that UGTV, as an educational digital television platform, effectively provides academic and innovative content useful for the community, particularly students. The contents are produced and packaged to be informative and appealing to the community.

The Unknown Gunmen and National Security in Nigeria

The study critically examines the notorious and anonymous armed group called the “Unknown gunmen” in relation to Nigeria’s national security. The study utilizes three sociological theories as tools of analysis in understanding the reasons for the emergence of this group, their motivations and consequences of their actions on national security as well as on the overall development of Nigeria. Consequently, the study reveals various reasons responsible for the emergence of this armed group, of which political marginalization and inequitable distribution of economic resources to sections of the Nigerian state, take preeminence. The study recommends, inter alia, the political inclusion of all component units in the Nigerian state as a way to foster a sense of belonging in Nigeria’s federal structure. Also, government policies at both the states and federal levels should address issues of unemployment and unequal distribution and access to economic resources of the nation among the citizenry. By this, we believe the monstrous problem of the unknown gunmen and its negative impacts on Nigeria’s national security would be drastically reduced if not eradicated.

The Effectiveness of Technology-Enhanced Learning Tools in English Language Education

The integration of technology into English language education has revolutionized traditional teaching methods, offering new avenues for language acquisition and cultural understanding. This literature-based article explores the effectiveness of technology-enhanced learning tools in English language education, focusing on their impact on student engagement, proficiency, and cultural competence. Through a comprehensive review of existing research, the article examines the factors influencing the success of these tools and discusses practical implications for educators and policymakers. Key findings suggest that technology-enhanced learning tools have the potential to enhance student engagement and motivation, personalize learning experiences, and provide access to authentic language use and cultural contexts. However, challenges such as unequal access to technology and the need for effective pedagogical integration remain significant considerations. The article concludes with recommendations for optimizing the use of technology in English language education to maximize its benefits and address existing challenges.

The influence of age at first regular digital device access on digital reading performance: the mediating effect of cognitive flexibility

Younger generations are receiving their first regular digital device access at progressively earlier ages than previous generations on average, whereas disparities in their early digital device access are still being observed globally. The inequality of first regular digital device access may have profound long-term effects on one’s information and communication technology (ICT) skills, but no evidence has suggested how unequal first regular digital device access impacts one’s digital reading, which enables one to process and comprehend information in this digitized world. Thus, the current study investigated the relationship between the age at which children first regularly access digital devices and their digital reading performance at age 15 while considering the potential mediating effect of cognitive flexibility. A multilevel mediation model was proposed and tested using data from a cross-national sample of 156,277 15-year-old students from 18 OECD countries from the Programme for International Student Assessment (PISA). The results suggested that first regular digital device access after age 9 exerted a negative influence on digital reading scores in countries that generally had high levels of early digital access, and after age 13 in countries that had lower levels of early digital access. Additionally, cognitive flexibility mediated the association between the age at first regularly accessing digital devices and digital reading performance. Starting using digital devices regularly only after age 6, more evident at ages 9 to 12, was associated with lower levels of cognitive flexibility, which in turn led to worse digital reading performance. These findings demonstrated the importance of early first regular access to digital devices before school age (age 6) and highlighted the need for the cultivation of cognitive flexibility in family and school uses of digital devices.

Whole genome sequencing as a ticket to cancer treatment in the Netherlands: Are inequalities in access to molecular diagnostics unfair?

Whole genome sequencing (WGS) of a tumour may sometimes reveal additional potential targets for medical treatment. Practice variation in the use of WGS is therefore a source of unequal access to targeted therapies and, as a consequence, of disparities in health outcomes. Moreover, this may even be more significant if patients seek access to WGS by paying a relatively limited amount of money out of pocket, and sometimes effectively buy themselves a ticket to (very) expensive publicly funded treatments. Should resulting unequal access to WGS be considered unfair? Drawing from current practice in the Dutch healthcare system, known as egalitarian, we argue that differences in employment of WGS between hospitals are the consequence of the fact that medical innovation and its subsequent uptake inevitably takes time. Consequently, temporal inequalities in access can be deemed acceptable, or at least tolerated, because and insofar as, ultimately, all patients benefit. However, we argue against allowing a practice of out-of-pocket payments for WGS in publicly funded healthcare systems, for four reasons: because allowing private spending favours patients with higher socio-economic status significantly more than practice variation between hospitals does, may lead to displacement of publicly funded health care, does not help to ultimately benefit all, and may undermine the solidaristic ethos essential for egalitarian healthcare systems.

Interactive Response Systems (IRS) in online English classes: Voices of foreign university teachers in Thailand

Technological advances have introduced English instructors to various ways of delivering successful online classes. Using an Interactive Response System (IRS) as a supporting tool is one of them. This qualitative study investigates the perceptions of foreign English language teachers in Thai universities regarding the use of IRS in online classes. The study involved 10 non-native English university teachers, 7 females and 3 males, aged 27 to 35, with 3 to 6 years of teaching experience in Thailand. They are affiliated with three different Thai universities. Data were gathered through multiple online interviews and observations via Zoom or Google Meet, tailored to each participant’s convenience. The data analysis was conducted using a robust content analysis approach. The findings of this study showed that educators integrated IRS tools to boost engagement, benefiting both students and instructors. Additionally, peer influence encouraged IRS adoption and enhanced teaching methods. IRS tools served various roles, ranging from assessment to promoting motivation and enhancing comprehension. The advantages of IRS tools included increased interactivity, competition, and engagement. They aided in monitoring student attentiveness and comprehension while fostering independent learning. Challenges such as unequal internet access, device limitations, technology literacy, fees, workload, and language barriers existed, along with concerns about potential cheating during IRS activities.

Towards sustainable development: Assessing social sustainability of Australian aged care system

AbstractThe importance of social sustainability, one of the three pillars of sustainable development, is increasingly recognised. Its implementation in the aged care system enhances stakeholders' quality of life and supports sustainable societal development. However, there is limited global research on social sustainability in aged care. This study aims to assess the overall social sustainability of the Australian aged care system and propose measures for its improvement. A conceptual framework was developed and applied to analyse the Final Report: Care, Dignity and Respect by the Australian Royal Commission into Aged Care Quality and Safety. The findings reveal that Australia's aged care system demonstrates significant deficiencies in social sustainability, with unequal access to care, services and facilities, and inadequate health and comfort for the elderly and their families. Employees contend with issues of unfair employment, insufficient compensation, unhealthy work environments, and inadequate education and training. Several measures are proposed to enhance social sustainability. This study provides a comprehensive analysis of social sustainability in the aged care system within a Western context. It enhances our understanding of the components of social sustainability in aged care, assesses its current status, identifies existing challenges, and provides possible directions for improvement. The insights from Australia's experience and potential solutions could inspire other countries to recognise the importance of social sustainability and reform their aged care systems towards sustainable development.

“I probably have access, but I can’t afford it”: expanding definitions of affordability in access to contraceptive services among people with low income in Georgia, USA

BackgroundDisparities in rates of contraceptive use are frequently attributed to unequal access to and affordability of care. There is a need to better understand whether common definitions of affordability that solely relate to cost or to insurance status capture the reality of individuals’ lived experiences. We sought to better understand how individuals with low incomes and the capacity for pregnancy conceptualized one domain of contraceptive access–affordability --in terms of health system and individual access and how both shaped contraceptive care-seeking in the US South.MethodBetween January 2019 to February 2020, we conducted twenty-five life-history interviews with low-income individuals who may become pregnant living in suburban counties in Georgia, USA. Interviews covered the ways individual and health system access factors influenced care-seeking for family planning over the life course. Interview transcripts were analyzed using a thematic analysis approach to identify experiences associated with individual and health system access.ResultsAffordability was identified as a major determinant of access, one tied to unique combinations of individual factors (e.g., financial status) and health system characteristics (e.g., cost of methods) that fluctuated over time. Navigating the process to attain affordable care was unpredictable and had important implications for care-seeking. A “poor fit” between individual and health system factors could lead to inequities in access and gaps in, or non-use of contraception. Participants also reported high levels of shame and stigma associated with being uninsured or on publicly funded insurance.ConclusionsAffordability is one domain of contraceptive access that is shaped by the interplay between individual factors and health system characteristics as well as by larger structural factors such as health and economic policies that influence both. Assessments of the affordability of contraceptive care must account for the dynamic interplay among multilevel influences. Despite the expansion of contraceptive coverage through the Affordable Care Act, low-income individuals still struggle with affordability and disparities persist.

Addressing Maternal Perinatal Mortality: State Responsibility in Primary Health Care in Perú

Using data from the Comprehensive Health Insurance, this study examined Primary Health Care (PHC) and disparities in maternal-perinatal health in Peru. Its primary goal was to assess how PHC affected the decline in high and persistent maternal and perinatal mortality. The investigation also encompassed regional inequities and unequal access to health services. The study used a technique that integrated a qualitative approach, a review of scientific literature, and data analysis. It made clear how crucial it is to address inequality characteristics such as sociocultural accessibility, geographic, and economic in order to enhance care in the nation. The findings demonstrate the necessity of resolving these disparities in order to improve prenatal and maternal care. The present study offers a robust basis for subsequent inquiries and the development of evidence-based health policies. The Ministerio de la Mujer y Poblaciones Vulnerables (2021) recommended changes in health policy, which this study supports in order to enhance the health of vulnerable people and reduce inequities in access to maternal-perinatal care. The study also highlights the critical necessity of PHC in Peru. Its primary contributions are to deepen our understanding of disparities in obstetric treatment and to set the stage for future studies and national health policy.

A Scoping Review to Improve Universal Health Coverage for Pediatric Dental Services Policies

Background: Poor oral and dental health significantly affects public health, impacting over half the world’s population. Dental caries can undermine children’s academic success and career prospects. Social inequities result in unequal access to oral healthcare, particularly among populations with lower socioeconomic status (SES). National policies that improve access to oral health can reduce these disparities. Objectives: This study aims to compile policies implemented by various countries to achieve universal health coverage (UHC) for pediatric dental services. Methods: This scoping review was conducted according to Arksey and O’Malley’s framework and is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A systematic search was conducted on databases including Scopus, PubMed, Magiran, SID, Irandoc, Google Scholar, the WHO website, and the databases of Iran’s Ministry of Health. The search aimed to identify literature discussing governmental steps taken to achieve UHC for pediatric dental health, published between January 1, 2011, and December 31, 2022. The results were charted and presented in a table. Results: This review included 22 studies. Six themes were identified based on the roles played by key players in this field, including schools, government policy and support, community-oriented preventive plans, insurance support, parents’ awareness, and inequality in accessing dental services. Conclusions: A comprehensive policy that reduces barriers to access, increases utilization, and engages all stakeholders—including parents, schools, and community centers—can effectively achieve UHC for pediatric dental health.

Losing the race before its start: inequities in early childhood development interventions in China

ABSTRACT Extensive research demonstrates the far-reaching impacts of early childhood development (ECD) interventions, including both pre-primary education (PPE) and in-home nurturing. At the same time, a limited understanding of inequalities in ECD exposure across groups of children in many countries poses a fundamental challenge to effective policymaking. This research investigates key factors driving unequal access to PPE and positive parenting for children in China using data from the nationally representative China Family Panel Studies 2010–2018. The research finds substantial and persistent disparities by children’s ethnicity, migration status, household wealth, and mother’s education. While mother’s education dominates variation in both PPE participation and parenting practices, household wealth and ethnicity strongly influence PPE participation but exert less influence than migration status on positive parenting. The research contributes to a deeper understanding of the factors driving inequality in ECD in China, with important implications for targeted policies and programmes in China and beyond.

Unequal Timeliness Protection Massive Access for Mission Critical Communications in S-IoT

Unequal Timeliness Protection Massive Access for Mission Critical Communications in S-IoT