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Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research paper brings the analysis on the impact of the digitization of public services in increasing transparency, institutional accountability and citizens' access to digitized public services in Kosovo. Digitization with dynamic developments in the field of technology remains almost surpassed as a concept and approach for the modernization of Public Administration, namely the deployment of public services on digital platforms. Digitization is an extremely complex and demanding process with particular emphasis on societies where the institutional culture is challenged by various problems such as lack of accountability, limited transparency, the presence of corruption, the lack of sustainable economic development, an education system that has not been achieved to adapt to the demands of the labour market as well as the last but not least the importance where disadvantaged groups in all their diversity are recognized and protected by the legal framework but their inclusion in practice is at an unsatisfactory level as a result of not being priority during policy planning and their budgeting. Therefore, it is of scientific interest, but simultaneously for the creation of applicable policies that aim to regulate and improve the access of citizens to public services, and to increase accountability, transparency, and reduce corruption in the Public Administration sector to analyse how and how much through the digitalization of public services, such an increase of the system in the service of citizens is possible, and what does digitalization actually bring. [ABSTRACT FROM AUTHOR]

This paper explores the tensions, disjunctures and politics that evaluators experience when tasked with evaluating widening participation programmes in English Higher Education Institutions (HEI). While much research has been conducted concerning the importance of evaluation in widening participation, comparatively little has been written about how the socio-organisational position that evaluators are situated in may impact the quality and 'rigour' of the evaluation exercises themselves. Consequently, this paper is intended to act as the starting point for discussions within the field of widening participation that critically reflect on the optimal circumstances in which we can evaluate widening participation initiatives. Drawing from the analysis of semi-structured interviews with 21 practitioners at four HEIs, four pressures are identified that act upon evaluators, namely: reputational concerns; personal involvement; accountability for donors, alumni and other interested parties; and position within an organisation. These pressures are outlined and explored in relation to how they shape the evaluation process. The implications of this research concern institutional change at both the HEI and the regulatory body level, movement towards methodological pluralism and an easing of the pressures that confront widening participation practitioners when tasked with evaluation. [ABSTRACT FROM AUTHOR]

Background: Many children with rheumatic and musculoskeletal diseases are unrecognized. Identifying these children requires health care provider awareness, knowledge, and skills to recognize disease features and how (and when) to refer to specialist care. The aim of this paper is to highlight the need for better access to health care, review the essential role that education and virtual care play to address unmet need in low resource areas and especially to expand workforce capacity. Using collaborative partnerships, virtual platforms, and innovative assessment methods, musculoskeletal care and education can be delivered to reach a greater audience than ever before. Increased awareness through multiple initiatives and readily available resources are imperative to improve global rheumatology care. Conclusion: The needs of children with rheumatic diseases and musculoskeletal conditions are vastly underserved around the world resulting in preventable morbidity and mortality. Expanded implementation of virtual education and e-health care platforms provides an opportunity to increase access to care for children globally. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) is crucial for the development of employability skills and has an influence on employment outcomes. Given the significance of WIL pedagogies for graduate preparedness and transitions into work, concerns have been raised on the barriers to access and participation in WIL for some cohorts of learners. Equity and inclusion in WIL, that is, considerations for diverse learners once enrolled into a subject or course with varying WIL components, is not a new concept with some guidelines purported over a decade ago. Designing WIL to accommodate for equity and inclusion, however, has presented challenges with few studies offering navigation for curriculum design. This paper draws on empirically sound curriculum design principles for inclusion for learner variability through Universal Design for Learning (UDL), to offer the UDL for WIL design framework. The paper presents conceptual and practical contributions for educators of WIL experiences to reduce barriers and integrate student voice to support all graduates’ career transitions. [ABSTRACT FROM AUTHOR]

Managing genetic disease using medically assisted reproductive technology is increasingly promoted as a feasible option, given revolutionary advances in genomics. Far less attention has been directed to the issue of whether there is equitable access to this option. Context and circumstance determine equitable access; however, reporting has drawn overwhelmingly from affluent Anglo-western populations in developed countries. The experiences of poorer, less educated subpopulations within affluent countries and populations in less developed countries are underreported. The ability of consumers to understand the opportunities and risks of medically assisted reproductive technology is likewise not well described in the literature despite significant technological complexity and evidence that genetic disease may be overrepresented within some disadvantaged population groups. Equity is achieved by identifying barriers and allocating appropriate resources to enable understanding and access. In the case of utilising medically assisted technology, social and power relationships, regulations, and the presumptions of authority figures and policymakers reduce equitable access. Physical or cultural marginalisation from mainstream health services may result in reduced access to genetic and prenatal testing, in-vitro fertilisation and genetic screening of embryos necessary for medically assisted reproduction. Cost and regulatory frameworks can likewise limit opportunities to engage with services. Moreover, the quality of the information provided to prospective users of the technology and how it is received governs understanding of prevention and inhibits adequately informed choice. Best practice care and adequately informed choice can only be achieved by conscientiously attending to these accessibility issues. Deep engagement with at-risk people and critical reflection on mainstream accepted standpoints is required. This paper outlines issues associated with engaging with medically assisted reproduction encountered by Aboriginal families living with Machado-Joseph Disease in some of the most remote areas of Australia. It is the right of these families to access such technologies regardless of where they live. Current barriers to access raise important questions for service providers with implications for practice as new technologies increasingly become part of standard medical care. [ABSTRACT FROM AUTHOR]

This paper investigates changes in the promissory visions articulated in education reforms around the world. We use structural topic modeling to inductively analyze the content of 9,268 reforms from 215 countries and territories during the period 1970–2018 using the World Education Reform Database. Our findings reveal a decline in traditional management-focused reforms and a rise in reforms related to data and information. We also find an expanding commitment to educational access and inclusion, but reforms framed explicitly in 'rights' language diminish. We argue that the rise of data-centric reforms and the retreat from rights-based approaches may both reflect and contribute to a broader erosion of the liberal world order. [ABSTRACT FROM AUTHOR]

This paper treats of phenomenal consciousness and its relation to an organism's capacity to be hedonically perturbed by its environment. This paper offers an empirically informed, phenomenologically descriptive conceptual analysis of subjective character in terms of an organism's ability to feel with its body. The subjective character of phenomenal consciousness is at least partially constituted by embodied affect, that is, by our ability to feel what is happening on and inside our living bodies. It is in virtue of our being able to feel with our bodies that our experiences disclose the world as seeming a certain way for us. I call this the "affectively embodied perspectival view" of subjective character (AEP). [ABSTRACT FROM AUTHOR]

Policymakers and scholars universally accept and recognize the influence of small, micro, and medium enterprises (SMMEs) on stimulating economic growth and job creation. To succeed and prosper, SMMEs need to establish a sound financial management function. Therefore, it is vital to investigate the financial challenges these firms are experiencing. The objective of this paper was to investigate possible challenges that SMMEs experience when applying for credit from banks. The study sought to answer the main research question - 'What challenges are encountered by SMMEs when applying for credit from banks?' The study adopted a qualitative research methodology. The population used in this research was derived from SMMEs and banking officials in the Vhembe District Municipality area. Stratified random sampling was used to select a sample of 10 research participants. An interview guide was used to gather data from the participants. Data was analyzed using Atlas.ti. The results indicated that most SMMEs in the Vhembe district are not adequately supported, especially in the areas of financial resources, as well as in financial literacy skills and expertise. Specifically, this study identified that the credit application challenges faced by SMMEs are related to - lack of collateral security, lack of financial application education, complex bank credit access regulations, non-satisfaction of banks' qualifying criteria, as well as stringent credit system, and documentation requirements. [ABSTRACT FROM AUTHOR]

Copyright of Water & Landscape (WAL) / Agua & Territorio (AYT) is the property of Editorial de la Universidad de Jaen and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Human papillomavirus (HPV) infections can cause cancers of the cervix, vagina, vulva, penis, anus, and oropharynx. The most recently approved HPV vaccine, Gardasil-9, protects against HPV infection and can prevent HPV-associated invasive cancers. However, Gardasil-9 is one of the most underused vaccines in the US today. Young adults are at risk for HPV infection, but many are not vaccinated. This study uses a randomized controlled trial (RCT) to test an innovative multilevel intervention to increase HPV vaccination rates among young adults. In this paper, we describe the research protocol. Methods: The study uses a two by three factorial design. A total of 1200 young adults in Texas, age 18–26 years, who have not been previously fully vaccinated against HPV will be randomly assigned to one of six conditions to receive: (1) standard CDC information about HPV vaccination (control); (2) video narratives about HPV vaccination; (3) written narratives about HPV vaccination; or (4–6) enhanced access to HPV vaccine combined with (4) standard CDC information, (5) video narratives, or (6) written narratives. The two primary outcomes are the rate of HPV vaccination initiation by 3-month follow-up and rate of HPV vaccination completion by 9-month follow-ups. We will determine the impact of the individual level intervention (i.e., persuasive narratives through video or written format), the systemic level intervention (i.e., enhanced access to HPV vaccines), and the combination of both levels, on HPV vaccination initiation and completion. We will also use purposive sampling to select participants to take part in semi-structured interviews/focus groups to better understand the mechanisms of the intervention. Discussion: Recruitment and data collection began in March 2022. We expect to complete data collection by March 2026. We expect that narratives, enhanced access, and the combination of both will improve HPV vaccination initiation and completion rates among young adults. If proven successful, these individual- and system-level interventions can be easily disseminated in regions with low HPV vaccination rates to improve HPV vaccination, and ultimately decrease HPV-related cancer burden. Trial Registration: NCT05057312. [ABSTRACT FROM AUTHOR]

Objectives Design Methods Results Conclusions While 5%–10% of children exposed to natural disasters develop PTSD, few children access support. This paper reports on the proactive ‘screen‐and‐treat’ approach deployed following devastating floods in Queensland, Australia, in 2011 and presents results for children in the Lockyer Valley (the most impacted community).Open treatment study (2011–2012) within a government‐funded post‐disaster service response.One hundred and fifty children (7–12 years) completed pencil‐and‐paper screening (PTSD, anxiety and depression) at school. Eighty children endorsing either clinical levels of PTSD, or moderate levels of PTSD and clinical levels of either anxiety or depression, and their parents, completed a structured diagnostic interview. Forty‐eight children were offered a free trauma‐focused CBT intervention. The parents of 19 children accepted this offer. Most clinicians were clinical psychology trainees from local universities. All measures were repeated at post‐treatment, 6‐ and 12‐month follow‐up. Note: The term ‘parents’ is used to refer to the wide variety of people serving as a child's primary caregiver.Pre‐treatment, all children met diagnostic criteria for full (N = 17) or sub‐clinical PTSD. By post‐treatment, 10.5% met criteria for PTSD, with 0% meeting criteria at the 12‐month follow‐up. The incidence of anxiety and depressive disorders also reduced significantly. There were no differences in outcomes for children seen by trainees compared to experienced clinicians.A school‐based screen‐and‐treat approach offers potential as a means of identifying and treating children following natural disaster exposure. However, engagement of families at the outset, and when offering intervention was challenging. Postgraduate trainees represent an effective potential workforce in a post‐disaster environment. [ABSTRACT FROM AUTHOR]

This paper explores the enduring impact of freeway construction on urban neighborhoods and communities, focusing on Los Angeles. The legacy of freeways in Los Angeles, often and purposefully constructed through marginalized communities during the mid-20th century for the benefit of white suburbanites, is reflected in significant social, economic, and environmental symptoms today. This paper also examines de-freeway methods to reconnect these divided communities, assessing their need and effectiveness through data analysis and case studies.The case studies presented in this paper offer a diverse range of solutions. They include the capping of I-5 for Freeway Park in Seattle, the tunneling of the Central Artery for Boston's Big Dig, the activation of I-5 underpasses for Chicano Park in San Diego, and the creation of the Ricardo Lara embankment park along the I-105 freeway in Lynnwood. These examples provide valuable insights into the processes, challenges, and successes of de-freeway and community reconnection efforts, showcasing the adaptability of these solutions in different urban contexts.The paper introduces three design proposals for freeway sites across six communities in Los Angeles. These proposals are guided by urban reformation around freeways and incorporating urban design principles prioritizing social equity, environmental sustainability, and economic revitalization for the most vulnerable and impacted communities. The proposed designs aim to restore community cohesion and foster resilient urban ecosystems.This study contributes to the ongoing discourse on sustainable urban transformation and the reclamation of public spaces for community benefit by providing a comprehensive analysis of historical impacts and contemporary solutions. The paper's findings should help inform and guide urban planning and policy advocates and professionals inspired by the reconnecting communities movement, underscoring the need for innovative approaches to mending bifurcated and ecologically disadvantaged communities.

In this paper, using a scanning electron microscope (SEM) and atomic analysis, the location map of microcomposites formed on the surface of n-Si, p-Si, n-Si and p-Si samples was studied. Force microscope (AFM) research devices. The atomic fractions of inclusions of carbon, oxygen and lutetium formed on the surface of the samples were studied. Also, using the ASM device, the sizes, relief and topographic appearance of defects formed on the surface of the samples were determined. In silicon samples doped with Lu, a decrease in the size of surface defects and the formation of nano-sized structures were found, which makes it possible to obtain materials with a more perfect crystal structure. Using a ZEISS GeminiSEM 300 scanning electron microscope, the structural structure, chemical composition and images of their arrangement of n-Si, p-Si, n-Si and p-Si samples were obtained. In this case, the electron accelerating voltage was 20 kV, and the pressure in the sample chamber was (10-3 mmHg). Research results show that the structural structure of microand nanocomposites formed in silicon mainly depends on the diffusion time and cooling rate of the samples after diffusion annealing. [ABSTRACT FROM AUTHOR]

Botswana has achieved a lot in education development since the country's independence in 1966. Public education funding and access increased significantly, literacy rates rose, more schools were constructed and student enrolment rates increased at both primary and secondary schools. However, this paper argues that Botswana's education system has been declining over the past 10 years, but that is concealed by the use of political spectacle. The data collected from secondary sources were used and subjected to content analysis. The findings show high public education expenditure and access in Botswana, but high failure rates; success narratives and pronouncements without commitment to educational effectiveness and efficiency; massive construction of public schools, but poor teaching–learning conditions; and trivialization of meaningful education reforms. This paper concludes by recommending the introduction of learner-friendly methods of assessment, improving teacher–government relations, the inclusion of stakeholders in education decision-making and the implementation of cost–benefit and cost-effectiveness measures in Botswana's education. [ABSTRACT FROM AUTHOR]

Canada has one of the most complex and rigorous drug approval and public reimbursement processes and is, unfortunately, one of the countries with the longest delays in drug access. To assess the overall impact of systemic delays in access to cancer therapy, a targeted literature review (TLR) was performed to identify studies associated with the clinical, economic, and quality of life impacts of delayed access to oncology drugs. Using MEDLINE/PubMed databases and snowballing, four unique records met the eligibility criteria. Results revealed that clinical outcomes were the most impacted by systemic delays in access to oncology drugs (e.g., life years lost, overall survival, and progression-free survival). The four articles retrieved by the TLR specifically illustrated that a substantial number of life years could potentially be saved by increasing systemic efficiency regarding the development, approval, and reimbursement processes of new drugs for advanced malignancies. It is imperative that initiatives are put in place to improve the performance and speed of Canadian drug regulatory and health technology assessment (HTA) processes, especially for new cancer therapeutics. The proposed solutions in this paper include better coordination between HTA and Canadian payers to harmonize coverage decisions, international collaborations, information sharing, and national standards for timeliness in oncology drug access. [ABSTRACT FROM AUTHOR]

Copyright of Journal of the American Institute for Conservation is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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

Several media studies have investigated the news consumption of young people and discussed where they get information and what motivates them to consume news. Little is known about the structural factors that influence young people's news consumption behavior. The aim of this paper is to fill this research gap by focusing on structural factors that play a major role in young people's news consumption. In a mixed-methods study, we investigated Swiss youth media behavior in news consumption from 2019 to 2020 in Switzerland. The results show that news consumption of people aged 12–20 is determined by three structural factors at home and outside: 1. access to media and internet; 2. regulation by parents and teachers, and 3. routines at home or school. These three factors shape the individual media environment and are related to young people's news consumption behavior. Changes in news consumption behavior were evident in school transitions where young people not only change teachers and get a new peer group but are often involved in a change of location. These changes can be normative transitions which have an influence on the structural factors of the individual media environment and thus influence the news consumption behavior of young people. Young Swiss people consume news via their smartphones, which are offered to them through news portals, various apps, or via social media feeds, on which they usually come across news by chance and consume it casually in their free time. Structural factors of media environments (i.e., access, regulation, and news consumption routines) play a major role in young people's news consumption. These structural factors can be influenced by parents, teachers, and peers. For schools in particular, the paradigm that emerges from these findings is to reduce barriers to accessing news content and to rethink certain regulations, and to make recommendations and establish routines that encourage young people to consume news. [ABSTRACT FROM AUTHOR]

Indigenous peoples in Canada have suffered from ongoing impacts of colonization. Narrowing the scope to First Nations people in British Columbia, their perspective on health and wellness spans from individual to kin, to land, economy, socialization, and cy-cles that exist in life. Such intricacies have been impacted by colonial systems wherein many Indigenous people have left their traditional lands and communities to pursue other opportunities or to flee unsettling circumstances. This paper uses Indigenous methodologies to collect qualitative data on the experiences of some First Nations peoples when relocating off-reserve as it relates to their health and wellness. The participants of this study were Elders connected to the Tillicum Lelum Aboriginal Friendship Centre, located on Snuneymuxw (Nanaimo) territory, Vancouver Island, British Columbia, Canada. Elders were selected as the sample group based on the traditional perspective of their knowledge and wisdom. Six common themes from Elders' experiences were connection, way of living, education and employment, colonialism, land, and quality of health care. Further, axial coding found four action-based themes that can be applied from the research: racism, relevance, restrictions and resources--creating the 'four Rs' as recommendations for larger health systems in British Columbia, Canada. [ABSTRACT FROM AUTHOR]

As work-integrated learning (WIL) expands in higher education, there is increasing attention on ensuring equitable access and inclusion for all students. These challenges are not unique to WIL, albeit WIL has some unique facets, but are pertinent to all parts of higher education and society more broadly. The WIL community recognizes that equity, diversity, and inclusion is their most significant professional development need, and with scholarship slowly on the rise, it is timely for a Special Issue dedicated to the topic within the context of WIL. This Special Issue includes 12 papers exploring equity, access, and inclusion within the context of WIL. Emergent themes include language, common barriers, disclosure, considerations for inclusive workplaces, curriculum, and assessments, as well as critical reflection, partnering with students, and resilience. It is intended that this Special Issue will continue the advancement of the journey for a more equitable society. [ABSTRACT FROM AUTHOR]

This paper draws on research conducted in four publicly funded secondary schools in the South-East of England that explored the higher education decision-making of prospective first-generation university entrants accessing school-based widening participation interventions. It begins by introducing an 'ecology of intersecting influences' approach that opens up the multifactorial and uncertain nature of decision-making. Interviews with staff and focus groups with young people (aged between 13 and 18) highlighted the incremental and inter-dependent nature of higher education decision-making but also the importance of attending more closely to the diversely constituted, non-linear intersections between its situated, structural, material, temporal and relational dimensions. In the English context, these include a highly socially stratified university sector and graduate labour market plus significantly increased personal costs, all of which make it harder to calculate the individual 'worth' of a university degree. The paper concludes that when higher education decision-making is conceptualised as both an 'ecology of intersecting influences' and an 'elastic plane', this better captures how opportunities and constraints differently play out in the decision-making of prospective first-generation entrants over time, avoiding the imposition of normative, homogenising and limiting assumptions about the difference made by different family/social positionings. [ABSTRACT FROM AUTHOR]

When the current generation of K-12 learners has the opportunity to improve global issues and quality of life, they are inspired to advocate for worthy and ethical causes. Thus, we consider moving beyond the perspective of STE(A)M education from a workforce and global economic focus towards empathy-oriented STE(A)M learning as a humanistic pursuit to generating equitable solutions. This position paper leverages the Design Thinking framework as a theoretical grounding in advocating for the use of empathy as a key intellectual component to learning within integrated K-12 STE(A)M instruction. The purpose of this position paper is to (1) provide an overview of the Design Thinking Framework and discuss how it centres empathy in STE(A)M instruction; (2) share existing literature on the use of empathy in STE(A)M education; (3) theorize and synthesize how the intentional incorporation of empathy in STE(A)M instruction might address needs in well-known STE(A)M instructional methods; and (4) propose and discuss future steps for integrating empathy into the field of STE(A)M education that can benefit K-12 students, particularly those historically excluded in STE(A)M. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation can positively affect quality of life, functional status, and physiological status for patients with head and neck or lung cancer. However, barriers and facilitators regarding access, referral, and participation in rehabilitation have not been outlined in the literature either from a healthcare professional or from a structural perspective. Therefore, the objective of this paper was to identify and map barriers and facilitators from structural and healthcare professionals' perspectives in relation to access, referral, and participation in rehabilitation for patients with head and neck or lung cancer. Materials and methods: Two systematic searches were conducted in five databases mapping peer-reviewed research literature. Results: In total, 17 studies of 3918 potential sources were included. Seven themes were identified. Four themes concerned access: Understanding Patients' Resources; Collaboration Determining Access; Education, Knowledge, and Evidence Impact Access to Rehabilitation; and Resources Affecting Availability to Rehabilitation Services. Two themes concerned referral: Referral Criteria; and Elements Affecting Referral Pathway. One theme concerned participation: Factors Influencing Participation. Conclusion: From structural and healthcare professionals' perspectives, barriers and facilitators impact access, referral and participation in rehabilitation. However, the findings on facilitators were limited; only one theme addressed participation and two findings concerned patients with low socioeconomic status. IMPLICATIONS FOR REHABILITATION: Healthcare professionals should be mindful that a diverse array of barriers and facilitators may impact the rehabilitation pathway for patients with head, neck, and lung cancer. Engagement by healthcare professionals and structural initiatives are needed to ensure comprehensive access to information concerning rehabilitation options. Local guidelines should be developed to prescribe methods for informing and guiding patients towards suitable rehabilitation options. It is important that healthcare professionals take the individual patient's resources into account when navigating aspects of access, referral, and participation in rehabilitation. [ABSTRACT FROM AUTHOR]

Community Eye Clinics (CEC) increase accessibility of specialist ophthalmic services in the community, reducing demand for tertiary eye services. This paper aims to evaluate the impact of CEC on first-visit referrals from Hougang Polyclinic (HOU) to Tan Tock Seng Hospital Ophthalmology Specialist Outpatient Clinic (SOC). A retrospective analysis was performed on first-visit referrals from Hougang Polyclinic (HOU) to Tan Tock Seng Hospital Ophthalmology Specialist Outpatient Clinic (SOC) over a similar 3-months period before and after the introduction of CEC in August 2018 (1 January to 31 March in 2018 and 2019, respectively). Data pertaining to patients' presenting complaints, referral reasons, final diagnoses, follow-up plans, and need for ophthalmic intervention were obtained. We included 978 patients in our study. There was a 27.5% reduction in the number of first-visit referrals seen at SOC after the establishment of CEC. Patients were more likely to be referred on to sub-specialty eye clinics (10.8% vs. 12.9%, p= p =.304) and receive more ophthalmic interventions (15% vs. 16.3%, p =.066) than prior to CEC. The CEC provides greater accessibility to eye care within the community. Optometrists are upskilled to manage patients with stable eye conditions, whilst eye specialists can provide timely care to the SOC for patients with more severe eye conditions. [ABSTRACT FROM AUTHOR]

Introduction: Access to medicines is a shared goal across healthcare stakeholders. Since health technology assessment (HTA) informs funding decisions, it shapes access to medicines. Despite its wide implementation, significant access variations due to HTA are observed across Europe. This paper elicited the opinions of European stakeholders on how HTA can be improved to facilitate access. Methods: A scoping review identified HTA features that influence access to medicines within markets and areas for improvement, while three access dimensions were identified (availability, affordability, timeliness). Using the Delphi method, we elicited the opinions of European stakeholders to validate the literature findings. Results: Nineteen participants from 14 countries participated in the Delphi panel. Thirteen HTA features that could be improved to optimise access to medicines in Europe were identified. Of these, 11 recorded a positive impact on at least one of the three access dimensions. HTA features had mostly a positive impact on timeliness and a less clear impact on affordability. 'Early scientific advice' and 'clarity in evidentiary requirements' showed a positive impact on all access dimensions. 'Established ways to deal with uncertainty during HTA' could improve medicines' availability and timeliness, while more 'reliance on real-world evidence' could expedite time to market access. Conclusions: Our results reiterate that increased transparency during HTA and the decision-making processes is essential; the use of and reliance on new evidence generation such as real-world evidence can optimise the availability of medicines; and better collaborations between regulatory institutions within and between countries are paramount for better access to medicines. [ABSTRACT FROM AUTHOR]

Documents of a classified nature may be of a contentious nature, the paper focusing on those concerning the service relationships of active officers. In the event of a dispute arising, the question arises as to the extent to which a plaintiff is able to mount an effective defence if he cannot know their content and whether he can be granted guarantees equivalent to respect for the right to a fair trial. Restricting the lawyer's access to important documents in a case affects to a large extent the represented party. In the European countries, the situation regarding conditional access to classified documents from the point of view of lawyers and parties against whom such documents are issued is similar, in that it is recognised that the principle of adversarial proceedings and the rights of the defence must be limited because of the need to protect national security. From a procedural point of view, it is important that the general principles of adversarial proceedings, equality, orality, non-disclosure and publicity are respected in every dispute. In this context, noting the difficulties that arise in the work of the court due to restricted access to classified documents, I have tried to identify guarantees equivalent to respect for the right to a fair trial in the cases referred to in the title of the paper, analysing national case law, that provided by the ECtHR and studies of doctrine. In accordance with these, I have developed equivalent guarantees compatible with Romanian law: the possibility of challenging the classification of the document, the request for declassification of classified information, the right of the interested party to be assisted by an ORNISS-certified lawyer and the possibility for the accused to participate in proceedings which reveal the content of classified documents.

This paper evaluates the multistage adaptive test (MST) design of a large-scale academic language assessment (ACCESS) for Grades 1–12, with an aim to simplify the current MST design, using both operational and simulated test data. Study 1 explored the operational population data (1,456,287 test-takers) of the listening and reading tests of MST ACCESS in the 2018–2019 school year to evaluate the MST design in terms of measurement efficiency and precision. Study 2 is a simulation study conducted to find an optimal MST design with manipulation on the number of items per stage and panel structure. The results from operational test data showed that the test length for both the listening and reading tests could be shortened to six folders (i.e., 18 items), with final ability estimates and reliability coefficients comparable to those of the current test, with slight differences. The simulation study showed that all six proposed MST designs yielded slightly better measurement accuracy and efficiency than the current design, among which the 1-3-3 MST design with more items at earlier stages ranked first. The findings of this study provide implications for the evaluation of MST designs and ways to optimize MST designs in language assessment. [ABSTRACT FROM AUTHOR]

Inherent biases, barriers to participation and other risks of exclusion thwart the UK cultural heritage sector's capacity to benefit all citizens equally. However, growing evidence bases – from local audits to regional insight reports to national censuses – ostensibly make it possible to identify these biases and risks in increasingly fine-grained ways, and from there to design programmes to engage individuals who might not otherwise participate in the historic environment. In this paper, we assess the efficacy of 'audience mapping' for supporting the inclusion of specific, underrepresented audiences in UK cultural heritage. The audience mapping methodology we applied in the Towards a National Collection project Unpath'd Waters (UNPATH) offers a case study. Sixty datasets (including audience interviews, web analytics, observations, etc.) from 18 organisations catering to maritime heritage were compared to support the project in reaching three audiences: visually impaired people, cross-disciplinary researchers and non-coastal communities. We review our method and its outcomes, then position our learnings against other audience mappings conducted by the Museum of London Archaeology for commercial clients. Like all audience methodologies, mapping has problematic dimensions that can heighten rather than halt inequities. We consider how to adapt approaches (e.g. to surveying, consulting and 'profiling' people) to sensitively respond. [ABSTRACT FROM AUTHOR]

This paper explains what the Access to Neighbouring Land Act 1992 does and how it fits into the legal landscape of issues for developers and property owners to be mindful over. It draws from case law learning and from the practical experience of the writer in dealing with site access, crane oversailing licences and Part 8 claims. Its aim is to give prospective parties to access licences and those advising them a full insight into the issues that arise, a warning as to the costs of litigation and the confidence to start negotiating within sensible limits. [ABSTRACT FROM AUTHOR]

Background Aims Discussion Post‐traumatic stress disorder (PTSD) poses a global public health challenge. Evidence‐based psychotherapies (EBPs) for PTSD reduce symptoms and improve functioning (Forbes et al., Guilford Press, 2020, 3). However, a number of barriers to access and engagement with these interventions prevail. As a result, the use of EBPs in community settings remains disappointingly low (Charney et al., Psychological Trauma: Theory, Research, Practice, and Policy, 11, 2019, 793; Richards et al., Community Mental Health Journal, 53, 2017, 215), and not all patients who receive an EBP for PTSD benefit optimally (Asmundson et al., Cognitive Behaviour Therapy, 48, 2019, 1). Advancements in artificial intelligence (AI) have introduced new possibilities for increasinfg access to and quality of mental health interventions.The present paper reviews key barriers to accessing and engaging in EBPs for PTSD, discusses current applications of AI in PTSD treatment and provides recommendations for future AI integrations aimed at reducing barriers to access and engagement.We propose that AI may be utilized to (1) assess treatment fidelity; (2) elucidate novel predictors of treatment dropout and outcomes; and (3) facilitate patient engagement with the tasks of therapy, including therapy practice. Potential avenues for technological advancements are also considered. [ABSTRACT FROM AUTHOR]

Historically, the constructs of inclusion, diversity, equity, and access (IDEA) have not been sufficiently considered or included in population health nutrition research and practice. Consequently, current nutrition assessment benchmarks and knowledge translation tools may not accurately or adequately reflect diversity in the Canadian population or produce meaningful dietary guidance. The purpose of this current opinion paper is to introduce the population health nutrition research and practice framework and explore the current application of IDEA within this framework. Recommendations are offered to incorporate the constructs of IDEA along the continuum of future nutrition research and services to improve population nutritional health. [ABSTRACT FROM AUTHOR]

This paper explores the socio-cultural and gender-based dynamics associated with place values, and their implications for women's access to water through case studies of upland and riverine communities in southern Nigeria. We used a range of fieldwork methods including public meetings, focus group discussions, in-depth interviews, keen observations, key informants and other secondary sources. Our findings show that drinking water sources are a part of the many forms of visible material structures that embody and generate automatic reproduction of gender-based beliefs, attitudes, feelings and practices. The outcome of such practices affects men and women differently in relation to access, workload and capacity for hygiene and other socio-economic practices. In discussing access to essential public goods, social and economic capacities take priority focus over the impact of 'place values' either as standalone or intersectional elements. Research should be expanded to incorporate these elements and their intersectional perspectives in shaping access to water. [ABSTRACT FROM AUTHOR]

Successful conservation in Africa hinges on the perceptions of communities bordering protected areas. It is therefore vital for protected area stakeholders to know the perceptions of neighbouring communities in order to determine the factors that generate or undermine community support for conservation, so that appropriate management interventions can be implemented. Numerous studies consider benefits, but less relate to perceptions regarding both losses/costs and intangible benefits. This paper demonstrates a methodology with which to determine these factors, focusing on Kekana Gardens community, bordering Dinokeng Game Reserve, in Gauteng Province, South Africa. This qualitative study with 13 residents utilised focus group interviews and adapted nominal grouping technique. Six themes emerged, four of which comprise intangible benefits. This methodology can be applied to any community bordering a conservation area, assisting in crafting solutions that benefit both people and parks. [ABSTRACT FROM AUTHOR]

In this paper, we present the results of a Europe-wide survey on the implementation of CoE Recommendation R (2000)13 on a European policy on access to archives conducted in October 2022 on behalf of the Council of Europe (CoE). It shows that overall great progress has been made in improving access to their public Archives. It also shows that there are still deficits in some instances, for example in the availability of finding aids for classified holdings or in the granting of access corrections for otherwise inaccessible archive holdings. We also highlight several challenges to the accessibility of archives, many of which are related to the ongoing process of digitalization. On the one hand, there is the growing expectation of users that collections be digitized and made accessible online, while at the same time the available resources of the Archives remain scarce. Finally, digitalization and the adoption of the GDPR also exacerbate the tension between data protection and freedom of information — often at the detriment of accessibility. [ABSTRACT FROM AUTHOR]

Urban ecosystems provide many crucial services to cities and their residents, particularly in adapting to the effects of climate change. Extensive research has been conducted in this field, covering various aspects of ecosystem services. However, little is known about issues related to the limited access to these ecosystem services, particularly among marginalized populations. This review systematically screened 3961 papers and synthesized findings from 98 papers to identify groups that are marginalized in terms of access to urban ecosystem services and provide policy measures to address the issue. We conducted an inductive content analysis and thematic analysis to review the literature comprehensively. Our findings revealed that marginalization is more prevalent in cultural ecosystem services (51 %) than in other ecosystem service types. The results also show that vulnerable populations, including minorities, low-income populations, physically challenged people, children/young people/students, older people, and migrants, are particularly marginalized. Among these groups, minorities (24 %) emerged as the most extensively studied category. Additionally, we identified a marginalized group labeled as 'generic,' consisting of individuals whose identities did not neatly fit within the previously defined groups or were mentioned across multiple groups simultaneously.The marginalization across all these groups stems from income disparities, cultural norms, racial and ethnic considerations, willingness to visit, age-related disparities, physical disabilities, and geographical location. Importantly, our study underscores the adverse effects of marginalization on these groups, leading to health disparities, lower quality of life, and reduced resilience to climate change. In light of these findings, we also spotlight policies from the literature such as inclusive urban planning, community engagement initiatives, and financial support aimed at ensuring more equitable access to urban ecosystem services. [Display omitted] • We discuss how some groups are marginalized in access to ecosystem services. • Minorities, urban poor, and physically challenged people are key marginalized groups. • Cultural norms and racial and ethnic considerations have exacerbated marginalization. • Marginalization is more prevalent in cultural ecosystem services. • Community-based programs and knowledge-sharing initiatives can help address the issue. [ABSTRACT FROM AUTHOR]

Seventy percent of smallholder farmers in Africa depend on rainfed farming systems, making them vulnerable to climate variability and extremes. Climate information services (CIS) adoption by smallholder farmers in Africa presents a promising solution for adaptation to climate variability. This paper unravels the complexities around climate services for smallholder farmers and explores opportunities to tailor CIS for the resources of smallholder farmers. We use a systematic literature review approach to assess how the human, social, physical/technical, natural and financial capitals may affect awareness, access and use of CIS by smallholder farmers. The study is based on 33 papers from Africa. Majority of the studies gave emphasis on education, information communication and technology literacy levels and advisory services as influencing CIS access, use and uptake. The results highlight that better resourced smallholder farmers have higher access and are more likely to adopt CIS. The human capital emerged as an important component of CIS adoption as it directly determines how the farmer makes decisions on the farm. The natural capital determines the specific preference for CIS when the financial and economic capitals enable farmers acting according to the information received. The social capital provides a basis for farmers to benefit from compounded resources. Thus, the livelihood resource capitals of the target farmers must be considered in CIS information production and dissemination to improve the chances of CIS adoption by vulnerable groups that is illiterate, women, elderly, farmers in agroecological zones prone to climate extremes and poorly resourced farmers.

Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives, when hormonal and physical changes are often accompanied by psychological and social evolution. Access to sexual health and sexual well-being (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high-income countries. A systematic review of the enablers and barriers to women (including trans-gender and non-binary people) aged 40–65 years accessing SHSW services in high-income countries was undertaken. Four databases (PubMed, PsycINFO, Web of Science and Google Scholar) were searched for peer-reviewed publications. Findings were thematically extracted and reported in a narrative synthesis. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their healthcare professionals (HCPs), and the over-arching effect of stigma, social connections and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities and financial incentives to access services for under-served groups. Efforts are needed to enhance education about SHSW and related services among midlife women and their healthcare providers. This increased education should be leveraged to improve research, public health messaging, interventions, policy development and access to comprehensive services, especially for midlife women from underserved groups. Plain language summary: Sexual health and sexual wellbeing services for midlife women in high income countries Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives. Access to Sexual Health and Sexual Wellbeing (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective of this systematic review was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high income countries. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their HealthCare Professionals (HCPs), and the over-arching effect of stigma, social connections, and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities, and financial incentives for under-served groups to access services. The appetite for education about SHSW and SHSW services among midlife women and their HCPs should be capitalised upon, and utilised to improve research, public health messaging, interventions and access to holistic services, particularly for midlife women from under-served groups. [ABSTRACT FROM AUTHOR]

Background: Primary health care is the first point of contact for patients from refugee backgrounds in the Australian health system. Sociocultural factors, including beliefs and value systems, are salient determinants of health literacy and access to primary health care services. Although African refugees in Australia have diverse sociocultural backgrounds, little is known about the influence of sociocultural factors on their experiences of accessing primary health care services. Guided by the theoretical framework of access to health care, this study examined from the perspective of African refugees how culturally and religiously conditioned, constructed and bound health beliefs, knowledge and practices influence their experiences of access to, acceptance and use of primary health care services and information in Australia. Methods: This exploratory, qualitative study involved 19 African refugees from nine countries living in New South Wales, Australia. Semi-structured interviews were conducted and recorded using Zoom software. The interviews were transcribed verbatim and analysed using a bottom-up thematic analytical approach for theme generation. Results: Four main themes were identified. The themes included: participants' experiences of services as inaccessible and monocultural and providing information in a culturally unsafe and insensitive manner; the impact of the clinical care environment; meeting expectations and needs; and overcoming access challenges and reclaiming power and autonomy through familiar means. The findings generally support four dimensions in the access to health care framework, including approachability, acceptability, availability and accommodation and appropriateness. Conclusion: African refugees experience significant social and cultural challenges in accessing primary health care services. These challenges could be due to a lack of literacy on the part of health services and their providers in servicing the needs of African refugees. This is an important finding that needs to be addressed by the Australian health care system and services. Enhancing organisational health literacy through evidence-informed strategies in primary health systems and services can help reduce disparities in health access and outcomes that may be exacerbated by cultural, linguistic and religious differences. [ABSTRACT FROM AUTHOR]

Closed captions are a vital tool of sonic access for D/deaf and hard of hearing audio-viewers, detailing dialogue alongside notable sound effects and music. As evidenced by the recent virality of the captions in the Netflix series Stranger Things, captions are increasingly playing a key role in the sonic experience for many audio-viewers. From captions such as [tentacles undulating moistly] to [wet footsteps squelch], captions shape and articulate sounds, working both alone and alongside other sonic elements. Yet, while captions crucially anchor sonic meaning for a growing audience, captions are still a critically understudied dimension of film and media sound. Drawing upon the visceral captions and squelching sound effects of the fourth season of Stranger Things, this article details the parallels between closed captions and the custom synchronized sound effects of Foley. Captions crucially emphasize the narrative and characterizing effects of Foley sounds, from an oozing moist [squelch] that turns the stomach to the vivid snap of [bones cracking]. In turn, Foley sound offers a vital new framework from which to understand the sonicity of captions. As an artistic practice of reconfiguration and substitutions, Michel Chion's seminal distinction between real and rendered sounds underpins theorizations of Foley, where a broken celery vividly renders the emotive impact of bones breaking. This article contends that captions can similarly be understood as rendering sound, a move that ultimately folds captions such as [wet writhing], [creatures chittering] and [flesh tearing] into larger sound theories, highlighting the sonic significance and generative possibilities of access tools. [ABSTRACT FROM AUTHOR]