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ABSTRACT Digital equity and accessibility for higher education (HE) students have become crucial since the early 21st century, especially for underserved, deprived, marginalised and oppressed students. The present study aimed mainly to reveal the barriers to digital access (BDA) faced by marginalised groups and to find effective strategies for promoting digital inclusion (DI). Another objective of the paper was to provide actionable policy insights (API) to improve DI in Pakistani universities. Participants (students from marginalised groups who face unique barriers to accessing digital education) were selected using a simple random sampling technique from the four provinces of Pakistan (Punjab, Sindh, KPK and Baluchistan). We used a cross‐sectional research design to collect quantitative data from 590 students selected from 12 universities in Pakistan using a self‐developed questionnaire via online platforms. The study's findings revealed a significant difference in digital access for marginalised groups, which contributes to educational inequalities for students in low‐income areas and remote areas facing enormous challenges. We also identified practices to improve digital accessibility, including technology‐based interventions and policy reforms to improve digital infrastructure. Based on preliminary findings, a combined effort toward digital equity can significantly improve educational outcomes for marginalised students, providing a roadmap for universities to bridge the digital divide. The present paper not only highlights the current state of digital equity and accessibility but also focuses on practical insights for policy and teachers and ensures that universities are inclusive and accessible to everyone. [ABSTRACT FROM AUTHOR]

Access to soft loans is an important tool in the promotion of self-economic sustenance and job creation. Moreover, globally the rate of unemployment is on the rise and particularly so for the youth and women. Therefore, the study aimed at assessing how access to soft loans issued by local government authority (LGA) contribute to job creation among the marginalised groups in the city of Dodoma, Tanzania. A cross sectional research design was used whereby using a questionnaire, data was collected from 336 randomly selected respondents. The collected data was analyzed using SPSS and STATA whereby both descriptive and inferential statistics were determined. In addition, binomial regression analysis was used to determine factors associated with the marginalised groups’ job creation following their access to LGA soft loans. Generally, findings from the study show that on average two jobs were created by the soft loan beneficiaries. In addition, findings show that the soft loan beneficiaries’ education, soft loan duration and type of income generating activity on which the loans were used were significantly (p ≤ 0.001) associated with job creation (p

Everyone has the right to feel welcome, safe and be able to access public green spaces without fear, anxiety or stress. However, the term "accessibility" is primarily used in relation to physical accessibility, while social and cultural dimensions of accessibility to urban public green spaces remains underexplored. Methods and tools for universal design and management that also meets the needs of marginalised groups, are needed. This requires involvement of both users and potential users through participatory methods, building on individual needs and perspectives. In Sweden, traditionally marginalised groups and non-users are rarely engaged in the development of public urban green spaces. Local governments may have the will, but lack resources and appropriate methods in order to do so. Research has recently described a further engagement of users as an unleashed potential in relation to planning and management of urban green spaces. Based on the study of three test beds and the use of public green space governance and management theory, we developed a process model for user participation in green space maintenance with focus on involving marginalised groups and non-users. The model balances what is theoretical optimal with what is practically feasible within the daily work of a municipal organisation. We present an empirically tested process model that can form the basis for future maintenance of urban green spaces, with the use of limited resources. [ABSTRACT FROM AUTHOR]

Based on the shift from face-to-face participatory action research (PAR) with groups in situations of vulnerability to digital methods during COVID-19, we reflect on how we can go beyond compensating for the physical absence of the researcher from the field. We argue that instead of simply aiming to replace face-to-face research with a digital equivalent for maintaining 'participatory' and 'inclusive' research practices, remote practices have the potential of being more-than compensatory. We suggest that when producing multi-method digital approaches, we need to go beyond a concern with participant access to remote practices. By rethinking remote PAR in the light of expressive rather than participatory research practices, we critically reflect on the (sometimes experimental) process of trying out different digital research method(s) with Brazilian youth in situations of digital marginalisation, including the initial 'failures' and lessons learned in encouraging diverse forms of participant expression, and ownership using WhatsApp. [ABSTRACT FROM AUTHOR]

Access to soft loans is an important tool in the promotion of self-economic sustenance and job creation. Moreover, globally the rate of unemployment is on the rise and particularly so for the youth and women. Therefore, the study aimed at assessing how access to soft loans issued by local government authority (LGA) contribute to job creation among the marginalised groups in the city of Dodoma, Tanzania. A cross sectional research design was used whereby using a questionnaire, data was collected from 336 randomly selected respondents. The collected data was analyzed using SPSS and STATA whereby both descriptive and inferential statistics were determined. In addition, binomial regression analysis was used to determine factors associated with the marginalised groups’ job creation following their access to LGA soft loans. Generally, findings from the study show that on average two jobs were created by the soft loan beneficiaries. In addition, findings show that the soft loan beneficiaries’ education, soft loan duration and type of income generating activity on which the loans were used were significantly (p ≤ 0.001) associated with job creation (p<0.01). In addition amount of loan received was negatively and significantly (p ≤ 0.05) associated with the marginalised groups’ job creation. Thus, it can be concluded that access to soft loan enables marginalised groups to create jobs. Therefore, it is recommended that Dodoma City Council should expand its provision of soft loans to marginalised groups so as to promote more job creation hence, reduce the rate of unemployment among the marginalised groups. [ABSTRACT FROM AUTHOR]

Abstract Background The response to the COVID-19 pandemic saw a significant increase in demand for the voluntary, community, faith and social enterprise (VCFSE) sector to provide support to local communities. In Greater Manchester (GM), the VCFSE sector and informal networks provided health and wellbeing support in multiple ways, culminating in its crucial supportive role in the provision of the COVID-19 vaccination rollout across the GM city region. However, the support provided by the VCFSE sector during the pandemic remains under-recognised. The aims of the study were to: understand the views and experiences of marginalised communities in GM during the COVID-19 pandemic; explore how community engagement initiatives played a role during the pandemic and vaccine rollout; assess what can be learnt from the work of key stakeholders (community members, VCFSEs, health-system stakeholders) for future health research and service delivery. Methods The co-designed study utilised a participatory approach throughout and was co-produced with a Community Research Advisory Group (CRAG). Focus groups and semi-structured interviews were conducted remotely between September-November 2021, with 35 participants from local marginalised communities, health and care system stakeholders and VCFSE representatives. Thematic framework analysis was used to analyse the data. Results Local communities in GM were not supported sufficiently by mainstream services during the course of the COVID-19 pandemic, resulting in increased pressure onto the VCFSE sector to respond to local communities’ need. Community-based approaches were deemed crucial to the success of the vaccination drive and in providing support to local communities more generally during the pandemic, whereby such approaches were in a unique position to reach members of diverse communities to boost uptake of the vaccine. Despite this, the support delivered by the VCFSE sector remains under-recognised and under-valued by the health system and decision-makers. Conclusions A number of challenges associated with collaborative working were experienced by the VSCE sector and health system in delivering the vaccination programme in partnership with the VCFSE sector. There is a need to create a broader, more inclusive health system which allows and promotes inter-sectoral working. Flexibility and adaptability in ongoing and future service delivery should be championed for greater cross-sector working.

Background: The response to the COVID-19 pandemic saw a significant increase in demand for the voluntary, community, faith and social enterprise (VCFSE) sector to provide support to local communities. In Greater Manchester (GM), the VCFSE sector and informal networks provided health and wellbeing support in multiple ways, culminating in its crucial supportive role in the provision of the COVID-19 vaccination rollout across the GM city region. However, the support provided by the VCFSE sector during the pandemic remains under-recognised. The aims of the study were to: understand the views and experiences of marginalised communities in GM during the COVID-19 pandemic; explore how community engagement initiatives played a role during the pandemic and vaccine rollout; assess what can be learnt from the work of key stakeholders (community members, VCFSEs, health-system stakeholders) for future health research and service delivery. Methods: The co-designed study utilised a participatory approach throughout and was co-produced with a Community Research Advisory Group (CRAG). Focus groups and semi-structured interviews were conducted remotely between September-November 2021, with 35 participants from local marginalised communities, health and care system stakeholders and VCFSE representatives. Thematic framework analysis was used to analyse the data. Results: Local communities in GM were not supported sufficiently by mainstream services during the course of the COVID-19 pandemic, resulting in increased pressure onto the VCFSE sector to respond to local communities' need. Community-based approaches were deemed crucial to the success of the vaccination drive and in providing support to local communities more generally during the pandemic, whereby such approaches were in a unique position to reach members of diverse communities to boost uptake of the vaccine. Despite this, the support delivered by the VCFSE sector remains under-recognised and under-valued by the health system and decision-makers. Conclusions: A number of challenges associated with collaborative working were experienced by the VSCE sector and health system in delivering the vaccination programme in partnership with the VCFSE sector. There is a need to create a broader, more inclusive health system which allows and promotes inter-sectoral working. Flexibility and adaptability in ongoing and future service delivery should be championed for greater cross-sector working. [ABSTRACT FROM AUTHOR]

Organisation-centric approaches in development communication and public relations that privilege the organisation can restrict communication to organisational mandates and goals. Organisation-centric approaches can reflect a modernist view of development or communication and have been critiqued for favouring technocratic development rather than serving marginalised groups. Currently, scholars in development communication and public relations place greater emphasis on publics or community participation and the processual nature of communication to overcome adverse organisational influence and propose better solutions. This article recognises theoretical advances in development communication and public relations and adopts the Collaborative Communication Approach, integrating current concepts from these two fields. The Collaborative Communication Approach facilitates an examination of communication in development in relation to five elements of power, context, participation, agency, and profession. This article shows how the five elements prove useful in addressing communication challenges in development through primary research and offers eight distinct categories to advance practice. [ABSTRACT FROM AUTHOR]

EU-funded project FRANCIS focuses on involving citizens in the development of so-called Frugal Innovations, i.e. simple, affordable and sustainable solutions. It does so by organising open-innovations challenges that are managed through an IT-platform and supported by various recruitment and ideation formats. Usually, Citizen Science only involves citizens for minor tasks such as data collection. FRANCIS jump ahead in science is that the project invites them to propose and work on new solutions that have a real chance to enter the market. Before starting the challenges, the team of FRANCIS already made some assumptions about how to encourage and support participants in the best possible way based on existing publications and first findings from primary research. Now that the first challenge is running, the team had the opportunity to check whether they have proven to be true so far. This paper presents the interim lessons learned and details the way forward [ABSTRACT FROM AUTHOR]

Context Social exclusion is characterised by and represents a form of disadvantage and marginalisation of vulnerable groups of people in society, who cannot fully participate in the normal activities of daily living. People who are socially excluded such as asylum seekers and refugees have complex healthcare needs and tend to present more to the acute hospital setting as emergency presentations. Little is known about barriers and facilitators experienced by this group to accessing nonhospital based care. Objectives This mixed methods systematic review, will critically examine the concept of barriers and facilitators for refugees and asylum seekers to accessing non hospital based care. Methods This methodological review will follow the Joanna Briggs Institute guidance for conducting mixed methods reviews. The following databases will be searched: Central Medline, PubMed, Embase, CINAHL, and the Cochrane Library. Relevant grey literature will be included. Title and abstract screening, followed by full-text screening will be undertaken independently by two reviewers. The Joanna Briggs Institute extraction tool will be adapted for data extraction. Discussion This mixed method review will comprehensively evaluate quantitative and qualitative data, synthesise both barriers and facilitators and follow a systematic approach through establishing use of mixed methods research across asylum seekers and refugees, and how they affect accessing non-hospital based care. It will explore conceptual models of access to healthcare and how they influence these factors.

AbstractFisheries crimes pose a significant challenge to Namibian and international law enforcement organisations and/or agencies. Such crimes are typically distinguished by illegal actions that, in certain instances, are transnational and organised in nature. Illegal shipping of marine resources, illegal fishing, corruption, money laundering, and document and tax fraud are all examples of fisheries crimes. Fighting fisheries crimes in the twenty-first century is a vital priority for ensuring long-term development and protecting marine resources for future generations. It is an essential component of sustaining a justifiable blue economy, as well as resource sharing and beneficiation, which helps underprivileged groups like small-scale fishers to profit from Namibia’s exploitation of marine resources. Effective fisheries law enforcement is required in Namibia to combat fisheries crimes. To achieve efficacy in fisheries law enforcement in Namibia, traditional policing methods and instruments, as well as knowledge of law, criminology, police science, and fisheries management and conservation, are required. This is far from the case, as fishery inspectors and observers are routinely underfunded and undertrained, both financially and technologically. As a result, the goal of this study is to look into the effectiveness of fisheries law enforcement in Namibia in the twenty-first century. Data from the author’s Fisheries Law Enforcement training session, which took place from November 28 to 12 December 2022, in Walvis Bay, Namibia, was utilised to assess Namibia’s readiness in combatting fisheries crimes. The implemented training received excellent response from participants. However, the training showed significant shortcomings in Namibia’s fisheries law enforcement. As a result, recommendations on how to strengthen fisheries law enforcement in Namibia will be made in this article.

In recent decades, the role of community forestry (CF) has been to address the livelihoods of local people beyond its original objective of forest protection. Yet, there have been governance-related concerns, particularly the distribution of benefits among group members. We used a case study approach to better understand the CF model from the perspective of household satisfaction and benefit distribution at the local level. For data collection, we used multiple methods, including key informant interviews, focus group discussions, and household surveys. The study utilised the Henry-Garret ranking for analysing key elements of forest governance and a probit regression model for identifying the major contributing factors of satisfaction towards CF governance. Results suggested greater equity in CF governance and the empowerment of marginalised forest communities. Though CF has created new opportunities to consolidate forest users' efforts toward provisioning broader environmental services, the system continues to favour elites and other influential groups in CF decision-making. The study suggests improving equity and introducing incentives to primary forest dependents. The additional incentives will not only help communities to adapt to the changing context but also increase their interest in decision-making, particularly for equitable distribution of benefits and local collective action. [ABSTRACT FROM AUTHOR]

This ethnographic study presents the results of a qualitative investigation into the absence of radicalisation that would lead to political violence among Romani in the Czech Republic and Slovakia. Despite facing ethnic and socioeconomic grievances, the largest ethnic minority in Europe does not exhibit a marked tendency towards violent radicalisation. The study seeks to clarify how certain cultural and sociopsychological factors contribute to the resilience of the Romani against radicalisation. Their strong sense of belonging, in-group solidarity, and social cohesion represent fundamental characteristics that prevent community members from seeking alternative routes to fulfil their social needs, for example, through involvement in violent extremist groups. Furthermore, the study explores the coping mechanism for conflict avoidance that the Romani tend to use to avert violent conflict with the majority population. By presenting a case of non-radicalisation based on 54 in-depth interviews and 40 extensive mixed-method questionnaires, this article intends to stimulate further theoretical reflections on the role of grievances in the process of radicalisation, contribute to the debate about the character of resilience against radicalisation, and also prove the usefulness of investigating negative cases of political violence.

In this piece we reflect on the tensions and complexities of drug use that narcofeminism has prompted us to grapple with in producing this collection. Narcofeminist approaches challenge us to move beyond simplistic, moralistic frameworks that pathologise and stigmatise those who use drugs, and instead seek more nuanced understandings of the social, cultural and political forces through which drug use materialises. By foregrounding the experiences of women and other marginalised groups who use drugs, narcofeminism highlights the ways in which drug consumption is always already gendered, racialised and classed. Narcofeminist approaches insist on a double vision attuned to violence and suffering as well as the possibility of alternative realities. This dual vision recognises a historical and contemporary context of dehumanisation while embracing and reclaiming new forms of humanness that challenge the figure of Enlightenment Man; it insists on the complexities of drug use that are all too often elided by singular stories of pain/pleasure and benefit/harm. Ultimately, narcofeminism challenges us to rethink our assumptions about drug use, and to recognise the voices and subjectivities of people who consume drugs, even in the face of intense hostility and oppression. By doing so, narcofeminist approaches have the potential to enrich and expand the sociological study of drug use and to contribute to drug policies that prioritise care and community over punishment and control. [ABSTRACT FROM AUTHOR]

Sociology has a long-standing interest in the consumption of licit and illicit drugs, particularly as a feminist concern with scholars highlighting the ways in which drugs are used as regulatory technologies to control the conduct and subjectivities of women and other marginalised groups. This monograph flips the focus from a feminist sociological concern with drugs as a means of confining minoritised peoples, to explore what they can do as a feminist practice. Employing the drug-user activist concept of 'narcofeminism', it aims to rethink how drugs are conceived in sociology and chart their role in shaping selves and worlds. This article introduces the guiding philosophy of the narcofeminist movement as articulated in an interview we conducted with founding narcofeminist activists from Eastern Europe and Central Asia. Threaded through the interview are vivid examples of the ingrained and overlapping hostilities that differentially constitute drug consumption practices for women and gender minorities, and the brave acts of resistance they perform in response. In introducing the collection, we foreground a key aim that has guided its development: thinking with the insights of narcofeminism, we have sought to address the complexities of drug use and to hold in focus its potentialities both in terms of its harms and benefits, risks and rewards and, importantly, to reflect on how people navigate these counterposing forces in their situated practices of drug use. We also discuss how the collection advances the sociology of drugs by bridging disciplinary divides and disrupting binary distinctions between licit and illicit drugs, volition and compulsion, pleasure and pain, and discourse and practice, among others. This article provides an overview of the contributions that comprise the monograph, highlighting how they grapple with the ethico-political commitments of narcofeminism to rethink drug consumption as a mode of living, capable of transforming social worlds. [ABSTRACT FROM AUTHOR]

Fisheries crimes pose a significant challenge to Namibian and international law enforcement organisations and/or agencies. Such crimes are typically distinguished by illegal actions that, in certain instances, are transnational and organised in nature. Illegal shipping of marine resources, illegal fishing, corruption, money laundering, and document and tax fraud are all examples of fisheries crimes. Fighting fisheries crimes in the twenty-first century is a vital priority for ensuring long-term development and protecting marine resources for future generations. It is an essential component of sustaining a justifiable blue economy, as well as resource sharing and beneficiation, which helps underprivileged groups like small-scale fishers to profit from Namibia's exploitation of marine resources. Effective fisheries law enforcement is required in Namibia to combat fisheries crimes. To achieve efficacy in fisheries law enforcement in Namibia, traditional policing methods and instruments, as well as knowledge of law, criminology, police science, and fisheries management and conservation, are required. This is far from the case, as fishery inspectors and observers are routinely underfunded and undertrained, both financially and technologically. As a result, the goal of this study is to look into the effectiveness of fisheries law enforcement in Namibia in the twenty-first century. Data from the author's Fisheries Law Enforcement training session, which took place from November 28 to 12 December 2022, in Walvis Bay, Namibia, was utilised to assess Namibia's readiness in combatting fisheries crimes. The implemented training received excellent response from participants. However, the training showed significant shortcomings in Namibia's fisheries law enforcement. As a result, recommendations on how to strengthen fisheries law enforcement in Namibia will be made in this article. [ABSTRACT FROM AUTHOR]

Plain English summary The National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational research Centre (GMPSTRC) carries out research to improve patient safety. We work in partnership with patients and members of the public to plan, manage, design, and carry out the research. This is labelled as patient and public involvement. A key area of GMPSTRC research focuses on people who may be marginalised from healthcare and potentially suffer increased patient safety risks relative to the general population. COVID-19 impacted on research in multiple ways, notably how researchers work with members of the public. Remote working via the use of internet enabled technology has now become more commonplace, although this raises concerns about digital exclusion and how to address barriers when face-to-face PPI is not possible. This article showcases three examples of how researchers and public contributors with lived experience have adapted to working together during the COVID-19 pandemic. These case examples are: (1) setting up a public involvement group for developing an intervention to reduce medication errors for adults with vision impairments; (2) working with a pre-existing group of public contributors who are adults and carers with lived experience of self-harm and/or suicide; and (3) working with a charity called Groundswell who train and support researchers with lived experience of homelessness. Challenges during COVID-19 have been making video conferencing meetings accessible to members who have a range of different needs, and addressing the digital divide by allowing members flexibility in how they contribute to research. The article provides examples of how these challenges were addressed.

Abstract Background Recruiting participants to randomised controlled trials (RCTs) is often challenging, particularly when working with socially disadvantaged populations who are often termed ‘hard-to-reach’ in research. Here we report the recruitment strategies and costs for the Trial for Healthy Relationship Initiatives in the Very Early years (THRIVE), an RCT evaluating two group-based parenting interventions for pregnant women. Methods THRIVE aimed to recruit 500 pregnant women with additional health and social care needs in Scotland between 2014 and 2018. Three recruitment strategies were employed: (1) referrals from a health or social care practitioner or voluntary/community organisation (practitioner-led referral), (2) direct engagement with potential participants by research staff (researcher-led recruitment) and (3) self-referral in response to study advertising (self-referral). The number of referrals and recruited participants from each strategy is reported along with the overall cost of recruitment. The impact of recruitment activities and the changes in maternity policy/context on recruitment throughout the study are examined. Results THRIVE received 973 referrals: 684 (70%) from practitioners (mainly specialist and general midwives), 273 (28%) from research nurses and 16 (2%) self-referrals. The time spent in antenatal clinics by research nurses each month was positively correlated with the number of referrals received (r = 0.57; p < 0.001). Changes in maternity policies and contexts were reflected in the number of referrals received each month, with both positive and negative impacts throughout the trial. Overall, 50% of referred women were recruited to the trial. Women referred via self-referral, THRIVE research nurses and specialist midwives were most likely to go on to be recruited (81%, 58% and 57%, respectively). Key contributors to recruitment included engaging key groups of referrers, establishing a large flexible workforce to enable recruitment activities to adapt to changes in context throughout the study and identifying the most appropriate setting to engage with potential participants. The overall cost of recruitment was £377 per randomised participant. Conclusions Recruitment resulted from a combination of all three strategies. Our reflections on the successes and challenges of these strategies highlight the need for recruitment strategies to be flexible to adapt to complex interventions and real-world challenges. These findings will inform future research in similar hard-to-reach populations. Trial registration International Standard Randomised Controlled Trials Number Registry ISRCTN21656568 . Retrospectively registered on 28 February 2014

Public participation (PP) has become a major feature of land-use planning, sanctioned by national and international laws as a platform for state, civil societies and citizens’ engagement. However, there is a dearth of information regarding ethnic minorities and marginalised groups about their interests and limitations in participatory planning. This article examines the level of citizens’ involvement and the constraints to participation in land-use planning. It analyses whether these constraints hinder some society groups more than their counterparts. These were examined using sampled participants in Nigeria. To test for the conceptual variance, factor analysis was used, while the likelihood of being hindered as against respondents’ socio-demographic characteristics was examined, using logistics regression. Findings show a low level of PP and yield a four-factor solution explaining 66.42% of the variance in PP. More hindrances to PP were perceived by ethnic minorities, the aged, females, tenants and rural dwellers compared to their counterparts. This gap between these community groups in PP was due to individual, community, and institutional factors. The article concludes that the structure of the Nigerian society still favours specific socio-demographic groups, even though the democratic transition and the subsequent constitutional amendments give all residents equal rights to political participation. There is the need for public policies, community and private investment to remove these constraints and make the PP programme truly public and attractive to all. The government and town-planning agencies may use the results in this article to help enhance their understanding of the hindrances to PP.

This paper presents a socially-engaged arts approach to exploring the variety and specificity of cultural benefits urban park-users associated with its treescape during the COVID-19 pandemic. Drawing on the cultural ecosystem services framework, cultural benefits are understood in terms of positive impacts to 'experiences' (our relational interactions with the environment), 'capabilities' (our knowledge and abilities in relation to environmental interaction) and 'identities' (our perceptions of our relationship with the environment). The research captured evidence of a broad range of people's interactions with the human and non-human world, whilst opening up an inclusive space for respondents to reflect on and share feelings about the significance of these experiences. The methods employed attracted a range of 'quieter voices' to participate, particularly more vulnerable park-users. They also attended to the multiple levels at which people connected with treescapes during this time, from less conscious material engagements to more emotionally and culturally driven transactions. This case study research highlights the important role of the park's treescape in supporting people to feel better during the COVID-19 crisis and their cultural associations and ties to it. However, it also explores feelings of concern for and perceived lack of influence over this valued resource as potentially disbenefiting wellbeing. It identifies experiences of environmental anxiety, emerging from a lack of certainty over and agency within urban green spaces and treescapes and the benefits they can provide. It concludes that management of treescapes and greenspaces should be sensitive to impacts on environmental emotion. [ABSTRACT FROM AUTHOR]

Patient and public involvement (PPI) is integral to research on patient safety in the NIHR Greater Manchester Patient Safety Translational Research Centre (NIHR GMPSTRC), and is central to our patient safety research within our theme focusing on people in marginalised groups. Due to the impact of COVID-19, researchers had to adapt how they do PPI. For marginalised groups, remote working and digital adaptations (the key adaptations made in accessing and utilising health services in the United Kingdom during COVID-19) can potentially lead to further marginalisation of people already marginalised and provide new barriers to others. This editorial showcases three case examples of PPI with marginalised groups during COVID-19, these are with: (1) adults with vision impairments, (2) adults and carers with lived experience of self-harm and/ or suicide and (3) adults with lived experience of homelessness. In these case examples, we focus on challenges relating to key aspects of PPI during the pandemic. First, setting up a PPI advisory group and secondly maintaining relationships and effective PPI with a pre-existing advisory group. We contrast these examples using more traditional ways of 'doing PPI' i.e. involving public contributors in various stages of the research cycle, with a more fully 'co-produced' approach to research when developing a new patient safety intervention. Important considerations for PPI with marginalised groups during COVID-19 include: how to avoid exacerbating the digital divide when using video conferencing for PPI, the need for enhanced awareness around flexibility and resources, and the value of working closely with specialist charities to enable adaptations that are sensitive to the changed circumstances and needs of PPI contributors. Plain English summary: The National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational research Centre (GMPSTRC) carries out research to improve patient safety. We work in partnership with patients and members of the public to plan, manage, design, and carry out the research. This is labelled as patient and public involvement. A key area of GMPSTRC research focuses on people who may be marginalised from healthcare and potentially suffer increased patient safety risks relative to the general population. COVID-19 impacted on research in multiple ways, notably how researchers work with members of the public. Remote working via the use of internet enabled technology has now become more commonplace, although this raises concerns about digital exclusion and how to address barriers when face-to-face PPI is not possible. This article showcases three examples of how researchers and public contributors with lived experience have adapted to working together during the COVID-19 pandemic. These case examples are: (1) setting up a public involvement group for developing an intervention to reduce medication errors for adults with vision impairments; (2) working with a pre-existing group of public contributors who are adults and carers with lived experience of self-harm and/or suicide; and (3) working with a charity called Groundswell who train and support researchers with lived experience of homelessness. Challenges during COVID-19 have been making video conferencing meetings accessible to members who have a range of different needs, and addressing the digital divide by allowing members flexibility in how they contribute to research. The article provides examples of how these challenges were addressed. [ABSTRACT FROM AUTHOR]

Abstract Background Non-governmental organisations (NGOs) collect and generate vast amounts of potentially rich data, most of which are not used for research purposes. Secondary analysis of NGO data (their use and analysis in a study for which they were not originally collected) presents an important but largely unrealised opportunity to provide new research insights in critical areas, including the evaluation of health policy and programmes. Methods A scoping review of the published literature was performed to identify the extent to which secondary analysis of NGO data has been used in health policy and systems research (HPSR). A tiered analytical approach provided a comprehensive overview and descriptive analyses of the studies that (1) used data produced or collected by or about NGOs; (2) performed secondary analysis of the NGO data (beyond the use of an NGO report as a supporting reference); and (3) analysed NGO-collected clinical data. Results Of the 156 studies that performed secondary analysis of NGO-produced or collected data, 64% (n = 100) used NGO-produced reports (mostly to a limited extent, as a contextual reference or to critique NGO activities) and 8% (n = 13) analysed NGO-collected clinical data. Of these studies, 55% (n = 86) investigated service delivery research topics and 48% (n = 51) were undertaken in developing countries and 17% (n = 27) in both developing and developed countries. NGOs were authors or co-authors of 26% of the studies. NGO-collected clinical data enabled HPSR within marginalised groups (e.g. migrants, people in conflict-affected areas), albeit with some limitations such as inconsistent and missing data. Conclusion We found evidence that NGO-collected and produced data are most commonly perceived as a source of supporting evidence for HPSR and not as primary source data. However, these data can facilitate research in under-researched marginalised groups and in contexts that are hard to reach by academics such as conflict-affected areas. NGO–academic collaboration could help address issues of NGO data quality to facilitate their more widespread use in research. The use of NGO data use could enable relevant and timely research in the areas of programme evaluation and health policy and advocacy to improve health and reduce health inequalities, especially in marginalised groups and developing countries.

Abstract Background Marginalised groups (‘populations outside of mainstream society’) experience severe health inequities, as well as increased risk of experiencing patient safety incidents. To date however no review exists to identify, map and analyse the literature in this area in order to understand 1) which marginalised groups have been studied in terms of patient safety research, 2) what the particular patient safety issues are for such groups and 3) what contributes to or is associated with these safety issues arising. Methods Scoping review. Systematic searches were performed across six electronic databases in September 2019. The time frame for searches of the respective databases was from the year 2000 until present day. Results The searches yielded 3346 articles, and 67 articles were included. Patient safety issues were identified for fourteen different marginalised patient groups across all studies, with 69% (n = 46) of the studies focused on four patient groups: ethnic minority groups, frail elderly populations, care home residents and low socio-economic status. Twelve separate patient safety issues were classified. Just over half of the studies focused on three issues represented in the patient safety literature, and in order of frequency were: medication safety, adverse outcomes and near misses. In total, 157 individual contributing or associated factors were identified and mapped to one of seven different factor types from the Framework of Contributory Factors Influencing Clinical Practice within the London Protocol. Patient safety issues were mostly multifactorial in origin including patient factors, health provider factors and health care system factors. Conclusions This review highlights that marginalised patient groups are vulnerable to experiencing a variety patient safety issues and points to a number of gaps. The findings indicate the need for further research to understand the intersectional nature of marginalisation and the multi-dimensional nature of patient safety issues, for groups that have been under-researched, including those with mental health problems, communication and cognitive impairments. Such understanding provides a basis for working collaboratively to co-design training, services and/or interventions designed to remove or at the very least minimise these increased risks. Trial registration Not applicable for a scoping review.

The possibility to use mobile phones to provide affordable, effective and accessible healthcare solutions has continued to attract significant investments in the application of formal m-health schemes in Africa. However, while the formal m-health schemes in Africa are limited and benefited only a handful of people, a majority of individuals are using their own phones to create an informal m-health ecosystem in an attempt to bridge primary healthcare access gaps. This paper draws on qualitative data from a four-year (2012-2016) anthropological study involving marginalised groups in Sierra Leone to document these health-seeking practices along with the benefits and challenges they create in a complex plural health system. It argues that the informal integration of mobile phones into the plural health system offers opportunities for marginalised individuals to search and secure primary healthcare of their choices, but poor network connectivity, high out of pocket maintenance costs, low digital literacy skills, and the lack of policy to streamline and regulate the practices can promise the effectiveness of the informal m-health system. It concludes by offering suggestions for addressing these challenges in the Sierra Leone context. [ABSTRACT FROM AUTHOR]

To contain the spread of COVID-19 within the UK over the past year, there have been a series of local and national lockdowns. These restrictions are likely to have impacted upon the health and well-being of marginalised groups who rely on now closed social and community support services to stay healthy. An understanding of the experiences of marginalised people is important; therefore, this study aimed to explore the impact of the COVID-19 restrictions on the health and well-being of marginalised groups in the UK. In summer 2020, a rapid telephone survey was conducted by trained, trusted volunteers with 76 participants who were from marginalised groups. As part of this survey, 64 participants consented to describe their experience of lockdown. These case studies were thematically analysed to identify patterns of meaning. Findings indicate that lockdown led to the deterioration of health of participants, impacted adversely on their socio-economic positions and affected access to food and essential supplies. In addition, government public health messaging was considered confusing and inadequate. This study highlights the need for pathways into services which support marginalised groups to remain accessible during periods of restrictions and essential supplies and food to be mapped and protected for marginalised individuals within our local communities. [ABSTRACT FROM AUTHOR]

Background: Recruiting participants to randomised controlled trials (RCTs) is often challenging, particularly when working with socially disadvantaged populations who are often termed 'hard-to-reach' in research. Here we report the recruitment strategies and costs for the Trial for Healthy Relationship Initiatives in the Very Early years (THRIVE), an RCT evaluating two group-based parenting interventions for pregnant women.Methods: THRIVE aimed to recruit 500 pregnant women with additional health and social care needs in Scotland between 2014 and 2018. Three recruitment strategies were employed: (1) referrals from a health or social care practitioner or voluntary/community organisation (practitioner-led referral), (2) direct engagement with potential participants by research staff (researcher-led recruitment) and (3) self-referral in response to study advertising (self-referral). The number of referrals and recruited participants from each strategy is reported along with the overall cost of recruitment. The impact of recruitment activities and the changes in maternity policy/context on recruitment throughout the study are examined.Results: THRIVE received 973 referrals: 684 (70%) from practitioners (mainly specialist and general midwives), 273 (28%) from research nurses and 16 (2%) self-referrals. The time spent in antenatal clinics by research nurses each month was positively correlated with the number of referrals received (r = 0.57; p < 0.001). Changes in maternity policies and contexts were reflected in the number of referrals received each month, with both positive and negative impacts throughout the trial. Overall, 50% of referred women were recruited to the trial. Women referred via self-referral, THRIVE research nurses and specialist midwives were most likely to go on to be recruited (81%, 58% and 57%, respectively). Key contributors to recruitment included engaging key groups of referrers, establishing a large flexible workforce to enable recruitment activities to adapt to changes in context throughout the study and identifying the most appropriate setting to engage with potential participants. The overall cost of recruitment was £377 per randomised participant.Conclusions: Recruitment resulted from a combination of all three strategies. Our reflections on the successes and challenges of these strategies highlight the need for recruitment strategies to be flexible to adapt to complex interventions and real-world challenges. These findings will inform future research in similar hard-to-reach populations.Trial Registration: International Standard Randomised Controlled Trials Number Registry ISRCTN21656568 . Retrospectively registered on 28 February 2014. [ABSTRACT FROM AUTHOR]

Recent studies have used the World Health Organization's new Behavioural and Social Drivers (BeSD) framework to analyse vaccine uptake. However, this study of COVID-19 vaccination among marginalised population groups highlights the framework's limitations regarding the centrality of the state in shaping people's vaccination intentions in high income countries. We conducted interviews and focus groups with service providers and community members to explore COVID-19 vaccination amongst Western Australians experiencing homelessness and/or from other marginalised populations (such as people with substance use dependence). Analysing this data iteratively to emphasise the state's role and functions, we elaborate how trauma and mistrust of government drive thoughts, feelings, and social interactions regarding vaccination programs, which are mutually reinforcing and which inhibit individuals' willingness to engage. Government systems that leave some populations behind increase those populations' susceptibility to misinformation. Policies may generate new unintended problems: social service providers worried about vaccine advocacy damaging clients' trust, especially in the context of vaccine mandates. Reframing the state's responsibility for designing culturally and socially appropriate services, we outline how end-users and trusted providers can lead this process. We share a new framework, "Recentering the State in Vaccine Uptake," arising from our analyses. • In Australia, people experiencing homelessness have low COVID-19 vaccination uptake. • Experiences with & perceptions of the state are important drivers of vaccine uptake. • Governments leaving cohorts behind increases susceptibility to misinformation. • People experiencing homelessness are disempowered, lacking choice. • Increasing trust and providing people with choices during outreach is vital. [ABSTRACT FROM AUTHOR]

Public participation (PP) has become a major feature of land-use planning, sanctioned by national and international laws as a platform for state, civil societies and citizens' engagement. However, there is a dearth of information regarding ethnic minorities and marginalised groups about their interests and limitations in participatory planning. This article examines the level of citizens' involvement and the constraints to participation in land-use planning. It analyses whether these constraints hinder some society groups more than their counterparts. These were examined using sampled participants in Nigeria. To test for the conceptual variance, factor analysis was used, while the likelihood of being hindered as against respondents' socio- demographic characteristics was examined, using logistics regression. Findings show a low level of PP and yield a four-factor solution explaining 66.42% of the variance in PP. More hindrances to PP were perceived by ethnic minorities, the aged, females, tenants and rural dwellers compared to their counterparts. This gap between these community groups in PP was due to individual, community, and institutional factors. The article concludes that the structure of the Nigerian society still favours specific socio-demographic groups, even though the democratic transition and the subsequent constitutional amendments give all residents equal rights to political participation. There is the need for public policies, community and private investment to remove these constraints and make the PP programme truly public and attractive to all. The government and town-planning agencies may use the results in this article to help enhance their understanding of the hindrances to PP. [ABSTRACT FROM AUTHOR]

The article considers a production of Hamlet by Maja Kleczewska at Teatr Polski in Poznań in the context of formal experimentation as well as its political and social ramifications, which are inextricably intertwined. Both the reasons for and consequences of choosing the sitespecific location of the Old Abattoir in Poznań as well as the lack of the division of the production space into stage and auditorium are analysed, with reference to reception processes, the ontological status of spectators and characters as well as the comments, which the production makes on the political and social situation of Poland and Central Europe in 2019 and 2020, especially immigration and marginalised groups within Central European societies. [ABSTRACT FROM AUTHOR]

Water is indispensable to human life. From references to water in numerous international treaties to ultimately, the adoption of United Nations (U.N.) General Assembly resolutions emphasising separate recognition of the “right to water” in 2010, we now have a freestanding human right to water. In this paper, I review the constitutional and legal framework underlying the right to water in India, and present a comprehensive analysis of judicial decisions that have enforced this right, based on insights from two original datasets. The first dataset is a compilation of all water laws, and the second is a compilation of all High Court and Supreme Court judicial decisions on the right to water. My review of the articulation of the “right to water” in India shows that this articulation has occurred largely oblivious of the international human rights movement on water. Apart from the mainstream articulation of the “right to water”, I also describe specific articulation of the right by two marginalised groups, namely Dalits and Adivasis. In so doing, I show how the articulation of the “right to water” has strengthened the claims of the former, but not those of the latter group.

Background: Lesbian, gay, bisexual and trans (LGBT) individuals have been shown to have poorer health when compared to those who identified as heterosexual. Additionally, they encounter barriers that deter participation in sports. Aim: To understand the experiences of LGBT individuals who participate in physical activity with peers. Method: An exploratory-descriptive qualitative (EDQ) study with data collected via face-to-face interviews from 12 participants. Data were thematically analysed to identify findings. Findings: exercising with peers represents a healthier way to meet people. Participants experienced improved physical, mental and social health. Conclusion: Engaging with a peer group for physical activity can have a transformational effect on members of the LGBT community, impacting on all aspects of their wellbeing. Nurses, and other health professionals, should be aware of the multifaceted benefits that exercising with a peer group can have, using their regular interactions with this patient group to recommend peer-supported exercise. [ABSTRACT FROM AUTHOR]

The topic of vulnerability has increased its visibility in the realm of human rights since the beginning of the new century. In the documentation regarding human rights policy by the European Commission, the case law of the European Court of Human Rights or the legal scholarship on human and fundamental rights, vulnerability has played different roles. The relationship that is therein established between vulnerability and human rights is not clear-cut or unidirectional. It shows some strength points in relation to the struggle against the exclusion of certain groups of people from the protection offered by current human rights mechanisms. On the other hand, there are also darker areas of contestation regarding the capabilities of vulnerability to push human rights instruments and their doctrine into a transformative and inclusive path for those groups so far rendered vulnerable. [ABSTRACT FROM AUTHOR]

Background: Non-governmental organisations (NGOs) collect and generate vast amounts of potentially rich data, most of which are not used for research purposes. Secondary analysis of NGO data (their use and analysis in a study for which they were not originally collected) presents an important but largely unrealised opportunity to provide new research insights in critical areas, including the evaluation of health policy and programmes.Methods: A scoping review of the published literature was performed to identify the extent to which secondary analysis of NGO data has been used in health policy and systems research (HPSR). A tiered analytical approach provided a comprehensive overview and descriptive analyses of the studies that (1) used data produced or collected by or about NGOs; (2) performed secondary analysis of the NGO data (beyond the use of an NGO report as a supporting reference); and (3) analysed NGO-collected clinical data.Results: Of the 156 studies that performed secondary analysis of NGO-produced or collected data, 64% (n = 100) used NGO-produced reports (mostly to a limited extent, as a contextual reference or to critique NGO activities) and 8% (n = 13) analysed NGO-collected clinical data. Of these studies, 55% (n = 86) investigated service delivery research topics and 48% (n = 51) were undertaken in developing countries and 17% (n = 27) in both developing and developed countries. NGOs were authors or co-authors of 26% of the studies. NGO-collected clinical data enabled HPSR within marginalised groups (e.g. migrants, people in conflict-affected areas), albeit with some limitations such as inconsistent and missing data.Conclusion: We found evidence that NGO-collected and produced data are most commonly perceived as a source of supporting evidence for HPSR and not as primary source data. However, these data can facilitate research in under-researched marginalised groups and in contexts that are hard to reach by academics such as conflict-affected areas. NGO-academic collaboration could help address issues of NGO data quality to facilitate their more widespread use in research. The use of NGO data use could enable relevant and timely research in the areas of programme evaluation and health policy and advocacy to improve health and reduce health inequalities, especially in marginalised groups and developing countries. [ABSTRACT FROM AUTHOR]