Related Barriers Research Articles

Barriers to lean construction implementation in Zimbabwe

Purpose Increased waste during projects execution has led to time and cost overruns within the Zimbabwean construction projects industry. However, contextual barriers to lean construction implementation are yet to be established for derivation of effective remedies. The purpose of this paper is to report on a study that sought to determine barriers to lean construction implementation and assess the existence of statistically significant differences because of gender, designation and educational levels of respondents. Design/methodology/approach A questionnaire survey was administered on construction professionals for the collection of quantitative data. Factor analysis was used to reveal interrelated significant sets of barriers to lean construction implementation. Non-parametric statistical methods were also used to determine significant differences because of demographic variables. Findings Integration- and performance-related, human capital management–related, quality management–related barriers were determined as the highest-ranked of the nine significant components. Significant differences because of gender, designation and educational levels were non-existent for aggregated barriers, generally indicating consensus on the barriers. However, individual barriers showed inadequacies in management requirements for lean construction implementation from architects and those with diplomas and degrees. Research limitations/implications The determination of barriers establishes the knowledge for construction policy evaluation for enhanced performance of the construction industry. However, because of the exploratory nature of this study, the insights of clients were not considered. Originality/value Context-specific barriers to lean construction implementation were determined for consequent construction policy improvements in the construction industry.

Application of the 2019 ESC/EAS dyslipidemia guidelines to a Mexican population: evaluating treatment targets for secondary prevention in clinical practice

Abstract Introduction In 2019 the ESC/EAS published the update on their guidelines for the management of dyslipidemias. For patients with prior myocardial infarction or stroke, they recommend achieving an LDL level <55mg/dL as a primary objective, and a non-HDL level <85mg/dL as a secondary target. Objective To analyze the impact and application that the 2019 ESC/EAS dyslipidemia guideline has on the management of dyslipidemia for secondary prevention. Methods Using data from a nationwide register in Mexico, a retrospective study was performed, including adult patients from 2018–2020 treated for hyperlipidemia and with prior history of stroke, myocardial infarction, or peripheral artery disease, with at least one follow-up visit. Patients were divided into 2 groups according to their LDL target attainment, furthermore, those with an appropriate LDL target were subdivided into 2 groups according to the attainment of the secondary target. Results 590 patients were included, the mean age at the last visit was 67 years, 68% were men. The most frequent cardiovascular event was myocardial infarction (75%). The most frequent comorbidity found was obesity (79%). 60% of the sample was on high-intensity statin treatment and 5% received only life-style modifications. When the LDL target attainment was analyzed, only 124 patients (21%) had an adequate control (group 1). Patients in this group had a lower mean age (66±12 vs 67±10), BMI was higher in this group (29 vs 28), meanwhile, blood pressure measurements were slightly lower (systolic 123 vs 126 mmHg, diastolic 73 vs 75 mmHg). They had, however, a higher frequency of comorbidities, such as T2D (46% vs 39%), hypertension (77% vs 73%) and heart failure (26% vs 23%). There were also differences in the pharmacological treatments: in group 1, 58% of the patients were treated with a high-intensity statin (vs 60% in group 2), 24% were treated with a moderate-intensity statin (vs 35% in group 2) and only 16% received a dual treatment strategy with ezetimibe (vs 13% in group 2). Only 8 patients received a PCSK9 inhibitor, and only one of them had an adequate LDL target. When the secondary target attainment was analyzed for patients in group 1, 85% of them had also an adequate control (subgroup 1). Conclusions The treatment targets from the update on the guidelines, are associated with undertreatment of high-risk patients on secondary prevention. At the current time, less than half of the patients included in this study achieved the optimal target, and only 60% of patients are receiving the appropriate intensity of treatment. There might be different patient-physician related barriers to achieving a good control, one to be considered is the important economic implication of the new pharmacologic options. More studies are required to study the before mentioned barriers and to suggest a proper population-based approach to improve adherence to cardiovascular guidelines for secondary prevention. Funding Acknowledgement Type of funding sources: None.

Optimal system design for energy communities in multi-family buildings: the case of the German Tenant Electricity Law

Involving residential actors in the energy transition is crucial for its success. Local energy generation, consumption and trading are identified as desirable forms of involvement, especially in energy communities. The potentials for energy communities in the residential building stock are high but are largely untapped in multi-family buildings. In many countries, rapidly evolving legal frameworks aim at overcoming related barriers, e.g. ownership structures, principal–agent problems and system complexity. But academic literature is scarce regarding the techno-economic and environmental implications of such complex frameworks. This paper develops a mixed-integer linear program (MILP) optimisation model for assessing the implementation of multi-energy systems in an energy community in multi-family buildings with a special distinction between investor and user; the model is applied to the German Tenant Electricity Law. Based on hourly demands from appliances, heating and electric vehicles, the optimal energy system layout and dispatch are determined. The results contain a rich set of performance indicators that demonstrate how the legal framework affects the technologies’ interdependencies and economic viability of energy communities with multi-energy systems. Certain economic technology combinations may fail to support national emissions mitigation goals and lead to lock-ins in Europe’s largest residential building stock. The subsidies do not lead to the utilisation of a battery storage. Despite this, self-sufficiency ratios of more than 90% are observable for systems with combined heat and power plants and heat pumps. Social CO2 mitigation costs range between 147.5–272.8 €/tCO2. Finally, the results show the strong influence of the heat demand on the system layout.

Assessment of the current practice of asthma exacerbation management in different health settings in Egypt

Abstract Background Asthma accounts for about one in every 250 deaths worldwide. Many of the deaths are preventable, being due to suboptimal long-term medical care and delay in obtaining help during acute exacerbation. Aim to assess knowledge, attitude and practice of Egyptian physicians about childhood asthma exacerbation treatment guidelines and to identify the barriers against application of guidelines in different hospital settings in Egypt. Methods a written questionnaire with different topics were added aiming at assessment of four important aspects about the involved physicians; physician's knowledge, practice, attitude and barriers against application of guidelines. This questionnaire was fulfilled by 200 pediatricians, all of them deal with childhood asthmatics. As regards Academic degrees, 94 (47.7%) had the Bachelor degree, 70 (35.5%) had Master degree, 23 had Diploma degree (11.7%), and 10 (5.1%) had Doctorate. As regards Hospital settings, 102 (51.8%) of the pediatricians were working in governmental hospitals, 76 (%38.6) of them were working in University hospitals, 13(6.6%) pediatricians worked in private hospitals and 6 (3%) pediatricians worked in other types of hospitals. Results low level of knowledge was found in 80.2% of participants, non adherence to guidelines was found in 59.4 % and negative attitude towards guidelines was found in 65.3% of them. Conclusion Most of the studied physicians have low level of knowledge, non adherence to guidelines and negative attitude towards guidelines. The main barriers against guideline application were the external barriers followed by patient related barriers then personal barriers. Guideline related barriers were in the last rank. So, Continuous training of physicians, increasing people’s awareness and improving facilities in hospitals are required to get better adherence to guidelines

EXPLORATION OF BARRIERS PERCEIVED BY ONCOLOGY NURSES RELATED TO CANCER PAIN MANAGEMENT

Objectives: To explore barriers perceived by oncology nurses in cancer pain management. 
 Methods: A descriptive Cross sectional study was conducted in oncology department of four tertiary care hospitals of Punjab which include Mayo hospital Lahore, Jinnah hospital Lahore, Allied hospital Faisalabad and Nishtar hospital Multan. Sample of 72 nurses working in oncology departments of four tertiary care hospitals were selected by using purposive sampling. Self-administered questionnaire was used to collect data. The data analysis was performed using SPSS version 20 and micro soft excel.
 Results: The results identified that system related barriers were found more prevalent. From system related barriers inappropriate nurse –patient ratio was found most prevalent barriers as 95.9% (n=72) respondent were agree for this barrier
 Conclusion: nurses face lot of barriers in pain management that hinder their efficiency to control pain.

Supporting Employment and Mental Health for Women Survivors of Intimate Partner Violence & Traumatic Brain Injury: A Community-Based Participatory Research Study

<h3>Research Objectives</h3> Explore employment and mental health related barriers and facilitators, service needs, and priorities for women survivors of intimate partner violence (IPV) with traumatic brain injury (TBI) and develop stakeholder informed knowledge translation (KT) materials and implement them through the Abused & Brain Injured Toolkit. <h3>Design</h3> Two sequential projects: one exploring knowledge and service gaps, and the second to develop KT materials to address those gaps. Data were collected via focus groups and semi-structured interviews. Reporting shall follow the consolidated criteria for reporting qualitative research. <h3>Setting</h3> Community-based, participatory research model with data collection taking place online via phone or videoconference interviews, online surveys, and email. <h3>Participants</h3> A convenience sample of key stakeholders including frontline workers, executive directors/program managers in the IPV sector, women survivors of IPV, health care professionals, and employers. 24 stakeholders participated in interviews or focus groups to inform development of the KT materials and were invited to provide feedback mid-design. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> We engaged in member checking to seek feedback on the prototype KT materials. <h3>Results</h3> Based on identified gaps and stakeholder input, two KT modules, one for employment and one for mental health, were developed for our existing online educational toolkit (Abused and Brain Injured Toolkit, abitoolkit.ca). Survivors' employment needs fell into two main categories, maintaining employment and obtaining employment. Mental health related challenges centred on difficulties parsing impacts of brain injury from mental health. <h3>Conclusions</h3> TBI knowledge among IPV service providers is increasing. As it does, additional education and resources will be needed to support survivors in various aspects of their lives. The development of KT modules directly addresses this, broadening available educational material in this area. <h3>Author(s) Disclosures</h3> The authors have no disclosures to report.

Assessment of health equity consideration in masking/PPE policies to contain COVID-19 using PROGRESS-plus framework: a systematic review

IntroductionThere is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE).MethodsA systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as ‘PROGRESS-Plus’: Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized.ResultsThis review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on “occupation” component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on “workers” such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to “worker focused” policy documents, most of the ‘whole population focused’ policy documents didn’t have a PROGRESS-plus equity component rendering them equity limiting for the society.ConclusionOur review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.

1220Barriers to care for people who use crystal methamphetamine

Abstract Background Crystal methamphetamine (‘ice’) causes significant societal harm in Australia and is perceived by the public to be the drug of most concern nationally. Although effective treatments exist, it is estimated that only a third of people dependent on amphetamine-type stimulants receive treatment each year. Barriers to care may for people who use ice can include psychosocial (e.g., knowledge, attitudinal) and structural barriers. This study aimed to look at the perceived and actual barriers to care for Australians, as well as help-seeking behaviours among people who use ice. Methods An online survey was conducted among 2,110 Australians including people with lived experience, health workers, affected family members/friends and community members. All participants were asked about perceived barriers to care. People with lived experience were asked additional questions about help seeking. Results Attitudinal reasons were the highest perceived barrier to care among 63.1% of participants, followed by knowledge (21.9%). People with lived experience were more likely to endorse attitudinal barriers (OR 1.35), whereas health workers were more likely to endorse knowledge related barriers (OR 0.69). Among people with lived experience who had sought help, 74.5% had visited a counsellor/psychologist and 60.6% had asked help from a family member/friend. Conclusions Understanding and reducing barriers to care is essential to reduce the harms associated with the drug. It is important to support families and friends as they are often asked to help or support a loved one using ice. Key messages It is important to understand and reduce the perceived and actual barriers to care for people who use ice. This is essential to reduce the harms associated with the drug.

Circular economy: a conceptual model to measure readiness for manufacturing SMEs

PurposeOver the last decade, circular economy (CE) has gathered interest from both industrialists and academics alike. Whilst CE research is widespread in such areas as supply chain and larger organisations, there is limited research into how small to medium enterprises (SMEs) can prepare for adopting CE. There is no comprehensive readiness model for SMEs adopting CE. The purpose of this paper is to explore the literature on change readiness and generate knowledge to fill this gap by developing a conceptual model to measure change readiness for SMEs' adopting CE.Design/methodology/approachThis study is based on a comprehensive literature review of change readiness models and frameworks. The paper reviews publications from Science Direct, Web of Science, Emerald, Scopus and Google Scholar. The readiness for change models and frameworks from the selected publications are evaluated and synthesised to develop a comprehensive conceptual model for change readiness for SMEs adopting a circular economy.FindingsA readiness conceptual model is developed by incorporating several factors as precursors to readiness, i.e. individual/collective difference, structural, contextual factors and related barriers. Eleven factors make up the individual/collective difference. Three factors make up the structural and contextual factors.Practical implicationsThis paper develops a conceptual model that can aid academics and practitioners in better understanding SMEs readiness to adopt CE.Originality/valueThis paper makes a unique contribution by proposing a comprehensive conceptual model of readiness for SMEs adopting CE.

Efficient, yet Effective: Improvements in Suicide-related Knowledge, Confidence, and Preparedness after the Deployment of a Brief Online Module on Suicide in a Required MSW Course

ABSTRACT Although social workers are increasingly likely to encounter suicidal clients in their practice, many are under-prepared to address the issue of suicide, and significant deficiencies in suicide education exist in social work graduate programs. This study examined the acceptability and effectiveness of a brief yet comprehensive online module covering suicide risk assessment and treatment deployed as part of a required master’s level social work course. Students completed online pre- and posttest surveys that measured suicide-related knowledge, perceived preparedness, and confidence, and rated various elements of the module. A total of N =53 MSW students participated in the study, of whom N = 45 completed both the pre- and posttests. Scores for suicide-related knowledge, perceived preparedness, and confidence increased significantly from pre- to posttest (p’s < .001). The majority of students (95.7%) were satisfied or highly satisfied with the overall content, comprehensiveness, and format of the module. However, most (70.2%) reported a preference for face-to-face or hybrid delivery methods for suicide-related material. Implications discussed include the use of synchronous elements to address student anxiety related to suicide-related content, the utility of pre-prepared online learning modules to address curriculum related barriers, and the importance of well-designed online materials.

A randomized clinical trial of in-person vs. home-based telemedicine delivery of Prolonged Exposure for PTSD in military sexual trauma survivors

Posttraumatic stress disorder (PTSD) is common in women who experienced Military Sexual Trauma (MST). Despite Veterans Affairs Medical Center-wide screening and tailored MST services, substantial barriers to care exist, and about 50 % of those who start evidence-based treatment for PTSD drop out prematurely. Home-based telemedicine (HBT) may reduce logistical and stigma related barriers to mental health care, thereby reducing dropout. The current randomized clinical trial (NCT02417025) for women veterans with MST-related PTSD (N = 136) compared the efficacy of HBT delivery of Prolonged Exposure (PE) to in-person delivery of PE on measures of PTSD and depression, as well as on “PE dose” received. Hypotheses predicted that women in the HBT PE group would complete more sessions, and evince greater PTSD and depression symptom reduction compared to in-person PE. Results revealed that there were no differences in dose received or PTSD symptom reduction between in-person and HBT conditions; however, dose (i.e., more sessions) was related to reduced PTSD symptom severity. Future research should examine other factors associated with high PTSD treatment dropout among MST patients.

Transforming Self-Employability & Entrepreneurship for Mothers via Mobile Sharing Economy Platforms

This research focuses on the extent sharing economy transforms employability for women impacted by domestic and reproductive work. We explore the experience of mothers, of how digital peer-to-peer (P2P) platforms can affect their real and perceived employability by unlocking human capital, through technology acceptance. It incorporates a case study research design with the Gioia methodology. A semi-structured telephone survey collected data to explore the decisions around usage of a new mobile P2P app, aimed to support employability among mothers. Analysis was conducted inductively using Leximancer, thematic analysis and Partial Least Squares Structural Equation Modelling (PLS-SEM). We found that mothers experience high rates of continued labor market attachment on a casual or part-time basis, difficulty in juggling family and work, and high levels of concern both about future employment/ entrepreneurial opportunities and expected stress in balancing dual roles of carer and earner. While they are interested in using new sharing economy technologies to reduce skills deterioration and improve signaling, there were both technology and non-technology related barriers. These included trust and security, life-stage mismatch, time poverty and limitation of service offerings. This exploratory study contributes to research by illustrating how sharing economy platforms can offer women a means to overcome the issues of signaling and skills deterioration in relation to aspects of human capital theory, and additionally, how the social interactions between mothers, through technology adoption, can provide a basis for improving future self-employment and entrepreneurship. Keywords: Self-employment, mumpreneurship, self-perceived employability, sharing economy, P2P platforms, technology acceptance, signaling, skills deterioration.

Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda.

Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal 'yes' or 'no' questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.

Health Care Professionals' Experiences With the Use of Video Consultation: Qualitative Study.

BackgroundThe number of remote video consultations between doctors and patients has increased during the last few years and especially during the COVID-19 pandemic. The health care service is faced with rising rates of chronic illness and many patients who are more confident in self-management of their illnesses. In addition, there is an improved long-term outlook for serious conditions, such as cancer, that might require flexibility in everyday life.ObjectiveThis study aimed to investigate how medical doctors in the outpatient clinic use and experience the use of video consultations with hematological patients, with a focus on relational and organizational aspects.MethodsThe study was designed as an explorative and qualitative study. Data were collected via participant observations and focus group interviews with medical doctors.ResultsThe study identified possibilities and barriers in relation to adapting to the alternative way of meeting patients in the clinical setting. One of the main findings in this study is that the medical doctors were afraid that they missed important observations, as they were not able to perform a physical examination, if needed. They also emphasized that handshake and eye contact were important in order to get an overall impression of the patient’s situation. It also became clear that the medical doctors used body language a lot more during video consultation compared with consultation in a physical setting. The medical doctors found the contact with the patients via the screen to be good, and the fact that the technology was working well made them feel comfortable with the video consultation.ConclusionsIn this study, we found that the medical doctors were able to maintain good contact with the patients despite the screen and were able to assess the patients in a satisfying manner. However, there were still uncertainties among some doctors about the fact that they could not examine the patients physically. New knowledge about how to use gestures and body language during video consultation was obtained.

The Adoption of Robotic Process Automation Technology to Ensure Business Processes during the COVID-19 Pandemic

The study provides knowledge on the adoption of the Robotic Process Automation (RPA) technology during the COVID-19 pandemic in 110 Polish service companies. As this research was the first of its kind in Poland, the objectives of the CAWI survey were to identify the technology features of the RPA technology and the related determinants and barriers influencing the adoption of the RPA as well as to determine correlations between them. Moreover, the statistical analyses involved considering whether there were differences in the evaluation of individual RPA technology features, mainly in terms of perceived usefulness, ease of use, security and functionality. The results of the study show that almost 60% of the respondents indicated that robotization tools allowed maintaining continuity of business processes during the pandemic. The highest rated were features related to usefulness of the RPA technology. Furthermore, the analysis pointed to the most frequently indicated barriers to technology implementation that were related to nonoptimized, nonstandardized and non-digitized processes with a large number of exceptions. The study contributes to scientific knowledge and has practical implications for process automation decision-makers concerned with the adoption of the Robotic Process Automation technology. The obtained results can help them to understand the potential drivers of and barriers to the adoption of software robots by enterprises and may be an important determinant for companies’ managers in the field of implementing such solutions.

Elevating Social and Behavior Change as an Essential Component of Family Planning Programs.

The global family planning community has made significant progress towards enabling 120 million more women and girls to use contraceptives by 2020, though we enter the decade ahead with a long road yet to travel. While investment in strong health systems and supply chains is still needed, the supply‐driven approach dominant in family planning fails to address the individual, relational, and social barriers faced by women and couples in achieving their reproductive intentions and desired family size. Overcoming these barriers will require a better understanding of behavioral drivers and the social environment in which family planning decisions are made, and an increased investment in the proven, yet underutilized, approach of social and behavior change (SBC). We make the case that a more intentional focus on the science of human behavior in family planning can help advance the achievement of global, regional, and national goals while also calling for strategic and sustained investment that reflects the critical importance and proven impact of SBC approaches.

Perspectives of psychiatric patients in rural areas of Jordan: Barriers to compliance and pharmacist role.

Successful management of psychiatric disorders is affected by patient perspectives and several barriers, that is, conceptual, psychological, social, or logistic reasons that can decrease patient adherence to therapy. In this perspective, pharmacists have a vital role in identifying patients in need of help and in dealing with barriers. The aim of this study was to investigate perspectives of patients diagnosed with psychiatric disorders, living in rural areas in Jerash, Jordan, regarding their awareness about their conditions, including religious and cultural factors, adherence to their treatment and related barriers, with special focus on pharmacist's role. This cross-sectional survey study was conducted in Jordan from August to November 2019. A validated questionnaire was administered by two pharmacy students via a structured interview with patients waiting for their appointment in the psychiatric clinic. Data were analysed using the Statistical Package for the Social Sciences. One hundred twenty patients (age 39.4±9.5, 66.7% males) completed the questionnaire. Most of them (71.0%) reported adherence to their medications, and 47.5% reported complete control of their symptoms with treatment. Most patients (59.2%) reported that they perceive their psychiatric problem in terms of religious faith as being counted for their favour in the Hereafter, and 52.5% of them always/usually looked at themselves positively and unaffected by their psychiatric problem; with both factors correlating significantly with better treatment adherence (P<.045 and P<.001; respectively). Barriers affecting adherence included mainly suffering from adverse effects (31.9%) and being unconvinced that they needed a medication (23.3%). Only 14.2% of patients reported that they refer to the pharmacist to get information about their medications. This study shows suboptimal symptom control of psychiatric patients in Jerash. Nonadherence is an issue, with barriers identified. Positive religious and self-image perspectives correlated with better adherence. Patient referral to pharmacists is minimal and needs to be optimised.

Multi-criteria analysis of social isolation barriers amid COVID-19 using fuzzy AHP

PurposeThe purpose of current analytical work is to identify the critical barriers in social isolation in India amid Coronavirus infection disease (COVID) outbreak using the fuzzy-analytical hierarchical process (AHP) method.Design/methodology/approachThe conventional AHP is insufficient for tackling the vague nature of linguistic assessment. Fuzzy AHP had been developed to resolve the hierarchical fuzzy problems, avoiding its risks on performance. In AHP, all comparisons are not included; thus, to find the priority of one decision variable over other, triangular fuzzy numbers are used.FindingsA total of eight critical barriers in social distancing in India during COVID-19 have been compared and ranked. Dense population has emerged as the most culpable barrier in social isolation in India amid COVID outbreak followed by compulsion for pecuniary earning and general incautiousness. A total of eight critical barriers in social distancing in India during COVID-19 in four categories (societal barriers, insufficient facilitation barriers, growth-related barriers and population related barriers) have been compared and ranked.Originality/valueOn the basis of the numeral values, “growth-related barriers” attained top position followed by “population-related barriers” and “insufficient facilitation barriers.” The current work has explored the possible factors which can become key game changers to control the pace of spread of the pandemic.

General practitioners’ self-reported competence in the management of sexual health issues – a web-based questionnaire study from Finland

Objective Although sexual problems are common, they are rarely brought up in appointments with general practitioners (GPs). We aimed to assess the barriers that hinder GPs from bringing up sexual health issues and to evaluate the need for education on sexual medicine. Design A web-based questionnaire was used. Setting Four fields were included: A) the self-reported competence in discussing sexual health and treating patients with these issues, B) the barriers to bringing up patients’ sexual health problems, C) the source of education on sexual medicine and D) the need for education on sexual medicine. Subjects A random sample of 1000 GPs in Finland (a response rate of 43.5%, n = 402). Main outcome measures GPs’ self-assessed competence in discussing and treating sexual health issues, related barriers to bringing up the topic and the reported need for education. Results The main reasons reported for not bringing up sexual health issues were shortness of the appointment time (85.6%), a lack of knowledge (83.6%) and a lack of experience with sexual medicine (81.8%). The male GPs reported better competence in discussing the issues and treating male patients, whereas the female GPs reported better competence in discussing the issues with female patients. No differences emerged between genders regarding treating female patients. Nearly 90% of the GPs expressed needing more education about sexual medicine. Conclusions Although the GPs reported good competence in discussing sexual health issues with their patients, several barriers to bringing up sexual health issues emerged. Continuing education was desired and could lessen these barriers. Key points Only a few studies have evaluated the competence of general practitioners (GPs) in addressing sexual health issues with their patients. In our study, the GPs reported a high competence in discussing patients’ sexual health issues regardless of the patient’s gender. However, several barriers to bringing up sexual health issues in appointments emerged. A majority of the GPs expressed a need for continuing education about sexual medicine.

AN INVESTIGATION INTO BARRIERS IMPACTING AGAINST FACULTY BLENDED LEARNING ADOPTION

Blended Learning has not attained campus-wide integration and adoption as the preferred teaching delivery mode by faculty members a few years after the management of a public university in Ghana decided to move from face to face delivery to the blended mode. This study investigates the barriers impacting faculty Blended Learning in Ghana. The study uses an exploratory qualitative approach to investigate the barriers to faculty non-adoption of blended learning. It also investigates their perceptions and experiences. A total of 22 faculty members from four faculties of the university were purposively selected and interviewed for this study. The data were coded and analyzed using a constant comparative analytical method. Thematic analysis was then applied to generate themes for the findings. The study found four themes that inductively constitute barriers to faculty BL adoption. These are infrastructure, faculty concerns, institutional, technical support barriers. The study provides insights into the lived experiences of faculty members relative to the impediments they face in adopting BL. Thus, administrative managers need to avert their attention to institutional related barriers, faculty related concerns, technical barriers, and infrastructure-related barriers when implementing BL.