Practical Barriers Research Articles

What no one has seen before: gravitational waveforms from warp drive collapse

Despite originating in science fiction, warp drives have a concrete description in general relativity, with Alcubierre first proposing a spacetime metric that supported faster-than-light travel. Whilst there are numerous practical barriers to their implementation in real life, including a requirement for negative energy, computationally, one can simulate their evolution in time given an equation of state describing the matter. In this work, we study the signatures arising from a warp drive “containment failure”, assuming a stiff equation of state for the fluid. We compute the emitted gravitational-wave signal and track the energy fluxes of the fluid. Apart from its rather speculative application to the search for extraterrestrial life in gravitational-wave detector data, this work is interesting as a study of the dynamical evolution and stability of spacetimes that violate the null energy condition. Our work highlights the importance of exploring strange new spacetimes, to (boldly) simulate what no one has seen before.

Mitigating risks in central line-associated bloodstream infection: a comprehensive insight into critical care nurses’ knowledge, attitudes, barriers, and compliance

BackgroundCentral venous catheter-related bloodstream infections (CLABSIs) are a significant concern in intensive care units (ICUs) as they lead to increased morbidity, mortality, and healthcare costs. Fortunately, these infections are largely preventable through strict adherence to CLABSI prevention guidelines. Nurses play a critical role in preventing CLABSIs.AimThis study aimed to investigate factors affecting critical care nurses' knowledge, attitudes, and perceived barriers related to implementing CLABSI prevention guidelines, and to predict factors influencing compliance with these guidelines.MethodsThis cross-sectional study was conducted from April to May 30, 2023, with a convenience sample of 470 critical care nurses from ICUs across eight hospitals in Sana’a, Yemen. Data were collected using an observational checklist and self-administered questionnaire. Descriptive statistics, Independent Student’s t-test, one-way ANOVA, Pearson’s correlation coefficient, multiple linear regression, and multilayer perceptron neural networks were performed.ResultsCritical care nurses exhibited low knowledge of CLABSI prevention guidelines, with compliance reaching an acceptable level. Despite the higher perceived barriers, the nurses demonstrated a positive attitude. Nurses with greater knowledge and positive attitudes displayed higher compliance levels. However, perceived barriers were negatively associated with knowledge and compliance. Notably, multilayer neural network analysis identified knowledge and perceived barriers as the strongest predictors of nurses' compliance.ConclusionThe current findings emphasize the need for multifaceted strategies to implement the CLABSI prevention guidelines. These strategies should address knowledge gaps, support positive attitudes, and address practical barriers faced by nurses to ensure successful implementation of CLABSI prevention.

A mixed-methods cross-sectional study to evaluate the public acceptability of a novel pharmacy-based response service for domestic abuse and/or suicidal ideation

BackgroundDomestic abuse (DA) and suicidal ideation (SI) are prevalent and often co-occur. Numerous practical and psychosocial barriers inhibit help-seeking, including accessibility and confidentiality concerns. Early intervention and referral are essential for both DA and SI. Pharmacies are accessible and may be perceived as a discreet venue for a DA and SI response service. There is a growing body of literature about the role of community pharmacy teams in suicide prevention and assisting domestic abuse victims globally. Whilst there have been some interventions in UK pharmacies to support domestic abuse victims and encouragement of staff training in suicide prevention, there is currently no commissioned service for DA and/or SI in pharmacies in the UK. ObjectiveTo assess public acceptability of a novel response service in community pharmacy for people in danger from domestic abuse and/or suicidal ideation. MethodsData collection consisted of an online public survey running for 6 weeks and qualitative interviews with pharmacy customers. Descriptive statistics were used to present the survey results and interviews were audio recorded, transcribed verbatim and then analysed using the Framework Analysis method and NVivo 11. ResultsThe majority of 501 survey respondents and all 12 customer interview participants were supportive of offering a response service for DA and/or SI in community pharmacy. Participants emphasised the need for appropriate staff training and support. They considered it an ethical and accessible approach and the majority said that they would recommend such a service to family or friends, and use it themselves if needed. However, awareness of the service was low and marketing materials were considered insufficiently clear. ConclusionsThere is strong public support and acceptability for a response service covering both suicidal ideation and domestic abuse in community pharmacies. Further research is required to develop appropriate marketing materials.

Credentials, Perpetual “Foreignness”, and Feeling out of Place: Three Stories of Resilience from Teachers of Refugee Background

This qualitative research project seeks to examine the obstacles faced by educators who come to the U.S. as refugees. The three participants in this study are from Iraq, Sudan, and Turkey. While there are similarities between them, there are also differences in terms of race, sex, and religion. While this work examines practical barriers, such as those related to credentialing, it also considers how these educators negotiate their identity in the workplace. Using labeling theory, the impact of the category of refugee and how that label impacts work life is interrogated. Partially as a result of the labels associated with being a refugee, findings indicate that, for educators from refugee backgrounds, there are significant barriers to credentialing, their knowledge and experience from outside of the U.S. is rarely taken seriously in many workplace environments, and, consequently, a lack of confidence can easily develop. Despite all of this, educators from refugee backgrounds often have extensive experience in education and can more easily connect to diverse student populations and their families. Suggestions for how best to expand the hiring of educators from refugee backgrounds are provided, as well as implications for future research.

Quantitative exploration of barriers to access cancer services experienced by cancer patients in Lesotho

Background: Cancer mortality has been estimated to increase in sub-Saharan Africa to more than a million deaths in 2023. There is a need for an increase in cancer screening, diagnosis and treatment infrastructure to curb this rise in cancer mortality. Many people with cancer face significant barriers to accessing treatment.Aim: The study aimed to explore barriers to accessing cancer care services experienced by cancer patients in Lesotho.Setting: This study was conducted at the Senkatana oncology clinic in Maseru, Lesotho.Methods: The study adopted a quantitative cross-sectional design. Cancer patient interviews were conducted using a structured questionnaire.Results: A total of 115 patients responded to the questionnaire, and 79.1% were female. Over half of the participants (53.9%) found it difficult to access cancer services because they had to get services from multiple healthcare facilities in different areas. All of them had to join long queues. Distance from the healthcare facilities was also a challenge for a significant number (64.3%), and a substantial number (66.1%) had difficulties arranging transport to such facilities. Finally, financial issues, such as paying for transport, healthcare and diagnostic tests, were determined to be major constraints.Conclusion: The study concludes that most cancer patients face financial and practical barriers. This affects access to cancer services, particularly for patients not residing in Maseru.Contribution: The study shares information regarded as barriers to cancer services in a low- and middle-income country.

Nursing practices on sexual health for people with neurological disorders: A narrative review.

To identify and describe nursing practices on the sexual health of people with neurological disorders. Narrative review. Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used. PubMed, Embase, ScienceDirect and CINAHL. In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles. Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions. Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized. Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients. PRISMA. No patient or public contribution.

Sense of Purpose, Reduced Stress, and Connection as Protective Factors for Longevity: An Exploration of Barriers

ABSTRACT Background Utilizing the Blue ZonesⓇ framework and the nine lifestyle factors that promote well-being with longevity, an interdisciplinary team of researchers examined protective factors and barriers to engaging in each of the nine lifestyle factors. Purpose To report on protective factors and barriers to improving three of the nine lifestyle factors – sense of purpose, stress, and connection. Methods Using a mixed-method approach, 185 residents living in a rural community in the mid-southern part of the USA participated in this study via e-mail and social media. Results Notable demographic factors including age were significantly associated with fewer obstacles to achieving purpose, reduced stress, and leaving the home regularly. Qualitative responses link disruptions from the COVID-19 pandemic and isolation to feelings of disconnect. Discussion Work, hobbies, and resilience were protective factors to achieving purpose, low stress, and connections. Translation to Health Education Practice Barriers (isolation and disruption) were salient during the pandemic. However, direct human interactions mattered in promoting belonging, having a sense of purpose, and reducing stress. Technologies should also be promoted as a necessary alternative in periods like COVID-19, to help communities and senior residents feel engaged and less lonely. Likewise, hobbies, and the resilience of local residents should be highlighted as sources of inspiration to promote healthy lifestyle practices that achieve low stress levels, good relationships, and a sense of purpose.

Integrating 3D Technology in Sculpture Courses: Challenges, Strategies, and Recommendations

The integration of 3D technology into sculpture courses presented both opportunities and challenges for students and educators alike. This research investigated the current landscape, challenges, strategies, and recommendations associated with incorporating 3D technology in sculptural courses. Through a comprehensive review and analysis, key challenges emerged, including the complexity of technology, inadequate educational resources, varying levels of instructor expertise, and practical issues such as equipment maintenance and material properties. These challenges highlighted the need for targeted interventions to enhance educational effectiveness and accessibility. Strategies proposed included curriculum enhancements to integrate 3D technology, professional development programs for educators, improvements in technology interfaces, and collaborations between industry and academia. These strategies aimed to address identified challenges and optimize learning experiences in sculpture courses. Recommendations emphasized the development of centralized educational platforms, increased funding for 3D research, advocacy for regulatory standards, and the establishment of peer learning networks. These initiatives sought to foster a supportive environment conducive to innovation and creativity in sculptural arts education. By addressing these technological complexities, enhancing educational resources, improving instructor proficiency, and overcoming practical barriers, this study advocated for a comprehensive approach to integrating 3D technology effectively into sculpture courses, ultimately empowering students and educators to use their full potential in artistic expression and professional practice.

Trust Development Between Speech-Language Pathologists and Laryngologists: A Thematic Analysis

ObjectivesSpeech language pathologists (SLPs) and laryngologists often work closely in interdisciplinary settings evaluating and treating patients with voice, swallowing, and airway disorders. This collaboration is integral to providing optimum patient care. We theorize that trust is an essential component of this relationship and contributes to effective patient care and professional satisfaction. There is currently no literature that explores the development and role of trust in this unique interprofessional relationship. We aim to explore the SLP and laryngologist interprofessional relationship and the development and role of trust in that relationship. Study DesignQualitative Realist Thematic Analysis MethodsThematic analysis of semi-structured qualitative interviews was performed to explore the relationship between SLPs and laryngologists. Through purposive sampling from November 2022 – January 2023, we recruited SLPs (n=10) and laryngologists (n=10) from 12 centers with varying years of practice, practice setting (academic or private), geographic location, and team structures. ResultsTrust between SLPs and laryngologists is comprised of confidence in 1) ability (clinical judgment, technical skill), 2) benevolence, and 3) integrity. Trust formation is enhanced by frequency and quality of communication, physical proximity, and reduction of practical barriers (scheduling, billing, departmental structure). Role negotiation was not identified as a factor. The presence of all three components of trust contributes to job satisfaction, perceptions of patient experience and care outcomes, and the willingness to collaborate in academic areas beyond clinical care. ConclusionsAll three elements (ability, benevolence, integrity) must be present for trust in an interprofessional relationship between SLPs and laryngologists, and formation of trust is facilitated by robust communication, physical proximity, and reduction of practical barriers to collaboration. The lack of these elements and lack of trust between the two professions can negatively impact collaboration, job satisfaction, and patient care outcomes, contributing to inefficiencies in patient care.

청년희망키움통장 사업 참여 경험이 있는 생계 급여 수급 근로 빈곤 청년의 정서적 자립과 경제적 자립 간의 관계 검증을 통한 자립 과정에 대한 탐구

The purpose of this study is to explore the relationship between emotional independence and economic independence among young adults receiving livelihood support in South Korea. Emotional independence is a concept composed of hope and barriers related to labor and employment, involving a process of increasing hope and overcoming obstacles. This research conceptualizes economic independence as transitioning from livelihood support to regular employment and examines the relationships between employment barriers, employment hope, labor in regular jobs, and the transition from livelihood support using structural equation modeling with a sample of 417 young adults receiving livelihood support. The results indicate that hope serves as a mediator between employment barriers and the transition from livelihood support. The findings highlight the importance of overcoming practical and psychological employment barriers and fostering employment-related hope, including recognizing one's own worth and abilities, being motivated by future prospects, setting goals related to work, and utilizing skills and resources to achieve these goals, for low-income young adults to achieve economic independence through the transition from livelihood support. The study's results extend the understanding of independence by revealing the importance of enhancing emotional capacities in the process of economic independence for low-income young adults. Furthermore, it is expected that these findings will stimulate related research and contribute to the development of a more multidimensional and integrated support system in South Korea's youth-related policies, moving beyond a focus on support for employment, housing, and education to support various aspects of young adults' lives, including entrepreneurship.

"I Did Not Want to Make a Bigger Deal Out of It than It Was": A Mixed-Method Study on the Help-Seeking Behavior of Victims of Image-Based Sexual Harassment and Abuse.

Experiencing image-based sexual harassment and abuse (IBSHA), or the sending of unsolicited nude or sexual images and the nonconsensual taking, sharing, or threats to share nude or sexual images, may have severe consequences for victims' well-being. While seeking help may be beneficial, not every victim seeks help. Little research has been conducted on IBSHA victims' help-seeking behavior. Therefore, the present mixed-method study examined the help-seeking behavior of IBSHA victims, particularly the barriers and facilitators to seeking help. The study used data from an online survey (N = 163) and interviews (N = 6) among 12-to-25-year-old victims. The quantitative data indicated that the majority of victims disclosed the incident (72.8%), but only a third received help (34.4%). Help-seekers reported greater experienced barriers to help-seeking, when compared to non-help-seekers. The experienced barriers positively predicted victims' reported help-seeking behavior. From the qualitative data, four types of barriers were identified: (a) individual barriers (e.g., feelings of shame), (b) practical barriers (e.g., affordability of help), (c) interpersonal barriers (e.g., fear of negative reactions from one's social environment), and (d) sociocultural barriers (e.g., normalization of IBSHA). Moreover, two types of facilitators were identified: (a) individual facilitators (e.g., the impact of victimization) and (b) interpersonal facilitators (e.g., social support). This suggests victims experience multiple barriers, which altogether can influence their help-seeking behavior. As a help-seeking trajectory is complex and unique to the individual, victims may encounter multiple new hurdles along the way. This may explain why help-seekers reported more barriers. The findings and corresponding implications highlight the importance of providing education on IBSHA and help-seeking on various levels in society.

Effect of women empowerment on treatment seeking practice for sexually transmitted infections among women in Ethiopia

BackgroundSexually transmitted infections (STI) are public health problems in Ethiopia. Women have a higher chance of acquiring STI. STI complications are more severe in women compared to men. Despite that, treatment seeking for STI among women is poor. Woman empowerment and gender related factors may be playing a role for treatment seeking practice for STI. However, there are no studies that assess the association between these factors and treatment seeking practice for STI among married reproductive age women in Ethiopia. Therefore, this analysis was designed to explore this association in Ethiopia.MethodsThis analysis used the 2016 Ethiopian demographic and health survey (EDHS) data. The 2016 EDHS collected data about STI treatment seeking practice for STI among other variables. Data was analyzed using STATA 17.0. Sampling weights were applied to improve the representativeness of the samples. Descriptive statistics were computed to describe the characteristics of the women. Binary and multivariable logistic regression models were fitted to identify the association between treatment seeking practice for STI and predictor variables. Multicollinearity was checked using variance inflation factors before running the multivariable logistic regression.ResultsIn this study, about 28% (95%CI: 20.87, 36.77) married reproductive age women with STI or STI symptoms sought treatment from the formal sector. Women whose husband attended secondary and higher education (AOR, 8.52; 95%CI 1.42, 51.21), and women with higher women empowerment scores (AOR 1.38, 95%CI 1.06, 1.81) had higher odds of treatment seeking for STI or STI symptoms. On the other hand, women who believe wife beating is justified had lower odds (AOR 0.32; 95%CI 0.15, 0.68) of treatment seeking for STI or STI symptoms.ConclusionsTreatment seeking practice for STI among married reproductive age women in Ethiopia is low. The Ministry of Health and development partners shall conduct further research to identify barriers for treatment seeking practice. Gender variables (women empowerment and belief that wife beating is justified) were significantly associated with STI treatment seeking practice among married reproductive age women. STI prevention and control strategies shall include women empowerment and gender issues as essential component in STI prevention, treatment, and control activities.

The Case for Assessing the Drivers of Measles Vaccine Uptake.

Global measles cases are on the rise following disruptions to routine immunisation programs during the COVID-19 pandemic, with devastating consequences. According to the World Health Organization, the behavioural and social drivers of vaccination include what people think and feel about vaccines, social processes, motivation to vaccinate and practical barriers to vaccination. However, the drivers of measles vaccine uptake are not necessarily the same as those for other childhood vaccines, and we lack data on how these drivers specifically have changed during and since the COVID-19 pandemic. Without accurately measuring the behavioural and social drivers for measles vaccination, and ideally measuring them serially over time, countries cannot design, target and implement interventions that effectively increase and sustain measles vaccine coverage. This paper outlines what is and is not known about the behavioural and social drivers of measles vaccination and provides recommendations for improving their post-pandemic assessment.

Bioplastics: No solution to healthcare's plastic pollution problem.

As Canadian policy-makers recognize the urgency for concerted actions to reduce plastics (e.g., Canada's involvement in the international plastics treaty negotiations, zero plastic waste strategy, and single-use plastics regulations), the healthcare sector must also consider a more sustainable plastics system. In this context, the potential for novel bioplastics to mitigate healthcare's substantial plastic waste problem must be carefully interrogated. Our analysis examines the complexities of bioplastics, highlighting the technical challenges of identifying legitimate sustainable alternatives, and the practical barriers for implementing bioplastics as substitutes for consumable plastics in healthcare. We focus on the Canadian healthcare sector and regulatory landscape with the insights gained being applicable to other sectors and countries. Given the limitations identified, the focus on reducing consumption should remain the priority.

Prophylactic somatostatin analogs for postoperative pancreatic fistulas: a cross-sectional survey of AHPBA surgeons

BackgroundPostoperative pancreatic fistulas lead to substantially increased morbidity, mortality, and healthcare costs after pancreatectomy. Studies have reported conflicting data on the role of prophylactic somatostatin analogs in the reduction of postoperative pancreatic fistula. Current practice patterns, surgeon beliefs, and barriers to using these drugs in the Americas is not known. MethodsAn online 26-question cross-sectional survey was distributed via email to the members of the Americas Hepato-Pancreato-Biliary Association in April 2023. ResultsOne hundred and two surgeons responded in spring 2023. 48.0% of respondents reported using prophylactic SSAs during their surgical training, however, only 29.4% do so in their current practice, most commonly when performing Whipple procedures. Octreotide was the most frequently used SSA (34.3%), followed by octreotide LAR (12.7%) and pasireotide (11.8%). Reasons for not prescribing included a lack of high-quality data (62.7%), perception of limited efficacy (34.3%) and high cost (30.4%). ConclusionThese results highlight key areas for future study including understanding surgeon rationale for patient and drug selection. Variable practice patterns amongst surgeons also underscore the importance of generalizability in the design of future clinical trials in order to maximize impact.

The “Team Tree” Professional Tree of Life intervention: development and evaluation within the acute inpatient psychiatric setting

PurposeMental health staff often experience significant levels of stress working in the acute psychiatric inpatient setting. Team-building interventions can mitigate stress in health-care settings, via improvements in team-cohesion, staff interactions and communication skills. The “Tree of Life” (ToL) is a specific narrative therapy approach which uses the metaphor of a tree to facilitate the construction and sharing of strength-based stories. This study aims to describe the development of and evaluate the feasibility, acceptability and staff experiences of the “Team Tree”, an adapted Professional ToL (PToL) intervention.Design/methodology/approachA one-hour, Professional ToL intervention was designed for multidisciplinary acute inpatient staff teams working within a psychiatric hospital in London, UK. A mixed methods approach was used to evaluate the feasibility, acceptability and staff experiences of the session.FindingsParticipants were 46 multidisciplinary staff (33 women; 13 men) working across four acute psychiatric wards. The intervention was feasible to deliver and was acceptable to participants. Results showed significant improvements in self-reported mental well-being and team-cohesiveness scores post-session.Practical implicationsPsychologists face myriad barriers in working with staff teams in the acute inpatient setting. The “Team Tree” intervention was both well received by staff and practical to deliver within the challenging environment of the acute ward.Originality/valueThis adaptation of the original PToL emerged from the author’s work with distressed inpatient teams with limited time resources. To the best of the authors’ knowledge, this is the first description of this intervention using a single tree metaphor to facilitate a reflective and creative session with health-care teams.

Identifying and Exploring the Cognitive Nature of Threshold Concepts in Pharmacology to Improve Medical Students’ Learning

Phenomenon: Pharmacology is a fundamental healthcare discipline, but it can be difficult and counterintuitive for learners to learn. Navigation toward understanding pharmacology can be troublesome, but once the threshold to comprehension is crossed, learners can experience a transformative shift in their ways of thinking and practicing. We conducted an in-depth examination of threshold concepts within pharmacology, aiming to identify and prioritize their learning to improve the medical curriculum and enhance medical treatment and patient safety. Approach: We carried out a consensus generation process using the Nominal Group Technique (NGT) to identify potential threshold concepts in pharmacology. Participant groups of pharmacology experts and medical students considered, identified, reviewed, and ranked potential pharmacology threshold concepts within their own group. Then, using a logical, step-by-step approach, we combined the final ranked data from these multiple NGT sessions. We further analyzed these data using an abductive analysis approach; data were coded, categorized, reorganized, and conceptually mapped after critical evaluation. Conceptual themes were established corresponding to different phases of cognitive schema development. Findings: Six comprehensive conceptual themes were identified: Drug Mechanism of Action; Pharmacotherapeutics; Pharmacokinetics; Drug Receptor Interactions; Drug Terminology and Nomenclature; and Signaling Pathways. These concepts align with many of the key attributes of threshold concepts (e.g., troublesome, integrative and transformative). The cognitive schematic themes generated were (i) acquisition-troublesome; (ii) acquisition-transformative; (iii) automation-troublesome; (iv) automation-transformative. Insights: Transformative learning involves different stages of cognitive schema evolution, including acquisition, elaboration, and automation, and is influenced by both the inherent challenges of the concepts and limitations of human cognition. The high interactivity of these troublesome concepts challenge schema acquisition and automation. Troublesome concepts underpinning procedures or skills, while not easily explained by cognitive rules, can lead to slow, awkward, error-prone performance, creating additional barriers for practice. Integrating concepts into a coherent structure leads to the irreversible assimilation of knowledge and the transferability of both knowledge and skills, influencing learners’ epistemological transitions and ontological transformations at theoretical and professional levels. Further work on designing instructional models around assisting and automating schemas around identified troublesome knowledge, while addressing the impact of cognitive load, has the potential to promote transformational learning.

Accelerated musculoskeletal magnetic resonance imaging with deep learning-based image reconstruction at 0.55 T-3 T

Magnetic resonance imaging (MRI) is acentral component of musculoskeletal imaging. However, long image acquisition times can pose practical barriers in clinical practice. MRI is the established modality of choice in the diagnostic workup of injuries and diseases of the musculoskeletal system due to its high spatial resolution, excellent signal-to-noise ratio (SNR), and unparalleled soft tissue contrast. Continuous advances in hardware and software technology over the last few decades have enabled four-fold acceleration of 2D turbo-spin-echo (TSE) without compromising image quality or diagnostic performance. The recent clinical introduction of deep learning (DL)-based image reconstruction algorithms helps to minimize further the interdependency between SNR, spatial resolution and image acquisition time and allows the use of higher acceleration factors. The combined use of advanced acceleration techniques and DL-based image reconstruction holds enormous potential to maximize efficiency, patient comfort, access, and value of musculoskeletal MRI while maintaining excellent diagnostic accuracy. Accelerated MRI with DL-based image reconstruction has rapidly found its way into clinical practice and proven to be of added value. Furthermore, recent investigations suggest that the potential of this technology does not yet appear to be fully harvested. Deep learning-reconstructed fast musculoskeletal MRI examinations can be reliably used for diagnostic work-up and follow-up of musculoskeletal pathologies in clinical practice.

Relationships among age, motivation, and exercise among women Veterans

Physical activity (PA) and exercise are central to maintaining health, however research has shown steep declines in PA and exercise among women Veterans as they age. Though motivation may be an important contributor to initiating and sustaining exercise that may change across the lifespan, little is known about exercise motivation and its relation to age and exercise behavior among women Veterans. This cross-sectional study sought to describe exercise motivations, examine relationships among exercise motivations and age, and explore the degree to which age and motivation predict self-reported exercise behavior among women Veterans. We conducted a secondary data analysis from a regional mail survey of 197 women Veterans (mean age = 51; SD = 10.5) enrolled in Veterans Health Administration primary care in a northeastern region (N = 180 in analysis). Measures included demographics (age, body mass index), self-reported exercise motivation, and an estimate of average weekly exercise. Participants endorsed multiple motivators for exercise, most prominently fitness and health management. Age was significantly negatively related to amount of exercise and with socializing as an exercise motivation. After accounting for body mass index, age was a significant predictor of exercise behavior, and exercise motivations accounted for an additional 7.3% of variance in self-reported weekly exercise. Our results suggest that although motivation is a potentially important predictor of exercise, factors beyond motivation may better predict exercise in women Veterans. Further research is needed on personal and practical facilitators and barriers to exercise in this population.

Determining factors and barriers to the uptake of climate change adaptation strategies of agriculture and aquaculture farm households in Myanmar

PurposeClimate change is an undeniable reality that threatens people’s livelihoods. Flooding and saltwater intrusion, along with the rising sea levels, are affecting agricultural and aquaculture livelihoods in Myanmar’s coastal areas. Although climate change adaptation is gaining popularity as a resilience strategy to cope with the negative effects of climate change, both agriculture- and aquaculture-farmers are more often deterred from implementing climate change adaptation strategies due to practical availability and socioeconomic barriers to adaptation. This study aims to evaluate the barriers and factors that influence farm household’ choice of climate change adaptation measures.Design/methodology/approachThis study was conducted with 599 farm households (484 rice-farmers and 115 fish farmers) based in the coastal areas of Myanmar during 2021–2022 to explore the farmer’s choice of climate change adaptation measures and the determining factors. The multinomial logit regression (MLR) model was used to examine the factors influencing the farmers’ choice of climate change adaptation strategies.FindingsThe study found out that farm households use a variety of adaptation methods at the farm level, with building embankment strategy (23.4%) in agriculture and net-fencing measure (33.9%) in fish farming being the most popular adaptation strategies. Farmers’ decisions to adopt climate change adaptation strategies are influenced by factors such as distance to market, education level of the household head, remittance income and the availability of early warning information, among others. The study also discovered that COVID-19 has had an impact on the employment opportunities of household members and the income from farming as well had a consequential effect on the adoption of climate change adaptation measures. Furthermore, lack of credit (42.4%), labor shortage (52.8%), pest and disease infestation (58.9%), high input costs (81%) and lower agricultural product prices (73%) were identified as major barriers to the adoption of climate change adaptation measures by both agriculture and aquaculture farm households.Originality/valueThis study demonstrates that the COVID-19 pandemic and farm-level barriers are the major factors influencing farm households’ choice of climate change adaptation measures, and that removing practical farm-level barriers and encouraging the adoption of adaptation techniques as potential COVID-19 recovery actions are required. This study also highlighted that the adaptive capacity of agriculture and aquaculture farm households should be strengthened through formal and informal training programs, awareness raising, the exchange of early warning information and the development of proper credit scheme programs.