Prominent Barriers Research Articles

Barriers to Green Financing in Developing Nation: An Investor’s Perspective for Promoting Sustainable Development

Green financing plays a pivotal role in addressing environmental challenges and fostering sustainable development, particularly in emerging economies. However, its adoption is often hindered by systemic barriers. This study examines the barriers to green financing in Nepal, focusing on four critical factors: the incapability of banks and financial institutions (BFIs), limited accessibility, political constraints, and public perception. Using a quantitative, cross-sectional survey design, data were collected from 228 investors across Nepal’s Kathmandu Valley. Statistical analyses, including correlation and regression, reveal that all four factors significantly influence investor participation in green financing, with political constraints and accessibility emerging as the most prominent barriers. The findings highlight a considerable communication gap, insufficient institutional capacity, and weak policy support as key obstacles. This study underscores the need for enhanced public awareness, institutional capacity building, and supportive regulatory frameworks to overcome these challenges. By addressing these barriers, Nepal can unlock the potential of green financing, advancing its sustainability goals and economic resilience. The research contributes valuable insights to the growing body of literature on green finance, offering actionable implications for policymakers, financial institutions, and investors in similar emerging markets.Green financing plays a pivotal role in addressing environmental challenges and fostering sustainable development, particularly in emerging economies. However, its adoption is often hindered by systemic barriers. This study examines the barriers to green financing in Nepal, focusing on four critical factors: the incapability of banks and financial institutions (BFIs), limited accessibility, political constraints, and public perception. Using a quantitative, cross-sectional survey design, data were collected from 228 investors across Nepal’s Kathmandu Valley. Statistical analyses, including correlation and regression, reveal that all four factors significantly influence investor participation in green financing, with political constraints and accessibility emerging as the most prominent barriers. The findings highlight a considerable communication gap, insufficient institutional capacity, and weak policy support as key obstacles. This study underscores the need for enhanced public awareness, institutional capacity building, and supportive regulatory frameworks to overcome these challenges. By addressing these barriers, Nepal can unlock the potential of green financing, advancing its sustainability goals and economic resilience. The research contributes valuable insights to the growing body of literature on green finance, offering actionable implications for policymakers, financial institutions, and investors in similar emerging markets.Green financing plays a pivotal role in addressing environmental challenges and fostering sustainable development, particularly in emerging economies. However, its adoption is often hindered by systemic barriers. This study examines the barriers to green financing in Nepal, focusing on four critical factors: the incapability of banks and financial institutions (BFIs), limited accessibility, political constraints, and public perception. Using a quantitative, cross-sectional survey design, data were collected from 228 investors across Nepal’s Kathmandu Valley. Statistical analyses, including correlation and regression, reveal that all four factors significantly influence investor participation in green financing, with political constraints and accessibility emerging as the most prominent barriers. The findings highlight a considerable communication gap, insufficient institutional capacity, and weak policy support as key obstacles. This study underscores the need for enhanced public awareness, institutional capacity building, and supportive regulatory frameworks to overcome these challenges. By addressing these barriers, Nepal can unlock the potential of green financing, advancing its sustainability goals and economic resilience. The research contributes valuable insights to the growing body of literature on green finance, offering actionable implications for policymakers, financial institutions, and investors in similar emerging markets.Green financing plays a pivotal role in addressing environmental challenges and fostering sustainable development, particularly in emerging economies. However, its adoption is often hindered by systemic barriers. This study examines the barriers to green financing in Nepal, focusing on four critical factors: the incapability of banks and financial institutions (BFIs), limited accessibility, political constraints, and public perception. Using a quantitative, cross-sectional survey design, data were collected from 228 investors across Nepal’s Kathmandu Valley. Statistical analyses, including correlation and regression, reveal that all four factors significantly influence investor participation in green financing, with political constraints and accessibility emerging as the most prominent barriers. The findings highlight a considerable communication gap, insufficient institutional capacity, and weak policy support as key obstacles. This study underscores the need for enhanced public awareness, institutional capacity building, and supportive regulatory frameworks to overcome these challenges. By addressing these barriers, Nepal can unlock the potential of green financing, advancing its sustainability goals and economic resilience. The research contributes valuable insights to the growing body of literature on green finance, offering actionable implications for policymakers, financial institutions, and investors in similar emerging markets.

Awareness of Lean Construction Concepts in the Construction Industry of the UAE

Question: Could a lack of awareness be the main obstacle to the adoption of Lean construction in the U.A.E.? Purpose: This research aims to investigate the extent of familiarity with lean construction principles and tools among engineers in the construction industry of the U.A.E and determine whether this lack of awareness is the major barrier to the implementation of lean construction practices in the U.A.E. Research Method: The paper employs a comprehensive literature review, quantitative surveys, and a qualitative case study among the engineers in the construction industry of the U.A.E. Findings: The study found that while many engineers were unfamiliar with the specific terminologies of LC concepts, they demonstrated an understanding of the underlying principles. This suggests that lack of awareness may not be a significant barrier, especially considering the increasing awareness among recent graduates. Additionally, when implementing LC into a firm, challenges such as resistance to change and lack of motivation were identified as more prominent barriers than lack of awareness. Limitations: The paper is based on 136 survey respondents and a single case study in a consultancy firm in the U.A.E, and future studies should seek to build on and refine the findings presented here. Implications: While the engineers in the study exhibited awareness, it would be presumptuous to generalize this finding to the entire industry. Value for authors: The study underscores that challenges in LC adoption can vary based on multiple factors therefore it is important to thoroughly assess the root causes of the barriers rather than opting for generic solutions. Keywords: Lean construction, Lean practices, Lean tools, Barriers, Awareness. Paper type: Full Paper

Evaluating the Paucity of Female Surgeons in Plastic Surgery: A Review of the Systemic Barriers to Entry and Success.

The percentage of practicing female plastic surgeons in the United States is notably low. This narrative review sought to identify prominent barriers affecting women's entry and success in plastic surgery. A literature search was conducted using the National Library of Medicine from 2013 to 2023, using MeSH terms of gender disparity and plastic surgery. Included publications were peer-reviewed articles and systematic reviews evaluating gender disparity in plastic surgery, examining experiences, challenges, or opportunities for female plastic surgeons. Excluded publications did not include data gathered from the United States, included other minorities, or did not focus on plastic surgery. Overall, 191 papers were identified, with 14 papers being selected for this review. Early barriers identified before residency training include the lack of female mentors and the underrepresentation of female presenters at national plastic surgery conferences, with females comprising only 29% of presenters and 16% of abstract senior authors at national plastic surgery conferences between 2014 and 2015. During residency training, the most prominent barrier is pregnancy, with 73% of women delaying childbearing during residency and only 39% of men reporting the same. A second barrier during training includes gender disparity in the number of research publications, with females publishing 8.89 ± 0.97 publications during residency and males publishing 12.46 ± 1.08 publications (p = 0.0394). After residency training, evidence of barriers to career advancement includes poor representation of women in higher academic positions, such as program chairs and directors, with female representation of 9.2% and 13.1%, respectively, and gender disparity in industry payments. Systemic barriers before, during, and after plastic surgery residency training seem to influence the representation of women in plastic surgery at all levels. These barriers should be addressed to increase the number of practicing female plastic surgeons and diversify the field.

Eyes on communication: strategies to facilitate uptake of clinical practice guidelines for implementation of eye-gaze control technology by people with cerebral palsy. A mixed methods study

Guidelines for implementation of eye-gaze control technology by people with cerebral palsy were published in 2021. The purpose of this study was to identify barriers and facilitators clinicians perceive exist relating to use of these guidelines for eye-gaze control technology, and to explore potential resources that may be developed to support their implementation. A two-phased mixed methods explanatory sequential design was adopted. In phase 1, an online survey containing quantitative and open-ended questions was completed by 97 health professionals and in phase 2 two online focus groups of five clinicians were conducted. The guidelines for eye-gaze control technology were considered helpful for clinicians new to eye-gaze control technology, useful to provide insight into processes for implementing eye-gaze control technology, were flexible, supported clinical reasoning and professional credibility, and were easy to use. However, time to read the guidelines for eye-gaze control technology, and insufficient funding for time to implement the technology were prominent barriers identified in this study. Through the qualitative findings four themes emerged: (1) Complexity of learning to use and implement the guidelines for eye-gaze control technology; (2) Time and resources in short supply; (3) Takes a dedicated team working together; and (4) guidelines for eye-gaze control technology informing practice. Participants in both study phases identified: case studies and video examples; education and training; and practice in implementing eye-gaze control technology, as facilitators to aligning their practice with the guidelines for eye-gaze control technology recommendations and to optimise outcomes.

IAPSM’s Position Paper on the Human Papilloma Virus (HPV) Vaccine for Adult Immunization in India

Cervical cancer ranks as the second most common cancer in women in India, primarily caused by persistent infection with the human papillomavirus (HPV). Given its long latent period, secondary prevention through screening and early detection is essential. However, fear and stigma associated with cancers and the costs involved in disease management are the prominent barriers to its uptake. HPV vaccination is one of the vital components of the World Health Organization’s (WHO) Global Strategy to speed up the elimination of cervical cancer as a public health problem. In India, four prophylactic HPV vaccines are currently available. These vaccines are non-infective and highly immunogenic, safe, and effective when administered before HPV exposure. According to WHO recommendations, the primary target group for HPV vaccination consists of girls between the ages of 9 and 14 years. Further, studies have confirmed that both single-dose and two-dose schedules of the HPV vaccine offer comparable efficacy and protection. HPV vaccines are administered intramuscularly in the deltoid region, with 0.5 ml as the standard dose. These vaccines may cause local reactions, as well as mild systemic reactions, such as headache and myalgia, but they are transient. Implementing catch-up vaccination for adolescent girls aged between 9 and 14 years at the time of HPV vaccine introduction would be a cost-effective and sustainable strategy. This would serve as a crucial component of public health efforts to manage HPV infections and eliminate cervical cancer in India.

Potential barriers and windows of opportunity for transboundary marine management in the sulu-sulawesi seascape: A policy analysis

Transboundary conservation aims to facilitate environmental conservation and management at the ecosystem level through the cooperation of two or more countries operating across political boundaries. Though there is increased interest and advocation for transboundary conservation initiatives around the world, there remains limited understanding of how to best support their success through coordinated policies. This is especially true for marine resources and seascapes, where management efforts are often more difficult and complicated to implement. This study addresses these key gaps through a policy analysis focusing on the Sulu-Sulawesi Seascape as a case study. Indonesian, Malaysian, and Philippine policies related to fisheries, coastal zones and marine protected areas, and environmental quality were examined to explore their similarities and differences across various policy elements important to facilitating more consistent and collaborative management across scales. Assessing policy alignment and disparateness may help highlight potentially prominent barriers to and opportunities for transboundary coordination that would be beneficial to acknowledge and address in future planning. The analyses focused on elements such as the policies’ authorities, restrictions, enforcement, and participation opportunities, among others. Analysis results emphasize that policies and management within Sulu-Sulawesi could benefit from greater adaptability to diverse community needs, participatory processes, and governance integration and standardization. These findings contribute to gaps in knowledge regarding how policy alignment may impact transboundary conservation and may help inform the best practices for increasing the social and environmental success of transboundary conservation initiatives in Sulu-Sulawesi and other transboundary marine systems.

Diabetes Control and Clinical Outcomes among Children Attending a Regional Paediatric Diabetes Service in Australia.

Australian children with diabetes commonly struggle to achieve optimal glycaemic control, with minimal improvement observed over the past decade. The scarcity of research in the rural and regional Australian context is concerning, given high incidence rates and prominent barriers to healthcare access in these areas. We conducted a retrospective audit of 60 children attending a regional Australian paediatric diabetes service between January 2020 and December 2023. The majority of patients had type 1 diabetes (n = 57, 95.0%); approximately equal numbers were managed with continuous subcutaneous insulin infusion (CSII) pumps vs. multiple daily injections (MDIs), whilst 88.3% (n = 53) also utilised continuous glucose monitoring (CGM). The mean age at last visit was 14.0 years (SD, 3.4), mean diabetes duration 5.8 years (SD, 4.6), and mean HbA1c level 8.1% (65.3 mmol/mol); only 36.8% achieved the national target of 7.5% (58 mmol/mol). Mean BMI-SDS was 0.8 (SD, 1.0); almost half (n = 27, 45.0%) were overweight or obese. Many patients had mental health conditions (31.7%), which were associated with higher hospitalisation rates (p = 0.007). The attendance rate was 83.2%, with a mean of 3.3 clinic visits per year (SD, 0.7); higher attendance rates were associated with increased CGM sensor usage (r = 0.395, p = 0.007 Overall, the diabetes service performed similarly to other clinics with regards to glycaemic control. Whilst achieving treatment targets and addressing comorbidities remains a challenge, the decent attendance and the high uptake of healthcare technologies is commendable. Further efforts are needed to improve diabetes management for this regional community.

Barriers and enablers to effective weight management for people living with overweight and obesity: A rapid scoping review.

A scoping review was conducted to identify barriers and enablers to effective weight management in healthcare settings for people living with overweight and obesity in English-speaking high-income countries. Peer-reviewed and gray literature were systematically searched in June 2024. Data were analyzed using inductive thematic analysis. Of the 15,684 unique articles identified and screened for relevance, 216 studies were included. Healthcare-related barriers and enablers to weight management were organized under three themes: a) healthcare provider-related factors, b) provision of care, and c) policy/funding. Prominent barriers included healthcare provider knowledge deficits and low prioritization of obesity management, mainly in the primary care setting. Weight management beyond the primary care setting was found to be especially challenging, with poor referral pathways, service fragmentation, lack of multidisciplinary practice, and restricted eligibility criteria, hindering the accessibility of services. Developing consistent policies and guidelines, improving the education of healthcare providers, and increasing funding to provide low-cost comprehensive care, were identified as enablers to access and uptake of weight management services. Considerable overlap in the identified barriers existed across healthcare providers and settings. A whole health system approach to minimize barriers and strengthen enablers to weight management services is needed, to address rising obesity rates.

A three-phase framework for mapping barriers to blockchain adoption in sustainable supply chain

PurposeBlockchain technology is one of the major contributors to supply chain sustainability because of its inherent features. However, its adoption rate is relatively low due to reasons such as the diverse barriers impeding blockchain adoption. The purpose of this study is to identify blockchain adoption barriers in sustainable supply chain and uncovers their interrelationships.Design/methodology/approachA three-phase framework that combines machine learning (ML) classifiers, BORUTA feature selection algorithm, and Grey-DEMATEL method. From the literature review, 26 potential barriers were identified and evaluated through the performance of ML models with accuracy and f-score.FindingsThe findings reveal that feature selection algorithm detected 15 prominent barriers, and random forest (RF) classifier performed with the highest accuracy and f-score. Moreover, the performance of the RF increased by 2.38% accuracy and 2.19% f-score after removing irrelevant barriers, confirming the validity of feature selection algorithm. An RF classifier ranked the prominent barriers and according to ranking, financial constraints, immaturity, security, knowledge and expertise, and cultural differences resided at the top of the list. Furthermore, a Grey-DEMATEL method is employed to expose interrelationships between prominent barriers and to provide an overview of the cause-and-effect group.Practical implicationsThe outcome of this study can help industry practitioners develop new strategies and plans for blockchain adoption in sustainable supply chains.Originality/valueThe research on the adoption of blockchain technology in sustainable supply chains is still evolving. This study contributes to the ongoing debate by exploring how practitioners and decision-makers adopt blockchain technology, developing strategies and plans in the process.

Identifying the zero-dose and under-immunized children in Bangladesh: Approaches and experiences.

This paper presents and elaborates on empirical methods and approaches used to identify Zero-Dose (ZD) and Under-immunized (UI) children as well as the communities that these children reside in within Bangladesh. This paper also describes demand- and supply side-barriers that lead to children being ZD and UI in the country. Time period for the study was December 2022-May 2023. The study methodology encompassed secondary data analysis using data from national surveys, primary data collection and analysis via a lot quality assurance sampling (LQAS) survey and also, qualitative data collection and analysis. Study population included caregivers of children aged 4.5 months (4 months 15 days) to 23 months for the LQAS survey. The qualitative component included policymakers, program managers and service providers working in immunization as well as mothers in the selected study areas who had a living child aged less than 2 years as the study population. Our data analysis confirms existence of ZD and UI children in areas which were categorized into haor (wetlands), hilly, char (sandy/silty land surrounded by water), coastal, plain land and urban slums. Determinant analysis showed that the mother's level of education, antenatal visits made, and access to media were significantly associated with children being ZD or UI. Reproductive autonomy emerged as a key factor that had prominent impact on a child being ZD. The qualitative analysis indicated the importance of population migration, health workforce shortages and lack of access to transportation as prominent barriers to immunization. Notably, the methods and approaches used in this study are both effective and easily replicable to identify ZD and UI children. The drivers of ZD and UI along with the barriers to immunization provide potential areas for intervention by policy-makers and can apprise about interventions to be tested in future implementation research.

Identifying Motivators, Facilitators, and Barriers to Engagement and Retention in Anal Cancer Screening Among Men and Women with HIV in One Ryan White HIV/AIDS Clinic.

Anal squamous cell carcinoma disproportionally affects people with HIV (PWH); however, engagement in anal cancer screening is low in many settings. This study was conducted to assess knowledge and perceptions of anal cancer screening to identify factors in the engagement and retention in prevention services among PWH. Semistructured interviews were conducted among adult PWH eligible for anal cancer screening in our Ryan White HIV/AIDS Program clinic. Descriptive statistics were tabulated; thematic analyses were performed to identify emerging motivators, facilitators, and barriers. Among 26 PWH, 9 had not been screened, 8 had undergone Papanicolaou (Pap) testing alone, and 9 had undergone anoscopy. The median age of the cohort was 55.2 years; 54% identified as men who have sex with men, and 54% identified as Black. In the unscreened cohort, participants were motivated by investing in their health and positive attitudes toward cancer prevention however were deterred by a lack of referral and low awareness about screening. Among those who had Pap testing, trust in healthcare providers and abnormal testing results were motivators to engagement, whereas lack of perceived risk of anal cancer and worry about pain of an anoscopy were prominent barriers. Among those who had anoscopy, perceived risk, positive experience with the procedure, and use of anxiolytics prior to anoscopy were motivators, whereas anxiety around a new cancer diagnosis and negative experience with anoscopy were barriers. Clinics seeking to build or strengthen their anal cancer screening programs can address the barriers described in this study to promote access to anal cancer screening among PWH.

Female Leaders in Lebanese Private Schools: Perceptions, Barriers and Leadership Characteristics

Globally females are underrepresented in leadership positions. In academic settings, despite the majority of teachers being females, there is no equal representation between the two genders when it comes to leadership. The trend remains that females teach and males manage. This is discriminatory and unfair, especially when female leaders have an advantage over male leaders in school settings. If females are more effective in academic leadership positions, why aren’t they provided with equal leadership opportunities? This paper uncovers the perceptions surrounding female leaders and their ability to lead, the barriers that forbid females from advancing to leadership positions, and the predominant leadership characteristics viewed in each gender. By surveying female and male teachers from Lebanese private schools in the district of Mount Lebanon, this paper indicates that female leaders are surrounded with positive perceptions, but are, however, prevented from advancing to leadership positions by several challenges. The two most prominent barriers to female leadership are found to be related to organizational discrimination, and societal pressures. Moreover, the predominant leadership characteristics visible in each gender are confirmed by this study. Similar to studies about the situation of female leaders in other Arab countries, this research reveals a growing acceptance for female leaders in Lebanese private schools, despite the presence of challenging barriers. By uncovering the current situation of Lebanese female leaders in private schools, this study helps pave the path for much needed solutions in terms of gender equality and equity.

Revision of the genera of Scolodontidae, part 2: Guestieria Crosse, 1872, Xenodiscula Pilsbry, 1919, and a misidentified planorbid

Currently, there are many issues with genus-level taxa within the Scolodontidae. This is the second paper in a series which aims to resolve the most prominent issues. Here, we highlight some of the more poorly known, smaller, discoid genera: Guestieria Crosse, 1872 and Xenodiscula Pilsbry, 1919. Guestieria is characterized by its small to medium-sized shell (2–18 mm), without or with only faint sculpture, and with a covered apex and closed umbilicus. Its known geographic distribution is confined to Andean countries and Brazil. Xenodiscula is small (up to 1.6 mm), discoid, and with prominent apertural barriers not seen in other scolodontids. Its known geographic distribution included all of the Amazon rainforest, the Tumbes-Chocó-Magdalena hotspot, and mainland Central America. We also discuss the enigmatic Guestieria shuttleworthi (L. Pfeiffer, 1851), which we show is a junior synonym of the planorbid freshwater snail Drepanotrema anatinum (d’Orbigny, 1835).

Effect of structured nurse-patient conversation on preventing falls among patients in an acute care hospital: A mixed study

ObjectivesInpatient falls are a major patient safety issue in acute care hospitals. Multifactorial in-hospital fall prevention programs have shown reductions in falls and related risks. One common element of successful programs is active patient involvement. This study objective was to explore patients’ and nurses’ experiences with a structured intervention to foster patient involvement. MethodsThis study was conducted between September 2020 and April 2021 in a university hospital neurological ward. The studied intervention consisted of a falls information leaflet, and a structured nurse-patient conversation about fall risk-reduction activities. Nurses were trained to deliver the intervention and supported throughout the study. Nurses’ and patients’ experiences regarding personal involvement, satisfaction, and confidence were surveyed and analyzed quantitatively and qualitatively. ResultsFifty-six patients recruited by ward nurses received the intervention. After receiving the intervention, patients reported high levels of satisfaction with the in-hospital fall prevention conversation. Twenty-one nurses indicated that they would use the leaflet and communication aid. Twenty-one nurses commented on intervention facilitators and barriers. More specific facilitators included their shared perception that “handing out the leaflet to patients was not problematic” and that the leaflet was seen as “applicable in many patient situations.” Their comments indicated two particularly prominent barriers to conducting the intervention in clinical practice: 1) “finding the time for the implementation in the daily clinical routine and workload” and 2) “environmental factors like a noisy and busy atmosphere on the ward.” ConclusionsThis study provides insights into a patient involvement intervention featuring a structured nurse-patient discussion about fall risks. The accompanying information leaflet and communication guide require adaptations to facilitate sustainable implementation into the hospital’s fall prevention program, but proved useful.

BIM IMPLEMENTATION FOR HERITAGE RENOVATION THROUGHOUT PROJECT LIFECYCLE: CURRENT USE, BENEFITS, AND BARRIERS

Introduction: Building Information Modeling (BIM) has garnered significant attention due to advancements in sophisticated technologies and methods. However, a comprehensive review of the existing literature indicates a lack of research exploring the application of BIM in managing the entire intervention design and renovation processes from a broader system perspective. The purpose of the study was to fill this gap by identifying and evaluating the current utilization, benefits, and barriers associated with implementing BIM in the lifecycle of renovation projects. The study methodology is based on conducting 31 structured interviews with experienced professionals who have employed BIM in their project deliveries. The results reveal that the primary benefits of BIM adoption, in descending order of importance, pertain to improved collective understanding of design intent, lower risk and better predictability of outcomes, better-designed and performing buildings, more accurate project documentation, and increased accuracy of the cost estimate. However, there are several prominent barriers: project budget, complexity of modeling historic structures, cost to hire BIM professionals, and the lack of BIM knowledge. The findings will advance BIM adoption for heritage renovation and enable project stakeholders to focus on realizing the benefits and potential uses of lifecycle BIM, while also addressing the critical challenges discussed in this study.

Translation, Cultural Adaptation of the Portuguese Provider Attitudes toward Cardiac Rehabilitation and Referral (PACRR-P) Scale and Assessment of Its’ Measurement Properties

Background/Objectives: Access to cardiac rehabilitation (CR) is contingent upon physician referrals, yet these are often inadequate, particularly in low-resource settings. This multi-method study aimed to translate, culturally adapt, and validate the Portuguese version of the Provider Attitudes toward CR and Referral (PACRR-P) scale, as well as to identify key factors influencing CR referral in a Latin American context for the first time. Methods: The PACRR was translated into Brazilian Portuguese through a rigorous process involving independent translation, back-translation, and expert panel review to ensure face, content, and cross-cultural validity. A total of 44 Brazilian physicians completed the questionnaire, allowing for an assessment of internal consistency, criterion validity, and convergent validity. Results: The findings confirmed the face, content, and cultural validity of the 20 translated items, with a mean item clarity rating of 4.8/5. The final version included 17 of the original 19 PACRR-P items, with a Cronbach’s alpha of 0.73. Referral rates were significantly associated with over one-third of the PACRR-P items, preliminarily supporting the scale’s criterion validity, while correlations with the ReCaRe scores further supported its convergent validity. The most prominent barriers to referral were a lack of familiarity with CR site locations, absence of a standard referral form, and lack of automatic referral processes. Conclusions: The PACRR’s validity and reliability among Portuguese-speaking providers are preliminarily supported.

Barriers in reporting adverse effects of medical devices: a literature review.

Medical devices play an essential role in the delivery of healthcare but its use is not entirely risk free. There are several instances where it causes mortality or morbidity among users. It is important to evaluate the risks involved at every stage of its application to bring improvement in the standard of healthcare. For the purpose Materiovigilance Program of India was launched on July 6, 2015. Despite these efforts, available data suggests that reporting of adverse events is very low. The present study aims to identify barriers that influence the reporting of adverse events of medical devices and outline a strategy to overcome these barriers. Systemic review method has been adopted to achieve these ends. Thirty-one papers have been selected based on the inclusion criteria related to objective of the study. Lack of awareness, attitude, and resources are found to be major barriers at the individual level for not reporting adverse effects of medical devices. The organizational factors such as hierarchical set up, lack of time and incentives, and furthermore lack of industry responsiveness have been identified as prominent barriers to the reporting of adverse events. In order to improve the reporting level, it is important to make access and contact easier with the reporting system. Engaging healthcare professionals at various levels by acknowledging and appreciating their contribution. The adverse events of medical devices should not be restricted to physicians; only rather other health care professional such as nurses, pharmacists, and technicians should also be encouraged to report any adverse event of medical devices.

Using Implementation Science in Surgical Care: A Scoping Review.

Improvement of surgical care is dependent upon evidence-based practices (EBPs), policies, procedures, and innovations. The objective of this study was to understand and synthesize the use of implementation science (IS) in surgical care. This article summarizes the existing literature to identify the frequency and types of EBPs selected for surgical care, IS frameworks that guided the published research, and prominent facilitators and barriers. A modified version of the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews Checklist were used to provide the guidance and standards to conduct this scoping review. We queried: Ovid MEDLINE; American Psychological Association PsycINFO; Embase; Cumulated Index to Nursing and Allied Health Literature; Web of Science; and Google Scholar for manuscripts published January 2001 - June 2023. The initial search found 3,674 citations of which 129 met inclusion criteria. The heterogeneity and volume of innovations within the surgical IS field were vast. The most frequent innovations were in peri-operative care, safety in surgery, and Enhanced Recovery After Surgery. Six constructs were identified as both major facilitators and barriers: support from leadership; surgeon and staff knowledge regarding EBPs; relationship/team building; environmental context; data; and resources. Identifying these implementation factors used in the surgical field enables us to determine variables that support and inhibit the adoption and implementation of new practices, support practice change, enhance quality and equity of surgical care, and identify research gaps for future IS in surgical care.

Exploring the barriers and enablers of industrial solutions in renovation projects: a mixed-methods study in the finnish AEC industry

Offsite construction is a major approach to promote industrialisation in construction. However, implementation of prevailing industrial solutions is often less adequate and unsatisfactory, especially in renovation projects. Thus, the overall objective of this study is to understand the reasons behind the poor performance in implementation of the industrial solutions. The specific objectives include identifying the prominent barriers and enablers of prefabricated products in renovation projects. This study employed exploratory sequential mixed method. The qualitative data were gathered via semi-structured interviews to collect experiences and perception of experts related to industrial solutions. This was followed by quantitative data collection via questionnaire survey using a seven-point Likert scale. The major barriers and enablers of industrial solutions in renovation projects have been ranked in this study. The findings reveal that immutability of heritage buildings, the tolerances of old buildings and insufficient spaces to ensure construction work ranked the top three barriers for implementing industrial solutions in renovation projects. Moreover, the study identifies the most significant enablers including shorter project schedules, quality improvement and work safety improvement. The novelty of the research lies in the comprehensive presentation of the barriers and enablers of industrial solutions in the renovation project context. Policymakers, designers, and contractors can utilize these findings as guiding principles to enhance decision-making processes and create viable solutions for the obstacles encountered in renovation projects. This study further represents a vital step towards the efficient and effective implementation of industrial solutions in renovation projects, resulting in more sustainable and cost-effective outcomes.

Evaluating the barriers of blockchain adoption in the Australian logistics industry

ABSTRACT Blockchain technology holds the potential to revolutionise the logistics industry by sharing tamper-proof information in a decentralised manner, building trust among parties. However, adoption in the Australian logistics industry lags behind other sectors. This study uses fuzzy DEMATEL to investigate barriers to blockchain adoption, identifying thirteen key barriers within the technology-organisation-environment (TOE) framework. Cost of investment and integration difficulties among partners are the most prominent barriers, particularly within organisational contexts. The findings offer a theoretical foundation and practical insights for overcoming barriers and successfully implementing blockchain in logistics.