Sustainable Strategies Research Articles

Eco-friendly treatment: a win-win for patients, health systems, and the planet. Rapid scoping review

Abstract Background As the fifth-largest CO2 emitter globally, the healthcare industry must act to mitigate its environmental impact. This includes de-implementing low-value care and adopting eco-friendly innovative treatment alternatives. Our study aims to explore existing research on the environmental effects of these actions and the outcome measures utilized. Methods We conducted a rapid scoping review following a pre-published protocol, searching Ovid MEDLINE® and Scopus (Elsevier) from January 2015 to June 19, 2023. Initially, dual abstract and full-text screening was performed, followed by a single review. Data extraction was cross-checked by a second reviewer. Findings were narratively described using summary statistics. Results We analyzed 182 articles, primarily life cycle assessments and modeling studies (92 out of 182), with only one study being a randomized controlled trial. The research covered various healthcare practices, including consultation methods/telemedicine (32%), surgical and medical device usage (26%), medication (25%), surgical procedures (19%), as well as diagnostic tests, screening, and imaging (13%). The main sustainability strategies mentioned were ‘Rethink’ (99%) and ‘Reduce’ (81%), with ‘Reuse’ (32%), ‘Recycle’ (19%), and ‘Refuse’ (10%) being less utilized. Environmental outcomes reported included global warming (88%), resource consumption (27%), and chemical hazards (23%). Most studies were conducted in Europe (48%), followed by the USA (37%), with 75% published after 2020. Conclusions The environmental impact of healthcare is a pivotal area for public health action and fortunately, it is also emerging as a significant research field. Utilizing methodological approaches less common in evidence-based healthcare research underscores the necessity for innovative interdisciplinary collaboration and capacity building. The most pressing research gap lies in the impact of de-implementation strategies (“refuse”) targeting low-value care practices. Key messages • Measuring the environmental impact of healthcare demands the development of novel cross-disciplinary research methods and collaborations. • De-implementing low-value care represents a future win-win scenario for patients, the financial viability of healthcare systems, and global environmental sustainability.

Evaluation of Managerial Economics Applications Strategy using the SPSS Method

Managerial Economics is an economy branch is, this economic theory and size using methods solve real-world managerial problems. It helps businesses and organizations make informed decisions by using economic analysis. Here are some common applications of managerial economics: Demand Analysis and Forecasting: Businesses use managerial economics to understand consumer behavior and forecast future demand for their products or services. This involves studying factors that affect demand, such as price, income levels, and consumer preferences. Production and Cost Analysis: Managerial economics helps businesses optimize production processes and minimize costs. It involves analyzing production functions, cost structures, and economies of scale to determine the most efficient way to produce goods or services. Pricing Strategies: A product or the right price for the service It is up to a company to decide Crucial to profitability. Managerial economics helps businesses set prices by considering factors like production costs, competition, and consumer willingness to pay. Market Structure Analysis: Understanding the type of market, a company operates in (e.g., perfect competition, monopoly, oligopoly) is essential for making strategic decisions. Managerial economics helps analyses market structures and determine appropriate strategies for each. Risk and Uncertainty Analysis: Businesses often face uncertainty in various aspects, such as demand fluctuations, production costs, and market conditions. Managerial economics provides tools to assess and manage risks, including techniques like decision tree analysis and expected value calculations. Capital Budgeting and Investment Analysis: Managerial economics assists in evaluating investment opportunities and capital projects. It involves methods Payback period analysis of investments. Regulatory and Government Policy Analysis: Managerial economics helps businesses understand and navigate government regulations and policies that affect their operations. This can include areas like taxation, environmental regulations, and trade policies. Strategic Planning: Using economic analysis, businesses can develop long-term strategies for growth and sustainability. This may involve assessing market trends, competitive dynamics, and potential expansion opportunities. Game Theory and Competitive Strategy: Managerial economics incorporates game theory to analyze strategic interactions between competitors. It helps businesses formulate optimal strategies in competitive environments. Resource Allocation: Efficient allocation of resources, including labor, capital, and technology, is crucial for a company's success. Managerial economics provides tools to distribute funds in a manner that optimisesoverall productivity and profitability. Demand Analysis and Forecasting, Production and Cost Analysis, Pricing Strategies, Market Structure Analysis, Risk and Uncertainty Analysis, Capital Budgeting and Investment Analysis and Regulatory and Government Policy Analysis. The Cranach’s Alpha Reliability result. The overall Cranach’s Alpha value for the model is .744 which indicates 74% reliability. From the literature review, the above 50% Cranach’s Alpha value model can be considered for analysis.

CAPTURE—Computational Analysis and Predictive Techniques for Urban Resource Efficiency

ABSTRACTMunicipal waste management (MWM) poses significant challenges in the context of rapid urbanisation and population growth. Accurate forecasting of waste production is crucial for designing sustainable waste management strategies. However, traditional forecasting methods often struggle to capture the complexities of waste generation dynamics. This paper proposes a novel methodology leveraging deep learning techniques to forecast municipal waste production. By harnessing the power of deep neural networks, our approach transcends the limitations of conventional models, providing more accurate and impactful predictions. We integrate heterogeneous data sources, including demographic and territorial information, into a comprehensive graph representation of municipalities. Graph Neural Networks are then employed to extract intricate spatial and temporal patterns from the graph structure. Empirical validation through a case study in the Apulia region demonstrates the effectiveness of our methodology in furnishing accurate forecasts for waste production. Our framework is adaptable and scalable, making it suitable for application across diverse geographical areas. This research contributes to advancing waste management practices by providing stakeholders with actionable insights for informed decision‐making.

Enhancing Sustainable Tourism in Medan through Heritage-Based Development

This study aims to analyze the strategies for developing heritage tourism in Medan, focusing on the Kesawan area as a key destination. The research utilizes SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats), which helps identify the internal and external potential in the development of heritage tourism in the city. The results show that Kesawan’s strengths lie in its historical, cultural, and architectural value, as well as its strategic location, making it an attractive tourist destination. However, the weaknesses identified include inadequate infrastructure, limited human resources, and insufficient funding. Opportunities include the growing trend of cultural tourism and government support for heritage development. Nevertheless, threats such as uncontrolled urbanization, climate change, and economic pressures require particular attention in managing the area. The integration of heritage aspects in the city’s tourism master plan is progressing well, with the Medan City Tourism Development Master Plan (RIPPARKOT) outlining sustainable development strategies and policies. This study recommends improving infrastructure, enhancing human resources, and adopting effective marketing strategies to support sustainable heritage tourism development. Proper management could position Kesawan as a premier heritage tourism destination, contributing to the local economy.

Carbonic Anhydrase-Mediated Phosphogypsum Degradation and Enhanced CO2 Sequestration: A Promising Sustainable Strategy for Biological Resource Utilization of Phosphogypsum.

This study continues our previous investigation of the intrinsic degradation of phosphogypsum (PG) by indigenous microorganisms on amending adequate nutrients. We aim to unravel the intricate mechanisms involved in PG biotransformation by a bacterial consortium. We isolated and characterised seven multi-metal-resistant bacterial strains from a nutrient-amended PG-contaminated microcosm and identified them through 16S rRNA gene sequencing. Primarily aerobic, gram-positive chemolithotrophs, these strains demonstrated significant heavy metal (HM) uptake and PG degradation potential.Further analysis revealed that all strains produced carbonic anhydrase (CA), while six also produced urease, which may facilitate microbial-induced carbonate precipitation (MICP). Microstructural and elemental analysis using SEM-EDX and XRD confirmed the PG bio-transformation, indicating substantial increases in carbonate concentrations and reductions in sulfate levels. The consortium, composed of seven urease and CA-producing bacterial strains, effectively degraded PG, transforming it from an acidic to an alkaline state and significantly enhancing CO2 sequestration.

Investing in green, sustaining the planet: The role of fintech in promoting corporate green investment in the Chinese energy industry

In recent years, fintech has rapidly developed on a global scale, bringing about significant transformations across various industries. Particularly in the energy sector, the potential of fintech to promote corporate green investment has increasingly become a focus. As the energy industry accounts for a significant proportion of global greenhouse gas emissions, guiding companies in implementing green investment has become an important issue for environmental protection and sustainable development. However, previous studies have rarely systematically investigated the influence of fintech on corporate green investment in the energy industry and the mechanisms involved. Hence, this study aims to bridge this research gap within the context of China. By utilizing valid survey data from 466 corporations in the Chinese energy industry and the method of structural equation modeling, the results indicate that: (1) Fintech can promote corporate green investment in the energy industry. (2) Fintech can promote corporate data-driven decision-making capability, information transparency, and sustainable development strategy. (3) Data-driven decision-making capability, information transparency, and sustainable development strategy can also promote corporate green investment in the energy industry. (4) Mediation analysis reveals that data-driven decision-making capability, information transparency, and sustainable development strategy each play a mediating role in the impact of fintech on corporate green investment. (5) Comparative analysis of the mediation effects indicates that there is a certain degree of difference among these three variables’ mediating effects, but it did not reach a statistically significant level. This study provides rich insights for business practices, encouraging companies to strengthen their focus on green investment in the fintech era and offer guidance and recommendations to relevant stakeholders, thereby providing practical guidance for corporate green transformation and sustainable development. Finally, this research also contributes to policy development and optimization.

Systematic Review on Sustainable Intensification Strategies in Brazilian Beef Production

Objective: To analyze studies on sustainable intensification strategies in beef production in Brazil, focusing on carbon neutralization and sustainable practices. Theoretical Framework: Addresses the relationship between livestock and environmental impacts such as deforestation and greenhouse gas emissions. It explores alternatives for pasture recovery and optimized management. Method: The Web of Science and Scopus databases were used to identify and select studies. Strict inclusion and exclusion criteria were applied to choose 31 relevant articles, which were used to systematize current knowledge. The PRISMA Protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used for the systematic literature review. The PRISMA 2020 Flow Diagram serves as a support tool for researchers in organizing the essential steps to conduct the systematic review. Results and Discussion: The studies highlight the importance of strategies such as sustainable intensification and crop-livestock-forest integration to mitigate environmental impacts. They reveal the evolution of the terms used and the importance of public policies and technologies to mitigate emissions and promote more sustainable practices. Research Implications: Contributes to the formulation of sustainable policies and practices, reinforcing the need for integrated approaches that consider economic and environmental factors in beef production. Originality/Value: Provides an updated and critical synthesis on the topic of sustainable beef and carbon neutralization, indicating gaps and opportunities for future research and policy interventions.

Carbon Neutral Strategies in the Case of Google Inc: A Case Study of Carbon Offset Mechanisms and Renewable Energy Projects

Abstract: Facing the serious challenge of global climate change, Google Inc. has adopted a series of innovative strategies to reduce its carbon footprint and promote corporate sustainability. This paper provides an in-depth analysis of how Google reduces carbon emissions and promotes sustainable development through a series of innovative measures, including large-scale investment in renewable energy, improving data center efficiency, implementing carbon offset projects, and promoting technological innovation in the field of transportation. These actions demonstrate Google's commitment to environmental protection and provide a model for other companies to follow. The study evaluated the economic feasibility and environmental benefits of Google's strategies through a cost-benefit analysis. The results show that despite technical challenges and market uncertainty, Google's environmental investments can bring significant economic benefits in the long term while having a positive impact on the environment. These strategies help Google achieve its carbon neutrality goals and provide momentum for the global transition to a low-carbon economy. In addition, the study emphasizes the importance of socio-cultural factors in promoting environmental strategies. Google has raised public awareness of climate change and enhanced social support for environmental actions through community involvement and educational programs. These findings reveal the need for companies to adopt environmental protection measures in the context of globalization and provide practical guidance for other organizations to implement sustainable development strategies.

Exploring the Interaction and Impact of Green Building Design on People and Space

Abstract: With the progress and development of society, people's living standards improve at the same time, environmental pollution and resource shortages environmental problems also come. Construction engineering is one of the largest energy-consuming industries in China, and the implementation of a sustainable development strategy has become a top priority. Therefore, the state put forward the concept of greening and sustainable development, and green building has become a mainstream design concept. The purpose of this paper is to elaborate on the principles and design points of green building design and to study and discuss the application cases of green building design. Analyze the interaction and impact of green building design on people and space by analyzing the effects and impacts of the implementation of different designs in green building design cases, including focusing on siting design, ventilation design, energy efficiency design, recyclable design, plant design, and lighting design. Summarise the importance of applying green building design concepts and effective designs that have a positive impact on people. The results of the study can provide practical suggestions on improving the sustainability and eco-friendliness of green buildings for green building design stakeholders, such as architects, policymakers, and related stakeholders, and this study has certain reference values and significance.

Analysis of implementation science strategies to train laparoscopic surgical skills among Liberian surgeons using ALL-SAFE.

Significant disparities exist in laparoscopic training opportunities for surgeons in low- and middle-income countries (LMICs). ALL-SAFE is an innovative, low-cost training system for LMIC surgeons' laparoscopic development. However, strategies to implement and scale ALL-SAFE are unstudied. We aimed to assess the impact of implementation science strategies on ALL-SAFE uptake in Liberia, a novel and low-resource context. This study used implementation science approaches to evaluate ALL-SAFE uptake in three Liberian hospitals: John F. Kennedy Medical Center, Phebe, and ELWA. Five validated implementation strategies of program orientation, local champions, network weaving, feedback mechanisms, and practical supervision were piloted. All five strategies were implemented at two hospitals, while four strategies, excluding clinician supervision, were implemented at the final site as a pseudo-control, to evaluate the impact of resource-intensive supervision. Participants included surgical consultants, residents, and medical students. Engagement was assessed with mixed methods including participant number, practice hours, module completion rates, and strategy feasibility through end-user interviews. Across three hospitals, 33 participants used ALL-SAFE for 87.8 total training hours (5,268min). Participant numbers varied across sites (NJFK = 20, 80%; NPhebe = 7, 88%; NELWA = 6, 86%), as did practice times (TotalJFK = 3,060min, Median time/ParticipantJFK = 103min; TotalPhebe = 1,434min, Median time/ParticipantPhebe = 126min; TotalELWA = 774min, Median time/ParticipantELWA = 100min). Sites with practical supervision demonstrated higher engagement than those without (P = 0.042). Interviews (n = 8) revealed positive perceptions toward program orientation, practical supervision, and network weaving. Participants recommended thirteen additional strategies for sustainability including translating ALL-SAFE skills to patient care. Our study is one of the first to evaluate implementation science strategies for laparoscopic training in sub-Saharan Africa. The implementation bundles of five validated strategies were considered feasible by Liberian surgeons in both urban and rural hospitals. Mixed methods suggested a positive association between engagement and the resource-intensive practical supervision strategy. Future studies should focus on quantifying individual strategy contributions with rigorous implementation designs and assessing sustainability strategies.

Fruit and vegetable waste as a raw material for obtaining functional antioxidants and their applications: A review of a sustainable strategy

AbstractThe growing concern about environmental sustainability and increasing fruit and vegetable waste (FVW) generation have stimulated research into their potential valorization. This paper explores using this type of waste to obtain beneficial antioxidants in various fields of study. It is imperative to delve into the problems associated with FVW, shedding light on the staggering amounts generated and the environmental and economic challenges of waste disposal. The biochemical composition of FVW reveals the diverse array of components present, such as carbohydrates, proteins, lipids, vitamins, minerals, and of course antioxidants, which can be obtained through different extraction methods, depending on the conditions, the efficiency and the purpose that is required during the process of separation of these compounds from the organic matter. Antioxidants are compounds that can neutralize free radicals, which contributes to combating various conditions and diseases to promote and preserve human health. Several groups of antioxidants have been described, such as polyphenolic compounds in significant amounts in plant biomass as FVW. These antioxidants demonstrate benefits, efficacy and potential applications in industries like medicine, cosmetics, pharmaceuticals and functional foods. The valorization of FVW as a source of antioxidants presents a promising avenue for sustainable waste management and the production of natural antioxidants. This approach contributes to environmental preservation and promotes circular economy principles by transforming waste into valuable resources. This paper provides valuable insights into the vast potential of FVW valorization for antioxidant production and its application across diverse industries.

Degradation of Decabromodiphenyl Ether Dispersed in Poly (Acrylo-Butadiene-Styrene) Using a Rotatory Laboratory Pilot Under UV-Visible Irradiation

The growing volume of plastics derived from electronic waste (e-waste) underscores the imperative for environmentally sustainable strategies for the management of this waste. In light of the paramount importance of this issue, a pilot demonstrator for the decontamination of polymers containing Brominated Flame Retardants (BFRs) has been developed. The objective is to investigate the potential for decontaminating BFR-containing polymers from e-waste via UV-visible irradiation using a rotatory laboratory pilot operating under primary vacuum conditions. This report focuses on binary model blends composed of 90 weight% (wt%) poly(Acrylo-Butadiene-Styrene) (ABS) pellets and 10 wt% Deca-Bromo-Diphenyl Ether (DBDE), which is one of the most toxic BFRs. The efficiency of the irradiation process was evaluated as a function of pellet diameter and irradiation time using Fourier Transform InfraRed spectroscopy (FTIR) and High-Resolution Laser Desorption/Ionization Mass Spectroscopy (HR-LDI-MS). As a consequence, ABS + DBDE achieved a decontamination efficiency of 97% when irradiated with pellets of less than 1 mm in diameter for a period of 4 h. Additionally, the thermal behavior of the irradiated samples was investigated through thermogravimetric analysis and differential scanning calorimetry. It was thus established that the application of UV-visible irradiation had no significant impact on the overall thermal properties of ABS.

The Identification of Problems in Creating Sustainable Organisations in Ghana

Organisations have been implementing strategies in their business to enhance the continuity of their operations. The emerging issues related to environmental and social problems have made organisations implement sustainability strategies in their business activities. The purpose of the study is to identify the problems in building sustainable organisations, and to make recommendations that will improve sustainable organisations. The article consists of three main parts. The first is the theoretical part, which analyses the challenges relating to sustainability implementations. The second involves the research methodology, which combined both quantitative and qualitative methods in the study. The third part of the research focuses on empirical analysis and evaluation. The findings reveal problems relating to an organisation’s inability to reward and motivate employees’ work or activities done, a lack of local funding associated with environmentally friendly materials, and a lack of economic development sustainability policies. The research concludes with recommendations for the effective building of a sustainable organisation.

Effect of surface charge on mechano-bactericidal activity of cellulose nanocrystals constructed chevaux-de-frise and meat preservation

The nanostructured insect wings have inspired the development of antimicrobial surfaces with mechano-bactericidal activity. For the first time, a chevaux-de-frise-like nanostructure was fabricated through the coating of cellulose nanocrystals (CNC) onto regenerated cellulose (RC) films via vacuum filtration and the impact of contact time, temperature, and surface topography on eliminating foodborne bacteria was examined. Herein, our focus is to explore in more detail how the surface charge of CNC affects the mechano-bactericidal activity and the performance of chevaux-de-frise-like nanostructure in meat preservation. CNC with neutral (weak), negative, and positive charges were prepared by hydrochloric acid hydrolysis (HCNC), TEMPO oxidation (TCNC), and amination (ACNC), respectively, and showed similar reinforcing effects on the tensile strength (increased from 74.23 ± 1.20 to about 100 MPa) and water vapor barrier property (reduced from 1.83 ± 0.08 to about 1.20 × 10−7 g m−1 h−1 Pa−1). Among them, RC-ACNC showed the highest log reduction against Escherichia coli (0.83 ± 0.06) and Staphylococcus aureus (0.69 ± 0.04) after 5 min contact, respectively, indicating the important role of attractive force in fast eliminating bacteria upon contact. It was worth noting that, during the meat preservation test, all three CNC-coated RC films exhibited a similar 0.4 log reduction of bacteria after day 4, likely due to the same physical attachment with an extended contact time. Therefore, the construction of chevaux-de-frise nanostructure from CNC on food packaging provides a sustainable strategy to contribute to preventing bacterial growth.

Molecular interactions of Trichoderma: from microbial competition to soil health promotion

The increasing demand for sustainable solutions to agricultural pest and disease management has positioned Trichoderma fungi as a promising biological control agent. Trichoderma is not only capable of suppressing various plant pathogens but also promotes plant growth and strengthens natural plant defenses. This mini-review explores the molecular mechanisms underlying Trichoderma's ability to function as a biocontrol agent, focusing on nutrient competition, antibiotic production, mycoparasitism, and the induction of plant resistance. Additionally, advances in genomics and transcriptomics have facilitated a deeper understanding of the signaling pathways and genes responsible for Trichoderma's biocontrol effectiveness, including G-protein and MAPK pathways. Beyond pathogen suppression, Trichoderma plays a key role in enhancing soil health and establishing symbiotic relationships with plants, contributing to improved nutrient absorption and growth hormone production. However, challenges remain in translating laboratory success to large-scale field applications. This mini review highlights the need for further research on optimizing Trichoderma formulations, understanding its interaction with other beneficial soil organisms, and exploring genetic engineering to enhance its biocontrol capabilities. The future of Trichoderma lies in its integration into holistic, agroecological systems alongside other sustainable pest management strategies.

Sustainable and Recyclable Acrylate Resins for Liquid-Crystal Display 3D Printing Based on Lipoic Acid.

The development of renewable vinyl-based photopolymer resins offers a promising solution to reducing the environmental impact associated with 3D printed materials. This study introduces a bifunctional lipoate cross-linker containing a dynamic disulfide bond, which is combined with acrylic monomers (n-butyl acrylate) and conventional photoinitiators to develop photopolymer resins that are compatible with commercial stereolithography 3D printing. The incorporation of disulfide bonds within the polymer network's backbone imparts the 3D printed objects with self-healing capabilities and complete degradability. Remarkably, the degraded resin can be fully recycled and reused for high-resolution reprinting of complex structures while preserving mechanical properties that are comparable to the original material. This proof-of-concept study not only presents a sustainable strategy for advancing acrylate-based 3D printing materials, but also introduces a novel approach for fabricating fully recyclable 3D-printed structures. This method paves the way for reducing the environmental impact while enhancing material reusability, offering significant potential for the development of eco-friendly additive manufacturing.

Knowledge and perceptions towards organic farming: a case of pineapple farmers in central Uganda

This study examined the knowledge and perceptions as well as factors that influence the knowledge and perceptions of pineapple farmers towards organic farming in Uganda. Through multi-stage sampling procedures, purposive and random techniques were applied at different stages to select participants from both Luwero and Kayunga districts in central Uganda. Data was collected using a semi-structured questionnaire. A composite index for knowledge and perceptions was computed for each respondent and subjected to descriptive statistics while the censored Tobit regression model was used to determine factors that influenced farmers’ knowledge and perceptions of organic farming. Results showed that both organic and non-organic farmers had a high level of knowledge and favorable perceptions towards organic farming with no significant difference. Perceived environmental and economic benefits of organic farming did not significantly differ (p > 0.05) among organic and non-organic farmers. However, mean scores for perceived health and nutritional (4.30 vs. 3.94) benefits, and access to markets (4.10 vs. 3.89) differed significantly (p < 0.05) between organic and non-organic farmers. There was a positive and significant relationship between knowledge and perception of organic farming among non-organic farmers while for organic farmers, a significant and negative relationship was observed. Factors that significantly influenced farmers’ knowledge were information sources and farmers’ experiences. Farmer perceptions were influenced by education, information sources, group membership and extension services. Therefore, to enhance the adoption and growth of organic pineapple production in Uganda, policymakers and promoters should consider these factors when designing policy documents and sustainability strategies for the development of organic agriculture.

Economic geography’s contribution to understanding the circular economy

Abstract This article explores the role of evolutionary economic geography in enhancing understanding and implementation of the circular economy (CE). By incorporating spatial and territorial dimensions into CE research, this study emphasizes the significant influence of geographical factors on achieving economic and environmental objectives. The research highlights the importance of localizing CE practices and emphasizes the contributions of proximity theory and territorial governance in promoting collaborative networks that are crucial for CE success. Furthermore, the article introduces the concept of Territorial Circular Ecosystems, which provides a framework for analyzing regional variations and the interplay between local actors, resources, and institutional support in the deployment of the CE. The findings offer fresh insights for policymakers and researchers, advocating for place-based policies to address CE challenges and optimize sustainability strategies.

Sustainable logistics development strategy based on SWOT and analytic hierarchy process.

Due to the implementation of sustainable green development strategy, the study uses the competitive situation method and analytical hierarchy process of logistics enterprises to conduct structural analysis and weight calculation of factor indicators for their development strategies. Afterwards, the exponential smoothing prediction method was used to weight the logistics data. Moreover, through comparative analysis of the indicator evaluation system, the average weights of the advantageous factors of logistics enterprises were found to be 0.0232, 0.1102, 0.0522, and 0.0468, respectively. The energy consumption, transportation volume, and turnover of logistics transportation increased by 68.9% and 52.3% in 2022, respectively, which had a significant impact on the sustainable development of the logistics industry. It has been demonstrated that a sustainable logistics development strategy based on the enterprise competitive situation method and the analytic hierarchy process is both feasible and superior. Furthermore, this strategy has the potential to enhance the environmental benefits and green development of the economy and society.

Telehealth Outreach Program for Child Traumatic Stress: Strategies for Long-Term Sustainability

Background: There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based behavioral health therapy for children. The delivery of TF-CBT via telehealth can decrease access to care barriers. An interdisciplinary clinical team developed a training program to guide clinicians to effectively provide TF-CBT via telehealth. The goal of this study was to describe variation in implementation processes of the telehealth TF-CBT program and identify barriers and facilitators to program implementation post-training, which were utilized to develop implementation strategies for intervention sustainability. Methods: Using a mixed-methods approach, data were collected on telehealth implementation processes and facilitators and barriers to the delivery of telehealth TF-CBT. This study was guided by an adapted implementation science framework, namely the Exploration, Preparation, Implementation, Sustainment model. Interviews and surveys were completed with clinical site leaders who had participated in the telehealth TF-CBT training. Results: Throughout clinical sites, there was varied adoption and penetration of the telehealth TF-CBT program. Facilitators to implementation included leadership and site staff buy in, community needs, and training resources, while barriers included funding, available logistical resources, and child and family involvement. Conclusions: The feedback gained from this project assisted in the development of implementation strategies for increased adoption and sustainment of TF-CBT delivered via telehealth. Strategies include ongoing interactive assistance and resource support, enhanced training for stakeholders, and program adaptations, with the goal to increase access to quality mental health care for underserved populations.