Sustainable Implementation Research Articles

The sustainability of group empowerment and training for people with diabetes in South Africa.

Group empowerment and training (GREAT) for people with type 2 diabetes enables self-management and lifestyle modification. GREAT for diabetes was implemented in primary care facilities in five South African provinces in the beginning of 2022. The aim was to evaluate implementation and to particularly explore factors that influenced the sustainability of implementation. An exploratory, descriptive qualitative study conducted semi-structured individual interviews with 17 key stakeholders at the end of 2023. Interviews explored factors within a theory of change framework derived from an initial evaluation in 2022. Data were analysed using the framework method and ATLAS.ti. Implementation and scale-up was sustained in the Western Cape. Governance and financing at a provincial and district level were key to health system structures. Space, staffing, resource materials and monitoring of implementation were key to the inputs. Facility managers, training and performance of facilitators, including the whole team, selecting patients, patient flow and appointments, stakeholder support and clinical governance were key to service delivery. Facilities that had implemented, reported reaching 300 patients per year. A range of motivational, behavioural and clinical outcomes were reported. Future implementation could include community health workers and group empowerment for insulin initiation. Implementation and scale-up was only sustained in one province and a range of factors related to sustained implementation were identified.Contribution:The factors identified can guide the successful implementation and scale-up of GREAT for diabetes in South Africa.

Influencing factors of hypertension and diabetes care cascade: a qualitative study

Objective: Employing the cascade care model, this qualitative study explores determinants influencing the cascading care stages of hypertension and diabetes by interviewing various stakeholders. Methods: In July 2023, purposive sampling was employed to recruit participants from Gongyi and Wugang cities in Henan Province, and Linqu County in Weifang City, Shandong Province. Semi-structured in-depth interviews were conducted with representatives of policymakers, healthcare institution managers, providers, and patients with hypertension and diabetes.And thematic analysis was performed using both inductive and deductive approaches. Results: A total of 82 individuals were interviewed, with an age range of (53.8±12.0) years, among which 48 (58.5%) were male; including 5 policymakers, 10 institutional managers, 20 healthcare providers, and 47 patients with hypertension and diabetes. The study identified both barriers and facilitating factors at the patient, healthcare provider, and system levels across various stages: awareness, screening, diagnosis, treatment, long-term management, and control of hypertension and diabetes. Conclusion: By delineating and analyzing the barriers and facilitators at each stage of hypertension and diabetes care, this study lays the groundwork for the development of effective, feasible, and sustainable implementation pathways, with significant implications for the enhanced management of hypertension and diabetes in China.

The Impact of AI in Sustainable Development Goal Implementation: A Delphi Study

Artificial intelligence emerges as a powerful catalyst poised to reshape the global sustainability landscape by facilitating the attainment of Sustainable Development Goals (SDGs). This comprehensive Delphi study meticulously probes the insights of domain experts, shedding light on the strategic utilization of AI to advance these critical sustainability objectives. Employing rigorous statistical techniques, encompassing measures of central tendency and interquartile deviation, this research scrutinizes consensus dynamics among experts and elucidates potential variations in their viewpoints. The findings resoundingly convey experts’ collective positive perspective regarding AI’s pivotal role in propelling the SDGs forward. Through two iterative rounds of extensive discussions, a compelling consensus crystallizes—AI indeed exerts an overall positive impact, exemplified by a robust mean score of 78.8%. Intriguingly, distinct SDGs manifest varied propensities toward AI intervention, with Goals 6, 7, 8, 9, 11, 13, 14, and 15 basking in the radiance of highly positive impacts. Goals 1, 2, 3, 4, 5, 10, and 12 exhibit positive impact scores, indicating a juncture ripe for positive advancements. Meanwhile, Goal 16 and Goal 17 languish with neutral scores, signifying a juncture demanding nuanced deliberations about AI’s impact on peace, justice, and strong institutions as well as on partnerships for the goals, respectively. This paper underscores AI as a formidable instrument poised to address humanity’s most pressing challenges while harmonizing seamlessly with the overarching SDG objectives. It gracefully dovetails into established practices across pivotal domains such as health, education, and resilient infrastructures, amplifying the collective global endeavor to navigate the path toward a more sustainable future.

Perspectives on telehealth implementation in Australia: An exploratory qualitative study with practice managers and general practitioners

BackgroundThere is a lack of understanding regarding the impact of telehealth on clinical delivery and the feasibility of sustained implementation by health services. The COVID-19 pandemic provided an ideal opportunity to identify factors related to the implementation of telehealth. This study assessed factors that influenced telehealth implementation during COVID-19 in the Western region of Victoria, Australia, from the perspectives of practice managers and general practitioners (GPs). MethodsEmploying a qualitative approach, we conducted semi-structured interviews with 14 GPs and 11 practice managers across metropolitan and rural settings in the Western region of Victoria, Australia. Interviews were conducted between December 2021 to June 2022, which included periods during and beyond the peak of the COVID-19 pandemic. Themes were synthesised using the Consolidated Framework for Implementation Research, which comprised five domains: innovation, inner setting, outer setting, individuals and implementation process. An additional domain related to billing and finances was added. ResultsThe innovation domain revealed that telehealth was identified by both stakeholder groups as a critical tool for improving healthcare access for vulnerable patients. GPs highlighted the role of telehealth in follow-up care and the need for extended telephone consultation services. For the implementation process, both stakeholder groups identified a shift in attitudes among GPs from reluctance to acceptance of telehealth. In terms of outer setting, constant changes in regulations posed challenges to administrative staff. Practice managers faced difficulties in acquiring information on changes, but those with robust professional networks were well supported. Initial loss of incentive funding and government-imposed billing methods posed hurdles for clinics. Both stakeholder groups highlighted the need for education around videoconference and a standardised telehealth platform. ConclusionEvolving telehealth regulations during the emergence of COVID-19 posed financial, operational and administrative challenges to primary care clinics. To ensure sustainability, policymakers should improve stakeholder communication, set interoperability standards, and ensure sustainable funding for telehealth.

Successful control of Echinococcosis in Argentina and Chile through a One Health approach, including vaccination of the sheep intermediate host.

Cystic echinococcosis control in South American countries requires a comprehensive integrative ‘One Health’ approach. While insular nations have seen successful in their elimination programmes, South American countries face persistent challenges in hostile environments, with Echinococcus granulosus s.l., posing a significant public health concern. Vaccination of intermediate hosts has demonstrated the efficacy of the EG95 vaccine in reducing transmission rates. For example, since 2009, Rio Negro Province in Argentina has added, with marked success, the EG95 vaccine to the control programme, supplementing dog deworming. The Aysen Region of Chile has also reported encouraging preliminary results in reducing cyst prevalence in vaccinated sheep after 3 years of vaccination. The challenges in aligning control strategies with socio-cultural factors, especially in indigenous communities, underlines the need for context-specific strategies. The Rio Negro programme demonstrated commendable compliance, underlining the importance of community engagement in achieving lasting success. The most promising strategies for effective echinococcosis control involved dog deworming and the routine vaccination of sheep and/or goats, underscoring the importance of sustained implementation until all grazing animals have been replaced. For lasting success, these interventions need to be combined with a robust surveillance system.

Factors in the implementation of expert standards in nursing: A qualitative study

Factors in the implementation of expert standards in nursing: A qualitative study Abstract: Background: Many German health and long-term care facilities face the challenge of implementing expert standards in practice. Implementation models, such as the Consolidated Framework for Implementation Research (CFIR), support the implementation process by identifying the relevant influencing factors that can determine the success of an implementation. Aim: The aim was to identify the factors influencing the implementation of expert standards in nursing care and their interactions. Method: The data were collected by means of guided interviews with ten facilitators of the model implementation units for the implementation of the expert standard on promotion of oral health in nursing and from the project progress records. The data were evaluated by content analysis. Results: In addition to the influencing factors according to the CFIR, two other factors were identified that can determine the success of the implementation of expert standards - local presence and knowledge of implementation theories and models. The various and complex interrelationships between the factors in the implementation of expert standards became particularly clear. Conclusion: Knowledge of the fundamentals of implementation science is helpful for the successful and sustainable implementation of expert standards and for general knowledge transfer in nursing.

Influence of sustainability in the positioning of the university brand: Study in universities in Medellín-Colombia

The implementation of university sustainability affects brand perceptions by conferring attributes related to commitment and reputation, especially by students. The proper management of sustainability is related to an improvement in the university brand perceived by its stakeholders, including students. For this reason, this research aims to analyse whether university sustainability positively affects brand positioning among university students. For this purpose, a theoretical and quantitative mixed-method investigation is proposed that allows the establishment of a structural model in which the relationships between the dimensions of university sustainability with the dimensions of brand positioning are evident. The empirical analysis found that some dimensions of university sustainability, such as the institutional framework, campus operations and some dimensions of the substantive functions, positively affect brand positioning in university students and generate commitment to the university from both the prestige and reputation of the brand.

AI in Bangladeshi libraries: opportunities and challenges

PurposeThis paper aims to explore the opportunities and challenges associated with adopting artificial intelligence (AI) in libraries in Bangladesh and provide recommendations to guide the responsible integration of AI to enhance library services and accessibility.Design/methodology/approachThe paper reviews relevant literature on the applications of AI in libraries, the current state of technology adoption in Bangladeshi libraries and the ethical considerations surrounding AI implementation. It analyzes the potential benefits of AI tools such as chatbots, intelligent search engines, text-to-speech and language translation for improving user services and inclusion. The challenges of infrastructure constraints, lack of resources and skills, data privacy issues and bias are also examined through the lens of the Bangladeshi context.FindingsAI offers transformative opportunities to automate operations, strengthen user services through 24/7 virtual assistants and personalized recommendations and promote accessibility for diverse users in Bangladeshi libraries. However, significant challenges such as inadequate technology infrastructure, funding limitations, shortage of AI-skilled staff, data privacy risks and potential biases must be addressed. Strategically planning for sustainable implementation, building AI capacity, prioritizing ethical AI development and fostering collaborations are critical factors for successful AI adoption.Originality/valueThis paper provides an in-depth analysis of the prospects and obstacles in leveraging AI specifically for libraries in Bangladesh. It offers original insights and context-specific recommendations tailored to the needs and constraints of a developing nation working to harness AI’s potential to create dynamic, inclusive knowledge centers serving all communities.

예술가 없는 예술지구

In the process of revitalizing hateful spaces in cities, cultural urban regeneration is known to play a positive role in fundamentally renewing the old negative image of an area. While the voluntary closure of Seonmi-Village, a notable red-light district in Jeonju City, through the implementation of cultural governance, is well-documented, little attention has been given to the operations and policy implications of Seonosong Arts Village. This study thus examines the transition from Seonmi-Village to Seonosong Arts Village, employing data collection and in-depth interviews with key stakeholders, including women’s rights advocates and local arts actors, with a focus on creative placemaking. As a result, it was stated that although the Women’s Rights Center’s solidarity activities with local artists in the process of publicizing women’s rights discourse showed tangible results, there was a relative lack of communication and solidarity between the actors. Furthermore, it was noted that artists tended to prioritize business endeavors over developing a comprehensive understanding of their locality. Hence, this study underscores the importance of nurturing a community of artists as local stakeholders for the sustainable implementation of cultural regeneration initiatives.

Interdisciplinary and Regional Cooperation Towards Head and Neck Cancer Interventional Radiotherapy (Brachytherapy) Implementation in Southeast Asia

We review the evolution of Brachytherapy to interventional radiotherapy and its current and potential roles in HNC management, and the requirements and challenges towards its effective and sustainable implementation in SEA.

DIGITAL EDUCATION AT EUROPEAN HIGHER EDUCATION INSTITUTIONS DURING COVID-19 PANDEMIC

Objective. The objective of this study was to identify and interpret state-of-the-play of the implementation of digital education (DE) in higher education institutions (HEIs) in the field of library and information science (LIS) during COVID-19 pandemic. Approach/Methodology/Design. In order to collect data, a questionnaire-based survey was conducted. A survey for the study's target audience - the heads/directors of LIS schools/departments in Europe - was created and disseminated. The collected data were analyzed using the method of descriptive statistics. Results. The survey was completed by the heads/directors of 56 LIS schools/departments in 23 European countries. The results indicate that DE presents a positive disruptive force that transforms the teaching and learning process and widens access to education, especially in crisis situations. It also indicates that despite the need for emergency response, almost all aspects of DE were deliberately and successfully implemented in most of the LIS higher education institutions. Further analysis of core topic areas (through interviews and focus groups) will provide a deeper insight into teachers' and students' practices and their overall appraisal of DE during the pandemic. Limitations. Limitations include the methods used to collect data and the lack of clarity and understanding of certain terms and concepts by a small number of participants. Originality/value. This paper offers an in-depth understanding of the role of DE in crisis situations within the field of LIS. It underlines the necessity for consistent monitoring and evaluation of DE to guarantee its quality. Consequently, this paper may contribute to more effective policy and decision-making processes concerning DE. Moreover, it aims to help create frameworks and guidelines that facilitate simpler, more sustainable, and broader implementation of DE in LIS HEIs.

Determination of apparent and standardized ileal digestibility of amino acids in corn HP-DDG fed to growing pigs

The corn-based ethanol production industry provides co-products with potential value as animal feed. However, the nutritional value of these co-products should be adequately determined for their sustainable implementation in swine diets. Therefore, a study was conducted to determine the concentration of amino acids (AA), apparent ileal digestible amino acids (AID), standardized ileal digestible amino acids (SID), and crude protein (CP) in corn distillers dried grains with high protein content (corn HP-DDG) for pigs. Six growing pigs (initial body weight: 46.30 ± 2.14 kg) were surgically fitted with a T-cannula at the distal ileum and allotted to a duplicate 2 × 3 incomplete Latin Square Design. Diets containing corn HP-DDG as the only AA source and a nitrogen-free diet (NFD) were formulated. Corn HP-DDG was used as a test ingredient to replace 40% of the starch in NFD, and titanium dioxide (0.5%) was added as an indigestible marker to both diets. Pigs were fed between 08:00 and 18:00 h during five days of adaptation and a sequence of two days of ileal digesta collection. On an as-fed basis, the chemical composition of corn HP-DDG was 40.41% CP, 1.39% lysine, 1.57% methionine + cysteine, 1.61% threonine, 0.23% tryptophan, and 2.15% valine. The AID and SID values of corn HP-DDG were 74.04% and 80.87% for CP; 76.32% and 79.15% for lysine; 84.75% and 86.52% for methionine + cysteine; 71.97% and 78.30% for threonine; 83.86% and 92.44% for tryptophan; and 76.34% and 80.47% for valine, respectively. In conclusion, the SID CP and AA in corn HP-DDG were within the previously published values, and the determined SID coefficients should be used to formulate accurate diets for pigs.

Beyond “Brain Breaks”: A New Model for Integrating Classroom-Based Active Breaks

Regular physical activity provides physical, mental and cognitive benefits for children. However, globally, only 20% of children meet the recommended levels of physical activity and, on average, students sit for three-quarters of the school day. Active breaks are a well-tested component of many school-based physical activity interventions, but there are many barriers to the sustainable implementation of active breaks by teachers in schools. To overcome these barriers, the narrow, traditional idea of the ‘brain break’ needs to be reconceptualized, where active breaks are viewed as being separate from learning and teaching, and where physical activity is perceived as an interruption to learning. This article presents the TransformUs Active Break (TAB) model, which positions active breaks as part of an overall approach to proactive classroom management and as a key contributor to effective teaching. The TAB model comprises five types of active breaks, each serving a specific educative function-structure, transition, manage, energize and learn. The model demonstrates how active breaks can be integrated meaningfully into lessons to enhance teaching and learning as an effective approach for sustained school-based physical activity.

Sustainable business models in SMEs: The customer’s perspective


 
 
 The main purpose of the study is to identify the relationship between sustainability goals and measures of the degree of sustainable policy implementation, as well as the customer perspective as determined by the business model (BM) template of A. Osterwalder and Y. Pigneur. In the conducted research, the customer perspective takes into account five elements of the BM and each element was examined by several characteristics. The elements of the BM from the customer perspective are: customer segment, value proposition, distribution channels, customer relationships, and revenue. The study used the authors’ survey questionnaire, in which respondents, who were enterprises in the SME sector, answered questions about their own BM divided into three layers – business, social, and environmental. The results were statistically analysed using SPSS STATISTIC 28 software and a logit model was developed to verify the significance of the relationship between the binary variables studied. 303 enterprises participated in the survey, 59% of which were enterprises guided by sustainability goals (SGs) in their BMs. However, only 27% of those surveyed had measures of the degree of sustainable policy implementation.
 
 
 
 The conducted research confirmed that acting in accordance with SGs is strongly related to customer-oriented elements of the business model, such as (1) customer segregation by sex or by level of environmental awareness, (2) value proposition – an environmental orientation, (3) distri- bution channels – direct sales online, (4) customer relationships through dedicated personal assistance or automated service based on personal customer profiles, (5) revenue – sales of products and services. Slightly different results were obtained for using measures of the degree of the SD policy implementation, where the highest correlation occurred for: (1) main customers – manufacturing entrepreneurs, (2) customer segregation by end-user experience or by level of involvement in socially important issues, (3) value proposition – strengthening democracy, (4) distribution channels – wholesale stores are run by partners, (5) customer relationships through self-service or automated service based on personal customer profiles or involving customers in the product development process, (6) revenue – rental/lease/leasing or licenses.
 
 
 
 
 

Participation in children's hospitals: approaches to participatory formats for paediatric patients

Based on the UN Convention on the Rights of the Child, children and young people have the right to participate in all matters and decisions that affect them. This applies in particular when they are patients in a children's hospital. In the international context, established formats for the participation of young patients regarding health issues already exist, for example "Children's Councils" or "Young Person's Advisory Groups". In Germany, such approaches are still mostly lacking. It thus remains important to develop suitable formats that enable meaningful and effective participation of young patients in the health system. These formats must be chosen in such a way that they can realistically be implemented in clinical settings as well as in pediatric research, and that they can be sustained in the long term. In order to strengthen the consideration of children's rights in the health system, the advancement of such participatory formats as well as their sustainable implementation and evaluation are desirable.

E-waste circular economy decision-making: a comprehensive approach for sustainable operation management in the UK

E-waste generation has broadly increased worldwide and is called intense pressure on sustainable practice implementation firms by recycling and redesigning the products. Thus, e-waste operation management in developed countries like the UK has become the top priority and is subjected to multiple sustainable circular economies (CE) contributing factors, including social, technical, environmental, and governmental policies. The authorized decision-makers can benefit from a well-established systematic decision-making tool to assess and evaluate the e-waste operation management considering the potential CE contributing factors. An extensive literature overview is expanded to identify the most relevant and influential contributing factors to e-waste CE. The city of London Metropolitan has been selected as the case location. In this regard, it is necessary to utilize an advanced multi-criteria decision-making tool to explore the interdependency and causality of CE-relevant factors. The present study proposed an innovative decision-making approach to address the multiple contributing factors of causality, interdependency, data, and model uncertainty in practice. It uses the step-wise weighted influence nonlinear gauge system method integrated with Fermatean fuzzy linguistic sets. This study conducted a sensitivity analysis to evaluate the effectiveness of the proposed decision-making approach in e-waste operation management. The results are promising, clearly demonstrating the framework’s competence. The CE index, crucial in designing e-waste operation management strategies, was calculated to be 2.8036. Among the various factors analyzed, “Environmental Management Systems” emerged as the most significant driving factor. This underscores the critical need to improve environmental management systems within e-waste operations.

Implementation and sustainability of student peer-led physical activity programs in a school community

PurposeThis study sets out to investigate the elements of the collaborative culture required for the successful implementation and sustainability of programs in schools. It draws on a case study of a student peer-led physical activity (PA) program implemented within the complex and dynamic environment of school communities in New Zealand. The article outlines four key components needed to effectively implement and impact long term sustainability of a program within the school context.Design/methodology/approachThis qualitative case study examines the implementation of a new peer-led PA program introduced across eight New Zealand schools. Data were collected from semi-structured interviews with senior leaders, teachers and parents and analyzed through a complexity theory lens.FindingsEffective and sustainable program implementation requires a strategic, collaborative approach through actively engaging with and resourcing four key interacting components: student choice, voice and agency; collective responsibility; shared understanding of purpose; and curriculum coherence.Originality/valueThis research offers a pragmatic approach to developing collaborative school communities that can effectively implement change by highlighting key areas of focus that policymaker, school leaders and program designers can plan for.

The walks often give me a reason to get up and get out in the morning rather than hiding. Towards sustainable community-health enhancing interventions

Physical activity (PA) community-based programmes are increasingly put forward to promote active, healthy lifestyles and bring about long-lasting benefits to beneficiaries. Programme sustainability refers to the maintenance of an intervention beyond the initial time, resources, or other inputs to support it. A range of factors contribute to sport/PA programme sustainability; however, research often overlooks the critical ingredients to long-lasting interventions. This study explores the elements that promote, or hinder sustainability of a walking-based intervention addressed to caregivers and care-recipients in Kent, United Kingdom. Drawing on interviews and focus group data with organisers and participants, findings were grouped under three overarching themes: Benefits on social and mental well-being, factors facilitating programme engagement and key implementation considerations. In discussing these findings in context, we provide implications for the sustainable planning and implementation of future community sport and PA programmes.

Spongy and anti-pollution MXene/Ag2S/cellulose acetate membrane for sustainable solar-driven interfacial evaporation and water purification

Solar-driven interfacial evaporation (SIE) technology stands out as a promising approach for seawater desalination, leveraging solar energy efficiently in an environmentally friendly manner. However, the enrichment of organic pollutants on the interfacial evaporator has posed significant obstacles to the sustained implementation of SIE. Herein, a spongy, anti-pollution cellulose acetate membrane consisting of Ag2S-doping MXene nanosheets (MT-Ag2S/CAM) is proposed for sustainable desalination. The MT-Ag2S/CAM exhibited ultralow water vaporization enthalpy of 1.50 kJ g−1. Meanwhile, the MT-Ag2S/CAM, featured by high porosity (75.25 %), excellent light absorption and salt resistance, demonstrated a notable solar-driven evaporation rate of 1.8 kg m−2h−1 and a remarkable photothermal conversation efficiency of 91.6 % under one sun irradiation. Meanwhile, MT-Ag2S/CAM can realize a removal efficiency of 93.3 % for methylene blue, exhibiting outstanding anti-pollution and self-cleaning capabilities as well as long-term stability due to its strong mechanical properties. Finally, a device for sustainable desalination, water purification and clean water collection is designed and implemented in a practical SIE process.

Building CapaCITY/É for sustainable transportation: protocol for an implementation science research program in healthy cities

IntroductionImproving sustainable transportation options will help cities tackle growing challenges related to population health, congestion, climate change and inequity. Interventions supporting active transportation face many practical and political hurdles. Implementation...