Types Of Barriers Research Articles

How can networks address barriers to nature-based solutions? The case of agriculture and construction in the Netherlands

Nature-based solutions (NBS) can play a critical role in sustainability transitions in both urban and rural areas, but their uptake is hindered by a wide variety of barriers. While networks have been identified as a support structure for mainstreaming NBS, it is unclear what specific roles networks play in addressing the multiple barriers that NBS mainstreaming faces. Through qualitative research using focus group meetings and semi-structured interviews within two sectors in the Netherlands where attempts towards a nature-based transition are observed – i.e., agriculture and construction – we identify seven different functions through which networks address six specific barrier categories. We find broad network functions (e.g., knowledge sharing) that address multiple types of barriers simultaneously and targeted network functions (e.g., lobbying towards policy makers) aimed at alleviating one specific type of barrier. We also document that networks leave certain barriers unaddressed, such as technological and political barriers in the construction sector and social barriers in both sectors. Our results contribute to a more in-depth understanding of network function – barrier combinations for nature-based sustainability transitions, both in an urban and a rural context, which can help networks to further strategize and allocate their resources.

Trends in using intraoperative parathyroid hormone monitoring during parathyroidectomy: Protocol and rationale for a cross-sectional survey study of North American surgeons.

Hyperparathyroidism is a common endocrine disorder that occurs secondary to abnormal parathyroid gland functioning. Depending on the type of hyperparathyroidism, surgical extirpation of hyperfunctioning parathyroid glands can be considered for disease cure. Intraoperative parathyroid hormone (IOPTH) monitoring improves outcomes in patients undergoing surgery for primary hyperparathyroidism, but studies are needed to characterize its institutional adoption and its role in surgery for secondary and tertiary hyperparathyroidism, as these entities can be difficult to cure. Hence, we will perform a cross-sectional survey study of surgeon rationale, operational details, and barriers associated with IOPTH monitoring adoption across North America. We will utilize a convenience sampling technique to distribute an online survey to head and neck surgeons and endocrine surgeons across North America. This survey will be distributed via email to three North American professional societies (i.e., Canadian Society for Otolaryngologists-Head and Neck Surgeons, American Head and Neck Society, and American Association of Endocrine Surgeons). The survey will consist of 30 multiple choice questions that are divided into three concepts: (1) participant demographics and training details, (2) details of surgical adjuncts during parathyroidectomy, and (3) barriers to adoption of IOPTH. Descriptive analyses and multiple logistic regression will be used to evaluate the impact of demographic, institutional, and training variables on the use of IOPTH monitoring in surgery for all types of hyperparathyroidism and barriers to IOPTH monitoring adoption. Ethics approval was obtained by the Hamilton Integrated Research Ethics Board (2024-17173-GRA). These findings will characterize surgeon and institutional practices with regards to IOPTH monitoring during parathyroid surgery and will inform future trials aimed to optimize the use of IOPTH monitoring in secondary and tertiary hyperparathyroidism.

American Shoulder and Elbow Surgeons perspectives on political advocacy

BackgroundPhysician involvement in political advocacy has become increasingly important in recent years. This study aims to explore the types of involvement and barriers to involvement in political advocacy among American Shoulder and Elbow Surgeons (ASES) members, identify issues considered most important by ASES members, and assess demographic factors that might correlate with involvement in political advocacy efforts among ASES members. MethodsThis survey was conducted by the ASES Political Advocacy Committee over a two-week period in June 2021. The survey collected demographic information including sex, ethnicity, years in practice, practice type, political affiliation, and level of current involvement in political advocacy. Additional questions consisted of thoughts regarding current health care policy issues and the role of the American Academy of Orthopaedic Surgeons (AAOS)/ASES regarding such policy issues. ResultsWe received 297 responses for a total response rate of 27%. Of those who responded, 24.6% identified as Democrat, 33% identified as Republican, and 42.4% identified as Independent. There was no difference in political affiliation between membership groups. Physician Reimbursement (82%), Medical Liability Reform (50%), and Physician Ownership (50%) were the most important issues identified among respondents. Physician Ownership, Physician Reimbursement and GME and Student Loan Reform were most important to those in early practice, while Quality and Research was most important to those with greater than 25 years of practice experience. ConclusionThere is strong agreement among surgeons regarding the most important political advocacy issues. The efforts of the AAOS and ASES should focus on these areas. Additionally, the vast majority of respondents felt that advocacy efforts had a positive impact on patients and surgeons.

Mechanisms of Low-Temperature Dislocation Motion in High-Entropy Al0.5CoCrCuFeNi Alloy

An analysis of the processes of plastic deformation and acoustic relaxation in a high-entropy alloy, Al0.5CoCrCuFeNi, was carried out. The following were established: dominant dislocation defects; types of barriers that prevent the movement of dislocations; mechanisms of thermally activated movement of various elements of dislocation lines through barriers at room and low temperatures. Based on modern dislocation theory, quantitative estimates were obtained for the most important characteristics of dislocations and their interaction with barriers.

The association of out-of-hospital cardiac arrest barriers to cardiopulmonary resuscitation initiation and continuation during the emergency call: A retrospective cohort study

BackgroundIn a previous study, we identified eight types of potential barriers to bystander cardiopulmonary resuscitation (CPR) initiation and continuation until the arrival of emergency medical services (EMS) on scene, in the context of emergency calls for out-of-hospital cardiac arrest (OHCA). Many cases had multiple barriers. In this study, we aimed to estimate the independent effects of these barriers after adjusting for case characteristics. MethodsWe used data for the 295 non-trauma OHCAs from the St John Western Australian (SJ-WA) OHCA Database. Excluded cases were: EMS-witnessed OHCA, callers not with/close to the patient, OHCA not recognised during the emergency call, bystander CPR in progress prior to the call and calls coded as obvious death by SJ-WA. We conducted two multivariable logistic regression models including the eight barriers (callers: 1) perceived inappropriateness of CPR, 2) emotional distress, 3) reluctance to perform CPR, 4) physical limitations, 5) access to the patient, 6) leaving the scene, 7) communication failure, and 8) on-scene distractions) and case characteristics. ResultsThe callers perceiving CPR as inappropriate (adjusted odds ratio [AOR] = 0.20, 0.11–0.37) and witnessed arrest (AOR = 2.88, 95% CI 1.48–5.60) were independently associated with CPR initiation. Caller distractions such as performing other tasks or relaying information to other bystanders were negatively significantly associated with callers continuing CPR to EMS arrival (AOR = 0.27, 0.10–0.73). ConclusionsPerceptions of inappropriateness and caller distractions were independent risk factors for the delivery of bystander CPR. Further research around how call-takers navigate these barriers and encourage callers should be performed.

Barriers to conservative kidney management for Japanese healthcare professionals involved in the treatment of end-stage renal disease.

Conservative kidney management (CKM) is a treatment alternative for patients with end-stage kidney disease (ESKD). Despite the increasing population of elderly dialysis patients in Japan, CKM is not as readily available compared with that in North America and Europe. Therefore, it is important to clarify the barriers to CKM in Japan. We interviewed 11 experts to explore their beliefs and issues regarding CKM. Based on the interviews, we categorized the CKM barriers into eight categories and created a 24-item questionnaire. A questionnaire survey was conducted among 112 medical professionals involved in ESKD management. To investigate the types of barriers, we conducted an exploratory factor analysis using the questionnaire results. Responses were obtained from 53 (47.3%) of 112 subjects (18 doctors, 29 nurses, 6 clinical engineers), with 94.3% considering CKM as a treatment option for ESKD. Factor analysis categorized the questions into the following: (1) Lack of palliative care experience, (2) Ethics and responsibility, (3) Patient's problem, (4) Dialog with patients and families, and (5) Lack of support system. Regarding barriers to CKM, "lack of experience in palliative care" and "lack of support system" scored the highest, and "ethics and responsibility" scored the lowest. Barriers to CKM may be classified into five factors, with "lack of experience in palliative care" and "lack of support system" being the important barriers to overcome. Additionally, most healthcare professionals consider CKM as the fourth option for renal replacement therapy.

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

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

User perspectives on outreach opioid substitution treatment among street-entrenched people who use drugs in Denmark

Background The COVID-19 pandemic had many serious consequences for vulnerable populations, but it also gave rise to innovations and changes of established ways of providing services for such populations. In Copenhagen, Denmark outreach opioid agonist therapy (OAT) was such an innovation. Methods Based on qualitative interviews with 15 individuals who received outreach OAT this article describes this new service and presents OAT clients’ experiences of previous OAT and outreach OAT. Analytically the article draws on literature about people who use drugs’ experiences of barriers when wanting to access drug treatment and other services. Results The participants had experienced significant systemic and social barriers in relation to outreach OAT. Outreach OAT helped to minimize both types of barriers. It also created new opportunities for providing care because treatment took place in participants’ own environments. Conclusion Outreach OAT has the potential to minimize treatment barriers for some of the most vulnerable people who use drugs. It is however also important to review and possibly change system design, guidelines, and practices of the existing system to better accommodate the program to the needs of vulnerable people.

Bridging the digital divide: Promoting equal access to online learning for health professions in an unequal world

AbstractOnline learning has the potential to enhance open and equitable access to medical education resources globally. Conversely, there are also concerns that it can perpetuate and exacerbate digital inequalities between developed (global North) and developing (global South) countries. In this article, we describe the historical lack of representation of the global South in the design of online medical education, as well as the resulting consequences and potential solutions. We compare the Northern and Southern views of online learning in medical education and identify the different types of barriers to its adoption. We describe how socioeconomic disparities and the historical dominance of the global North over the global South have led to systemic digital inequalities in the design and implementation of online learning in education generally, and in medical education particularly. The lack of representation of global South voices hinders the development of digital learning solutions relevant to local contexts, therefore limiting their effectiveness and sustainability. Thus, we propose approaches to build more equitable partnerships by soliciting local input and local expertise. Further, we discuss the need to maintain local relevance while setting global standards. Overall, we hope to inform and guide the development of more equitable and accessible online education training for a diverse global population.

Barriers to mental health service utilization among Arab society in Israel: Perspectives from service providers

This study attempted to identify the barriers to the utilization of mental health services among the Arab society in Israel, as perceived by professionals working with this population. Twenty-seven therapists from community mental health services participated in structured in-depth interviews with at least 5 years of experience. Five main types of barriers to the utilization of mental health services were discovered: barriers related to attitudes and perceptions regarding mental disorders and their treatment, low literacy in the field of mental health, exposure and stigma, family characteristics and cultural values, and instrumental barriers. Flexibility and sensitivity to the socio-cultural context of the target population while allocating resources to create equality in access to mental health care may increase the utilization of mental health services in a traditional society such as the Arab society in Israel.

What Is the Real-Life Experience of Older Adults on Smart Healthcare Technologies? An Exploratory Interview Study

Introduction: Smart healthcare technologies (SHCTs) exhibit the great potential to support older Hong Kong adults with their health problems. Although there are various SHCTs in the Hong Kong market, and some adoption predictors have been proposed and investigated, little is known about older users’ views on and real-life experiences with these technologies. This exploratory study examined the experiences, functional needs, and barriers of three kinds of SHCT (i.e., smart wearable devices, smart health monitors, and healthcare applications) with older adults in real life. Methods: A convenience sampling method was applied to recruit twenty-two older adults from the Hong Kong community. The interview was designed in semi-structured and conducted in a face-to-face setting. The content analysis was used to summarize the older adults’ functional needs and barriers in real life. Results: We found older adults mainly applied SHCTs to address physical health, but there are few technological solutions for mental health in practice. There are four types of barriers in using SHCT. However, social support in Hong Kong community greatly helps reduce the barriers in technology use. Based on the findings, we discussed the possible solutions based on the social and technology perspective. Conclusion: Current technologies still could not fully address older adults’ needs for healthy aging, and various barriers still hinder the actual adoption. By deeply understanding and considering the social context, technology innovation can facilitate the adoption of SHCT and promote a healthy aging society.

INSTITUTIONAL FACTORS OF THE TECHNOLOGIC ACADEMIC ENTREPRENEURSHIP DYNAMICS

The article deals with identifying the obstacles to the commercialization of academic research results generated by the differences in institutional environment for the production of scientific knowledge and the production of technological products by innovative start-ups. To do this, it gives the characteristics of the above-mentioned institutional environments, as well as patterns of behavior in them that do not have the character of formal or informal institutions. Particular attention is paid to psychological traits of entrepreneurs and their cognitive abilities, which may not be available to teachers and researchers at universities and research organizations. Comparison of the content of these environments gives grounds for distinguishing two types of institutional barriers: the first one is of a general economic nature and can generate significant costs for the work of innovative start-ups; the second one is intra-organizational in nature and can generate high risks of transition from science to commercial industry, preventing researchers and teachers from making decisions about creating innovative technology start-ups. The paper concludes with recommendations to reduce the level of barriers of the second type. In particular, to compensate for the risks associated with possible consequences of failure to create a startup and the difficulties of returning to the field of research activity, university management could legally guarantee a teacher or researcher a return to work in scientific or educational departments of faculties for at least five years after creating a startup.

Racial literacy development in online intercultural education in the EFL classroom

ABSTRACT Intercultural competence refers to people’s ability to understand and respect each other across all types of cultural barriers, and racial literacy stands out as a fundamental component of this competency. Particularly, in Korea, which has recently rapidly become a multicultural society, understanding diversity and cultivating racial literacy are important competencies. To achieve this goal, the teacher's role is important in developing and operating English classes using various teaching materials. This study introduces the development and application of an innovative online intercultural exchange programme conducted in a middle school using multiple technology resources. Going beyond dealing with superficial textbook coverage of multiculturalism, this programme encourages students to reflect on their own prejudices and share cultural experiences through engaging in technology-based open discussions and critical thinking about sensitive issues. In this paper, we first introduce the online intercultural exchange programme and teaching materials that we designed and operated for one semester and then carefully examine each class activity aimed at improving students’ intercultural competence and racial literacy. Finally, we report the presiding teacher’s reflections on the impact of this programme on the students in the class and suggest points for further discussion.

Deterrents to the IoT for smart buildings and infrastructure development: A partial least square modeling approach

Implementing Internet of things (IoT) technology in the context of intelligent buildings and infrastructure development has garnered significant attention within the construction sector. Nonetheless, the implementation of IoT could be improved by assessing various barriers. The purpose of this study was to examine the obstacles related to the adaptation of IoT techniques within the construction sector, as well as the effects on the advancement of intelligent building and infrastructure systems. The study employed a mixed-method approach involving exploratory factor analysis (EFA) and structural equation modeling (SEM) to determine six types of barriers: knowledge, technical, standardization, creativity, complexity, and economics. The study revealed that the implementation of IoT for developing smart construction and infrastructure in the construction sector was significantly influenced by all six constructs. The results of this study offer significant ramifications for the field. The study underscores the necessity for heightened consciousness and instruction regarding the advantages of implementing IoT. The study posits that the technical barriers, including interoperability, modernization of legacy infrastructure, and coordination and collaboration difficulties, require attention from the industry. The study highlights the significance of establishing industry-wide standards and protocols for implementing IoT and regulatory and legal frameworks. Finally, the study underscores the necessity for augmented funding and financing options for IoT endeavors. Subsequent study endeavors may expand upon the present findings by delving into the barriers encountered by alternative sectors and nations and assessing the efficacy of the suggested measures in this investigation.

“They don't trust me”: Service providers reflections of father‐centric treatment and engagement

AbstractObjectiveThis study sought to illuminate the barriers service providers experience in delivering healing services to enhance father and child well‐being.BackgroundManifestations of structural barriers, such as racism, mother‐centric practices, and disproportionate incarceration among Black and Brown fathers prevail. Little is known, however, about how providers describe barriers they encounter toward engaging fathers in services to equip them with the capacity to coparent effectively.MethodA convenience sample of providers (n = 24) representing a diverse array of child and family service systems responded to questions from a semistructured interview guide. Thematic analyses were conducted to describe how providers engage with fathers and their perceptions of barriers related to their ability to engage them in services.ResultsFindings revealed three types of barriers, each representing a separate theme: micro (biases, colorblindness), societal (devaluation of fathers' role), and systemic (racism, mother‐centrism). Strategies to address barriers included implementing strengths‐based practices, creating spaces to engage in reflexivity, and investing in father‐centric programming. Most strategies involved modifying the micro context, conveying that future efforts should focus on developing procedures and policies that will enhance micro practices.ConclusionThis study captured the experiences of change agents and healers working with fathers and families. Their experiences illuminate obstacles they must contend with at the micro, societal, and systemic levels of practice.ImplicationsProviders indicated that fathers will not benefit from services unless organizations embrace father‐centric, strength‐based healing practices and allocate space to engage in reflexivity about biases and the impact of systemic racism.

The Use of Wind Turbine Blades to Build Road Noise Barriers as an Example of a Circular Economy Model.

This project's objective was to create a circular economy in the composites sector by examining the possibility of using wind turbine blade composite materials to construct noise-absorbing barriers for roads. The possibility of constructing road noise barrier panels from components obtained from turbine blades was conceptually examined, and the geometry and construction of wind turbine blades were evaluated for their suitability as filler components for panels. The tensile strength parameters of two types of composites made from windmill blades-a solid composite and a sandwich type-were established based on material tests. The strength of the composite elements cut from a windmill propeller was analyzed, and a three-dimensional numerical model was created using the finite element method. The strength values of the composite used to construct the noise barriers were compared with the stresses resulting from loads operating on the road noise barriers, as determined in compliance with current standards. It was discovered that acoustic screens composed of composite materials derived from wind turbine blades may withstand loads associated with wind pressure and vehicle traffic with sufficient resistance. In order to evaluate the environmental benefits resulting from the use of composite material made from wind turbine blades to make noise barriers, this study presents the values of the embodied energy and embodied carbon for several types of road noise barriers using life cycle assessment.

Shining a spotlight on the inclusion of disabled participants in clinical trials: a mixed methods study

BackgroundIt is crucial to include a wide range of the population in clinical trials for the outcome to be applicable in real-world settings. Existing literature indicates that under-served groups, including disabled people, have been excluded from participating in clinical trials without justification. Exclusion from clinical trials exacerbates disparities in healthcare and diminishes the benefits for excluded populations. Therefore, this study was conducted to investigate potential obstacles that prevent disabled people from participating in clinical trials in the United Kingdom (UK).MethodsThe study was carried out through an explanatory sequential mixed methods design. The Imperial Clinical Trials Unit devised and implemented an online questionnaire-based survey (with open/closed-ended questions) and an online focus group discussion. The target population were disabled people, family members/carers of disabled people and staff involved in clinical trials, whereupon the sample was recruited by convenience sampling methods via posters and emails through various networks. The Qualtrics XM survey system was used as the host platform for the online survey, and Microsoft Teams was used for an online focus group discussion. The focus group discussion was conducted to gain a deeper understanding of the themes identified from the survey responses. We analysed responses to the survey via descriptive analysis and used thematic analysis to synthesise the free-text answers from the survey and focus group discussion.ResultsWe received 45 responses to the survey questionnaire and 5 disabled people took part in a focus group discussion. Our findings highlighted the differences between the perspectives of researchers and those “being researched” and different types of barriers experienced by disabled people: opportunity barriers (inadequate recruitment strategy and ambiguous eligibility criteria), awareness barriers (perception of disability) and acceptance/refusal barriers (available support and adjustment, and sharing of trial results).ConclusionOur findings support perspectives drawn from the Ford Framework regarding the need to consider all barriers, not just up to the point of enrolment into trials but also beyond the point of inclusion in clinical trials. We support calls for the introduction of legislation on including disabled people in clinical trials, implementation of industry/community-wide participatory approaches and the development of guidelines, a combined public–private approach.

Interacting Barriers: How Barriers Compound Across Levels of Analysis to Affect Teams

Collaboration remains a central aspect of contemporary work and a source of emergent barriers that hinder team success. Scholarship has identified the breadth of barriers teams can face when working together and recognizes barriers as interdependent. This paper builds on this scholarship to address the types of relationships barriers can have as they interact across levels of analysis to affect teams. We draw on qualitative interview data with scientific teams to explore relationships among barriers stemming from teams’ internal processes and context. We identify common relationship patterns among barriers that can be used as a framework for analyzing complex, multi-level barrier systems affecting team outcomes. Our data highlight the importance of considering longitudinal, strategic support for targeting cross-barrier interactions when seeking to intervene in collaborations. This framework has practical application in supporting teams and creating policies that support collaborative work.

Navigating Digitalization: AHP Insights for SMEs' Strategic Transformation

The digital revolution presents Small and Medium Enterprises with potential and danger in the dynamic world of modern business. However, several substantial obstacles are in the way of digitalization, making it difficult to move forward. This study sets out to discover and remove these hurdles to fully realize the potential of digital transformation for small and medium-sized enterprises (SMEs). It looks through the Analytical Hierarchy Process (AHP) prism. Our research identifies five types of barriers, each presenting different hurdles for digitalization: organizational, technological and infrastructure, legal, social-cultural, and strategic. We investigate several options in response, such as government regulations, technology acquisition, management support, cybersecurity, and training. Using the AHP methodology, we give each alternative a normalized value and find that management support is the most critical, closely followed by cybersecurity, government regulations, training, and technology acquisition. With these discernments, SMEs can deliberately arrange their endeavours to eliminate obstacles, clearing the path for triumphant digital transformation and sustained expansion.

Partnerships in the recovery planning process: lessons from Puerto Rico after Hurricane Maria and Irma

PurposeTo assess which partnerships were most critical during the recovery planning process following Hurricanes Maria and Irma. We discuss the roles and impact of different types of partners, barriers and facilitators to partnerships and lessons in collaboration during the development of the economic and disaster recovery plan for Puerto Rico.Design/methodology/approachThe Homeland Security Operational Analysis Center (HSOAC) was tasked with assisting the Puerto Rican government with an assessment of damages from Hurricanes Maria and Irma and the development of the Recovery Plan. During the process, a small team compiled and coded a database of meetings with non-HSOAC partners. The team was divided into sector teams that mirrored FEMA’s Recovery Support Functions. Each sector completed two surveys identifying high impact partners and their roles and contributions, as well as barriers and facilitators to partnerships.FindingsA total of 1,382 engagements were recorded across all sectors over seven months. The most frequently identified high impact partners were federal and Puerto Rican governmental organizations partners. NGOs and nonprofits were noted as key partners in obtaining community perspective. Sector teams cited a lack of trust and difficulty identifying partners as barriers to partner engagement. Given the expedited nature of disaster response, establishing partnerships before disasters occur may help facilitate community input. Early networking, increased transparency and defining roles and responsibilities may increase trust and effectiveness among partnerships.Originality/valueTo our knowledge, this is one of the few studies that quantifies and illustrates the partnerships formed and their contributions during recovery planning, and lessons learned.