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Background: Historical socio-political processes have produced gross inequity of health resource for Aboriginal Australians and New Zealand Māori. Objectives: This paper argues that socio-political factors resulting from the entrenchment of colonialism have produced significant personal and structural barriers to the utilisation of healthcare services and directly impact the health status of these two vulnerable groups. Design: Discussion Paper. Conclusions: Understanding the actual barriers preventing the utilisation of healthcare facilities, as perceived by Indigenous people, is essential in reducing the gross disparity between Indigenous and non-Indigenous morbidity and mortality in Australia and New Zealand. [ABSTRACT FROM AUTHOR]

The objective of this paper is to explore the perceptions of key stakeholders involved and/or affected by existing paper-based decision support guidelines (known as Community Case Management (CCM)) and a proposed digitised mobile clinical decision support system (CDSS) of CCM in rural settings of Malawi, Africa. Data was collected using field notes and semi-structured interviews with 17 key stakeholders (i.e. clinical, technical, development aid support (NGO), government and community health workers both in Malawi, Europe and USA). Stakeholders provide a rich insight into the variety of both perceived benefits and challenges of the existing guidelines and the proposed electronic CDSS. It was found that all stakeholders believe that the CDSS will improve adherence to guidelines and subsequently result in better care for children. It is further envisioned that the time needed for administration with the current paper-based approach could be reduced using electronic, as opposed to manual, collation and sending of records. This paper acts to underpin the rationale and motivation for the development and rollout of an electronic CDSS to support community health workers in their assessment, classification and treatment of young children in rural settings in Malawi, Africa. [ABSTRACT FROM PUBLISHER]

In this study, we develop a new paradigm, Circular Lean Six Sigma 4.0 (CLSS4.0) to promote manufacturing sustainability. This paper aims to provide a practical and holistic view of the drivers and barriers that can help companies design an integrated CLSS4.0 model. The paper is based on a qualitative exploratory study using multiple case studies within 12 Moroccan manufacturing firms conducted through semi-structured interviews with top executive managers. The results show that the drivers are related to expected operational and environmental performance, increasing customer requirements, gaining competitive advantage and market growth while barriers are related to insufficient tangible (finance, human and equipment) and intangible (skills and techniques) resources, data privacy, technical issues and management support. The proposed framework identifies the assessment of drivers and barriers and their attributes as a starting point for managers to lead the CLSS4.0 transformation, thereby contributing to its successful implementation. To the best of our knowledge, this study is among the very first studies to discuss the CLSS4.0 drivers and barriers. It could be useful to managers as a diagnostic tool to assess their ability to implement CLSS4.0 before investing in the initiative. [ABSTRACT FROM AUTHOR]

Introduction: The emphasis on clinical trials to inform evidence-based medicine remains paramount within the cardiovascular community. Although such high-quality evidence is often translated into national and international guidelines, there exists a large gap between guideline development and guideline implementation into daily clinical practice.Areas covered: This article outlines barriers that impede guideline adherence and possible strategies to overcome such barriers. Barriers intrinsic and extrinsic to clinicians are discussed. The structured process of guideline implementation including guideline adoption, diffusion, and dissemination is discussed. Lastly, the authors review in detail the current and potential future elements of guideline diffusion and dissemination.Expert opinion: Improving guideline adherence remains challenging as it requires understanding of and navigation through various barriers. However, further research specific to cardiovascular medicine guidelines is necessary to better understand the objective effectiveness of various strategies employed by guideline writers and medical societies to improve adherence. The cost-effectiveness of nationwide dissemination strategies in improving guideline adherence and patient outcomes is also necessary but is largely unknown. [ABSTRACT FROM AUTHOR]

The focus of this paper lies in our special interest in women leaders and those aspiring to leadership positions in schools and other educational contexts within Australia. Leadership is a gendered concept, and due to a myriad of factors including conscious and unconscious bias, and the challenges of balancing career with other life commitment, the reality is that women's career journeys are different from men's. Women's unique career trajectories have implications for achieving their leadership potential. In addition to reviewing some of the extant literature in the area of women in educational leadership, we share our experiences and reflections based on our research and the leadership development programmes we have run for women mainly in Australia. These programmes have reinforced to us their value, place, and contribution to enhancing women's capacities for leadership. In this paper, we address the following four key questions as they pertain to women leaders within the Australian context: (1) Why a focus on gender and leadership? (2) What are some of the barriers impeding women leaders? (3) Why is it important to have multiple faces of leadership? (4) Why is women's leadership development everyone's responsibility? [ABSTRACT FROM AUTHOR]

This paper aims to 'identify', 'analyse', and 'categorise' the barriers affecting the green transformation process in healthcare using Total Interpretive Structural Modelling (TISM) and MICMAC analysis. The TISM technique was utilized to determine how the components interacted and the green transformation process barriers criteria were ranked and categorized using the MICMAC method. This study identified 11 barriers to green transformation process in healthcare organizations. The key factors identified in this study are inadequate strategic planning, financial barriers, and high technology adoption cost, information barriers, international issues in healthcare environmental sustainability, lack of supportive atmosphere. The TISM technique for healthcare is proposed in this paper as a novel attempt to address the subject of green transformation process barriers. This research will aid key stakeholders and academics in the better understanding the barriers affecting the green transformation process in healthcare organizations. [ABSTRACT FROM AUTHOR]

To tackle climate change and resource depletion, the construction industry has to shift to more sustainable developments. For which, as a low-embodied carbon construction material, earth represents an opportunity. However, earth material is still barely used in mainstream construction. This paper aims to assess what are the current knowledge about factors (barriers and opportunities) affecting the use of earthen architecture through a systematic search and review of the literature. The analysis of the data was conducted by classifying the factors into five categories, economical, organizational, political, social, and technical. The results differ, depending on the context, high/low-income country and stabilized/unstabilized earth. The data is analysed, breaking down some drivers, barriers and opportunities. Results show there is a lack of literature in the field. The paper also provides key parameters to consider for future research to promote earthen construction and to fill the knowledge gap. Additionally, two main new areas of research should be developed, (i) to design appropriate training supports for the education of all the stakeholders, (ii) to clarify how earthen architecture is related to the circular economy and how it can help to preserve natural resources and foster the shift to a circular economy of the construction industry. [ABSTRACT FROM AUTHOR]

In this paper, we describe the construction and validation process of a new measurement scale, the APTD questionnaire (Accessibility, Processes, Training, Demand), which consists of four factors related to the evaluation of the accessibility of university campus, the inclusive educational actions and processes carried out by university professors in class, the degree of permanent training in attention to diversity and, finally, the training demanded by professors in attention to diversity. To the best of our knowledge, we are not aware of any instruments that measure the response of university professors to the inclusion of students with special educational needs, taking into account these dimensions. The sample was made up of a total of 580 professors from different Faculties of Education of public universities of Andalusia (Spain). The results obtained show agreement among the judges/experts in relation to the clarity, coherence and relevance of the scale of measurement. On the other hand, the validation process carried out concludes that it is a valid and reliable instrument to measure the degree of inclusion of students with special educational needs in universities through the response of university professors. [ABSTRACT FROM AUTHOR]

The UN Conventions on the Rights of Persons with Disabilities urges the establishment of inclusive education and expansion of educational opportunities to maximize access to education among children with disabilities (CwDs). However, more than 90% of 150 million CwDs do not have access to education Rather, they are left without school participation, specifically in developing countries and low-income settings. This scoping review aimed at discovering the literature available around the barriers and facilitators to accessing education for CwDs in low and lower-middle income countries in eastern Africa. Medline, CINAHL, Global Health, ERIC, and Embase were searched. After a rigorous systematic search of peer reviewed articles, 188 articles were obtained, and 15 studies were included within this scoping review after iterative and constant readings and screenings of selected articles. A review of grey literature was also conducted and compared to the results gathered from the research literature. In this paper, we report on a variety of barriers and facilitators to accessing education in low and lower-middle income countries in eastern Africa described by the literature. The study findings will inform inclusive education policy and practice, as well as future disability and inclusive education research. [ABSTRACT FROM AUTHOR]

Coaching researchers from different academic disciplines have been occupied for years in exploring the constraints and barriers that women face when entering the coaching profession, not only at the level of individual agency but also at a structural and socio-cultural level. This paper reprises some of their findings and recognises that historians of coaching have made little contribution to the debate, apart from confirming the critical part played by networks, community, and experience in facilitating coaching careers. While the existing historiography has focused almost exclusively on male coaching practices and on a masculine orientated cultural heritage of coaching, attention is drawn here to the way in which the limited literature on women in coaching has been the result of adopting a very narrow definition of 'coach'. This introduction to the special issue of Sport in History highlights the range of terms historically used by women in coaching-related roles and the way in which women transcended social constraints to become coaches. Although the 'herstory' of sports coaching is only just being uncovered, these contributions represent an important stimulus to the further development of the topic and the paper concludes by highlighting how historians of women's coaching will be taking their research forward. [ABSTRACT FROM AUTHOR]

The success of plant-based beverages hinges not only on their inherent properties but also on an understanding of consumer behavior. Factors such as health conditions, sustainability awareness, and constant innovation drive consumer interest, while barriers like food neophobia and sensory attributes can deter consumption. To address these challenges, strategies such as nutrient complementation and customization of taste, color, and texture cater to individual preferences, expanding the appeal of plant-based beverages. Despite challenges, the plant-based beverage industry presents significant opportunities for growth, with consumer behavior playing a pivotal role in shaping this trend. This paper investigates the multifaceted factors influencing consumer behavior towards plant-based beverages, offering specific examples of motivations and barriers, drawing from a comprehensive analysis of available literature. The findings suggest that a consumer-centric approach, informed by a nuanced understanding of consumer behavior, is essential for the success of the plant-based beverage industry. By addressing consumer needs and preferences, companies can attract new customers and foster loyalty among existing ones, thereby capitalizing on the significant opportunities for growth within the plant-based beverage market. This paper highlights the implications of consumer behavior for industry stakeholders and underscores the importance of ongoing research and innovation in meeting evolving consumer demands. [ABSTRACT FROM AUTHOR]

AACSB adopted new and revised standards in 2020 that require business schools to demonstrate positive societal impact through internal and external activities. While many schools are already engaged in such activities, there seems to be no agreed-upon conceptualization or measurement of societal impact. This paper aims to help business schools organize, measure, and demonstrate their efforts to create positive societal impact and thus meet the updated AACSB standards. By using data from semi-structured interviews, this paper identifies different dimensions of positive societal impact and offers enablers and barriers in business school efforts to create such societal impact. [ABSTRACT FROM AUTHOR]

Stroke survivors receive considerable rehabilitation efforts as inpatients, but one-on-one therapy decreases after discharge. The gap between the amount of required therapy and the lack of its availability in this phase of care may be partly overcome by self-practice. However, patient's adherence to prescribed programs is often low. While single studies have examined factors affecting adherence in this specific case, they have not been reviewed and synthesised previously. A thematic synthesis of qualitative studies explored factors affecting stroke survivors' adherence to prescribed, recovery-oriented self-practice. Five databases were systematically searched for references: Medline, Psycinfo, CINAHL, Embase, and ASSIA. Quality assessment was undertaken using the CASP tool. From 1308 references, 68 potential papers were read in full, and 12 were included in the review. An overarching theme was identified as: "Tailoring and personalization rather than standardization." It was informed by the following three analytical themes: "The meaning of 'self' in self-practice," "Identifying self-practice as a team effort," and "Self-practice that is grounded in one's reality." To have a positive effect on adherence to self-practice, clinicians are advised to spend time learning about each individual's life circumstances, so they can tailor proposed exercise programs to patients' personal situations, preferences, and needs. The topic of patient's adherence to self-practice of prescribed exercise is a common concern, often voiced by frustrated rehabilitation health professionals. Bridging the gap between the patient's needs for post-discharge intensive therapy and the inability of healthcare systems to provide it could be filled partly by self-practice. Adherence to self-practice has become even more essential since the COVID 19 pandemic and the decrease in face-to-face delivery of rehabilitation due to social distancing requirements. Adherence to exercise is a broad topic. Reasons for poor adherence differ between patient populations and the exercises they are prescribed. This study focuses on post-discharge stroke survivors' adherence to recovery targeted exercise that could be described as repetitive and less physically demanding movements and functions. Reviewed studies were qualitative and usually included a relatively small number of participants within a specific context. Using thematic synthesis, we combined these small pieces of the puzzle into a larger picture, to produce recommendations that could be drawn on by clinicians to improve self-practice adherence. [ABSTRACT FROM AUTHOR]

Traditionally, veteran research and support have centred on the requirements of a predominantly male population. However, as female participation in the Armed Forces increases and their roles diversify, consideration of women's unique mental health needs is imperative. Women veterans are at greater risk of post-service mental health challenges than their male counterparts, and female mental health outcomes have deteriorated in recent years. To determine the provenance of these outcomes, a scoping review considering both barriers and facilitators to female veteran participation in mental health services was conducted. A review was carried out following the 2020 Joanna Briggs Institute Scoping Review framework. Twenty-four papers were identified, with all but one originating from the US. This research indicated that whilst women experience barriers common to male veterans (e.g. help-seeking stigma), they also experience unique gender-specific barriers to accessing mental healthcare services (e.g. lack of gender-sensitive treatment options, feeling uncomfortable) and such barriers result in under-utilization of services. Literature indicates that consideration and mitigation of these barriers might improve access and health outcomes for women veterans. Further research is required outside the US to understand the barriers to mental healthcare experienced by women veterans internationally. [ABSTRACT FROM AUTHOR]

A significant, if relatively small, body of literature provides a picture of PGR mental health and wellbeing, and key factors influencing this. However, little has been written on interventions, practices and changes to institutional support for PGRs, how these impact on wellbeing, and what factors influence their success. This paper summarises and synthesises research that has evaluated interventions or institutional changes aimed at supporting PGR mental health and wellbeing. A rapid systematic review methodology identified 21 papers, which evaluated interventions or practices to support PGR wellbeing, gathering data from 1066 students, 33 staff members (mainly supervisors) and 11 recent graduates. The papers included were diverse but limited and therefore did not offer strong evidence for the effectiveness of specific approaches. However, they provided valuable insight, which we conceptualise in a model of approaches to enhancing PGR wellbeing before exploring barriers to implementation of interventions, and recommendations for research, policy and practice. [ABSTRACT FROM AUTHOR]

Museums are increasingly employing innovative digital techniques to curate, link, and market collections, enabling new kinds of public engagement to better connect with popular culture. By embracing contemporary modes of delivery to open access to their collections, museums are signalling a drive toward greater democratisation of knowledge and information through increased interaction and accessibility. Yet with this has come a series of copyright and legal complexities. This paper reviews current copyright barriers for museums in Australia and examines how international examples offer potential models and ways forward. The authors conclude that recent copyright modernisation reviews offer the museum sector an opportunity to restructure its strategies. As online formats evolve, there is an urgent need to explore how amendments to copyright laws in some countries have allowed for more fair and flexible use of cultural artefacts and orphan works. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResults and conclusion\nIMPLICATIONS FOR REHABILITATIONThroughout the world, mobility devices are usually distributed using product-based business models, where a device is provided to a user, and serviced or replaced when the user returns to the clinic with an issue. Moving to a service-based business model can provide continuous and customised support for the user, and provide the clinicians and manufacturers with better data to base their decisions on. This study reviews papers on assistive technology service-based business models and considerations in designing such a model to optimise economic and social value. It then applies the findings to the mobility device space.A systematic literature search was undertaken in PubMed, Web of Science, and OVID databases to analyse studies that discuss service delivery models used to provide assistive products. Inductive thematic analysis determined the themes, facilitators and barriers associated with providing a service. Findings were applied to mobility device service provision.Themes from the 29 relevant papers were grouped into four categories: Access (affordability/availability/education), Utility (customisability/usability/adaptability), Integrity (quality/sustainability/impact), and Compliance (policy/privacy/security). The most common themes were customisability, affordability, availability, and education. There is a need for service-based delivery models to replace conventional product-based models, and many considerations to optimise their design. No publications discussed the design and implementation of a service-based model for mobility device provision that uses modern sensors, software and other digital technologies to optimise the service. Service-based models that use modern digital technologies are new for the mobility device field, but much can be learnt from other fields.Service-based business models that make use of modern digital technologies are likely to improve ongoing individual rehabilitation, but they are new for the mobility device field and currently lack research and evidence-based practice.The systematic review found that modern digital technologies like sensors, apps, and AI might be useful for providing ongoing support and more personalised rehabilitation for users of assistive products.To provide ongoing support for end-users, a successful design of service-based business model for assistive products should be accessible, both physically and financially, as well as easy to customise and adapt over time.Service-based business models that make use of modern digital technologies are likely to improve ongoing individual rehabilitation, but they are new for the mobility device field and currently lack research and evidence-based practice.The systematic review found that modern digital technologies like sensors, apps, and AI might be useful for providing ongoing support and more personalised rehabilitation for users of assistive products.To provide ongoing support for end-users, a successful design of service-based business model for assistive products should be accessible, both physically and financially, as well as easy to customise and adapt over time. [ABSTRACT FROM AUTHOR]

This paper aims to gain a better understanding of co-creative research key principles and their enactment in real-life practices. The study is based on interviews and a focus group with academic researchers and professionals (n = 16) involved in eight co-creative research projects funded by the Brussels Regional Institute for Research and Innovation (Innoviris). The study demonstrates the tension between respondents’ understanding of the key principles of co-creative research (e.g. a transformative aim, considering the community as actors, shared ownership, valuing experiential knowledge) and the power issues they face related to a ‘project-funding’ and ‘academic research’ logic when enacting those principles in real-life practices. This paper concludes that although dealing with power relations is inherent in co-creative research, power imbalances should be questioned on the level of (1) the linear, limited and inflexible nature of ‘project-funding’ logics and (2) the exclusive character of research methods, settings and institutions in ‘academic research’ logics. Finally, introducing a political and emancipatory dimension in co-creative research can contribute to reducing the gap between principles and their enactment in real-life practices. [ABSTRACT FROM AUTHOR]

Entrepreneurship is a complex, multidimensional phenomenon that is associated with value creation and considered a driver of economic development. While Africa exhibits a strong upsurge in the number of women entrepreneurs, the continent is still struggling in terms of gender equality and women's empowerment. The region is entrepreneurially disadvantaged, with a low degree of female participation in this field and a large gender gap in favor of men. Therefore, this paper aims to present original insights into female entrepreneurship from the context of Morocco, exploring the motivations and barriers to women entrepreneurs in the service sector. It adopts a multi-level integrative framework and combines feminist and institutional theory to capture the agency and enabling factors along with institutional regulative and normative constraints associated with female entrepreneurship. The paper adopts an interpretative qualitative research approach capitalizing on in-depth interviews with twenty women entrepreneurs in the service sector. The data is analyzed using thematic coding and identified factors are classified into micro-meso-macro levels. The findings highlight the importance of integrating multiple lens and levels of analysis to capture the complexity of the phenomenon and illustrate the imbrication and interplay of enablers and constraints and contribute theoretically and empirically to knowledge on female entrepreneurship in the North African context and a factor-driven economy through the case of Morocco. [ABSTRACT FROM AUTHOR]

Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15–80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals. [ABSTRACT FROM AUTHOR]

I draw on the United Nations Convention on the Rights of Persons with Disabilities as a human rights model of disability to analyze how the United Arab Emirates (UAE) is meeting its obligations toward disabled people in higher education and employment. This paper argues that institutions in the Emirate of Abu Dhabi adopted a paternalistic and reactive approach to address the rights of disabled people. Drawing on the experiences of disabled people in the UAE and evidence from interviews conducted from 2016 to 2018, the analysis identifies several key challenges to inclusion that stem from a weak enforcement and accountability framework, which results in a lack of accessibility measures and supports in university and workplace settings. The paper recommends interventions that would create an institutional environment where disabled people are treated as rights holders and given equal and equitable access to higher education and employment. This paper studies the barriers that disabled people face in higher education and employment in the United Arab Emirates (UAE). The UAE is a very rich oil-producing country located in the Arabian Gulf with a small number of citizens and a large migrant population. The key problems disabled people talked about are how they are denied equal access to learning supports in the university and how employers do not give them measures and tools to do their work. Because the UAE has signed the United Nations Convention on the Rights of Persons with Disabilities (CRPD), it should not allow that disabled people are treated unfairly or that they are treated in an unequal way. The UAE should make its laws stronger and monitor the implementation of the CRPD. [ABSTRACT FROM AUTHOR]

Vision loss is a public health challenge adversely affecting over a billion people worldwide. Low and middle income countries (LMICs) have a disproportionately higher prevalence of vision loss compared to high-income countries. Over 80% of vision loss can be addressed with either spectacles or cataract surgery. Both of these interventions are low cost and cost effective. Despite this, several barriers prevent individuals from accessing eye care. This paper covers various elements of access (approachability, acceptability, affordability, availability and appropriateness) and presents barriers that prevent access to eye care services in LMICs. Disease-specific barriers and various models and strategies that address the accessibility challenges are presented with a special reference to the use of technology to improve access. Strategies such as providing free eye care, lowering direct and indirect costs, improve access to cataract surgery. While access-related challenges related to cataract surgery are well studied, there is inadequate information on access to refraction services for refractive errors and other conditions. Future research can focus on addressing this information gap. This can then help develop strategies to address the burden of uncorrected refractive errors and other causes of vision loss and contribute towards achieving universal eye health coverage. A literature search was carried out to identify the relevant articles reporting barriers to seeking eye care in the Medline, CINHAL and PsycINFO databases between 20 and 27 May 2023. From this search, the relevant articles were shortlisted for data extraction. [ABSTRACT FROM AUTHOR]

The aim of this paper is to improve the knowledge of collaborative challenges when planning and implementing Bus Rapid Transit (BRT). Collaborative challenges are here understood as the barriers that may arise in BRT planning and implementation as a consequence of several formally independent actors, occasionally with different interests, participating in the planning. The results are based on an analysis of actor interactions in Swedish BRT projects. These projects are analysed in relation to the state of the art in the research field of collaborative approaches. The results show two main and interrelated collaborative challenges. The first category of challenges concerns difficulties for actors in creating a common understanding of what a BRT system is, the second category concerns details of bus priority measures, e.g. busways, priority at intersections, and how to handle and deal with conflicting interests when removing speed bumps or pedestrian and cycle crossings. In terms of policy is in the early stages of the planning processes. This can be generated by working practices and tools that facilitate agreements on how to handle different interests and trade-offs. BRT guidelines adapted to national transport policy, legal and organisational conditions could function as tools in assisting actor dialogue. [ABSTRACT FROM AUTHOR]

This paper addresses one of the greatest challenges facing education systems globally, that of making progress in relation to inclusion and equity in schools. Building on the findings of a programme of international collaborative action research carried out over the last twenty years, it reports on a pilot study carried out in Uruguay using professional learning materials developed by UNESCO. This points to the potential of a strategy for moving thinking and practice forward based on a collaborative action research approach. At the same time if shows how attempts to introduce the strategy have thrown light on local cultural and structural barriers that limited its implementation. Drawing on this analysis, the paper makes recommendations for future developments in Uruguay. It then concludes by arguing that the strategy could be used in other countries to identify factors that are limiting progress in order to develop more effective interventions. [ABSTRACT FROM AUTHOR]

The city of Chongqing in southwestern China has adopted a systematic set of urbanization policies since the late 2000s. Due to their emphasis on the role of the government and their scale, they deserve close attention. Yet, few studies have examined both positive and negative impacts of the urbanization policies regarding land acquisition, hukou conversion and urban housing as a complete process from rural migrants' perspective. More longer-term empirical studies focusing on rural migrants' reactions to the urbanization policies are needed. By conducting interviews with rural migrants, this paper aims to fill this gap. The results show that the migration intentions of rural migrants living in public rental housing are well-organized and purposive. The motivations for migration are not exclusively financial, but include the opportunities for better schooling and enhanced family bonds that come with living in public rental housing. Meanwhile, the institutional and social barriers faced by rural migrants were also identified. The goal of the paper is to enrich the understandings of the effects of urbanization policies in China. [ABSTRACT FROM AUTHOR]

This paper investigates the perception of healthcare providers in regard to the challenges that hinder the development of e-health initiative in Jordan based on a classification of challenges that was developed from the pre-existing literature. Twenty-six semi-structured interviews were conducted with various stakeholders of the e-health system. These challenges are Lack of Regulations and Policies to Support Health Information Systems, lack of financial resources, Privacy Concerns, and Nature of Healthcare Sector. The paper concludes that all of the unique findings that emerged in this paper are directly related to human and cultural issues. These two aspects appear to have a huge impact on the development of the e-health in Jordan. In order to ensure a smooth transformation of health services delivery and as an outcome and contribution of this paper to the managers and decision makers in the healthcare sector, a few findings were highlighted and could be of great value to people in charge of e-health initiatives these include: proper laws and policies that support the e-health development, secure the necessary needed funds, addressing privacy concerns of stakeholders, and standardization of e-health development. This paper serves as one of the newest interpretive studies that empirically explore the challenges to e-health in Jordan. It also attempts to bridge the gap found in the existing literature as it investigates the key issues that affect the development of e-health in Jordan from a different angle that was not adequately looked at and discussed previously. [ABSTRACT FROM AUTHOR]

Blockchain is an emerging technology with a wide array of potential applications. This technology, which underpins cryptocurrency, provides an immutable, decentralised, and transparent distributed database of digital assets for use by firms in supply chains. However, not all firms are appropriately suited to adopt blockchain in the existing supply chain primarily due to their lack of knowledge on the benefits of this technology. Using Total Interpretive Structural Modelling (TISM) and Cross-Impact Matrix Multiplication Applied to Classification (MICMAC), this paper identifies the adoption barriers, examines the interrelationships between them to the adoption of blockchain technology, which has the potential to revolutionise supply chains. The TISM technique supports developing a contextual relationship-based structural model to identify the influential barriers. MICMAC classifies the barriers in blockchain adoption based on their strength and dependence. The results of this research indicate that the lack of business awareness and familiarity with blockchain technology on what it can deliver for future supply chains, are the most influential barriers that impede blockchain adoption. These barriers hinder and impact businesses decision to establish a blockchain-enabled supply chain and that other barriers act as secondary and linked variables in the adoption process. [ABSTRACT FROM AUTHOR]

Currently available evidence indicates that energy demand in the Kingdom of Saudi Arabia (KSA) is generally increasing and solar energy constitutes a promising new source of energy. Thus, this paper aims to identify and assess the most critical barriers and drivers of the implementation of solar energy in KSA. This study develops and employs a systematic decision-making framework based on the judgment of experts. The interactions between the barriers and drivers are evaluated using rough DEMATEL (integrated crisp DEMATEL and rough set theory) and interpretive structure modelling (ISM). Rough set theory serves to address the involvement of vagueness. Furthermore, this paper conducts MICMAC analyses to evaluate the driving and dependence power of the drivers and barriers. This paper finds that the most significant barrier to solar energy in KSA is the expensive electricity generated by solar energy while the most significant driver of solar energy in KSA is the availability of solar irradiation. This study will assist industrial managers who are working on the implementation of solar energy projects in KSA, enabling them to properly assess and evaluate the solar energy sector in the country. This study is amongst the first of its kind to address the barriers to and drivers of the implementation of solar energy in KSA by using the rough DEMATEL method. [ABSTRACT FROM AUTHOR]

Southern Africa has fewer innovative entrepreneurs per capita than other regions of Africa and a high failure rate amongst SMEs. Common problems such as corruption, crime and poverty plague the region, and as a result many of the economies do not perform well. The purpose of this paper is to investigate what barriers hinder the development of innovative entrepreneurship and economic performance in the region, based on entrepreneurial ecosystem theory. Panel data at national level was collected for eight countries in the region. Using SEM-PLS estimation, it was found that poor national strategies, corruption, excessive taxes, and high entry barriers put innovative entrepreneurship out of reach for many people. Government policies and the socio-cultural elements encourage entrepreneurship; however, the support is not enough to contribute positively towards economic growth. Unhealthy entrepreneurial ecosystems block access to resources and opportunities, limiting entrepreneurial activity and economic output. These findings highlight problem areas that can be used as the basis for policy formulation and restructuring efforts to target the most crucial barriers to innovative entrepreneurship, thereby encouraging entrepreneurial development. This study contributes towards the understanding of entrepreneurial ecosystem dynamics in the novel and unique context of middle- and low-income countries and can inform appropriate policy restructuring to ameliorate entrepreneurship in the region. [ABSTRACT FROM AUTHOR]

Collaborative planning, forecasting and replenishment (CPFR) as an interconnection scheme between organisations have been shown to have significant benefits. Since its inception in the 1990s, its uptake has been lower than originally predicted. This paper identifies the major barriers and their interrelationships in CPFR implementations with a focus on high-tech industries. Interpretive Structural Modelling is used with a group of CPFR experts from industry/academia and Matrice d’Impacts Croisés Multiplication Appliquée àun Classement analysis to identify the driving and dependence powers. The paper identified 45 CPFR barriers and classifies them into four categories based on expert opinion, with only 13 of these determined to be significant. The results indicate that in terms of categories, managerial barriers are a significant root cause for both process and cultural barriers and CPFR implementation difficulties. It also indicates that although the importance of information technology to launch collaborative schemes has been addressed by many scholars, technology alone is not the complete solution for successful CPFR implementation. The paper has significant practical implications for organisations as it identifies the main CPFR barriers and their causal relationships. This will help firms in the process of CPFR strategy development particularly for mitigation strategies for dominant barriers. [ABSTRACT FROM PUBLISHER]

This paper aims to identify what factors are barriers to gastronomic innovation in the hotel sector and which ones facilitate it. The paper analyses whether external or internal barriers and demand or competition orientation and network-based knowledge influence whether a hotel implements more or less gastronomic innovation. It also investigates the impact on performance from a financial and non-financial perspective, using a structural equation model to test the hypotheses. Gastronomy becomes a priority for hotels as guests look for experiences at the destination. A sample of 131 three to five-star hotels in the province of Santa Cruz de Tenerife (Canary Islands, Spain) was selected for the purpose of this study. Respondents were different categories of managers of the participating hotels. The results show that there are internal and external obstacles that have a negative influence on gastronomic innovation, whereas risk-taking does not show any significant negative influence. Furthermore, when a hotel is driven by demand and competition, there is a favorable outcome on gastronomic innovation. It is also apparent that applying of higher levels of network-based knowledge has a positive impact on gastronomic innovation. The study’s findings show that a stronger focus on gastronomic innovation improves financial and non-financial performance. [ABSTRACT FROM AUTHOR]

The character of professional development offered to those who teach in higher education is changing. There is a shift towards the adoption of more flexible, work-based, apprenticeship models, where experiential routes are increasingly valued. This paper seeks to understand the factors that impact engagement in academic professional development. A quantitative study reveals that experience, years of service, and discipline have little impact on educators' professional development preferences, nor on the recognition of individual needs and contextual nuances to ensure optimal engagement in academic professional development. We demonstrate that it is not possible to profile professional development pathways in these ways, thus strengthening the evidence base for a flexible approach to it. [ABSTRACT FROM AUTHOR]

The present study aims to build a structural model based on Total interpretive structural modeling (TISM) to analyze barriers affecting healthcare waste management (HCWM). Through scanning of literature and expert opinion, a total of fifteen barriers are recognized. Inputs acquired from the professionals in the field are used to develop the TISM model, and Cross impact matrix multiplication is applied to classification investigation to sort out the factors. From the TISM model, five barriers are identified as drivers. We identified two of these five barriers: 'No support from top authorities' and 'No support from the government.' MICMAC analysis classifies four barriers as dependent, five as driving, and the remaining six as linkages. The author's original contribution is to develop a model to analyze barriers influencing HCWM. This paper helps to complete the research gap by providing the different characteristics of barriers. This study clarifies that good coordination of hospitals with other authorities is necessary to properly implement healthcare waste management services. Government support will also play a vital role, and the Involvement of top management of hospitals is required to organize everything properly. Case studies and structural equation modeling (SEM) can be applied to explain further and support the findings. [ABSTRACT FROM AUTHOR]

Lean Six Sigma (LSS) is an inclusive approach based on the concept of waste and variation reduction to achieve quality and sustainability. The successful adoption of any approach depends upon the awareness and readiness measures of a particular one. This paper contributes toward Micro-Small and Medium Enterprises (MSMEs) to adopt a comprehensive LSS approach in their existing system through the identification, analysis, and prioritization of LSS enablers and barriers. In the present study, 25 enablers and 21 barriers of LSS adoption are identified through literature review and are validated by using questionnaire-based survey. The screened enablers and barriers are further formulated into logical groups using factor analysis. These formulated groups are prioritized through Analytical Hierarchy Process (AHP) and compared the obtained results with the fuzzy decision-making trial and evaluation laboratory (Fuzzy-DEMATEL). The result reveals that among the main group of enablers, "management-based factor" is the top-ranked followed by "training- and education-based factor" and "technology-based factor" with AHP weights 0.4008, 0.2742, and 0.1465 respectively. On the other hand, among the main groups of barriers, "training and education based factor" is at first rank trailed by "management-based factor" with AHP weights 0.4780 and 0.2915 respectively. The outcomes of current research will facilitate the MSMEs to make a favorable environment toward the LSS approach for increasing productivity and profitability dynamics. An engineering manager can use this paper to enhance social sustainability through the incorporation of LSS approach in the communities where they work. Moreover, this study provides a guiding reference for practitioners and academicians to undertake similar nature of problems into other industrial sectors. [ABSTRACT FROM AUTHOR]

The energy crisis has pushed Pakistan way down the economic rankings. More than 70% the total population resides in rural regions. The energy crisis has crippled the lifestyle of the rural class (RC) in many aspects. For rural Pakistan, the energy scarcity, a hurdle in sustainable development, can be eliminated by biogas. Almost every rural family is associated with agriculture and owns livestock animals, therefore self-sufficient in biogas plant's fuel. Fuel abundance and favourable climatic conditions make energy extraction from biomass facile and fruitful; still there are many reasons that RC is dumped in the energy crisis. In this paper, a survey is conducted in villages of Pakistan to discover the reasons due to which domestic biogas plants have not yet gained their due importance. Institutional, financial, awry planning and social barriers are highlighted at the grass root level in the development of biogas technology in rural Pakistan. In contrast, villages where biogas plants are present, the survey analysis revealed prosperity rendered through savings, reduction in diseases and workload. The paper concludes with an emphasis on the requirement of concrete and comprehensive policy that is capable to deal with the barriers in the route of biogas technology. [ABSTRACT FROM AUTHOR]

Innovation is believed to be a key driver of societal and economic well-being. In many cases, it has also led to more sustainable lifestyles and a more efficient use of natural resources. But despite the relevance of innovation as a tool to support sustainable development, there is a need for research that analyses current trends in order to guide future efforts. The present paper addresses this research need. It examines existing methods and tools for fostering social innovation in matters related to sustainable development, within the framework of the SDGs. By means of an online survey undertaken among sustainability and innovation experts in a sample of industrialised and developing nations, this study has identified some of the means via which social innovation is being pursued, along with its applications and limitations. A number of case studies showing examples of sustainable innovation have been mapped to demonstrate its usefulness. A causal loop diagram, which links the factors associated with social innovation within the context of the UN Sustainable Development Goals, is also presented, offering a greater understanding of their interconnections. The paper concludes by outlining some measures that may help to take better advantage of the many opportunities offered by social innovation that put the principles of sustainable development into practice. [ABSTRACT FROM AUTHOR]

This communication is a review over the major market and technical challenges and opportunities for nanocellulosic materials on a large scale but in low-to-medium-end markets. Basically, the potential use of nanocellulose as a wet-end strength additive in papermaking has been known for decades, but not come into operation because of the high-energy costs of producing these materials. Cost performance compared to starch derivatives is one challenge, and the other is to design suitable dewatering/retention aid systems. Other paper applications are as a surface-sizing agent and as a barrier coating material. Major challenges are associated with the high viscosity of nanocellulosic materials and how to apply the nanocellulose in order to obtain good surface coverage. There are several opportunities in the nanocomposite markets. The packaging sector together with the automotive sector and the building sector constitute large potential markets. Challenges are related to the mixing of hydrophobic and hydrophilic materials so that a good dispersion of nanocellulose is obtained. Scaling up of nanocellulose production processes and procedures for nanocomposite manufacturing in order to obtain price–performance in the various applications remains, as expected, the largest challenge [ABSTRACT FROM AUTHOR]

This paper analyses strategies to overcome barriers to a modal shift to inland waterway transport (IWT). Barriers identified in research literature have been categorised as regulatory, financial, service quality and market characteristics. Using two cases involving Swedish entrepreneurs initiating IWT, this paper has shown how barriers to the modal shift to IWT can be managed where markets are limited. Modal shift involves multiple actors, and the entrepreneurs interacted with ports, shippers, shipping companies, regulatory actors, forwarders and hauliers, depending on the barrier. Strategies to manage barriers included negotiating, educating stakeholders, securing volumes, conducting a proof-of-concept run and identifying business opportunities for stakeholders. The findings can increase stakeholders' knowledge of IWT. Policy makers aiming to promote modal shift must understand that fees and legislation act as barriers. [ABSTRACT FROM AUTHOR]

A spectrum of operational, structural, and cultural conditions leads to the success or failure of community-based tourism (CBT) initiatives. Knowledge of these factors is crucial in the design, evaluation, and monitoring of CBT. Therefore, the aim of this paper is to identify the factors that facilitate and inhibit CBT in the natural areas of developing countries. A directed content analysis of 68 case studies from literature identified 25 external and 32 internal factors. Based on the 77 factors obtained, a methodology to evaluate CBT initiatives is proposed that can serve as a framework to (1) evaluate initiatives in terms of their feasibility for CBT, current performance, and issues to be solved by management; (2) compare the performance of various initiatives; (3) prioritize factors for the success of CBT; and (4) statistically analyse the relationships among factors. The paper concludes that although several previous studies identified success factors and barriers for CBT, surprisingly little work has been published to create a universal framework to evaluate CBT initiatives. Further research is suggested to explore the statistical relationships among the factors and to define the relative importance of each factor in the success or failure of CBT initiatives. [ABSTRACT FROM AUTHOR]

Incorporation of smart devices within the older framework has brought along significant challenges. This paper presents a detailed analysis of the barriers faced during the implementation of Internet of Things (IoT) within the manufacturing sector. In addition, the authors aim to obtain a hierarchical structure, which will help the policymakers to identify the most crucial barriers enabling them to make an informed decision. With the help of databases like Scopus, Web of Science, etc. a comprehensive list of 22 barriers was initially obtained. This list was further narrowed down to 10 critical barriers. The first step of the analysis involved the application of Decision Making Trial and Evaluation Laboratory (DEMATEL) technique, which quantifies the influence of the barriers amongst one another. Maximum Mean De-Entropy (MMDE) technique is then used to obtain a scientific threshold value, which is later used in the Interpretive Structural Modelling (ISM) technique from which a hierarchical structure of the barriers is obtained. The results of this study are expected to highlight the most crucial barriers wherein the researchers and practitioners can focus their strategic efforts. This will facilitate the addressal of implicit issues while implementing IoT Techniques in the manufacturing industry. [ABSTRACT FROM AUTHOR]

Individuals with intellectual and developmental disabilities (IDD) have unique and complex health care needs that require health care access. Barriers, such as decreased health literacy and a lack of experienced physicians working with this population, make access to inclusive health care increasingly difficult. Therefore, it is important for occupational therapists to intentionally create opportunities to improve healthcare access and utilization for this population. This paper describes the collaborative health narrative development process as well as the inclusion of three examples created by co-authors with intellectual or developmental disability. [ABSTRACT FROM AUTHOR]

Abstract\nPoints of InterestThis article analyses the difficulties that 16 graduate with disabilities from 8 Spanish universities in the area of Health Sciences experienced during their academic career. It also shows how they overcame these difficulties, as well as their insight into their own resilience. This qualitative study used semi-structured and individual interviews. The results showed that the difficulties, the strategies to deal with them, and the opinions of the participants about their resilient characteristics are multiple and relate to both external and internal factors. The results reveal that participants’ voices from these Health Sciences degree contain useful strategies for the ­university community to promote the academic success of students with disabilities for the benefit of all students.Healthcare degrees tend to present greater challenges for students with disabilities.Students often experience exclusion during their healthcare training due to the fact that disability is based on a ‘medical’ perspective of disability.This paper analyses the difficulties and coping and resilience strategies used by university students with disabilities with a Bachelor’s degree in Health Sciences to successfully overcome these difficulties.Numerous internal and external factors enable students with disabilities to successfully complete health studies.This study can contribute that including students with disabilities in healthcare degrees improves healthcare improves for vulnerable populations, as well as the relationship between professionals and patients. [ABSTRACT FROM AUTHOR]

Building information modeling (BIM) is a disruptive information technology tool in the construction sector. Although this technology had a significant impact on the manufacturing industries, it, like any other technology, encountered several challenges when applied to the construction sector. Conversely, small and medium-sized enterprises (SMEs) in developing economies often face significant impediments when using innovative technologies. Thus, this paper seeks to determine and investigate the perceived barriers to applying BIM in construction SMEs based in Iran. Three rounds of Delphi surveys were carried out with 15 BIM experts engaged in construction SMEs to identify the key barriers to BIM implementation in SMEs. An empirical survey questionnaire comprising these identified barriers was subsequently designed and disseminated to the invited experts. Altogether, 56 valid survey responses were received and analyzed. The study's findings revealed SMEs management's hesitancy to adopt BIM, stakeholders' reluctance to change their established methods, and a lack of technical understanding as the critical impediments to BIM adoption in construction SMEs. Also, the study identified four barrier dimensions – technology, legal, management, and financial. These BIM implementation barrier dimensions can be employed to better allocate resources and financing for BIM deployment and construction innovation in SMEs. The study will assist major project stakeholders and SMEs make better-informed BIM adoption decisions, particularly in developing nations like Iran. [ABSTRACT FROM AUTHOR]

AbstractSmall and medium sized enterprises (SMEs) within the tourism sector play crucial yet often underestimated roles in climate change mitigation, contributing to approximately half of the sector’s greenhouse gas emissions. Although the existing literature has examined barriers to climate change action and potential drivers for the involvement of small firms, these aspects have not been comprehensively explored within the context of tourism. The article addresses this gap by conducting a narrative review that analyzes 78 papers and reports published on the topic. The results substantiate a differentiation among barriers, pressures, and incentives. Barriers encompass aspects related to knowledge and personality, understanding and perceptions, management, data, finances, technology, legislation, and community. Pressures originate from costs, customer expectations, and compliance. Incentives manifest in economic considerations, subsidies, marketing strategies, staff benefits, and community advantages. The findings are synthesized into a series of conceptualizations, offering pathways for progress on mitigation. Findings emphasize the significance of legislation and efforts of destination management organizations for accelerating SME engagement with climate change. [ABSTRACT FROM AUTHOR]

A major internal barrier to new venture growth is employee effort that diminishes with expansion of the venture's workforce. This paper advances entrepreneurial growth theory by exploring conceptually how management measures that leverage three distinct employee motivations – extrinsic, intrinsic, and prosocial – affect this barrier. I argue that "agency measures" which leverage employees' extrinsic motivations likely lose their effectiveness as firms grow; in contrast, measures that leverage employees' prosocial motivations are better placed to overcome the internal growth barrier and spur ongoing new venture growth. [ABSTRACT FROM AUTHOR]

This paper explores women smallholder livestock farmers' barriers to effective participation in the livestock vaccine value chain (LVVC) and strategies for optimising the use of vaccines against poultry (Newcastle disease), and goat diseases (Peste des Petits Ruminants) in Sembabule District, Uganda. Using the three domains of empowerment theory: intrinsic, instrumental, and collective agency combined with USAID's gender analysis framework, we found that limited control over resources, and inadequate gender responsive policies hinder women's participation. Self-help groups increased opportunity for livestock ownership, autonomy, and decision-making. Engagement of women in the LVVC, is an entry point for improved vaccine accessibility, and agency. [ABSTRACT FROM AUTHOR]

Riding a bike for transport purposes is an effective way to improve population and environmental health. Despite this, participation levels in many countries are low. Identifying the barriers and enablers to riding a bike for transport is essential to developing interventions that encourage bike riding. In this mixed-methods systematic review, we aimed to identify the perceived barriers and enablers to adults riding a bike for transport in Organisation for Economic Development (OECD) countries. A systematic database search was conducted to identify relevant peer-reviewed and grey literature. Fourty-five papers/reports met eligibility criteria. There were 34 barriers and 21 enablers identified. The leading barriers related to riding on the road alongside motor vehicles. Other factors identified included the provision and quality of cycling infrastructure, personal factors such as physical fitness, attitudinal factors such as community perceptions of cyclists, and environmental factors. While this review highlights the complexity of factors that influence the uptake of riding a bike for transport, many of the leading factors could be overcome through the provision of high-quality protected infrastructure for bike riders. Other interventions to address other known barriers and enablers are needed to increase the uptake of bike riding. [ABSTRACT FROM AUTHOR]

Introduction Research in palliative care (PC) is often regarded as challenging due to the vulnerability of the population and other peculiarities. We aim to systematically identify barriers to research in PC in the literature. Methods The electronic databases CINAHL, MEDLINE were searched for papers published in the last 25 years. Citations and then abstracts were screened for inclusion. Original papers were included on first-level analysis. On a second level reviews, reports, and position papers were analyzed. Papers containing a direct patient report were specifically analyzed. Barriers were categorized (ethical considerations, financial and time expenses, study design and methodology, human resources and politics) and results quantified. Results Twenty-one original papers and 65 other papers were included. Five studies involved patients directly, five were systematic reviews, three were study experiences, and seven were surveys or workshop reports. Most papers originated from UK, USA, or Norwegian Universities. Ethics and methods were the most often mentioned categories on both levels. Accrual, attrition, and gatekeeping were frequently named barriers. Complex invasive studies or possible side effects hinder patients' participation, as patients are often willing to participate for altruistic motivations. Discussion Barriers to PC research are ethical concerns and methodological challenges. Possible strategies to overcome methodological barriers include international collaborative efforts to include more patients and improve study designs. Ethical barriers indicate the need for patient involvement in the research development process and tailoring research specifically to the PC population. [ABSTRACT FROM AUTHOR]

The paper compares the case of Jamaica, which despite a two-decade-long journey, has experienced unsatisfactory progress in implementing e-Government, with that of Singapore, which has achieved considerable success, despite being small island-states of similar-sized populations with British colonial histories, with both nations gaining their independence around the same time in the mid-1960s. Qualitative data gathered from interviews and documentation from supply-side stakeholders were analyzed to better understand the drivers for, and barriers to, the successful implementation of e-Government initiatives. Based on the existing literature, a novel conceptual framework was used to guide the data collection and analysis process. This enabled the presence of previously identified drivers and barriers for e-Government initiatives to be assessed in the context of both countries. The study was also able to surface new and additional factors influencing e-Government implementation, which have not been previously identified within the e-Government research literature, namely Administration/Leadership, e-Readiness, and Communication. The research findings enabled practical and actionable recommendations to those leading e-Government initiatives in Jamaica to improve implementation by overcoming forces that hinder progress. The findings from this study are limited as the research draws on data from limited sources in just two countries. [ABSTRACT FROM AUTHOR]

It is well documented that there is a shortage of mental health care providers, mental health literacy, and underutilization of mental health services in Pakistan. This systematic review aimed to assess the available evidence on factors hindering and/or facilitating access to care among people with mental health issues, health care providers, carers, or any other population group (e.g., students, teachers) in Pakistan. Thirteen published studies of barriers and facilitators in Pakistan were identified through nine electronic databases: Ovid MEDLINE, Ovid Embase, Ovid Emcare, CINAHL plus, Proquest Central, PsycInfo, Scopus, Pubmed, and ScienceDirect. Thematic analysis revealed that factors facilitating access to mental health services were trust in the effectiveness of mental health services and acknowledging the seriousness of the problem. However, factors hindering the access were financial issues/constraints, personal issues/other priorities, stigma, low mental health knowledge, side-effects/dissatisfaction from previous treatments, time and distance constraints, reliance on traditional/religious healers, and lack of social (i.e., family and peers) support/encouragement. Findings suggest the need for reducing barriers to and enhancing facilitators of seeking mental health services. To improve help-seeking, the focus of strategies should be on enhancing mental health literacy, lowering stigma, and increasing trust in mental health services' effectiveness. What is known about this topic? There is a scarcity of empirical evidence on mental health and its correlates in Pakistan-a developing country and mental health services are restricted to psychiatry departments of teaching hospitals or in privately run clinics. There is a scarcity of psychiatrists in rural areas having 60% population and there is a need for recognizing facilitators and reducing barriers to reasonable mental health care is crucial. What the paper adds: Factors facilitating access to mental health services were trust in the effectiveness of mental health services and acknowledging the seriousness of the problem. Factors hindering the access were financial issues/constraints, personal issues/other priorities, stigma, low mental health knowledge, side-effects/dissatisfaction from previous treatments, time and distance constraints, reliance on traditional/religious healers, and lack of social (i.e., family and peers) support/encouragement. This recognition can help to design adequate programs and policies for people with mental health issues. There is a need to raise public awareness of the importance of seeking mental health services as well as for designing, testing, and executing strategies to reduce self and social stigma related to mental health problems. [ABSTRACT FROM AUTHOR]