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Digital transformation (DT) readiness is usually associated with the technological maturity of an organisation more than with its readiness from a strategic point of view, which makes it essential to have artefacts that allow this type of evaluation, which still needs to be sufficiently expanded and tested. Based on Rogers's [1] framework, this work developed a conceptual model to assess the impact and relevance of the six enablers in strategic readiness and benefits resulting from a DT project. Through a qualitative study with a panel of experts from six Portuguese organisations, it was possible to validate the model, conclude which are the most relevant strategic enablers for greater DT readiness, and also that conducting more business through digital platforms significantly improves the resulting benefits. Furthermore, it will be possible to apply this model in broader quantitative contexts to determine which factors are most prevalent according to the context, be it an industry, a region, or an organisation's dimension. [ABSTRACT FROM AUTHOR]

The adverse environmental consequences arising from road-based logistics operations have prompted stakeholders, including transport service providers, logistics managers, and shippers, to initiate a modal shift from unimodal road to intermodal railroad (IRR) freight transportation. However, the adoption pace of IRR in developing nations is slow. Modal shift enablers (MSEs) facilitate IRR adoption, while modal shift benefits (MSBs) signify favorable performance outcomes from MSEs' application. The main objective of this study is to rank the MSBs resulting from the adoption of MSEs in IRR freight transportation. This study proposes an integrated multi-criteria decision-making framework utilizing the spherical fuzzy analytic hierarchy process (SF-AHP) to evaluate MSEs' weights and the spherical fuzzy technique for order of preference by similarity to ideal solution (SF-TOPSIS) to rank the MSBs. The case study performed in the Indian logistics sector reveals that 'government policies and legislation enablers', 'infrastructural enablers' and 'strategic and management enablers' are the most significant MSEs, whereas reduction in vehicular pollution and related negative externalities as well as reduction of the freight transport costs including storage and handling charges are most crucial MSBs realized due to adoption of MSEs. A sensitivity analysis is conducted to assess the stability of the ranking. The results help decision-makers in implementing MSEs for MSBs and develop effective IRR adoption strategies. This study also promotes sustainable freight transportation and provides logistics practitioners, researchers, and policymakers with a precise, systematic, and practical decision-support tool. • 36 enablers of modal shift to intermodal railroad (IRR) transport were identified. • 15 benefits realized through adoption of modal shift enablers were recognized. • An empirical case analysis was conducted in the Indian logistics sector. • A hybrid framework of SF-AHP and SF-TOPSIS approach was applied. • It helps stakeholders to understand the key enablers and benefits of IRR adoption. [ABSTRACT FROM AUTHOR]

Familial hypercholesterolaemia (FH) is a genetic condition that is a preventable cause of premature cardiovascular morbidity and mortality. High-level evidence and clinical practice guidelines support preventative care for people with FH. However, it is estimated that less than 10% of people at risk of FH have been detected using any approach across Australian health settings. The aim of this study was to identify the implementation barriers to and facilitators of the detection of FH in Australia. Four, 2-hour virtual focus groups were facilitated by implementation scientists and a clinicians as part of the 2021 Australasian FH Summit. Template analysis was used to identify themes. There were 28 workshop attendees across four groups (n=6–8 each), yielding 13 barriers and 10 facilitators across three themes: (1) patient related, (2) provider related, and (3) system related. A "lack of care pathways" and "upskilling clinicians in identifying and diagnosing FH" were the most interconnected barriers and facilitators for the detection of FH. The relationships between barriers and facilitators across the patient, provider, and system themes indicates that a comprehensive implementation strategy is needed to address these different levels. Future research is underway to develop a model for implementing the Australian FH guidelines into practice. [ABSTRACT FROM AUTHOR]

The use of modular construction (MC) is well-established in developed countries and is known to promote sustainability. However, MC is not widely utilised in developing countries. To address this issue, a study was conducted to identify enablers that can increase the adoption of MC in developing countries, specifically for residential projects. A survey was conducted to determine the relative value of 21 enablers that boost the adoption of MC. The data collected was analysed using Exploratory Factor Analysis (EFA), which classified the enablers into four main components: Optimization, Planning and Management, Preparation, and Promotion and Improvement. Then, Fuzzy Synthetic Evaluation (FSE) was employed to rank these four components, where it was found that "Optimization" is the top performing component while " Promotion and Improvement " is the least performing component. The study's results provide a roadmap for the Egyptian construction industry to adopt MC, which can improve the construction sector, particularly in residential construction. Additionally, the findings of this research help fill a gap in knowledge about the enablers that can enhance the use of MC in developing countries. [ABSTRACT FROM AUTHOR]

Background: A review conducted in 2015 reported community pharmacists are willing to adopt a professional role in counselling consumers about the appropriate and safe use of traditional and complementary medicines (T&CM) but faced multiple barriers in doing so; including the role being poorly defined. This current review aimed to update and extend these findings, by identifying studies published since 2015 that reported on pharmacists across any setting.Methods: Eligible studies published between January 01, 2016 and December 31, 2021 were identified across six databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). A grounded theory approach was used to thematically synthesize the data extracted.Findings: A total 64 studies representing pharmacists across 30 countries were included for review. Study designs varied including cross-sectional surveys (n = 36), qualitative studies (n = 14), and pseudo-patient studies (n = 3). Eight studies reported on practice and/or bioethical responsibilities and 19 studies reported on factors that would enable pharmacists to fulfill these responsibilities, while 37 studies reported about both.Conclusion: These findings indicate research about pharmacists' responsibilities associated with T&CM is evolving from gap analysis towards research that is proactive in advocating for change in multiple areas. These findings can be used to inform a consensus discussion among pharmacists and key stakeholders regarding a set of professional responsibilities that would serve in the development of: a clearly defined role and associated practice standards, and competency requirements that inform educational learning objectives for inclusion in undergraduate, post-graduate and continuing professional pharmacy education. [ABSTRACT FROM AUTHOR]

Special health care needs (SHCNs) individuals experience higher levels of dental problems including accessing oral health (OH) facilities. Improving standard of OH care in SHCNs requires identifying barriers and enablers. The aim of this study was to perform a systematic review of prior researches to identify OH care barriers and enablers for SHCN individuals. Electronic searching was conducted systematically in PubMed and Cochrane databases. The PICOS parameters were formulated for the inclusion of studies, and the PRISMA method was used to select the articles. Two reviewers independently screened the articles for eligibility and to minimise the risk of bias in the studies and also searched the contents of key articles, quality of methodology, outcomes and reference lists of all the studies included. A total of 1316 (PubMed 956, Cochrane 360) studies were found initially and after title and abstract screening and also removal of duplication, reviewers selected 53 papers from PubMED and 19 articles from Cochrane to go through full articles and led to the final confirmation of 21 studies. Common challenges included lack of OH knowledge and awareness, difficulty in accessing treatment, transportation problem, treatment cost, and lack of inter-professional collaboration for specialized services. Potential solutions included OHE training and services for patients and caregivers, easy access to dental services, specialized dental practitioners and use of a combination of expertise to meet the demands of SHCN individuals. This brief analysis will establish dental obstacles to the provision of information to policymakers for SHCN population at organizational, individuals and policy levels. It will help in effective planning for providing and improving OH care quality in caregivers. [ABSTRACT FROM AUTHOR]

The integration of artificial intelligence (AI) with human intelligence (HI) has been asserted to provide transformational power across the humanitarian supply chain (HSC). However, there is little rigorous work that analyses the enablers that promote AI–HI integration and application in the HSC. Thus, this paper reports a hybrid decision support framework for analysing enablers of AI–HI integration in the HSC with complicated, uncertain, and periodic information. First, to collect interdependent preference data from experts, the complex spherical fuzzy weighted Heronian mean operator with a weighted distance measures-based optimization model is established to generate a group decision matrix. Next, to measure the influence strength of enablers, a complex spherical fuzzy decision-making trial and evaluation method is established to determine enabler weights, taking into account their interactive relationships. After that, to explore the enabler level of AI–HI integration in different participants of the HSC, the complex spherical fuzzy measurement of alternatives and ranking according to the compromise solution method is developed by combining the former two procedures. Finally, a case study of enablers analysis for AI–HI integration in HSC is presented to assess the feasibility of the current method, which includes sensitivity and comparison studies. The results reveal that the factor "enhancing the efficiency of relief operations" (0.084) is the most important driving factor for AI–HI integration. The outcomes of this study can provide a new decision support method for understanding the enablers of AI–HI integration in key parts of the HSC. • An integrated CSF-decision framework is proposed to assess enablers of AI-HI integration. • The inter-dependencies between estimation information distributions are considered. • The expansion of the CSF-DEMATEL is proposed to assign enablers weights. • An improved CSF-MARCOS model is developed to estimate enablers of AI-HI integration in HSC. [ABSTRACT FROM AUTHOR]

The study aims to understand the enablers and barriers of circular economy (CE) adoption along with the impact of CE actions on sustainable performance in the context of Australian small and medium enterprises (SMEs). Based on the analysis of primary data from 352 SMEs in Australia, the questionnaire survey-based study revealed a lack of clearly defined business processes to be the major impediment towards CE adoption. Analysis also showed environmental performance having a significant positive relationship with design, process, and recovery. Surprisingly, the research showed that the benefits associated with careful energy and resource management does not seem to be important to Australian SMEs. This is in direct contrast to the growing level of interest amongst Australian SMEs towards conservation of water resources and emission reductions. The findings of this research may drive SMEs to focus on CE adoption, as the results suggest that it is positively related to sustainable performance. [Display omitted] [ABSTRACT FROM AUTHOR]

Pneumococcal disease causes substantial morbidity and mortality in older adults. Pneumococcal polysaccharide vaccine (PPV23) is routinely recommended to reduce the disease burden in this population. However, the vaccination coverage in older adults remains suboptimal in high-income countries. We sought to understand the current landscape of published literature on the predictors of pneumococcal vaccine uptake in older adults aged 65 years and older in high-income countries, and to identify the gaps in literature to inform future research. We conducted a scoping review employing the Arksey and O'Malley framework and Joanna Briggs Methods. We searched Medline, EMBASE, CINAHL, PsycInfo and Cochrane databases. We included quantitative and qualitative studies on predictors of pneumococcal vaccination in older adults that reported older adult- and pneumococcal vaccine-specific results, conducted in high-income settings, and published in English between January 2015 and April 2020. We excluded studies assessing interventions to improve vaccine uptake. We followed the Strategic Advisory Group of Experts on Immunization Working Group Vaccine Hesitancy Determinants Matrix to map the predictors within contextual, individual and social group, and vaccine and vaccination-specific influence determinants. Studies on providers and institutions were also included and results summarized separately. We included 52 publications in our review. Most of the predictors in 39 quantitative studies belonged to the individual and social group influences (n = 12), followed by contextual influences (n = 11) and vaccine and vaccination-specific issues (n = 3). Few qualitative studies explored the barriers to pneumococcal vaccination. Only five studies examined predictors from the healthcare providers' perspective. Three studies examined the institutional characteristics as the predictors of pneumococcal vaccination in older adults. We identified enablers and barriers of pneumococcal vaccination among older adults in high-income settings. We also identified gaps in the literature and provide recommendations for future research to address the gaps. [ABSTRACT FROM AUTHOR]

The Anthropocene has brought with it many challenges, the primary of which are climate change and food security. The growing global population increasingly demands more from a shrinking resource base, while variable climate conditions make future provision uncertain. To address issues of low agricultural productivity and land degradation, conservation agriculture (CA) has been promoted in smallholder settings across Africa. CA is an agricultural package that consists of three key principles (minimum soil disturbance, mulching, and crop rotation) and its success depends on the simultaneous implementation of all three principles. However, CA has met with limited success. A scoping review was conducted to assess the barriers and enablers of CA for smallholder farmers in the Southern African Development Community (SADC) – a regional inter-governmental economic community. The scoping review included peer-reviewed articles, book chapters, reviews, and grey literature written in English that focused on the contextual links between CA adoption and the smallholder context, since 2015. Six electronic databases were consulted, and included records were charted according to a pre-defined data extraction form. A total of 66 records were included. A qualitative content analysis was performed. The findings indicated four central themes – physical resources, human resources, informational resources, and financial resources. The four central themes and their respective categories, detailing barriers and enablers, were combined to produce the Conservation Agriculture Suitability Framework for Smallholder Farmers. The review contributes to the knowledge base of the CA discipline and practice by revealing the contextual determinants of successful CA implementation. Ultimately, the success of CA in southern Africa will be underpinned by how well it fits into the broader smallholder farming system. • Climate variability and population growth in Africa has created vulnerability in the smallholder farming sector as well as food security challenges. • Conservation agriculture (CA) has been promoted to address these challenges but has seen low adoption rates and high disadoption rates. • A scoping review was conducted to assess the barriers and enablers of CA for smallholder farmers in southern Africa • Barriers and enablers are context specific, not universal, and are not unique to CA but are rather general constraints of smallholder livelihoods. • The CA Suitability Framework for Smallholder Farmers created to facilitate appreciation of the heterogenous smallholder context and promote incremental change through flexible and participatory approaches that accommodate local barriers and enablers. [ABSTRACT FROM AUTHOR]

Zero-emission buses (ZEBs) currently face the challenge of switching from small-scale implementation to large-scale deployment. This stage is affected by multiple decision-making factors that either hinder or enable the ZEB adoption, also depending on local contexts and stakeholder perspectives. This study develops a holistic framework relating the transition towards ZEB fleets based on an extensive literature review. The review aims at fully capturing the supporting and limiting factors for the bus fleet decarbonisation and organising them in a comprehensive taxonomy and hierarchy. Subsequently, the impact of each of the identified factors was quantitatively analysed. The results show that technological, economic and managerial factors have hampered the large-scale deployment of ZEBs, while social, environmental, and institutional dimensions have stimulated their diffusion. However, more recent studies show that advances in the technological and managerial domains are reducing some drawbacks linked to ZEBs. Finally, the proposed framework is used to identify factors of growing significance that merit further research. [Display omitted] • A framework and taxonomy for assessing alternative bus technologies is proposed. • Decision-making factors of bus fleet decarbonisation are comprehensively discussed. • The impact of each factor depends on local context and stakeholder standpoint. • Technological and economic factors hindered the adoption of zero-emission buses. • Zero-emission bus deployment is mainly driven by public incentive programs. [ABSTRACT FROM AUTHOR]

• There is a lack of adequate knowledge on the factors that influence men's involvement in maternal healthcare in SSA. • Cultural issues and stigma associated with maternal health hinder men's involvement. • A lack of financial resources, and unfriendly health facility environments also hinder men's involvement. • Health education and preferential treatment of women accompanied by their partners were enablers. • Involving men in the formulation of maternal healthcare policies is also crucial. Globally, there are about 800 maternal deaths every day, with low-to-middle-income countries accounting for most of these deaths. A lack of access to maternal healthcare services is one of the main causes of these deaths. In sub-Saharan Africa (SSA), one of the barriers to accessing maternal healthcare services by women is a lack of their male partners' involvement. This scoping review aimed to assess the enablers and barriers to men's involvement in maternal healthcare services. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist was used as a guide for this review. We searched for peer-reviewed articles published between 2013 and 2023 in the English language from SCOPUS, ScienceDirect, PubMed, Africa Journals Online (AJOL), and Google Scholar databases. Two reviewers independently conducted the data extraction and article selection. All of the authors discussed and decided on the codes and categories for enablers and barriers after using NVivo to generate them. Twenty-seven articles were used in this review. Of these, seventeen were qualitative studies, six were quantitative studies, and four were mixed-methods studies. The enablers of men's involvement in maternal healthcare were grouped into sociodemographic factors, health system factors, and policy factors, while barriers were grouped into sociodemographic, cultural, economic, and health system barriers. The lack of maternal health knowledge, insufficient economic resources, and unfriendly staff at healthcare facilities all contributed to a lack of involvement by men. To improve men's involvement in maternal healthcare in SSA, there should be economic empowerment of both men and women, health education, and the provision of adequate infrastructure in healthcare facilities to accommodate men. [ABSTRACT FROM AUTHOR]

Objective: To examine older adults' perceptions and identify barriers and enablers to initiating a conversation about stopping medication(s) with their healthcare provider.Methods: We conducted one focus group (n = 3) and in-depth, face-to-face, individual interviews (n = 6) using an interview guide. Older adults aged ≥65 years in a retirement community who were taking ≥5 medications were recruited. Focus groups and interviews were audio-recorded and transcribed verbatim. Both a deductive analysis, informed by the Theoretical Domains Framework, and an inductive analysis were conducted.Results: Five themes and fourteen sub-themes were identified. Theme 1, 'older adult-related barriers', discusses limited or varying self-efficacy, past unsuccessful deprescribing experiences and limited familiarity with medications/deprescribing. Theme 2, 'provider-related barriers', discusses trust, short office visits, lack of communication and multiple providers. Theme 3, 'environmental/social-related barriers', involves limited availability of resources and access to telehealth/internet. The remaining themes (Themes 4-5) identified enablers including strategies to promote older adults' self-efficacy and improved healthcare communication.Conclusion: Consumer-centric tools could improve older adults' self-efficacy to initiate deprescribing conversations.Practice Implications: Removing barriers and implementing enablers may empower older adults to initiate deprescribing conversations with providers to take fewer medications. Ultimately, this could be a catalyst for increased translation of deprescribing in practice. [ABSTRACT FROM AUTHOR]

• Workforce limitations are a barrier to COVID-19 testing in Papua New Guinea. • Lack of cold chain and reliable transport inhibits COVID-19 testing targets. • Supply chains need to be strengthened to ensure safety of health care workers. • Risk communication and community engagement is a priority to increase swabbing. • Innovative approaches are needed to reach Papua New Guinea's COVID-19 testing targets. We aimed to identify the barriers and enablers that Health Care Workers (HCWs) in Papua New Guinea experienced in swabbing for COVID-19. We conducted a cross-sectional multi-methods study: a qualitative scoping exercise and a telephone survey. The target population was COVID-19-trained HCWs from all provinces of Papua New Guinea. A descriptive analysis of survey responses was conducted alongside a rapid qualitative analysis of interviews and open-ended survey questions. Four thematic areas were identified: human resources, logistics, HCW attitudes and community attitudes. The survey response rate was 70.3% (407/579). Commonly reported barriers to COVID-19 swabbing were insufficient staff trained (74.0%, n = 301), inadequate staffing in general (64.9%, n = 264), insufficient supply of personal protective equipment (60.9%, n = 248) and no cold chain to store swabs (57.5%, n = 234). Commonly reported enablers to swabbing were community awareness and risk communication (80.8%, n = 329), consistent and sufficient supplies of personal protective equipment (67.8%, n = 276), increased surge workforce (63.9%, n = 260) and having a fridge to store swabs (59.7%, n = 243). A comprehensive community and HCW engagement strategy combined with innovations to improve the supply chain are needed to increase COVID-19 swabbing in Papua New Guinea to reach national testing targets. Investments in increasing numbers of frontline workforce, consistent supplies of PPE, swabs, transport medium, cold boxes and ability to make ice packs, in addtion to establishing regular tranport of specimens from the facility to the testing site will strengthen the supply chain. Innovations are needed to address these issues. [ABSTRACT FROM AUTHOR]

Domestic and family violence (DFV) is known to escalate during pregnancy. Routine screening for DFV in maternity departments is a widely acceptable practice according to staff and women. This study is part of a 3-year follow-up of an organisational intervention evaluation and aimed to identify clinicians' perceptions of current practices, as well as barriers and enablers to DFV antenatal screening. Semi-structured interviews were conducted with ten midwives about conducting DFV screening within the maternity department of a large tertiary public hospital in Queensland, Australia. Interview transcripts were read and thematically analysed by two independent researchers. Four main themes emerged from the data: uncertainty despite education and training; fear of opening Pandora's Box; working with 'red flags' and 'gut feelings'; and it's all about the relationship. Although clinicians identified the importance of guidelines for managing DFV and knowledge of resources and services, confidence varied. Ongoing, formal, mandatory training in the area of DFV was highlighted. Managing partner presence in the room, building rapport with the woman, and time constraints continue to be challenging barriers to DFV detection. Routine screening, continuity of care, and staff knowledge and experience were major enablers to successful detection and response. [ABSTRACT FROM AUTHOR]

The amount of weight gained in pregnancy has the potential to impact the health of a woman and her baby in the short and long term. The existing literature demonstrates that women identify several barriers and enablers to maintain healthy weight gain in pregnancy. Understanding these barriers and enablers assists practitioners and maternity services to better support women to maintain healthy gestational weight gain. While the existing literature is largely focussed on women who are overweight or obese, this paper aims to explore the experiences of women from a range of pre-pregnancy body mass index (BMI) categories regarding their weight gain in pregnancy. Fifteen women from the Australian Capital Territory participated in semi-structured interviews in the postpartum period to explore the barriers and enablers for healthy weight gain in pregnancy. Qualitative data were analysed using descriptive thematic analysis techniques. Women identified several barriers and enablers to maintain healthy weight gain in pregnancy. These included pregnancy-related physiological changes, personal and cultural attitudes and beliefs, availability of psychological support, social and community networks, attitudes and advice from their treating health professionals, and availability of education. This study is consistent with existing literature in confirming that women experience a range of personal, social, and cultural factors that impact upon weight gain in pregnancy. Participants identified inconsistent education and advice regarding gestational weight gain. This has clinical implications for clinicians and maternity services for improvement in the education and support of pregnant women regarding weight gain in pregnancy. [ABSTRACT FROM AUTHOR]

[Display omitted] • Circular supply chain (CSC) implementation enablers are identified. • Performance outcomes realized due to the adoption of CSC enablers are recognized. • An empirical case analysis is conducted in an Indian manufacturing industry. • The proposed framework is analyzed through a hybrid PF-AHP and PF-CoCoSo approach. • Sensitivity analysis is performed to check the robustness of the proposed framework. In the last few years, the Circular Supply Chain (CSC) has gained considerable attention among researchers, practitioners, and policymakers. It offers immense opportunities to embrace supply chain operations in three dimensions of sustainability. This study aims to identify and rank the performance outcomes (POs) realized due to CSC enablers (CSCEs) adoption. The study proposes a hybrid framework of the Pythagorean fuzzy analytic hierarchy process (PF-AHP) and Pythagorean fuzzy combined compromised solution (PF-CoCoSo) to achieve the objectives of this research. PF-AHP is used to obtain the CSCEs relative weights while PF-CoCoSo is used to ranks the POs concerning the CSCEs. An empirical case study is conducted for an Indian manufacturing organization to demonstrate the proposed framework's applicability. The result reveals that 'global climate pressure and ecological scarcity of resources' is the most significant CSCE to achieve the sustainability in the supply chain, followed by 'government rules, legislations and directives for CSC adoption', 'environment management certifications and systems', whereas, 'reduces waste and promotes green development' is the most critical PO realized due to adoption of CSCEs in CSC implementation process. The proposed framework is a systematic, more comprehensive, accurate, and structured approach to the business organization to improve its POs in a step-wise manner by implementing CSCEs. Sensitivity analysis is performed to check the effectiveness of the proposed framework. This research provides substantial contributions to sustainable development in the society as well as in the industry, and it will help researchers, practitioners, and policymakers working in the domain of CSC. [ABSTRACT FROM AUTHOR]

Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care. To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions. A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development. Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia. Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated. Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis. Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement. This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided. The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation. [ABSTRACT FROM AUTHOR]

Achieving sustainability has become an antecedent motive for numerous organizations since the last decade, and it has even accelerated with the introduction of sustainable development goals. Researchers and practitioners are trying different things to integrate sustainability principles in various fields of application, including manufacturing, which is one of the largest contributors to global GDP. This study investigates to improve the effectiveness of sustainable manufacturing implementation through customer participation. Existing literature in sustainable manufacturing is largely lacking with a stakeholder perspective, particularly with regard to customer participation. To bridge the gap, this study analyzes and evaluates the common enabling factors of customer participation for sustainable manufacturing implementation. Common factors have been collected and validated and the same has been analyzed with DEMATEL. Input for the study is taken from a case industry located in Saudi Arabia. Results revealed that among the 15 possible factors considered, 'cost implications of sustainability' (E1) has the top position and 'government regulations' (E14) has the least position in influencing customer participation in the implementation of sustainable manufacture. Finally, this study concludes by highlighting important contributions and opportunities for future expansion of customer-led sustainable manufacturing. [ABSTRACT FROM AUTHOR]

Demand response can be an effective mechanism to balance electricity demand and supply. While there is an increasing research interest in demand response for private households, its realistic potential in industrial and commercial sectors remains largely untapped, with limited research on the barriers hindering adoption. This study identifies and examines the barriers in industrial and commercial sectors, shedding light on their significance. We conducted 20 semi-structured interviews with experts from German industrial and commercial companies and national industry associations. The most frequently cited barriers encompass concerns about diminished product quality, disruptions to production processes, human resource management, and revenue uncertainty. Despite some recent industrial participation in demand response programs in Germany, our findings suggest that numerous barriers impede widespread participation, which can partly be explained by the heterogeneity of production processes and facilities. Overcoming these barriers entails bridging knowledge gaps and allocating sufficient resources within an organization. Moreover, adapting external incentives and policies may be necessary to encourage widespread demand response adoption. Recognizing these challenges, alongside the underlying motivations and apprehensions, can guide policy makers in devising strategies to support the adoption of demand response among industrial and commercial consumers. [Display omitted] • Empirical study on demand response barriers in industrial and commercial sectors. • Barriers include a lack of profitability and fear of reduced product quality. • Barrier dimensions categorize and illustrate demand response barrier interrelations. • Resources and information are vital for fostering demand response within a company. • More external incentives and adapted regulations needed to overcome barriers. [ABSTRACT FROM AUTHOR]

The sharing economy (SE) represents a paradigm shift in resource consumption and ownership while facilitating a promising path towards a more circular and sustainable future. Despite increasing enthusiasm for this concept, limited studies focus on potential shareable resources, the process of SE, stakeholders of SE, and factors that influence SE practices, which are essential to comprehend the key aspects of SE before delving into further theoretical applications and operationalisation of the concept. This study aims to explore key aspects contributing to the successful applications of the SE concept across diverse industries by conducting a systematic literature review (SLR). Out of 4848 articles, 57 peer-reviewed articles in two databases published between 2013 and 2022 were subjected to descriptive and content analysis. The descriptive analysis revealed that 95% of articles were published in the last four years. The case study method was involved in most articles (30%), in addition, modelling, questionnaire survey, and social media analytics were also prominent as data collection methods. Moreover, most SE studies primarily concentrated on the accommodation, and transport/delivery sectors. Among various shareable resources, the highest number of studies focused on the space/storage resource category as a shareable resource. The results of the content analysis discovered 14 types of potential sharable resources (people, animals, robots, goods, space/storage, mobility/logistics, capital, food/ingredients, drugs, materials/equipment/tools/machines/devices, data and information, energy, Wi-Fi, and fashion elements) and the 7-step process of SE practices (identification of idle resources to be shared, registration of idle resources on a digital platform, exploration and identification of suitable resources, negotiation and decision-making on terms and conditions, transaction, and review and feedback) while identifying key stakeholders involved in the SE. Furthermore, enablers, barriers, and factors with a duality of quality were also recognised. The study also proposes a conceptual framework that provides a significant contribution to industries and sectors aiming to apply the SE concept. • Resources that can be shared in the sharing economy can be systematically categorised into 14 distinct types. • The application of the sharing economy concept is influenced by a range of factors, which can be classified into enablers, barriers, and the duality of quality factors. • Resource provider, resource consumer and platform facilitator act as the main three parties in the sharing economy practices. • Sectors such as accommodation and transport feature more prominently in the existing literature on the sharing economy concept. [ABSTRACT FROM AUTHOR]

• Nurse practitioners (NPs) contribute to patient care, coordination, and education in pediatric specialty settings. • Enablers include mutual trust, role clarity, and organizational structure. • Barriers include ineffective teamwork, lack of resources and complex communication systems. The objective of this study was to explore the enablers of and barriers to the contribution of nurse practitioners (NPs) in pediatric specialty care. A total of 11 NPs in pediatric medical specialties were interviewed regarding teamwork, communication, documentation, satisfaction, overall role, and perception of the value they contribute to care. Themes were identified related to structural and organizational enablers and barriers that facilitate or hinder the NPs' contribution to pediatric specialty care. The findings of this study can provide a better understanding of the role of NPs caring for pediatric patients in the specialty setting and can also help guide organizational environments to maximize the potential of pediatric NPs to positively affect patient care. [ABSTRACT FROM AUTHOR]

Nowadays, there is a paradigm shift in medical education. This shift occurred following the Covid-19 crisis. The world uses digital e-learning to support the public health response to this pandemic. The study's objective was to determine the medical students' acceptance and perceptions of e-learning during the Covid-19 closure time in Jeddah. A cross-sectional, web-based study was done among 340 medical students from King Abdulaziz University, 2020. A standardized, electronic, self-administered, Google Form data collection sheet was distributed. It included the E-learning acceptance measure (ElAM) containing three constructs, namely: tutor quality (TQ), perceived usefulness (PU), and facilitating conditions (FC). The sheet also inquired about the students' perceptions of the benefits, enablers, and barriers to e-learning. Descriptive, inferential statistics and multiple linear regression analyses were applied. Blackboard and Zoom were the most preferred Learning Management Systems (LMS) by our medical students. The mean score of ElAM was 102.82 ± 24.102. Better achievers obtained significantly (P < 0.001) higher scores in all ElAM constructs. About three-fifths of the students confirmed that e-learning substituted classical on-campus learning and was an adaptable, and less time-consuming method. The educator's good e-learning skills, the subject, instructional design, interaction, motivation, and good LMS were agreed as enablers of e-learning. However, most students accepted that clinical teaching is the most challenging learning outcome and that exams could be affected by low internet quality. Medical students moderately accepted e-learning during the Covid-19 Pandemic closure time. More training of the students and tutors, better designing e-courses, more interaction, motivation, and blended learning are recommended. [ABSTRACT FROM AUTHOR]

Diabetes is a significant public health challenge for India. Self-management, including dietary management, physical activity, stress management, and adherence to medication, is critical in glycaemic control. Though data concerning self-management, in general, are available among persons with Type 2 Diabetes Mellitus (T2DM), exclusive research on dietary self-management was limited. A qualitative study to explore the knowledge, current dietary practices, and the barriers and enablers for dietary self-care management in persons with T2DM. In this qualitative study, in-depth interviews were conducted among 35 participants with T2DM who scored minimally and optimally in the Diabetes Self-Management Questionnaire (DSMQ). Interviews were conducted using a validated interview guide. In-depth interviews were audio-recorded, transcribed to verbatim and thematically analysed. The study included 20 males and 15 females. The three major themes derived in the study. Firstly, "Knowledge, Interpretation and Information" the majority of the participants have understood the influence of diet on control of blood glucose level includes food choices and quantum of food. Secondly, "Current Dietary Practices-Preferences, Availability of food and Convenience influence dietary practices': All participants had their own belief on the side effects and benefits of certain food items. Most of the participants followed a three-meal pattern: breakfast, lunch and dinner. Finally, Barriers and Enablers in dietary self-management practice. Knowledge, physical and emotional factors, behaviour, planning were the intrinsic factors. Elements of the research, social support, season and climate, food environment were the extrinsic factors and communication, and financial management was the intermediate influences observed. The themes generated by this research provide insight into self-management and patient expectations in dietary matters. It would be desirable for physicians and health care providers to be aware of these practices when advising people with T2DM on dietary self - management. • A qualitative study from the rural and suburban area on dietary self-management among people with T2DM. • An exploration of knowledge, insights, belief, behavioural and environmental physiognomies. • Stimulation of explored factors on food selection, dietary patterns and eating behaviour. • Dietary self-management is driven by barriers and enablers. • People with T2DM would also have preferences, which should guide dietary interventions. [ABSTRACT FROM AUTHOR]

There are currently 429 midwives in Australia who hold the Nursing and Midwifery Board of Australia's Endorsement for scheduled medicines for midwives. Little is known about how midwives are using the endorsement and what factors impact on its use. To critically examine the literature to discover what the barriers and enablers are for midwives to use the endorsement. A search was undertaken examining literature published since 2004. Due to a lack of articles specific to midwifery, the search was widened to include literature related to similar non-medical health professions. The search was divided into two streams: accessing the Medicare Benefits Schedule and accessing the Pharmaceutical Benefits Scheme and prescribing. Twenty-six primary articles from 2009 onward met the review criteria. Although singular barriers and enablers to both streams were identified, many of the themes act as both enabler and barrier. Themes common to both the Medicare Benefits Schedule focus and the Pharmaceutical Benefits Scheme and prescribing focus are that of medical support, scope of practice, ongoing support from health care consumers and management, and endorsement processes. Barriers occur approximately three times more frequently than enablers. Barriers and enablers occur for various reasons including legislative, regulatory, organisational, and the individual's support for and attitude towards these roles. To overcome barriers and facilitate the success of emerging non-medical extended practice roles, significant buy-in and investment is needed across all levels of the health system. The review highlights a significant gap in knowledge about the endorsement's use in midwifery. [ABSTRACT FROM AUTHOR]

• The paper describes a study of enablers and barriers to the development of MaaS. • The study involves informants with actual experience of MaaS developments. • A number of formal but also equally important informal factors have been identified. Mobility-as-a-Service (MaaS) has been argued as part of the solution to prevalent transport problems. However, progress from pilots to large-scale implementation has hitherto been slow. The aim of the research reported in this paper was to empirically and in-depth investigate how, and to what extent, different factors affect the development and implementation of MaaS. A framework was developed, with a basis in institutional theory and the postulation that formal as well informal factors on different analytical levels (macro, meso and micro) must be considered. The research was organised as a multiple case study in Finland and Sweden and a qualitative approach was chosen for data collection and analysis. A number of factors with a claimed impact on the development and implementation of MaaS was revealed. At the macro level, these factors included legislation concerning transport, innovation and public administration, and the presence (or not) of a shared vision for MaaS. At the meso level, (the lack of) appropriate business models, cultures of collaboration, and assumed roles and responsibilities within the MaaS ecosystem were identified as significant factors. At the micro level, people's attitudes and habits were recognised as important factors to be considered. However, how the 'S' in MaaS fits (or not) the transport needs of the individual/household appears to play a more important role in adoption or rejection of MaaS than what has often been acknowledged in previous papers on MaaS. The findings presented in this paper provide several implications for public and private sector actors. Law-making authorities can facilitate MaaS developments by adjusting relevant regulations and policies such as transport-related subsidies, taxation policies and the definition of public transport. Regional and local authorities could additionally contribute to creating conducive conditions for MaaS by, for example, planning urban designs and transport infrastructures to support service-based travelling. Moreover, private actors have key roles to play in future MaaS developments, as both public and private transport services are needed if MaaS is to become a viable alternative to privately owned cars. Thus, the advance of MaaS business models that benefit all involved actors is vital for the prosperity of the emerging MaaS ecosystem. [ABSTRACT FROM AUTHOR]

In a world where the consequences of inequalities in access to safe drinking water persist, Household Drinking Water Treatment Technologies (HDWT) remains the most readily available and promising alternative solution to prevent waterborne diseases. While successful cases of combating waterborne diseases with HDWT have been documented, there are also reports of failures in reducing water-related illnesses. Understanding the reasons behind these inconsistent results is crucial. This work aimed to identify and critically discuss barriers, enablers, and technology delivery strategies for HDWT-based interventions to improve drinking water safety. Data from 147 articles covering Solar Disinfection, Chlorination, Flocculation-Disinfection, BioSand Filter, and Ceramic Water Filter were extracted from a total of 11,982 systematically retrieved records. Among the identified factors, 77 barriers and 76 enablers were distributed across different domains: psychosocial (37.7, 47.4%), promotion (22.1, 26.3%), technology (28.6, 10.5%), economic (9.1, 14.5%), and environmental (2.6, 1.3%) for barriers and enablers, respectively. Technology delivery strategies primarily included water education and technology promotion, training for technology usage, provision of HDWT through donation or promotional sale, donation of safe water storage, technical assistance, and the use of a diarrhea control diary. All barriers and enablers affect the initial adoption, regular, and sustained use of HDWT and should be considered when planning and implementing interventions. The health impacts of interventions decreased over time since HDWT adoption. Adequate user training, HDWT donation, and high compliance are important predictors of success for HDWT-based interventions. In general, identifying and exploring the listed enablers can help overcome many of the reported limitations. [Display omitted] • Barriers and enablers to HDWT-based interventions are reviewed and discussed. • Most of the identified factors are psychosocial, promotional and technological. • Notion of risk and fear of drinking untreated water determine the adoption of HDWT. • Regular use of HDWT is conditioned by social norms, attitudes and user skills. • User training, HDWT accessibility, and compliance are good predictors of performance. [ABSTRACT FROM AUTHOR]

The changed customer perception and environmental regulations have enforced organizations to device the ways that remain sustainable and at the same time meet the expectations of customers. Green Lean Six Sigma (GLS) is one of the inclusive approaches that reduces the variations and wastes in the system and at the same time decreases the negative environmental impact. But, in order to implement a comprehensive GLS approach, it is indispensable to look at the enablers or foundations that consequently lead to the success of this program. The present work deals with GLS enablers identification and modeling using Interpretive Structural Modeling (ISM) to meticulously adjudicate interactions among the enablers. Besides, Impact Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) analysis has been used here to classify these enablers for better understanding. This work will facilitate the organizations to have a readiness for a strategic GLS implementation by detailed understanding of mutual relations among the enablers of GLS. • Present study investigates the enablers of Green Lean Six Sigma (GLS) implementation. • The modeling of GLS enablers is indispensable for the success of GLS program. • GLS enablers have extracted from literature, validated by experts and statistically. • ISM and MICMAC analysis are utilized to find interaction among GLS enablers. [ABSTRACT FROM AUTHOR]

Under mobile Internet environment, users are switching from PC search to mobile search. Prior studies largely focused on users' early adoption and continual usage of mobile search. Limited attention has been paid to searching switch. This study is to identify enablers (i.e. perceived ubiquitous connectivity, perceived contextual offer and perceived convenience) and inhibitors (i.e. habit of PC search and relative disadvantage of mobile search) influencing users' switching intention from PC to mobile, as well as examining their different effects. [ABSTRACT FROM AUTHOR]

The aim of this study is to summarise the qualitative findings from systematic reviews to identify what pregnant women perceive as barriers and enablers to smoking cessation during pregnancy. Smoking during pregnancy is a predictor of adverse maternal and infant outcomes. Despite known health risks, less than half of pregnant smokers quit during pregnancy. An umbrella review using the Johanna Briggs Institute methodology was conducted. A comprehensive literature review was completed in July 2017. All included papers were subject to an eligibility criterion and checked for quality by at least two reviewers. A total of n = 529 papers were identified and screened. Of these, only two met all inclusion and quality criteria and were included for review. More barriers than facilitators were identified from the available literature. An enabler or barrier to smoking cessation for pregnant women is not a fixed entity but dependent on the context of an individual's life. What is an enabler for one woman may be considered a barrier for another, and these are dependent on support provided by family and friends. Further research is needed to optimise ways of addressing these barriers. [ABSTRACT FROM AUTHOR]

Abstract 'Sustainable business practice' is an aspiration for an increasing proportion of small and medium-sized enterprises (SMEs) around the world, promising profitability, resilience and positive social and environmental impacts. 'Lean thinking' has evolved as a popular business strategy for SMEs to achieve sustainable business practice, addressing the need for efficiency in production and waste reduction. In this study we explore the co-evolution of 'lean and green thinking' and the potential for lean and green practices to enable successful transitions to sustainable business practice. Focusing on investigations into manufacturing SMEs in Queensland, Australia, we first establish four key enablers and six key barriers to sustainable business practice, derived from a series of in-depth interviews with Chief Executive Officers and senior managers involved in sustainability and lean manufacturing. We offer an institutional theory perspective on these findings, concluding the potential for normative, coercive and mimetic drivers to influence SMEs to shape environmental, social and economic decision making and legitimize the transition to sustainable business practice. We then present a novel 'Model of strategic enablers of sustainable business practice' to guide SMEs to intentionally use their lean and green strategies to successfully adopt sustainable business outcomes. We propose that through adopting lean and green thinking to transition to sustainable business practice, SMEs can more rapidly contribute to the circular economy at the level of firm. Agencies and professional bodies can support SMEs in this transition through targeted interventions that address the enablers and barriers presented. Highlights • Engaging in lean and green thinking can drive sustainable business practice in SMEs. • We share insights on enablers and barriers to implementing lean and green thinking. • Institutional theory perspective is discussed regarding informed decision-making. • We present an enabling model of strategic enablers of sustainable business practice. • We conclude the importance of findings for circular economy at the level of firm. [ABSTRACT FROM AUTHOR]

Abstract Sustainability is defined a triple bottom line approach, which concentrates on economic, social and environment growth of any organization. In order to achieve sustainability objective, the human resource focused enablers are playing a significant role in optimising expenses, improving productivity and quality of work. Therefore, the present study seeks to build a model for the enablers of human resource development for sustainability in India power sector. The study findings help the sector to improve the productivity of their workers and establish all the enablers, which can be seen to improve quality of work life in the Indian power sector. Improved human resource capabilities and work conditions provide not only much needed motivation to power sector employees to improve their efficiency but also assist to accomplish social-ecological-economic organizational sustainability. Total Interpretive Structural Modelling with Matrice d'Impacts Croisés Multiplication Appliqués à un Classement (MICMAC) analysis has been applied to build a structural model and to identify the driving force and dependence power of enablers. Validation of relationships among the enablers and managerial implications are also discussed. According to the findings, the enablers 'work safety and healthy working conditions' have the highest driving power. The outcomes of this study can help the power sector to enhance human resource capabilities and quality of work life within the organization through provision of a benchmark model and help to accomplish sustainable development initiatives in its business. Graphical abstract Image 1 Highlights • Modelled the enablers of human resource development for sustainability in India power sector. • Four phased study solution methodology framework is used. • The hierarchical structure of enablers discovers how driver-dependent relations work. • Validation of relationships among the enablers are also discussed. [ABSTRACT FROM AUTHOR]

Abstract 'Access to Electricity' has been a major issue in India over the past many years. With the goal of achieving Universal Electrification, Government of India has been proposing various modifications in existing electrification schemes as well as new models to accelerate the intensive electrification. One such model is the Community Energy (CE) system which is predicted to be a clean and sustainable means of energy production and use. However, there are certain challenges associated with such systems which remain unexplored due to major focus on centralized electrification approach followed over the years. Thus a holistic policy framework for such systems presently lacks in Indian context due to insufficient literature available discussing barriers and incentives associated with such projects. This paper lists out relevant challenges and enablers associated in the deployment of CE projects in India with their effect on the installation and operation of the project. Thereby, TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) analytical tool is applied to rank the associated challenge or enabler in their respective domain. Necessary inferences are drawn to provide policy implications depending upon the priority of barriers/enablers in the deployment of CE projects. [ABSTRACT FROM AUTHOR]

Abstract Questions What are the attitudes of women diagnosed with gestational diabetes mellitus (GDM) towards physical activity during pregnancy? What are the perceived barriers to and enablers of physical activity during pregnancy in women with GDM? Design A qualitative study with phenomenology and interpretative description as theoretical frameworks. Participants Pregnant women experiencing an uncomplicated singleton pregnancy, diagnosed with GDM, and aged 18 to 40 years were recruited using purposive sampling. Method Semi-structured interviews were recorded, transcribed verbatim and returned to participants for member checking. Three researchers independently and thematically analysed the qualitative data using an inductive method. Data were coded and compared, and themes were developed, discussed and defined. Recruitment continued until data saturation. Emergent themes were sent to participants and peer reviewed for confirmation. Results The participants were 27 women, with mean age 32 years (SD 3), mean gestation 30 weeks (SD 5), mean pre-pregnancy body mass index 26 kg/m2 (SD 5), and born in 10 different countries. The process of communicating information about physical activity (messaging) was the main theme to emerge. Sub-themes included: wanting information about physical activity from credible sources; wanting clear, specific information about safe physical activity during a GDM pregnancy; receiving information at GDM diagnosis because this event triggered women's desire to be more physically active; understanding why physical activity is important to improving outcomes for themselves and their babies; and wanting information about flexible, convenient and practical physical activity options. Conclusion To feel confident and safe about being physically active during pregnancy, women with GDM wanted clear, simple and GDM-specific messages from credible sources. Health professionals can support women with a GDM pregnancy with targeted physical activity messages. [ABSTRACT FROM AUTHOR]

Purpose: In spite of the recent progress in understanding how radio frequency identification (RFID) systems can substantially advance health care service, there is a significant gap in the literature concerning determinants of RFID application in managing various forms of health care operations. Hence, this study attempts to fill this gap by examining the key enablers and impediments of using RFID systems in patient and medical asset operations management using the technology, organization and environment framework (TOE).Methods: A research model was developed using a variety of TOE factors that may enable or impede RFID adoption in managing health care operations. Then, the model was empirically tested by means of Structural Equation Modelling (SEM) based on survey data of 311 online questionnaire responses that were collected from managers, technicians, physicians and nurses in charge of asset and patient management in public and private hospitals in the United Arab Emirates. The majority of respondents were over 30 years old (63%) and have more than 5 years of experience in the medical context (88%). They work mainly in private hospitals (71%) in managerial positions (65%). This profile designates sufficient experience and knowledge of participants to understand the questions.Results: The findings demonstrate the effect of technical advantages and organizational capacity on both asset and patient management is significant, while the effect of environmental competitiveness is only evident in patient management operations. Furthermore, the results confirm the negative influence of technical complexity and environmental uncertainty on both asset and patient management. Surprisingly, using RFID in asset and patient management tend to be not influenced by organizational resistance. The paper proposes a number of implications that can guide leaders and vendors to successfully implement RFID technology for managing healthcare operations. It directs the attention of RFID research toward future venues within the health care context.Conclusions: Hospitals must contemplate the impact of technological, organizational and environmental forces to leverage the benefits of RFID in patient and asset operations management. The results of SEM confirmed the strong effect of the variables on patient management since 57 per cent of its variance is explained by five factors (i.e., technical advantages, organizational capacity, environmental competitiveness, technical complexity and environmental uncertainty). Four factors explain about 48 per cent of the variance in asset management (i.e., technical advantages, organizational capacity, technical complexity and environmental uncertainty). The results provide robust implications for health care managers and RFID vendors to better understand crucial RFID implementation issues, increase its technology fit into service operations, and accelerate its implementation as follows: (1) while organizational resistance does not show significant impact on RFID adoption for managing patient and asset operations, health care professionals should consider that RFID implementation decision is mainly organizational at the firm level rather than an individual choice, as long as RFID benefits are well communicated to the staff. (2) while the effect of environmental competitiveness is only evident in using RFID in managing patient operations, health care professionals should focus on RFID applications that have direct impact on enhancing health service quality, flexibility and delivery considering patients as a base for competitiveness; (3) with regard to the impact of technical advantages, RFID benefits such as enhancing work efficiency and reducing cost should be documented, communicated and nurtured to medical and administrative employees; (4) In response to the impact of organizational capacity, the contribution of RFID applications to medical and managerial knowledge generation and utilization should be tracked and integrated into daily work processes; (5) Vendors should provide appropriate orientations and training sessions targeting RFID complexity involving networks, architectures and operating; and (6) the customization of commercial RFID technology for managing health service operations must be deliberated between all stakeholders in health care context. Forthcoming research is needed to reexamine this model with different variables (e.g., culture) and under further health care conditions or contexts. [ABSTRACT FROM AUTHOR]

This study investigated enablers to seeking professional help for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and six individual interviews were conducted among adult patients with/without known distress, significant others of the distressed, and the general public. The identified potential enablers were further investigated in a questionnaire survey with data from 1626 patients. Survey respondents who had sought professional help for distress ( n  = 231) and those without this experience ( n  = 1395) showed similar attitudes to the enabler items. However, the first group had more “strongly agree” responses and their top five enablers were: crisis caused by distress, distress affecting daily life, wanting to treat associated physical symptoms, having trust in doctor, and encouragement by family/friends to seek help. Qualitative interviews found that the patients often somatised distress and they felt comfortable to consult for somatic symptoms. There was strong family involvement in help-seeking whereas the doctors were the authoritative figures to convince the patients for treatment. The findings, in line with Western literature, indicate that crisis and interference in daily life due to distress are the top enablers to seeking professional help. The other three key enablers are likely to be influenced by Chinese culture. [ABSTRACT FROM AUTHOR]

This paper analyses the importance of emerging technologies, especially the impacts of the Internet of Things on Global Trade activities of multinational companies. The relevance of this research is based on the approach to emergent technologies articulating the appliance and its impacts on multinational companies. Two analytical dimensions have been considered to formulate the research problem: The Internet of Things and the impacts, inhibitors and enablers of its implementation anchored to the research question: What are the perceived impacts, the inhibitors and the enablers of the Internet of Things on global trade activities of multinational companies? The methodology was based on interviews and on a survey online launched in multinational companies. The research finds that the Internet of Things revolution is changing all sectors of global economy: manufacturing, energy, agriculture, transportation and others. It transforms how the work could be performed through human-machine interactions. [ABSTRACT FROM AUTHOR]

This paper provides a strategic approach to strengthening research methods skills in Higher Education Institutions (HEIs) to improve disaster resilience (DR). The findings are based on an initial assessment of the nature, scale and beneficiaries of the research methods training program developed as a part of an ERAMUS+ project called ASCENT (Advancing Skill Creation to ENhance Transformation). This project aims at addressing Research and Innovation (R&I) capacity strengthening for the societal DR. The paper examines what research methods skills are needed to be improved in HEIs in three countries, i.e. Bangladesh, Sri Lanka and Thailand. This was examined mainly with the use of an online survey questionnaire that was sent to 08 HEIs from these three countries. Altogether 530 responses were received from both the academic and research staff in these institutions. The responses were analysed using version SPSS 23.0 with several analysis techniques such as Mann-Witney U-test, Kruskal-Wallis test, and Principal Component Analysis. The research findings revealed that both academic and research staff lack capacity in research methods such as elite interviews, observations, document studies (e.g. secondary data analysis), probabilistic method, interdisciplinary thinking, field experiments, sampling techniques and Delphi studies. The strategic approach to strengthening research methods skills, therefore, focuses on developing a comprehensive and structured research methods training programme encompassing the aforementioned research methods. In addition, several modes of training such as face-to-face, and online training were incorporated in this strategic approach to suit the nature, scale and beneficiaries of the research method training program. [ABSTRACT FROM AUTHOR]

Question What are the attitudes, barriers and enablers to physical activity perceived by pregnant women? Design In a systematic literature review, eight electronic databases were searched: AMED, CINAHL, Embase, Joanna Briggs Institute, Medline, PsycInfo, SPORTDiscus (from database inception until June 2016) and PubMed (from 2011 until June 2016). Quantitative data expressed as proportions were meta-analysed. Data collected using Likert scales were synthesised descriptively. Qualitative data were analysed thematically using an inductive approach and content analysis. Findings were categorised as intrapersonal, interpersonal or environmental, based on a social-ecological framework. Participants Pregnant women. Intervention Not applicable. Outcome measures Attitudes and perceived barriers and enablers to physical activity during pregnancy. Results Forty-nine articles reporting data from 47 studies (7655 participants) were included. Data were collected using questionnaires, interviews and focus groups. Meta-analyses of proportions showed that pregnant women had positive attitudes towards physical activity, identifying it as important (0.80, 95% CI 0.52 to 0.98), beneficial (0.71, 95% CI 0.58 to 0.83) and safe (0.86, 95% CI 0.79 to 0.92). This was supported by themes emerging in 15 qualitative studies that reported on attitudes (important, 12 studies; beneficial, 10 studies). Barriers to physical activity were predominantly intrapersonal such as fatigue, lack of time and pregnancy discomforts. Frequent enablers included maternal and foetal health benefits (intrapersonal), social support (interpersonal) and pregnancy-specific programs. Few environmental factors were identified. Little information was available about attitudes, barriers and enablers of physical activity for pregnant women with gestational diabetes mellitus who are at risk from inactivity. Conclusion Intrapersonal themes were the most frequently reported barriers and enablers to physical activity during pregnancy. Social support also played an enabling role. Person-centred strategies using behaviour change techniques should be used to address intrapersonal and social factors to translate pregnant women’s positive attitudes into increased physical activity participation. Registration PROSPERO CRD42016037643. [Harrison AL, Taylor NF, Shields N, Frawley HC (2018) Attitudes, barriers and enablers to physical activity in pregnant women: a systematic review. Journal of Physiotherapy 64: 24–32] [ABSTRACT FROM AUTHOR]

Objectives To identify barriers and enablers that impact access to early screening, detection, and diagnosis of breast cancer both globally and more specifically in the Middle East and North Africa (MENA) region (with a specific focus on Egypt, Jordan, Oman, Saudi Arabia, United Arab Emirates [UAE], and Kuwait) with a specific focus on the health system. Study design A systematic review of literature. Methods We conducted a systematic reviewing using the PRISMA methodology. We searched PubMed, Global Index Medicus, and EMBASE for studies on ‘breast cancer’, ‘breast neoplasm,’ or ‘screening, early detection, and early diagnosis’ as well as key words related to the following barriers: religion, culture, health literacy, lack of knowledge/awareness/understanding, attitudes, fatalism/fear, shame/embarrassment, and physician gender from January 1, 2000 until September 1, 2016. Two independent reviewers screened both titles and abstracts. The application of inclusion and exclusion criteria yielded a final list of articles. A conceptual framework was used to guide the thematic analysis and examine health system barriers and enablers to breast cancer screening at the broader macro health system level, at the health provider level, and the individual level. The analysis was conducted globally and in the MENA region. Results A total of 11,936 references were identified through the initial search strategy, of which 55 were included in the final thematic analysis. The results found the following barriers and enablers to access to breast cancer screening at the health system level, the health provider level, and the individual level: health system structures such as health insurance and care coordination systems, costs, time concerns, provider characteristics including gender of the provider, quality of care issues, medical concerns, and fear. In addition, the following seven barriers and enablers were identified at the health system or provider level as significantly impacting screening for breast cancer: (1) access to insurance, (2) physician recommendation, (3) physician gender, (4) provider characteristics, (5) having a regular provider, (6) fear of the system or procedure, and (7) knowledge of the health system. More specifically, the largest increased odds for having a mammogram was from having insurance, having a physician recommendation, type of provider (mainly gynecologist), and having regular contact with a physician. Clinical breast examinations were increased by having insurance and having regular contact with a physician. The eight studies identified from the MENA region identified barriers to breast cancer screening related to service quality, fear of pain and of cancer itself, female versus male provider, having a physician recommend the screen, cost issues as well as time and convenience of the services. Conclusions There are a number of system changes that can be made to remove barriers to breast cancer screening. Some of these system changes apply directly to MENA countries. A larger health system assessment of a country is warranted to determine which health system changes should be made to most efficiently and effectively improve access to breast cancer screening. [ABSTRACT FROM AUTHOR]

In South Africa the electricity generation mix is relatively un-diverse whereas globally the transformation of the sector is advancing rapidly. Coal remains the predominant fuel source and limited success has to date been achieved in the renewable energy sector. The electricity generation sector is therefore hindered from moving towards an electricity generation landscape where alternative fuel sources is utilised. This research is aimed at gaining insight into the enablers that led towards an increasing trend (observed globally) in exploiting waste as a fuel for electricity generation, and to outline the presence of obstacles that hinder separation of waste for electricity use in the South African context. Furthermore it is an attempt at informing what appropriate interventions (operational and policy) may be considered suitable for South Africa to overcome these barriers in order to enable a sustainable South African waste to electricity (WTE) Industry. Findings show that numerous barriers to a WTE exists in the South African context, however overcoming these barriers is not as simple as adopting the European model with the aim to modify the electricity generation mix and waste management landscape. Selected enablers deemed appropriate in the South African context are adapted from the European model, and are greatly influenced by the prevailing socio-economic status of South Africa. Primary enablers identified were, (i) government support is needed especially in the form of subsidisation for green energy, (ii) increase landfill costs through the implementation of a landfill tax, (iii) streamline the process for Independent Private Power Producers (IPPPs) to connect to the national grid with off-take guaranteed and the inclusion of WTE into an electricity roadmap (effectively government’s strategy). The proposed enabling interventions would help in overcoming the barriers for a South African WTE industry. [ABSTRACT FROM AUTHOR]

The management of solid waste has been recognized as the cornerstone for sustainable development and closed loop circular economy models. Moreover, solid waste management is at the forefront of initiatives seeking to cut greenhouse gas emissions. This research stems from the limited success that solid waste management programs have had in the context of developing countries and the need to overcome the obstacles and impediments hampering the implementation of a sustainable solid waste management framework. It aims to facilitate the optimization process of the applied technical, operational, and managerial schemes, streamline sustainable practices and close the circularity gap that currently exists in waste management taking Lebanon as a case example. Accordingly, a performance assessment and optimization tool was developed to evaluate the administrative, environmental, and operational performance of 27 unions of municipalities and large municipalities encompassing more than 90 villages/cities. The model compares different technologies based on a set of user defined constraints and groups municipalities and operational facilities into four classes: (A) Superior, (B) Satisfactory, (C) Poor, and (D) No service. The excessive amounts of disposal rates, failure in the adoption of a comprehensive solid waste management framework, the absence of a contingency plan, and the consistent reliance on ad hoc strategies for handling solid waste characterized the sector in Lebanon. A thorough analysis of the various waste management systems revealed that none could be classified as "superior", with the ratings of most schemes compounded in the lower end of the spectrum. • Development of an optimized multi-criterion solid waste decision support model. • Model evaluates waste management systems and highlight areas of improvement. • Model categorically stratify municipalities and operational solid waste facilities. • Analyses of various waste systems provide technical indicators of system efficiency. • Identifying enablers for a sustainable and circular economy approach. [ABSTRACT FROM AUTHOR]

Originating in Germany, Industry 4.0 quickly became the new standard with industries adopting it worldwide. However, in the hurry to become digitalized for increasing production and efficiency, industries have failed at embracing the sustainability aspect of production. With the rise in concern for environmental safety and the re-introduction of circular economy, the authors have identified the integration of I4.0 and CE as a strong research point for overcoming the obstacles in achieving sustainable operations management (SOM). The research explains the criticality of the integration of I4.0 and CE and how it is the next step in becoming sustainable and resilient in today's turbulent environment. The study incorporates a four-step hybrid methodology with the identification and validation of enablers as the first phase using the PRISMA statement and PF-Delphi technique respectively. The second phase employs the PF-AHP technique for calculating the criteria weights which are subsequently used in the third phase by applying PF-CoCoSo to rank the enablers in priority order. Lastly, sensitivity analysis is performed to check the robustness of the results. The paper identified service and policy framework as the most critical criteria and product lifecycle management as the highest priority enabler for achieving SOM. The authors have also put forward seven recommendations for industries looking to implement I4.0 and CE for SOM by taking instances from previous case studies. • Exploring criteria and enablers for industry 4.0 (I4.0) and circular economy (CE) • List down the enablers using systematic review of literature and Delphi method • Evaluating relationship between enablers using Pythagorean Fuzzy AHP and Pythagorean Fuzzy Combined Compromise Solution • Identified service and policy framework and industrial ecosystem as critical enablers • Propose recommendations to be adopted and verified by different sectors to achieve resilient and sustainable operations. [ABSTRACT FROM AUTHOR]

Abstract: A $12 million Commonwealth funded consortium project trialled energy efficiency initiatives in six remote Indigenous communities over three years. This project, which won several awards, employed and educated over 80 local Yolŋu to educate their fellow community members to use power wisely. The research and evaluation component was designed together by Indigenous and non-Indigenous researchers and entailed ethnography and a local Indigenous co-researcher approach. Sixteen local Yolŋu co-researchers conducted 125 in-depth qualitative interviews with community members across six communities in the local languages. At the beginning of the project, the Yolŋu co-researchers conducted 40 narrative interviews with fellow Indigenous community members to find out how they use power, and to identify barriers to and enablers of using power efficiently. Towards the end of the project, Yolŋu co-researchers conducted 85 in-depth interviews with fellow Indigenous community members and with Yolŋu who had educated community members to evaluate the project. The interpreted and transcribed interviews were analysed using a combination of thematic and narrative strategies (interviews at the start of the project) and of content, thematic and narrative strategies (evaluation interviews). The stories provide rare insights into how Yolŋu used, experienced and interpreted fire or power in the old days, missionary times and government days. The stories identify barriers to, and enablers of, Indigenous and non-indigenous people working together designing and conducting projects. The stories capture how Yolŋu educators and Indigenous community members experienced and interpreted the project—including effective practices, challenges, impediments and recommendations for the future. In this paper, we share the essence of these stories to provide an overview of the key barriers and enablers of Indigenous and non-Indigenous people working together in remote Indigenous communities to use power efficiently. We propose that, for projects with Indigenous people to be effective, non-indigenous partners need to closely and genuinely work together with remote Indigenous communities prior to applying for funding and implementing projects as well as throughout the projects. The projects need to employ a long-term and adaptive process. [ABSTRACT FROM AUTHOR]

There are 15 large-scale CCS projects operating globally. Ten out of these fifteen projects, are located in North America [1] . The European Union's (EU) stated ambition was to have up to twelve operating CCS projects by 2015 [2] , however this goal was not accomplished. The two projects currently operating storage in the European Economic Area, Sleipner and Snøhvit, are located in Norway. Because of this disparity in the number of projects operating in North America and in Europe – ten vs. two – we have analysed business models of major CCS projects in North America and in Europe, with an aim to identify risks and enablers in CCS project financing development on both continents. We find that successful CCS project development depends on multiple factors, such as (i) clarity of regulatory frameworks, (ii) efficiency of permitting processes, and (iii) early and sustained stakeholder engagement for public acceptance. However, project finance remain the most challenging piece. [ABSTRACT FROM AUTHOR]

Study Design Qualitative study. Introduction Adherence is paramount to the successful outcome of exercise-based treatment. Purpose of Study The barriers and enablers to adherence to a home- and class-based exercise program were explored in this qualitative study. Methods Semi-structured interviews were carried out to establish common themes relating to the participants' experiences during a year-long randomized controlled trial. Results/Discussion Twelve participants were interviewed. The main enablers to exercise were highlighted as equipment, perceived benefit from the exercises, and longer and more intensive monitoring. Barriers included the lack of motivation, lack of equipment, and pain. Conclusions Implications for practice are incorporating enablers and addressing barriers including self-discharge from classes; the importance of longer term follow-up and the benefits of adopting exercise into a well-established routine may provide potential benefits. Level of Evidence N/A. [ABSTRACT FROM AUTHOR]

Summary Objective To identify the barriers to and enablers of the prevention of mother-to-child transmission (PMTCT) of HIV program in China. Methods A systematic review of the existing literature regarding barriers to and enablers of the implementation of the PMTCT program in China was performed. The checklist from the SURE guidelines (Supporting the Use of Research Evidence) was used to synthesize the barriers and enablers (supporting strategies) and to analyze their relationships. The HIV testing rate, vertical transmission rate, and antiretroviral treatment (ART) acceptance rate among HIV-infected women and their infants was also extracted from the included studies to assess the effectiveness of the enablers. Results Initially 794 publications were identified, and ultimately 14 articles were included. Eighteen types of barrier and nine types of supportive strategy were identified, mainly at the level of social and political issues, healthcare recipients, healthcare providers, and the healthcare system. Based on government-oriented multi-sector cooperation, enablers in China have included community–hospital–family promotion, comprehensive financial support for service recipients, free HIV testing at marriage registration, the opt-out model, and the one-to-one service model. Conclusions Experience in China suggests that the government’s role in coordination and the acceptability and accessibility of the service should be the primary concerns in regard to the PMTCT project. [ABSTRACT FROM AUTHOR]

Manufacturing performance is very crucial to the success of any organization. Hence, it becomes imperative for manufacturing industries to adopt sustainability measures considering their dependence on non-renewable resources along with the generation of a large amount of wastes. This study aims to propose comprehensive sustainability framework for manufacturing domain to strengthen the enablers and mitigate barriers based on the responses of researchers, and industry professionals. Decision-making Trial and Evaluation Laboratory approach has been applied to identify most influential factors amongst ten identified enablers and barriers in both the groups. Further, a scientific approach, Maximum Mean De-Entropy algorithm has been utilised to integrate the obtained results with Interpretive Structural Modeling based on threshold value to develop a hierarchical structure of the complex system. Finally, the study has been statistically validated for enablers and barriers by employing structural equation modeling based on the responses of both the groups. The obtained results are expected to highlight the underlying differences in their opinions which can be jointly worked upon to minimize this gap towards sustainability implementation. [ABSTRACT FROM AUTHOR]

Ever increasing customer choices, environmental concerns and competitiveness among manufacturers across the globe has engaged the industry to embrace newer manufacturing strategies. Predominantly, there are three dimensions to modern manufacturing systems viz. economic, environmental and social. The integration of lean-green-agile manufacturing strategies would be a complete and comprehensive manufacturing system which is the need of the 21st century. The adoption of Lean-Green-Agile Manufacturing System (LGAMS) would be facilitated by few enablers. The influence of these enablers is a matter of investigation which is addressed by the present study. An attempt has been made to prioritize the facilitating capacity of each enabler. The outcome of the research would facilitate the policy makers in the industry and government to frame policies. [ABSTRACT FROM AUTHOR]