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Globalization of the food supply chain (FSC) has brought significant challenges to the food system, such as fraud, safety, security, and quality issues, due to information asymmetry. Globalization also increases the difficulty and complexity of solving these problems to improve FSC efficiency. Blockchain technology (BCT) has proven to have the capability to transform FSC based on its potential benefits. However, studies of BCT adoption in FSC are relatively new and scarce. This study systematically reviews the current state of research in the space of BCT and FSCs. In carrying out the research, a systematic literature review (SLR) was deployed using two prominent databases, Scopus and Business Source Complete (EBSCO), covering articles from 2016 to 2021, with 52 articles synthesized to identify blockchain enablers, benefits, and barriers. Based on this review, a conceptual framework was developed for BCT adoption within the FSC. The study identified scalability, interoperability, high cost, lack of expertise, and regulations as the most likely barriers to BCT adoption. It contributes to the body of knowledge by providing insights into BCT adoption in the FSC and offers evidence-based direction for other industries to build their BCT strategies.

Abstract Introduction There is increasing evidence that Simulation-based learning (SBL) is an effective teaching method for healthcare professionals. However, SBL requires a large number of faculty to facilitate small group sessions. Like many other African contexts, Mbarara University of Science and Technology (MUST) in Uganda has large numbers of medical students, but limited resources, including limited simulation trained teaching faculty. Postgraduate medical trainees (PGs) are often involved in clinical teaching of undergraduates. To establish sustainable SBL in undergraduate medical education (UME), the support of PGs is crucial, making it critical to understand the enablers and barriers of PGs to become simulation educators. Methods We used purposive sampling and conducted in-depth interviews (IDIs) with the PGs, key informant interviews (KIIs) with university staff, and focus group discussions (FGDs) with the PGs in groups of 5–10 participants. Data collection tools were developed using the Consolidated framework for implementation research (CFIR) tool. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique. Results We conducted seven IDIs, seven KIIs and four focus group discussions. The barriers identified included: competing time demands, negative attitude towards transferability of simulation learning, inadequacy of medical simulation equipment, and that medical simulation facilitation is not integrated in the PGs curriculum. The enablers included: perceived benefits of medical simulation to medical students plus PGs and in-practice health personnel, favorable departmental attitude, enthusiasm of PGs to be simulation educators, and improved awareness of the duties of a simulation educator. Participants recommended sensitization of key stakeholders to simulation, training and motivation of PG educators, and evaluation of the impact of a medical simulation program that involves PGs as educators. Conclusion In the context of a low resource setting with large undergraduate classes and limited faculty members, SBL can assist in clinical skill acquisition. Training of PGs as simulation educators should address perceived barriers and integration of SBL into UME. Involvement of departmental leadership and obtaining their approval is critical in the involvement of PGs as simulation educators.

Objective: To identify and map barriers and facilitators to the acceptance of pain neuroscience education for chronic musculoskeletal pain conditions. Introduction: Pain neuroscience education aims to reconceptualize the understanding of the biology of pain. This includes the acknowledgment of physiological and psychological processes relevant to pain experiences to ultimately change maladaptive beliefs and behaviors. Pain neuroscience education in chronic musculoskeletal pain conditions has been demonstrated to positively influence relevant treatment outcomes. Inclusion criteria: Only qualitative studies will be included. The population will include patients with chronic musculoskeletal pain and healthcare providers involved in pain management. The phenomenon of interest encompasses educational interventions on the biology and psychology of pain, which aim to reconceptualize patients’ understanding of pain. Methods: A comprehensive search strategy will be conducted on MEDLINE (PubMed), Web of Science, PsycInfo, and CINHAL. Two reviewers will independently conduct the study selection process, critical appraisal, data extraction, and data synthesis. Discrepancies will be resolved by a third reviewer. The assessment of methodological quality will be guided by JBI’s critical appraisal checklist for qualitative research. Qualitative data synthesis will follow the JBI SUMARI meta-aggregation approach. Considerations of the certainty in the results will be reported in accordance with a ConQual Summary of Findings.

There is a debate at the highest levels of government and civil society over whether the rise in fraud is a blip exacerbated by the pandemic or a more fundamental transformation (or flip) in the structure of crime. This paper examines this debate by exploring the social factors influencing the level of fraud. It does so by conceptualising these factors as a fraud field, offering a novel way to visualise and consider vulnerability through the broad categories of ‘threats’ and ‘safeguards’ which influence levels of fraud. In doing so it offers the first attempt to map the wide range of ‘forces’ that influence levels of fraud and produces a mathematical expression of this, which will provide a basis for further debate, refinement and research. The threats include the myriad of opportunities, the large population of fraudsters, and the range of human and technology enablers that support the fraudsters. The principal safeguards that resist the fraud threat are culture, the law and the defensive resilience of individuals and organisations. Using the fraud field and official crime statistics, the paper argues that the safeguards are so structurally weak that the fraud epidemic is not a blip, but an opportunistic flip from traditional acquisitive crimes. The forces influencing levels of fraud mean high volumes of fraud will continue at the current levels or even accelerate further, unless there is a collective national strategy to strengthen the safeguards.

BackgroundThe importance of advance care planning (ACP) has been highlighted by the advent of life-threatening COVID-19. Anecdotal evidence suggests changes in implementation of policies and procedures is needed to support uptake of ACPs. We investigated the barriers and enablers of ACP in the COVID-19 context and identify recommendations to facilitate ACP, to inform future policy and practice.MethodsWe adopted the WHO recommendation of using rapid reviews for the production of actionable evidence for this study. We searched PUBMED from January 2020 to April 2021. All study designs including commentaries were included that focused on ACPs during COVID-19. Preprints/unpublished papers and Non-English language articles were excluded. Titles and abstracts were screened, full-texts were reviewed, and discrepancies resolved by discussion until consensus.ResultsFrom amongst 343 papers screened, 123 underwent full-text review. In total, 74 papers were included, comprising commentaries (39) and primary research studies covering cohorts, reviews, case studies, and cross-sectional designs (35). The various study types and settings such as hospitals, outpatient services, aged care and community indicated widespread interest in accelerating ACP documentation to facilitate management decisions and care which is unwanted/not aligned with goals. Enablers of ACP included targeted public awareness, availability of telehealth, easy access to online tools and adopting person-centered approach, respectful of patient autonomy and values. The emerging barriers were uncertainty regarding clinical outcomes, cultural and communication difficulties, barriers associated with legal and ethical considerations, infection control restrictions, lack of time, and limited resources and support systems.ConclusionThe pandemic has provided opportunities for rapid implementation of ACP in creative ways to circumvent social distancing restrictions and high demand for health services. This review suggests the pandemic has provided some impetus to drive adaptable ACP conversations at individual, local, and international levels, affording an opportunity for longer term improvements in ACP practice and patient care. The enablers of ACP and the accelerated adoption evident here will hopefully continue to be part of everyday practice, with or without the pandemic.

BackgroundAccess to sexual and reproductive health (SRH) services is a fundamental human right, but people with disabilities (PwDs) in low-and middle-income countries often face multiple barriers to utilisation. This study aimed to assess the level of SRH services utilisation and the enabling and inhibiting factors among PwDs in Ghana’s Ashanti region.MethodsA sequential explanatory mixed-methods study design was employed, involving quantitative (n = 402) and qualitative (n = 37) data collection from PwDs. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed using inductive thematic analysis.ResultsThe study found that only 33.8% of the PwDs had ever used SRH services. Utilisation was associated with sex, marital status and travel duration to health facility. The qualitative data revealed that factors at the individual, family/community and health facility levels influenced utilisation of SRH services, acting as both enablers and barriers.ConclusionPwDs had relatively low utilisation of SRH services in Ghana’s Ashanti region. To increase utilisation, it is recommended to address the stigma and discrimination towards PwDs, provide more training for healthcare providers, improve the accessibility of healthcare facilities, and strengthen the national health insurance scheme. Further research could explore PwDs’ SRH outcomes and strategies to improve these outcomes in Ghana.

Objective: This study investigated research capacity and culture in people with lived experience of mental health challenges by developing a quantitative tool that measures capacity to engage in research. Method: A cross-sectional, correlational methodology was employed, which comprised of three phases: lived experience consultations for item development (n = 15), item refinement (n = 20) and tool piloting. Items were adapted from, and extended, an existing research capacity and culture tool for healthcare workers. People (N = 112) with lived experience as mental health consumers, carers, peer workers and/or advocates aged 18–75 years took part in the tool piloting survey. Results: Overall, participants rated their individual research capacity and culture skills as moderate (mean = 5.41, standard deviation = 2.04). The most commonly reported barriers to research engagement related to lack of knowledge, familiarity or experience with the research process. The most commonly reported enablers were altruistic, such as using their experiences to improve services and help others. Research capacity and culture significantly correlated with current research activities (rs = 0.25–0.41; ps < 0.05), but not with being a research participant (r = 0.09; p > 0.05), suggesting that building research capacity of people with lived experience requires them to be active members of research teams. Conclusion: The Lived Experience research capacity and culture tool developed in this study revealed that people with lived experience of mental health challenges are intrinsically motivated to engage in research to improve consumer outcomes. The tool may be useful to assess self, research team and organisational preparedness to conduct genuinely co-designed research, and to assess changes in lived experience research capacities and culture over time. [ABSTRACT FROM AUTHOR]

This paper aims to provide evidence and analysis of the conveyor belt that allows Politically Exposed Persons (PEPs) to rehabilitate their money in western financial centres, while inserting Nigerian material into debates about transnational kleptocracy. It fleshes out the chain of service provision going from developing countries to western boutique firms or 'rogue' providers, ultimately reaching out to the large blue-chip firms that are instrumental for the validation of PEP wealth and reputations. We use an interpretive practice tracing methodology to elucidate the steps leading to money-laundering, relying on data from a wealth of primary and secondary sources as well as a wider dataset of residential real estate purchases. On the basis of these empirical insights, we find that enabling practices cannot be neatly situated in a dichotomy of lawful and unlawful behaviour. Given that the current assumptions lack nuance, the policy response is likewise skewed, often looking to identify the 'exception to the rule' rather than appreciating the more systemic nature of the problem. Consequently, we argue that there is a need for a conceptual shift in the way professional enablers are framed and analysed, suggesting that their environment can be more helpfully divided into upstream and downstream roles. [ABSTRACT FROM AUTHOR]

Unexplained Wealth Orders, introduced in the United Kingdom in 2017, were designed to tackle the problem of transnational kleptocracy. However, our research on real estate purchases in the UK by elites from post-Soviet kleptocracies demonstrates that incumbent elites are invulnerable to attempts to question the legality of their wealth while exiles from these states often lose their property. From our original dataset of properties, we take a single exemplary case: one of incumbents Dariga Nazarbayeva and Nurali Aliyev, the daughter and grandson of Kazakhstan's first president, Nursultan Nazarbayev who were subject to one of the few UWOs issued and thereby had their properties frozen. In a close analysis of the legal documents from this case, this paper analyses how the properties were purchased and how the sources of wealth were subsequently explained as legitimate. We elaborate an exemplary case of transnational kleptocracy revealing how British legal services actively, passively, and structurally enable specific acts of money laundering. We further expose how they effectively explain kleptocratic wealth and why they are likely to continue to do so despite recent changes to laws and regulations. [ABSTRACT FROM AUTHOR]

Introduction: The development of a structured curriculum, relevant teaching and learning methods, and support facilities and access is necessary to improve palliative care education by preparing nursing students as future professional nurses in the palliative care area. This review aims to synthesize available literature explaining the barriers and enablers in implementing palliative care education in undergraduate nursing students. Method: This review uses a systematic narrative review approach. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) was used in this study. Studies were identified from the PubMed, Scopus, CINAHL, and ProQuest Nursing databases from January 2012 to August 2022. Results: A total 23 of 890 studies were included. The findings were grouped into obstacles and enablers in four parts, namely curriculum and learning strategies, personal and professional competencies, relationships and enablers, and facilities and access. Conclusions: Identifying barriers and enablers can help educational institutions to provide palliative care education according to the needs and expected developments in clinical practice. Collaboration and cooperation between stakeholders must be increased effectively to help provide maximum education. [ABSTRACT FROM AUTHOR]

Smart and sustainable agricultural practices are more complex than other industries as the production depends on many pre- and post-harvesting factors which are difficult to predict and control. Previous studies have shown that technologies such as blockchain along with sustainable practices can achieve smart and sustainable agriculture. These studies state that there is a need for a reliable and trustworthy environment among the intermediaries throughout the agrifood supply chain to achieve sustainability. However, there are limited studies on blockchain technology adoption for smart and sustainable agriculture. Therefore, this systematic review uses the PRISMA technique to explore the barriers and enablers of blockchain adoption for smart and sustainable agriculture. Data was collected using exhaustive selection criteria and filters to evaluate the barriers and enablers of blockchain technology for smart and sustainable agriculture. The results provide on the one hand adoption enablers such as stakeholder collaboration, enhance customer trust, and democratization, and, on the other hand, barriers such as lack of global standards, industry level best practices and policies for blockchain adoption in the agrifood sector. The outcome of this review highlights the adoption barriers over enablers of blockchain technology for smart and sustainable agriculture. Furthermore, several recommendations and implications are presented for addressing knowledge gaps for successful implementation. [ABSTRACT FROM AUTHOR]

In recent years, because of global challenges resulting from increased resource shortages and the climate crisis, interest in and the commitment to transition to a more sustainable economic system, especially a circular economy, has increased among scientists, politicians, and practitioners in Europe. To create a system that maintains the value of products as long as possible and minimizes waste, new business models, so-called circular business models (CBMs), are required. So far, as a result of far-reaching barriers, no breakthrough regarding CBMs has been observed and there are a lack of comprehensive analyses on the barriers and drivers of CBMs. Using a systematic literature analysis, this gap was filled and 637 barriers and 394 drivers were extracted from 76 publications, which were categorized into eight areas and synthesized in a comprehensive framework. The results show that an undifferentiated analysis of CBMs could result in incorrect assumptions, as the barriers between them differ. Overall, however, the most significant effect on all CBMs is from external barriers at a macro level. In this paper, drivers, in the form of success factors and political measures, were assigned to concrete barriers, indicating that policy interventions are needed in Europe in order to overcome these barriers and accelerate systematic change. The article provides research, policy, and practice with a theoretically grounded basis for analyzing these barriers and overcoming them. [ABSTRACT FROM AUTHOR]

Purpose: This research identifies the enablers for implementing circular supply chains (CSCEs) and analyzes interrelationships between them to quantify their driving and dependence power to understand the critical CSCEs. Design/methodology/approach: Initially, 10 CSCEs are identified for the Indian apparel industries through an extant literature review and validated using the Delphi method by seeking experts' opinions. The identified CSCEs are subjected to a novel neutrosophic interpretive structural modeling (N-ISM) method to capture the interrelationships between CSCEs and compute the driving and dependence power of CSCEs. Findings: The findings of the present research work revealed that "supportive legislative framework, awareness of circular economy's potential for revenue gain and availability of trained research and development (R&D) team" are the critical CSCEs that need to be considered while implementing a circular supply chain in apparel industries. Research limitations/implications: This study offers insightful implications to guide practitioners in implementing the circular economy in apparel supply chains. Originality/value: This research work is one of the earlier studies to analyze the enablers for implementing circular supply chains. This study has explored CSCEs in the context of apparel industries. From a methodological perspective, the novel N-ISM method is worth highlighting as the originality of the work. [ABSTRACT FROM AUTHOR]

The debate about the adoption of green technologies (GTs) is trending due to increasing environmental concerns across the globe. In the context of the manufacturing industry, the research about enablers to GT adoption while using the ISM-MICMAC approach is scarce. Hence, the empirical analysis of GT enablers is being done in this study using a novel ISM-MICMAC method. Firstly, the research framework is developed by using the ISM-MICMAC methodology. Then, enablers to GTs were extracted from existing studies and validated by experts. Results showed that the most significant enabler to GT adoption is providing incentives for green manufacturers (1) in the ISM model. So, manufacturing firms must take initiatives for GTs to mitigate the negative environmental impact of industrialization without losing their earnings. This research brings substantial empirical scholarship to understand GT enablers and their contribution in GT enabler incorporation in the manufacturing industry of developing economies. [ABSTRACT FROM AUTHOR]

Background: South Africa's progress towards forming a health promotion workforce lags behind the health promotion career opportunities and professional standards guided by the Australian Health Promotion Association (AHPA), from which South Africa can learn valuable lessons. Problem statement: Despite the existence of a national health promotion strategy, inconsistencies in health promotion workforce standards are a national reality. In one of the 10 National Health Insurance pilot districts in South Africa, researchers investigated health care workers' experiences of the barriers and enablers for the health promotion workforce. Methodology: A qualitative explorative descriptive design was used. Health care workers (health promoters, n = 8; operational managers, n = 6; senior managers, n = 3) in Dr Kenneth Kaunda District's public health sector were sampled using purposive proportional quota sampling. Data were gathered through semi‐structured individual interviews until data saturation was reached (N = 17). Transcribed interviews were thematically analysed, supported by ATLAS.ti 8. Results: Five themes and thirteen sub‐themes emerged, and barriers to the health promotion workforce exceeded enablers. Health promotion workforce structure and policies were deficient. Managerial supervision and monitoring were lacking. The health promotion workforce received insufficient resources with limited implementation of health promotion programs. Formal and informal health promotion training was necessary. Recommendations: The AHPA's proposed Health Promotion Workforce model is considered, focusing on a clear workforce structure, strengthened by managerial buy‐in and efficient monitoring and evaluation. Formal and informal health promotion training and advocacy of the health promotion workforce industry are highlighted. Countries with emerging economies and similar health systems to South Africa might find this article useful. [ABSTRACT FROM AUTHOR]

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Aim: To describe the non‐significant results in nurses' outcomes after the implementation of person‐centred care (PCC) and discuss if and how enablers of the WE‐CARE roadmap for implementing PCC could abate the non‐significant results. Design: In this paper, an innovative framework of enablers in the WE‐CARE Roadmap is explained in relation to increased PCC and nurses' job satisfaction. Method: Findings from a scoping review and published material provided how PCC and nurses' outcomes connect. The WE‐CARE roadmap entails five enablers: Information technology, Quality measures, Infrastructure, Incentive systems and contracting strategies. Results: The WE‐CARE roadmap was described and each enabler in the WE‐CARE roadmap is discussed concerning PCC and the nurses' job satisfaction. Thus far, the effects of PCC on nurses' outcomes have been non‐significant. The WE‐CARE roadmap enablers can be implemented to ensure an increased PCC implementation and higher nurses' job satisfaction. [ABSTRACT FROM AUTHOR]

BACKGROUND:To develop effective and sustainable simulation training programs in low-resource settings, it is critical that facilitators are thoroughly trained in debriefing, a critical component of simulation learning. However, large knowledge gaps exist regarding the best way to train and evaluate debrief facilitators in low-resource settings. METHODS:Using a mixed methods approach, this study explored the feasibility of evaluating the debriefing skills of nurse mentors in Bihar, India. Videos of obstetric and neonatal post-simulation debriefs were assessed using two known tools: the Center for Advanced Pediatric and Perinatal Education (CAPE) tool and Debriefing Assessment for Simulation in Healthcare (DASH). Video data was used to evaluate interrater reliability and changes in debriefing performance over time. Additionally, twenty semi-structured interviews with nurse mentors explored perceived barriers and enablers of debriefing in Bihar. RESULTS:A total of 73 debriefing videos, averaging 18 min each, were analyzed by two raters. The CAPE tool demonstrated higher interrater reliability than the DASH; 13 of 16 CAPE indicators and two of six DASH indicators were judged reliable (ICC > 0.6 or kappa > 0.40). All indicators remained stable or improved over time. The number of 'instructors questions,' the amount of 'trainee responses,' and the ability to 'organize the debrief' improved significantly over time (p

A truly sustainable circular economy is more than just recycling, making it a complex matter. We argue that reducing complexity will ease the path to circular economy. Complexity reduction potential lies in lower material diversity, increasing accessibility and intuitive use for consumers, as well as simplifying business operations.

Background: 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. Methods: 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. Results: 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. Conclusion: 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 Background Hypertension, a major but modifiable risk factor for cardiovascular diseases, is a global health problem including Ethiopia. In a limited infrastructure task sharing of hypertension screening for community health workers is a feasible strategy to improve hypertension management. Recent finding have shown that trained health extension workers (HEWs) can identify high blood pressure, which was effective and feasible. Identifying barriers and enablers for home-based hypertension screening by HEWs is crucial for its implementation. This study aimed to explore barriers and enablers that influence health extension workers’ home-based hypertension screening in the community. Methods The interpretive descriptive design was implemented. In-depth interviews were conducted during October, 2020. A total of 26 participants including HEWs, supervisors, and heads of district health office were purposively selected. They were asked to describe their perception toward home-based hypertension screening by the HEWs. The interviews were audio-recorded, transcribed verbatim into Amharic, and translated into English. The transcripts were coded and themes were identified. Thematic approach was used for data analysis. Results The participants identified key perceived barriers and enablers of HEWs home-based hypertension screening. The most common barriers were a lack of hypertension training, blood pressure measuring devices, blood pressure guidelines and manuals, skilled HEWs, financial incentives, and poor community awareness of the disease. The most common enablers were support from community leaders, presence of functional development army and community trust for HEWs, presence of routine campaign on vaccination and community based health insurance, and an integrated health system. Conclusions Our findings have implications for the HEWs' ongoing implementation of home-based hypertension screening. Successful implementation of this strategy requires scaling up of hypertension training programs for health extension workers and their supervisors, provision of standardized protocols, provision of adequate blood pressure measuring equipment, and regular supportive supervision.

Abstract Background In 2018, the concept of clusters was introduced as a new model for data-driven quality improvement in general practice in Denmark. However, there is little research on the development and implementation of general practice clusters. The study explores how the cluster coordinators responsible for leading the clusters forward enacted and experienced their role during the early years of the clusters with attention to the challenges and enablers perceived in the process. Methods Qualitative, semi-structured interviews with 25 cluster coordinators from clusters that had carried out at least two meetings on a specific professional topic. The coordinators represented clusters of varying sizes and different geographic locations. Key topics in the interview guide were the development and structure of the cluster, the role of the coordinator, obtainment of data for the meetings, the role of external support, the form and content of the meetings, the participation and engagement of the members. A thematic analysis – shaped by the original aims and categories of the study while also being open to emerging themes – was performed on the transcribed interview material. Results Important enablers in the process of developing the clusters included the positive engagement of the GPs, the support offered by regional quality units and a national quality organisation for general practice, and the funding provided by the formal cluster framework. Challenges initially included setting up the clusters administratively and translating the open cluster concept into a local, workable model; and later obtaining relevant data for the cluster meetings and facilitating peer discussions about the data. Conclusion The coordinators generally experienced that the development of the clusters had progressed relatively fast with engagement from most of the participating GPs. Still, challenges with data obtainment, data analysis, and facilitation will have to be addressed ongoingly. Future research should investigate learning processes at the cluster meetings and how the clusters impact clinical practice and collaborative relations between general practice and other health care providers.

Abstract Background Decreasing the burden of Tuberculosis (TB) among PLHIV through TB screening is an effective intervention recommended by the World Health Organization (WHO). However, after over a decade of implementation in Ghana, the intervention does not realize the expected outcomes. It is also not well understood whether this lack of success is due to implementation barriers. Our study, therefore, sought to examine the factors influencing the implementation of the intervention among people living with HIV (PLHIV) attending HIV clinics at district hospitals in Ghana. Methods This was a qualitative study conducted from 6th to 31 May 2019 in three regions of Ghana. We conducted 17 in-depth interviews (IDIs – comprising two regional, six districts and nine facility TB/HIV coordinators) and eight focus group discussions (FGD – consisting of a total of 65 participants) with HIV care providers. The Consolidated Framework for Implementation Research (CFIR) guided the design of interview guides, data collection and analysis. All responses were digitally audio-recorded and transcribed verbatim for coding and analysis using the Framework Approach. Participants consented to the interview and recording. Results The main barriers to TB screening relate to the low commitment of the implementers to screen for TB and limited facility infrastructure for the screening activities. Facilitators of TB screening include (1) ease in TB screening, (2) good communication and referral channels, (3) effective goals and feedback mechanisms, (4) health workers recognizing the need for the intervention and (5) the role of chemical sellers. Conclusions Key barriers and facilitators to the intervention are revealed. The study has shown that there is a need to increase HIV care providers and institutional commitment towards TB screening interventions. In addition, cost issues need to be assessed as they are drivers of sustainability. Our study also advances the field of implementation science through CFIR to better understand the factors influencing the implementation.

Introduction: A key component of achieving respectful maternal and newborn care is labor companionship. Despite important health benefits for the woman and baby, there are critical gaps in implementing labor companionship for all women globally. The paper aims to present the perceptions and experiences of pregnant women, postpartum women, and health care providers regarding companionship during labor and childbirth, and to identify barriers and facilitating factors to the implementation of labor companionship in Burkina Faso. Methods: This is a formative study to inform the "Appropriate use of cesarean section through QUALIty DECision-making by women and providers" (QUALI-DEC) study, to design, adapt and implement a strategy to optimize the use of the cesarean section, including labor companionship. We use in-depth interviews (women, potential companions, and health workers) and health facility readiness assessments in eight hospitals across Burkina Faso. We use a thematic analysis approach for interviews, and narrative summaries to describe facility readiness assessment. Results: In all, 77 qualitative interviews and eight readiness assessments are included in this analysis. The findings showed that all participants acknowledged an existing traditional companionship model, which allowed companions to support women only in the hospital waiting room and post-natal room. Despite recognizing clear benefits, participants were not familiar with companionship during labor and childbirth in the hospital as recommended by WHO. Key barriers to implementing companionship throughout labor and birth include limited space in labor and delivery wards, no private rooms for women, hospital rules preventing companionship, and social norms preventing the choice of a companion by the woman. Conclusion: Labor companionship was considered highly acceptable in Burkina Faso, but more work is needed to adapt to the hospital environment. Revisions to hospital policies to allow companions during labor and childbirth are needed as well as changes to provide private space for women. Training potential companions about their roles and encouraging women's rights to choose their companions may help to facilitate effective implementation. Plain Language Summary: A labor companion is a person who supports a woman throughout labor and birth, typically a woman's spouse/partner, family member, or friend. We were interested to explore if a labor companion throughout labor and birth was acceptable to women and health workers, and feasible to start doing for women in Burkina Faso. To achieve this objective, we interviewed 77 women, companions, and health workers about their beliefs and opinions about labor companions, and what might help or be a challenge to having companions. We also visited eight hospitals to understand what the labor ward looks like, and any policies about companions. We found that hospitals were allowing a 'traditional model' of companionship, allowing companions to accompany women only in the waiting and postnatal rooms (not during labor or birth). Both women and health workers believed that companionship during labor and birth would be helpful and desired, which might help to make it a reality for all women. We also identified some challenges, due to crowded labor rooms with limited privacy, and hospital rules that did not allow companionship. We found that sometimes a woman's family would choose the companion, instead of the woman herself, which may mean the woman does not want this person present. We plan to use these findings to help us to develop a program that allows any woman to have a companion present during labor and birth, in a way that ensures that she chooses the companion, and the companion can support her well. [ABSTRACT FROM AUTHOR]

Background: 'Exercise snacking', which is characterised by shorter and more frequent exercise bouts compared with traditional exercise guidelines, may be an acceptable strategy for increasing physical activity and reducing sedentary behaviour in older adults. Aim: The aim of this study was to evaluate the enablers and barriers for older adults associated with participation in a home-based exercise snacking program delivered and monitored using an Amazon Echo Show 5 device (Alexa). Methods: This study used an interpretive description qualitative design to conduct semi-structured interviews following a 12-week pilot study in 15 adults aged 60–89 years with at least one chronic condition. All participants were prescribed a home based, individualised, lower limb focussed 'exercise snacking' program (involving ≤ 10 min of bodyweight exercises 2–4 times per day) delivered and monitored by an Alexa. Qualitative interview data were analysed using thematic analysis. Results: All 15 participants (mean age 70.3 years) attended the semi-structured interview. Themes including time efficiency, flexibility, perceived health benefits, and motivation were enablers for participation in the 'exercise snacking' program. A lack of upper body exercises and omission of exercise equipment in the program, as well as a lack of time and motivation for performing exercise snacks three or more times per day, were barriers to participation. Conclusion: While 'exercise snacking' is acceptable for older adults, future trials should provide equipment (e.g. adjustable dumbbells, exercise bands), prescribe whole-body exercise programs, and establish strategies to support participation in more than three exercise snacks per day. [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]

Veterinarians sometimes prescribe antimicrobials even when they know or suspect that they are unnecessary. The drivers of this behaviour must be understood to design effective antimicrobial stewardship interventions. Semi-structured interviews were conducted with 22 veterinarians who treated companion animals in Australia. The Theory of Planned Behaviour was used to organise interview themes, focusing on a decision to withhold antimicrobial therapy in the absence of a clear indication. Many background factors influenced antimicrobial-withholding decisions, including the veterinarian's communication skills, general attitudes towards antimicrobial resistance (AMR), habits and energy levels. Client awareness of AMR and the veterinarian–client relationship were also important. Beliefs about the consequences of withholding antimicrobials (behavioural beliefs) were dominated by fears of the animal's condition deteriorating and of failing to meet client expectations. These fears, weighed against the seemingly distant consequences of AMR, were major barriers to withholding antimicrobials. Normative beliefs were primarily focused on the expected approval (or disapproval) of the client and of other veterinarians. Control beliefs about the difficulty of withholding antimicrobials centred around client factors, most importantly, their capacity to adequately monitor their animal, to pay for further investigations, or to undertake non-antimicrobial management, such as wound care, at home. The use of antimicrobials by companion animal veterinarians in the absence of a clear indication is often powerfully driven by behavioural beliefs, chiefly, fears of clinical deterioration and of failing to meet client expectations. [ABSTRACT FROM AUTHOR]

The lack of stakeholder collaboration has been recognised as a prominent hindrance in implementing risk-sensitive urban planning for creating resilient environments for communities against climate-induced risks. This study presents the outcome of a systematised literature review that was conducted to identify the barriers to stakeholder collaboration, as well as the enablers that assist stakeholder collaboration in risk-sensitive urban planning. The study identified thirty-three barriers which were classified under thirteen themes and four major categories (external barriers, inter-organisational barriers, intra-organisational barriers, and personal barriers). The review also identified forty-five enablers which can be used in surmounting the identified barriers. The dependency analysis of the barriers, conducted by adopting the interpretive structural modelling approach, shows that the barriers with a high driving power are external barriers, which are political barriers, policies and legislation-related barriers, and governance-related barriers that are beyond the organisational boundary and control. The research found that the enablers to overcome those high driving barriers are gaining political support for implementing inter-organisational collaboration or adapting the apolitical approach for the collaboration process, strengthening the laws and forming adaptive policies to support collaboration, and establishing transparent and accountable collaborative governance. [ABSTRACT FROM AUTHOR]

An international need exists for effective programmes that will enhance learners' interest in studies and careers related to science, technology, engineering and mathematics, i.e. STEM. When considering the impact of STEM programmes, it is important to identify what can enable or constrain effective programme implementation. As such, enablers can be systematically supported and constraints tackled to maximise a programme's impact. This study considers a nationwide STEM programme in Finland that involved 450 teachers and their learning communities. The study followed an interpretative paradigm, collecting data through semi-structured interviews and analysed with data-driven thematic analysis. The study participants were 14 external change agents operating between participating learning communities and the national programme administration and, thus, had a valuable overview on how the programme evolved. The most important enablers of effective programme implementation were versatile support, programme flexibility and long-term vision. Two major constraints were limited resources and collaboration challenges. Considering the findings of this study can help design effective STEM programmes by providing various support mechanisms for educators, particularly scaffolding; peer and school administrator support; flexibility to enable embedding activities and adapting programme objectives to participants' everyday work; long-term vision to support both lifelong learning and a continuum between different STEM programmes; sufficient time and economic resources to achieve a long-term impact; and collaboration and networking opportunities at the local, regional, national and international levels. [ABSTRACT FROM AUTHOR]

The Reconfigurable Manufacturing System (RMS) has drawn the interest of researchers and practitioners due to its ability to meet dynamic customer needs while also providing flexibility and productivity in manufacturing. To increase RMS adoption, it is necessary to identify Reconfigurable-Manufacturing-System-Enablers (RMSEs) and develop a structural framework to guide practitioners to focus at different stages of implementation. To identify RMSEs, an extensive literature review is conducted, and the structural framework is developed using hybrid Robust-Best-Worst-Method (RBWM)-Interpretive Structural Modelling-(ISM) method with the assistance of expert opinion. The interactions among the selected RMSEs are further investigated, and their driving-dependence power is computed using the fuzzy-MICMAC (cross-impact matrix multiplication applied to classification, abbreviated as MICMAC) method. The study's findings clearly show that four RMSEs in the low-intensity cluster are excluded during initial framework development phase, while the remaining are utilised further for framework development to achieve better RMS implementation. The presented study has clear practical implications for both researchers and practitioners in the industry. This is a unique study that offers an integrated view of major RMSEs. The authors believe that the proposed structural framework will act as a roadmap for researchers working in the RMS domain and will assist in its adoption. [ABSTRACT FROM AUTHOR]

Transformative urban development is urgent to achieve future sustainable development and wellbeing. Transformation can benefit from shared and cumulative learning on strategies to guide urban development across local to national scales, while also reflecting the complex emergent nature of urban systems, and the need for context-specific and place-based solutions. The article addresses this challenge, drawing on extensive transdisciplinary engagement and National Strategy co-development processes for Australia. This includes generation of two frameworks as boundary objects to assist such transdisciplinary strategy development. An 'enabling urban systems transformation' framework comprises four generic overarching transformation enablers and a set of necessary underpinning urban capacities. This also built cumulatively on other sustainability and urban transformation studies. A complementary 'knowledge for urban systems transformation' framework comprises key knowledge themes that can support an integrated systems approach to mission-focused urban transformations, such as decarbonising cities. The article provides insights on the transdisciplinary processes, urban systems frameworks, and scoping of key strategies that may help those developing transformation strategies from local to national scales. Science highlights • Transdisciplinary national urban strategy development is used to distil generic frameworks and strategy scopes with potential international application. • The frameworks also build on other published framings to support convergent, cumulative and transdisciplinary urban science. • The 'enabling transformations' and 'urban knowledge' frameworks include the perspective of those developing sustainable urban systems strategies. • The enabling framework also informs 'National Urban Policy' and 'Knowledge and Innovation Hub' strategies, and prevailing power imbalances. • The knowledge framework can help frame urban challenges, missions and knowledge programs. Policy and practice recommendations • An urban 'transformation imperative' and 'strategic response' can be co-developed from local to national scales. • Local initiative is crucial to drive urban strategies, but sustained national leadership with coherent policy across sectors and scales is also key. • Diversity in engagement participation and processes generates whole-of-urban-systems and local-to-national perspectives. • Urban solutions are context-specific but generic frameworks can help collaborative issue framing and responses. • Collaborative issue framing informed by generic frameworks can bring broader perspectives to context-specific and contested policy and practice issues. [ABSTRACT FROM AUTHOR]

Next Generation Internet of Things (NGIoT) addresses the deployment of complex, novel IoT ecosystems. These ecosystems are related to different technologies and initiatives, such as 5G/6G, AI, cybersecurity, and data science. The interaction with these disciplines requires addressing complex challenges related with the implementation of flexible solutions that mix heterogeneous software and hardware, while providing high levels of customisability and manageability, creating the need for a blueprint reference architecture (RA) independent of particular existing vertical markets (e.g., energy, automotive, or smart cities). Different initiatives have partially dealt with the requirements of the architecture. However, the first complete, consolidated NGIoT RA, covering the hardware and software building blocks, and needed for the advent of NGIoT, has been designed in the ASSIST-IoT project. The ASSIST-IoT RA delivers a layered and modular design that divides the edge-cloud continuum into independent functions and cross-cutting capabilities. This contribution discusses practical aspects of implementation of the proposed architecture within the context of real-world applications. In particular, it is shown how use of cloud-native concepts (microservices and applications, containerisation, and orchestration) applied to the edge-cloud continuum IoT systems results in bringing the ASSIST-IoT concepts to reality. The description of how the design elements can be implemented in practice is presented in the context of an ecosystem, where independent software packages are deployed and run at the selected points in the hardware environment. Both implementation aspects and functionality of selected groups of virtual artefacts (micro-applications called enablers) are described, along with the hardware and software contexts in which they run. [ABSTRACT FROM AUTHOR]