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Background: The clinical utility of whole genome sequencing (WGS) in paediatric cancer has been demonstrated in recent years. WGS has been routinely available in the National Health Service (NHS) England for all children with cancer in England since 2021, but its uptake has been variable geographically. To explore the underlying barriers to routine use of WGS in this population across England and more widely in the United Kingdom (UK) and the Republic of Ireland (ROI), a one-day workshop was held in Cambridge, United Kingdom in October 2022. Methods: Following a series of talks, delegates participated in open, round-table discussions to outline local and broader challenges limiting routine WGS for diagnostic work-up for children with cancer in their Principal Treatment Centres (PTCs) and Genomic Laboratory Hubs (GLHs). Within smaller groups, delegates answered structured questions regarding clinical capability, education and training needs, and workforce competence and requirements. Data was recorded, centrally collated, and analysed following the event using thematic analysis. Results: Sixty participants attended the workshop with broad representation from the 20 PTCs across the UK and ROI and the seven GLHs in England. All healthcare professionals involved in the WGS pathway were represented, including paediatric oncologists, clinical geneticists, clinical scientists, and histopathologists. The main themes highlighted by the group in ensuring equitable access to WGS identified were: lack of knowledge equity between NHS trusts, with a perception of WGS being for research only; and perception of lack of financial support for the clinical process surrounding WGS, including lack of time to take informed consent from patients. The latter also included limited trained staff available for data interpretation, affecting the turnaround time for reporting. Finally, the need for an integrated digital pathway to order, track, and return data to clinicians was highlighted. Conclusion: At the workshop, the general motivation for including WGS in the diagnostic work up for children with cancer was high throughout the UK, however a perceived lack of resources and education opportunities limit the widespread use of this commissioned assay. This workshop has led to some recommendations to increase access to WGS in this population in England and more widely in the devolved national of the UK and the ROI. [ABSTRACT FROM AUTHOR]

We study the effect of the double potentials (barrier, well) on the Goos–Hänchen (GH) shifts in phosphorene. We determine the solutions of the energy spectrum associated with the five regions that make up our system. By studying the phase shifts, we find that the GH shifts are highly sensitive to the incident energy, the y directional wave vector, the potential heights and widths. To validate our findings, we perform a numerical analysis of the GH shifts as a function of the transmission probability under various conditions. In particular, we observe a consistent pattern in which a positive peak in the GH shift is always followed by a negative valley, a behavior evident at all potential height values. Notably, the energies at which the GH shift changes sign coincide exactly with the points at which transmission drops to zero. In particular, the transmission resonances that occur just before and just after the transmission gap region are strongly correlated with the points at which the GH shift changes sign. This study advances our understanding of how the double potential influences the GH shift behaviors in phosphorene. The ability to fine-tune the GH shifts by changing system parameters suggests potential applications in optical and electronic devices using this two-dimensional material. [ABSTRACT FROM AUTHOR]

Background: Exercise has been demonstrated to result in improvements in physical function, cognition, and quality of life in People with Parkinson's (PwP) but its adoption is variable. Objectives: To investigate exercise preferences, levels, influencing factors among a diverse Parkinson's disease (PD) population, to understand exercise adoption patterns and plan informed interventions. Methods: A cross‐sectional survey collected data through online platforms and paper‐based methods. The Exercise Index (ExI) calculated exercise level based on frequency and duration. Results: Of 2976 PwP, 40.6% exercised regularly, 38.3% occasionally, and 21.2% did not exercise. The overall mean ExI was 18.99 ± 12.37. Factors associated with high exercise levels included exercising in groups (ExI 24–26), weightlifting (ExI 27 (highest)), using muscle‐building equipment (ExI 25–26), and exercising at home following an app (ExI 26). A positive trend between ExI and varied exercise groups, locations, types, and equipment was observed. No expected benefit from exercise achieved the lowest ExI (8). Having at least two exercise‐promoting factors, a bachelor's degree or higher, receiving exercise advice at initial visits, and aged ≤40 years at PD onset were strong predictors of exercise (adjust OR = 7.814; 6.981; 4.170; 3.565). Falls and "other" most troublesome PD symptoms were negative predictors (aOR = 0.359; 0.466). Barriers to exercise did not predict the odds of exercise. Conclusions: The study shows that PwP's exercise behavior is influenced by their exercise belief, age at PD onset, doctor's advice at initial visits, education level, symptoms, and exercise‐promoting factors. High exercise levels were associated with certain types of exercises and exercising in groups. [ABSTRACT FROM AUTHOR]

Background: Climate change-induced geohazards are increasingly posing a critical threat to the sustained functionality and resilience of constructed infrastructures. Among these hazards, debris flows represent significant natural disasters, particularly in mountainous terrains, causing widespread property damage and loss of life globally. These phenomena involve complex interactions between solid and fluid forces, resulting in long run-out distances and high-speed flows. Predicting and monitoring debris flows is challenging due to the intricate interplay of these forces. Objective: The objective of this study is to evaluate the structural damage caused by debris flows and assess the efficacy of rigid barrier structures with passages/apertures. Method: Employing Smoothed Particle Hydrodynamics, a Lagrange-based mesh-free computational technique, the researchers simulated the impact of debris on a stiff structure. The focus was on the Rishiganga river valley in the Indian state of Uttarakhand, a region recently devastated by a debris flow that severely compromised essential infrastructure, including a hydroelectric power station. The research entailed modeling the debris flow in this specific locale and analyzing its effects on an assumed downstream rigid structure. Additionally, the study explored the outcomes of introducing a rigid barrier upstream. Results and Conclusion: Results indicated a substantial reduction in the impact on the downstream structure with the presence of an upstream rigid structure. Moreover, as the number of apertures in the upstream barrier was increased, the impact of flow on the downstream structure further diminished, because of a more streamlined flow pattern. [ABSTRACT FROM AUTHOR]

Background/Objectives: Surgical removal of deep endometriosis lesions is an established method of reducing patient symptoms, but it often results in iatrogenic adhesions that lead to further problems. This pilot study presents the safety evaluation of a novel self-cross-linked hyaluronic acid gel used to reduce adhesions after non-bowel deep endometriosis surgery. Methods: A single cohort, single-center, non-randomized pilot study was conducted in patients diagnosed with non-bowel deep endometriosis who underwent a three-stage treatment regimen consisting of first surgery, hormone therapy and second surgery. The present report is limited to an analysis of the inflammatory parameters, pain and complications occurring within a 72 h period following the initial laparoscopy (FLL) utilizing the anti-adhesion gel. Results: 60 patients (28.48 ± 5.9 years old) were included. 24 h after the intervention, a slight elevation in C-reactive protein levels was observed in 38.33% of cases (0.98 ± 1.46 mg/dL), with a statistically significant difference after FLL (0.98 ± 1.46 mg/dL before FLL vs. 1.03 ± 1.29 mg/dL after FLL; p =< 0.001); there were no patients with levels above 10 mg/dL before or after surgery. 24 h after FLL, 29.33% of patients had a leukocyte count greater than 11 Thous/μL, with a maximum observed value of 16.2 Thous/μL. The count was found to be statistically significantly higher after FLL (6.03 ± 1.91 Thous/μL before FLL vs. 9.15 ± 2.61 Thous/μL after FLL; p =< 0.001). At 72 h post-intervention, postoperative pain was reported in up to 63.33% of cases, and one urinary tract infection with fever occurred but was not considered to be related to the product. No serious adverse events were observed. Conclusions: The results of this exploratory study showed a safe range of inflammatory response within a 24 h period following the application of the novel self-cross-linked hyaluronic acid antiadhesion gel (HyaRegen®) in patients who underwent laparoscopic surgery for non-bowel deep endometriosis. [ABSTRACT FROM AUTHOR]

The distribution of species and the way that lineages are structured are the result of intrinsic historical processes of the species and their relationships with landscape features. Paleosuchus palpebrosus is one of the smallest crocodilians in the world and has a wide geographic distribution in South America, occurring in different habitats. Here, we analyzed mitochondrial cytochrome b sequences of 227 individuals, investigated how elements of landscape heterogeneity impact genetic differentiation, and evaluated the evolutionary and phylogeographic history of the species. Thus, we hypothesized that landscape structures, such as aridity and slope, should act as resistance surfaces to population connectivity, while rivers could mediate the dispersion of the species as a conductor of the gene flow. The analyses recovered three main lineages of P. palpebrosus. While most of the observed genetic variation was explained by geographic resistance distance, river connectivity had a smaller contribution for the observed variation. We also found a recent history with limited genetic divergence throughout the wide distribution of the species. Our findings highlight the main drivers for the evolutionary history of the species and how landscape features can shape the diversification, especially if we consider rivers as a facilitator of gene flow. [ABSTRACT FROM AUTHOR]

Even though classic literature has cultural and educational value in heritage education, students often have trouble becoming interested because of the archaic language, a lack of good learning materials, the idea that the literature is not relevant, and complicated plots. This research aims to enhance heritage education by identifying barriers and drivers in youth engagement with classic Thai literature and exploring how Universal Design for Learning (UDL) principles could be applied to increase motivation in learning classic literature through multimedia. Ten interviews with experts, 100 on-site questionnaires filled out by students aged 15–25 years, and a multimedia e-book were used together in this mixed-methods study. As a case study, the researchers asked both experts and students to read the Thai classic poem "Phra Aphai Mani: Escaping from the Sea Witch" and make suggestions for how it could be better. The results show that there are barriers to heritage education, such as 'the story is not connected to the present' (mean = 4.52/5), 'archaic vocabulary and language barriers' (mean = 4.36/5), and 'learning materials' (mean = 4.25/5). Surprisingly, Thai students showed more positive attitudes towards literature courses than expected based on international trends. Key drivers for enhancing heritage education include 'classic literature in modern, easy-to-read language' (mean = 4.65/5), 'including multimedia' (mean = 4.58/5), 'the plot/story adapted to the current era' (mean = 4.50/5), and 'new presenting technologies' (mean = 4.49/5). Next, as an innovative way to improve heritage education, this study developed a free e-book titled "Phra Aphai Mani: Escaping from the Sea Witch", which includes motion graphics and other multimedia elements. This research contributes to knowledge by demonstrating how UDL can be applied to classic literature within heritage education, enhancing understanding of student needs, and creating more effective, inclusive multimedia teaching methods for preserving and transmitting cultural heritage. [ABSTRACT FROM AUTHOR]

Systematic assessments of interprofessional collaboration barriers and enablers in long-term care settings are critical for delivering person-centered healthcare. However, research on factors influencing interprofessional collaboration in long-term care settings is limited. For this study, 65 healthcare professionals across multiple facilities experienced in long-term care in Japan participated in online focus group discussions and individual interviews to discuss cases. The qualitative data were analyzed using qualitative content analysis. Seven themes emerged: coordination, the need for care manager training, hierarchy among healthcare professionals, specialization but not the mind-set of overspecialization, casual conversations, electronic group communication tools, and excessive fear of personal information protection. These findings highlight the need to develop coordinator roles and for interprofessional education on the proper approach to personal information protection laws. Furthermore, daily casual conversations, the use of online platforms, and the prevention of patients being left behind due to overspecialization are required. [ABSTRACT FROM AUTHOR]

As a critical component of electrostatic capacitors, the polymer dielectric directly affects the performance of the capacitor. In this work, Polycarbonate (PC)/Polyvinylidene fluoride (PVDF) asymmetric bilayer polymer dielectrics were prepared, and the influence of different polymer materials' barrier characteristics on various electrical properties of composite dielectrics was studied by changing the direction of applied electric fields. Research has found that the dielectric constant of a composite dielectric is between PVDF and PC (approximately 4.8 at 10 Hz) and is independent of the relative position of PVDF and PC in the dielectric. However, the relative position of PC and PVDF has a significant impact on the energy-storage characteristics of composite dielectrics. When PVDF comes into contact with the negative electrode, even though PC has a higher hole barrier, the composite dielectric can only withstand a maximum electric-field strength of 400 MV/m, which is much lower than the maximum electric-field strength that pure PC can withstand (520 MV/m), and it only achieves an energy-storage density of 3.7 J/cm3. When the PC comes into contact with the negative electrode, the high electron barrier of the PC effectively suppresses the injection of electrons at the electrode. It can withstand the same electric-field strength as PC (520 MV/m), achieving an energy-storage density of 5.48 J/cm3, which is 1.46 times that of pure PC and 1.64 times that of PVDF. This experiment effectively combined the advantages of PC and PVDF by utilizing the electron/hole barrier of polymer materials to obtain a fully organic dielectric with excellent energy-storage performance. [ABSTRACT FROM AUTHOR]

Aim: To identify and synthesise qualitative studies on barriers and facilitators perceived by dialysis patients in relation to self‐care and disease management. Design: Systematic review of qualitative studies. Data Sources: Qualitative study articles were extracted from PUBMED, MEDLINE, COCHRANE, WEB OF SCIENCE (WOS), CINAHL PsycINFO and EMBASE and electronic journals of the Spanish Society of Nephrology and Spanish Society of Nephrological Nursing until May 2022. Studies on barriers and/or facilitators affecting self‐care and disease management expressed by people undergoing haemodialysis or peritoneal dialysis were included. Review Methods: The SPICE (Setting, Perspective, Intervention, Comparison and Evaluation) strategy was used to develop issues and subissues through the thematic synthesis of the qualitative findings. GRADE‐CERQual was used to evaluate the articles. Results: From 172 articles, 15 qualitative articles about barriers and facilitators perceived by patients concerning self‐care and disease management were finally included. Identified eight facilitators and four barriers. Conclusion: Patients perceived a significant number of barriers and facilitators. It is possible to identify which aspects facilitate self‐management of their disease and to understand that the processes are individualised. This is why therapeutic strategies should be designed to foster the participation and empowerment of the person in the management of the disease. Implications for the profession and/or patient care: Identifying the barriers and facilitators concerning the management of chronic kidney disease furnishes us with knowledge for individualised clinical practice and improved care processes. Impact: This review is the first to synthesise barriers and facilitators in haemodialysis patients about the management of their disease and treatment. The results enable the proposal of improvements in the training of healthcare personnel, clinical practice guidelines and action protocols to improve the daily life and management of the disease by patients. No patient or public contribution due to this is a systematic review. [ABSTRACT FROM AUTHOR]

The 4th Davos Declaration was developed during the Global Allergy Forum in Davos which aimed to elevate the care of patients with atopic dermatitis (AD) by uniting experts and stakeholders. The forum addressed the high prevalence of AD, with a strategic focus on advancing research, treatment, and management to meet the evolving challenges in the field. This multidisciplinary forum brought together top leaders from research, clinical practice, policy, and patient advocacy to discuss the critical aspects of AD, including neuroimmunology, environmental factors, comorbidities, and breakthroughs in prevention, diagnosis, and treatment. The discussions were geared towards fostering a collaborative approach to integrate these advancements into practical, patient‐centric care. The forum underlined the mounting burden of AD, attributing it to significant environmental and lifestyle changes. It acknowledged the progress in understanding AD and in developing targeted therapies but recognized a gap in translating these innovations into clinical practice. Emphasis was placed on the need for enhanced awareness, education, and stakeholder engagement to address this gap effectively and to consider environmental and lifestyle factors in a comprehensive disease management strategy. The 4th Davos Declaration marks a significant milestone in the journey to improve care for people with AD. By promoting a holistic approach that combines research, education, and clinical application, the Forum sets a roadmap for stakeholders to collaborate to improve patient outcomes in AD, reflecting a commitment to adapt and respond to the dynamic challenges of AD in a changing world. [ABSTRACT FROM AUTHOR]

This paper investigates the use of a protective pile row barrier to mitigate the risk due to a deep excavation in soft soils adjacent to an existing tunnel. The study includes two reduced-scale 1 g model tests with and without the barrier, along with monitoring data from a case history in Wuhan, the Huazhong Science and Technology Industrial Park basement; physical testing and numerical sensitivity study results are compared to the case history to evaluate the barrier efficiency. The monitoring data show successful excavation and basement construction within allowable displacement thresholds in the presence of the barrier. The entire tunnel settled and translated towards the excavation, although different types of ovalization of the tunnel cross-sections were recorded depending on their alignment to the excavation (centre and corners). Experimental results indicate that the pile row barrier can withstand a portion of the soil pressure on the diaphragm wall, leading to a substantial reduction in tunnel bending moments and displacements; in particular, experimental results showed a greater percentage reduction in settlements than horizontal movements of the existing tunnel. When a pile row barrier is constructed in proximity to the retaining wall, it can help to minimise the detrimental effects of the deep excavation on the existing tunnel, similar to twin retaining wall scenarios. [ABSTRACT FROM AUTHOR]

To explore how injury, as a primary barrier, impacts physically inactive Australian women's engagement in sport and physical activity. Concept mapping. Participants used online concept mapping to brainstorm the meaning of injury, then sorted and rated statements for impact and importance (1 (low)–5 (high) scale). Multi-dimensional scaling, hierarchical cluster analysis and descriptive statistics were applied. Forty-five Australian women, aged 25–64, brainstormed 94 statements representing the meaning of an injury. Nine clusters emerged from analysis of the sorting data (highest to lowest mean cluster impact order): Fear and frustration ; Physical implications of injury ; Activity restrictions ; Financial implications ; Modification and management ; Recovery ; Mental and emotional wellbeing ; Impact on daily life ; and Social impact and engagement. A high correlation was found between rating scales (r = 0.92). A holistic approach is fundamental to understanding how the multi-dimensional impacts of injury and recovery affect physically inactive women. This approach should extend beyond the medical/physical aspects to other challenges and contextual factors (i.e. environmental and personal) impacting women's functioning. Understanding the diverse needs and experiences of physically inactive women is crucial for tailoring interventions that can effectively support recovery and sustained engagement, through person-centred strategies focused on injury prevention/management. Furthermore, this understanding is essential to fostering collaborative system-wide understanding and change, involving diverse stakeholders (e.g. health practitioners, those in delivery/practice settings, insurance) to improve long-term health and wellness outcomes, and promote greater participation in sport/physical activity. [ABSTRACT FROM AUTHOR]

Background: GPs' participation in continuous medical education (CME) is essential for patient care, GPs' wellbeing, and healthcare expenditure. However, one-quarter of Danish GPs did not use their reimbursement for CME in 2022. Knowledge of barriers for participating in CME is limited. Aim: To analyse the barriers GPs face to participation in CME, and patterns in perceived barriers. Design & setting: A cross-sectional questionnaire study design was used. The study population comprised all 3257 GPs in Denmark who, in May 2023, were registered as entitled to reimbursement for CME. Method: The response rate was n = 1303/3257 (40%). Based on a question about use of CME, the responders were divided into 'frequent', 'partial', and 'seldom' users. Partial and seldom users answered questions about barriers related to CME (n = 726). The presence of barriers was quantified, and a latent class analysis (LCA) was used to stratify GPs according to their barrier patterns. Results: The most frequent barriers were as follows: too busy (67%); fully booked courses (45%); and no substitute or locum doctor (39%). Based on the LCA, we found three distinctive patterns, clustering around the following: GPs from clinics with no tradition for CME (class 1, 17%); GPs who used time on professional work outside clinic (teaching, organisational work) (class 2, 43%); and GPs who were personally or professionally affected (class 3, 40%). Singled-handed and male GPs were slightly overrepresented among seldom users. Conclusion: We have identified barriers for CME. We found three different profiles of GPs who perceived different patterns of barriers. Identified patterns in barriers should be considered in future CME initiatives. [ABSTRACT FROM AUTHOR]

A CFD (computational fluid dynamics) analysis to investigate the effects of the installation of a barrier in a hydrogen refueling station (HRS) mock-up facility, with a dummy vehicle and dispensers in the vapor cloud region, during a hydrogen-air explosion using a gas mixture volume of 70.16 m3 was conducted to determine whether the radXiFoam v2.0 code with the established analysis methodology to predict the peak overpressure can be utilized to evaluate the safety of a HRS with such a barrier installed in a large city in the Republic of Korea. The radXiFoam v2.0 code was developed on the basis of the XiFoam solver in the open-source CFD software OpenFOAM-v2112 by modifying C++ source codes in several libraries and governing equations so as to ensure effective calculations of the hydrogen-air chemical reaction and radiative heat transfer through water vapor in a humid air environment and to remove unnecessary warning messages that arise when using the radXiFoam v1.0 code. First, we conducted a validation analysis on the basis of measured overpressure datasets from a near field to a far field of a vapor cloud explosion (VCE) site in the HRS mock-up facility to evaluate the uncertainty in prediction datasets by radXiFoam v2.0. After this validation analysis, we undertook CFD sensitivity calculations by installing barriers with heights of 2.1 m and 4.2 m at a horizontal distance of 2.3 m from the VCE region in the grid model used for the validation analysis to assess the effects of these barriers on reducing the peak overpressure of the blast wave. From these calculations, we judged that the radXiFoam v2.0 code can accurately simulate the effects of the barrier during a VCE, as the calculated overpressure reduction values according to the barrier height are reasonable on the basis of previous validation results from Stanford Research Institute's explosion test with such a barrier. The results herein imply that the radXiFoam v2.0 code is feasible for use in HRS safety when barrier installation must meet the technical regulations of the Korea Gas Safety Corporation in a large city. [ABSTRACT FROM AUTHOR]

The study was conducted to explore teachers' barriers in implementing the revised common curriculum for learners with special educational needs in Northern Namibia. The study used a mixed research approach to collect data from the sample of 20 special education teachers currently teaching at two special schools located in Northern Namibia. Participants were selected using the total population sampling method and data were collected using a questionnaire and focus group discussion. Quantitative data were analysed using descriptive statistics while qualitative data were analysed using the thematic analysis method. The study found that the special education teachers' barriers in implementing the revised curriculum for deaf learners include a shortage of specialised teaching and learning materials, inadequate time per lesson for scaffolding deaf learners, lack of teaching methodology, lack of refresher workshop, minimal parental involvement in learners' education, teachers inadequate knowledge of sign language, lack of assessment tools for deaf learners, insufficient teaching assistance to assist learners, and no specialised curriculum for learners with hearing impairment. The study recommended that the schools as well as the Regional Directorate of Education should organise more workshops for special education teachers in sign language to enable them to develop common signs to teach the learners. Additionally, the government should install Wi-Fi in the Special schools to enable the teachers to access and utilize relevant online resources such as visual teaching materials when teaching. The Universities in Namibia should introduce a teaching specialisation course in Sign language to train teachers. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionThe purpose of the present study was to construct a substantial theory that can systematically deal with barriers, promotors, and adaptive actions when older adults with chronic conditions move in a community.The present study is qualitative research based on grounded theory methodology. We recruited participants in 2 day-service facilities and one nursing station, and selected participants according to principle of theoretical sampling.We included sixteen participants. We have constructed a theory including eight categories. The core category of the theory was “the set of primary indicators in community mobility” This core category is related to difficulty, comfortability, and safety when persons move in a community, and consists of four elements: difficulty of general actions, degree of psychological burden, degree of accumulated fatigue, and probability of accidents.The theory integrated around the core category could provide a way of thinking for clinical practice. [ABSTRACT FROM AUTHOR]

Non-adherence to immunosuppressive medication among transplant patients is associated with poor clinical outcomes and higher economic costs. Barriers to immunosuppressives are a proximal determinant of non-adherence. So far, international variability of barriers to adherence in transplantation has not been studied. As part of the cross-sectional multi-country and multi-center BRIGHT study, barriers to adherence were measured in 1,382 adult heart transplant recipients of 11 countries using the 28-item self-report questionnaire "Identifying Medication Adherence Barriers" (IMAB). Barriers were ranked by their frequency of occurrence for the total sample and by country. Countries were also ranked the by recipients' total number of barriers. Intra-class correlations were calculated at country and center level. The five most frequently mentioned barriers were sleepiness (27.1%), being away from home (25.2%), forgetfulness (24.5%), interruptions to daily routine (23.6%) and being busy (22.8%), fairly consistently across countries. The participants reported on average three barriers, ranging from zero up to 22 barriers. The majority of the variability among reported barriers frequency was situated at the recipient level (94.8%). We found limited international variability in primarily person-level barriers in our study. Understanding of barriers in variable contexts guides intervention development to support adherence to the immunosuppressive regimen in real-world settings. [ABSTRACT FROM AUTHOR]

Polyamide composites with varying filler concentrations are prepared using the hot melt extrusion method, employing polyamide 56/6 (PA56/6) and modified talc as fillers. Initially, the thermal characteristics of PA56/6 composites (PA56/6‐talc) are examined through thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC), encompassing parameters such as melting temperature, crystallinity, and decomposition temperature. The hydrophilicity and barrier properties of PA56/6‐talc are assessed using an optical contact angle meter, a water vapor transmission rate tester, and an oxygen transmission rate tester. Furthermore, the mechanical properties of PA56/6‐talc are also scrutinized. The results indicate that PA56/6 exhibits superior hydrophobic, barrier, and mechanical properties, thereby demonstrating its immense potential in garment fabrics and packaging materials. [ABSTRACT FROM AUTHOR]

In this study, a novel debris flow resisting structure is proposed that incorporates negative Poisson's ratio (NPR) cables to unite a flexible net and a rigid barrier; this structure is referred to as the NPR barrier. The NPR barrier attempts to utilize the mechanical properties of the NPR cable—the constant resistance and large deformation—to convert the impact into particle friction resistance and support force. NPR cables can effectively improve the performance of the resisting barrier. To investigate the mechanical response of an NPR barrier, physical experiments are conducted on a debris flow impacting an NPR barrier at two distances with four volume fractions. The experimental results reveal that the impact model of a debris flow with an NPR barrier is a hybrid model that simultaneously incorporates both runup and pileup mechanisms. During the buffering, run-up, and backflow-depositional stages of the debris flow, the NPR cables correspondingly demonstrate a sharp increase in resistance, slight decrease in resistance, and constant resistance, respectively, effectively transforming the impact into resistance. The relationship between the buffer force and impact force exhibits an inverse correlation as the material volume fraction increases. When the material volume fraction increases from 40 to 70%, the buffer force significantly increases by 73.4%, and the impact force substantially decreases by 35.6%. Finally, the calculation methods for the impact force, NPR cable tension, and buffer force are discussed. This study represents an attempt to generate novel insights into the structural optimization of debris flow control systems. Highlights: A novel debris flow barrier, which incorporates Negative Poisson's ratio (NPR) cables, a flexible net, and a rigid barrier, is proposed and referred to as the NPR-anchored barrier (NPR barrier). The impact model of a debris flow with an NPR barrier is a hybrid model that simultaneously integrates both run-up and pile-up mechanisms. The NPR barrier utilizes the constant resistance and large deformation properties of the NPR cable to achieve a sustained equilibrium of impact load and to enhance the efficiency of dissipating impact energy. The mechanical response properties of the NPR barrier have been validated through physical experiments and mechanical calculation analyses. [ABSTRACT FROM AUTHOR]

In this study, we assessed the impact of hepatocyte growth factor (HGF) on corneal endothelial cells (CECs), finding that HGF concentrations of 100–250 ng/mL significantly increased CEC proliferation by 30%, migration by 32% and improved survival under oxidative stress by 28% compared to untreated controls (p < 0.05). The primary objective was to identify non-fibrotic pharmacological strategies to enhance corneal endothelial regeneration, addressing a critical need in conditions like Fuchs' endothelial dystrophy (FED), where donor tissue is scarce. To confirm the endothelial nature of the cultured CECs, Na+/K+-ATPase immunohistochemistry was performed. Proliferation rates were determined through BrdU incorporation assays, while cell migration was assessed via scratch assays. Cell viability was evaluated under normal and oxidative stress conditions using WST-1 assays. To ensure that HGF treatment did not trigger epithelial-mesenchymal transition, which could lead to undesirable fibrotic changes, α-SMA staining was conducted. These comprehensive methodologies provided robust data on the effects of HGF, confirming its potential as a therapeutic agent for corneal endothelial repair without inducing harmful EMT, as indicated by the absence of α-SMA expression. These findings suggest that HGF holds therapeutic promise for enhancing corneal endothelial repair, warranting further investigation in in vivo models to confirm its clinical applicability. [ABSTRACT FROM AUTHOR]

Pyroptosis is an inflammatory form of programmed cell death that is distinct from necrosis and apoptosis. Pyroptosis is primarily mediated by the gasdermin family of proteins (GSDMA‐E and PVJK), which, when activated by proteolytic cleavage, form pores in the plasma membrane, leading to cell death. While much of the past research on pyroptosis has focused on its role in cancer, metabolic disorders, and infectious diseases, recent experimental and observational studies have begun to implicate pyroptosis in allergic diseases. These studies suggest that gasdermin‐mediated pyroptosis contributes to the development of allergic conditions and could offer novel targets for therapy. Here, we review our current understanding of pyroptosis with an emphasis on the role of gasdermins as executioners of pyroptosis and potential mediators to allergic disease. We highlight new discoveries that establish a mechanistic link between the biochemical actions of gasdermins and the onset of allergic diseases. Additionally, we discuss how pyroptosis and gasdermins might contribute to the dysfunction of epithelial barrier, a key factor believed to initiate the progression of various allergic diseases. [ABSTRACT FROM AUTHOR]

This paper examined barriers to succession planning of family-owned businesses in Abia state. Specifically, the study determined barriers to succession planning related to: founder, family and employees of family-owned businesses. The paper adopted survey research design. A total of 345 family-owned businesses drawn from Ariaria international market and Umuahia ultra-modern market served as the population of the study. Data were collected using questionnaire. Data were analysed using frequency counts, percentages and weighted mean. Findings show that the founder’srelated barriers to succession planning ranged from fear of death (x̄= 3.5), and reluctance to let go of his leadership position (x̄= 3.7). Family-related barrier included the family’s unwillingness to relinquish their places in the business (x̄= 3.6); as well as, socio-cultural challenges within the environment the business is situated. The employees’ disinclination toward formalization of the business (x̄= 3.4) constituted employee-related barrier. The paper therefore recommended that owners of family businesses should bring in the successor into the family business as early as possible, and also make available to the would-be successor, vital information that has been used to manage the business right from beginning of the business up to the time of the entrepreneur’s exit. [ABSTRACT FROM AUTHOR]

Objectives To estimate the level of physical activity among geriatric population, to determine the motivating factors for being active and identifying barriers that prevent participants from engaging in physical activity. Methods A community-based cross-sectional study was carried out at one of the wards within Ahmedabad city following multi-stage random sampling. The calculated sample size was 230. A pre-designed, validated, short version International Physical Activity Questionnaire (IPAQ) and Behaviour Regulation in Exercise Questionnaire (BREQ-3) were used for data collection by personal interview. From selected sampling-frame, geriatric people residing in every 5th household were interviewed after obtaining oral informed consent following simple-random sampling. Results Of total 230 study participants, 67 (29.13%) were physically active (cumulative for Category 2 and Category 3), while the remaining 163 (70.87%) were found physically inactive (i.e., minimally active [Category 1]). Motivational scores, particularly in identified regulation, showed higher median scores across subdomains of the BREQ-3. Amotivation exhibited a strong negative correlation with physical activity, while intrinsic regulation displayed a strong positive correlation. Conclusion More than two-third of study participants were physically inactive. Level of educational status, type of previous occupation involved, presence of addiction, BMI, electronic device usage duration per day and presence of chronic illness were statistically significant determinants to decide involvement of elderly people in category of physical activity. Amotivation, external and introjected regulation had negative correlation with physical activity, while intrinsic regulation and RAI (Relative Autonomy Index) showed positive correlation with physical activity. None of the behavioural regulators had statistically significant association with category of physical activity. [ABSTRACT FROM AUTHOR]

The implementation and sustainability of evidence-based practice (EBP) is a complex process. Best practice guidelines (BPGs) can facilitate the translation of knowledge from theory into practice, but they require working groups to adapt recommendations and encourage adherence to them. The aim of this study was to identify facilitators and barriers of BPGs in the Registered Nurses' Association of Ontario®, within the framework of Best Practice Spotlight Organisations® (BPSOs®), in a hospital setting. Methods: This study was conducted using the modified Delphi method (two rounds) with a cohort of BPSO® Best Practice Champions. The facilitators and barriers included in the first round were identified through a bibliographic search. The degree of concordance was determined in the second round using the highest mean resulting values. Results: A total of 44 nurses responded, with a mean age of 42.57 ± 8.563. The facilitators included the following: work environment; working in a hospital that encourages research; and dedicating time to EBP (p < 0.001). The barriers included the following: excessive workload; professional mobility (p < 0.001); and lack of time (p = 0.002). Implications for practice: As such, it is necessary to approach human resource management by implementing new policies that guarantee systemic sustainability. The BPSO® programme is an excellent framework for promoting the translation of theoretical knowledge into practice and effecting institutional change. [ABSTRACT FROM AUTHOR]

Abstract Background This study protocol outlines the phased construction of a questionnaire, data collection, and a strategy for analysis within the framework of the ATTAS project. This study has two primary objectives. First, it allows us to map the duration of the various phases of the abortion trajectory for women presenting for abortion in Flanders, Belgium. Second, it identifies barriers that cause delays within these phases. Methods The questionnaire was distributed to all women seeking abortion care at one of the five Flemish abortion centers; specifically, the LUNA centers, which are located in Ostend, Ghent, Antwerp, and Hasselt, as is the VUB-Dilemma center in Brussels during the fall and winter of 2023–2024. Ethical clearance for the described research was obtained from the University of Antwerp’s Ethics Committee for the Social Sciences and Humanities (reference numbers: SHW_2023_48_1 and SHW_2023_48_2). Discussion The collected data provide a dataset on the abortion trajectories of Flanders women who presented for abortion. This study protocol outlines the ATTAS project’s rationale, phased development, and implementation of the questionnaire, as well as the upcoming data analyses. To our knowledge, this is the first study within the Flemish context to investigate abortion trajectories, timing, and access. Furthermore, this study protocol provides a phased and systematic approach to adapt validated research instruments to fit within diverse legal and cultural contexts. Building on this protocol, future research will seek to advance reproductive justice for all women in Belgium.

Abstract Background The clinical utility of whole genome sequencing (WGS) in paediatric cancer has been demonstrated in recent years. WGS has been routinely available in the National Health Service (NHS) England for all children with cancer in England since 2021, but its uptake has been variable geographically. To explore the underlying barriers to routine use of WGS in this population across England and more widely in the United Kingdom (UK) and the Republic of Ireland (ROI), a one-day workshop was held in Cambridge, United Kingdom in October 2022. Methods Following a series of talks, delegates participated in open, round-table discussions to outline local and broader challenges limiting routine WGS for diagnostic work-up for children with cancer in their Principal Treatment Centres (PTCs) and Genomic Laboratory Hubs (GLHs). Within smaller groups, delegates answered structured questions regarding clinical capability, education and training needs, and workforce competence and requirements. Data was recorded, centrally collated, and analysed following the event using thematic analysis. Results Sixty participants attended the workshop with broad representation from the 20 PTCs across the UK and ROI and the seven GLHs in England. All healthcare professionals involved in the WGS pathway were represented, including paediatric oncologists, clinical geneticists, clinical scientists, and histopathologists. The main themes highlighted by the group in ensuring equitable access to WGS identified were: lack of knowledge equity between NHS trusts, with a perception of WGS being for research only; and perception of lack of financial support for the clinical process surrounding WGS, including lack of time to take informed consent from patients. The latter also included limited trained staff available for data interpretation, affecting the turnaround time for reporting. Finally, the need for an integrated digital pathway to order, track, and return data to clinicians was highlighted. Conclusion At the workshop, the general motivation for including WGS in the diagnostic work up for children with cancer was high throughout the UK, however a perceived lack of resources and education opportunities limit the widespread use of this commissioned assay. This workshop has led to some recommendations to increase access to WGS in this population in England and more widely in the devolved national of the UK and the ROI.

Abstract Background Climate change-induced geohazards are increasingly posing a critical threat to the sustained functionality and resilience of constructed infrastructures. Among these hazards, debris flows represent significant natural disasters, particularly in mountainous terrains, causing widespread property damage and loss of life globally. These phenomena involve complex interactions between solid and fluid forces, resulting in long run-out distances and high-speed flows. Predicting and monitoring debris flows is challenging due to the intricate interplay of these forces. Objective The objective of this study is to evaluate the structural damage caused by debris flows and assess the efficacy of rigid barrier structures with passages/apertures. Method Employing Smoothed Particle Hydrodynamics, a Lagrange-based mesh-free computational technique, the researchers simulated the impact of debris on a stiff structure. The focus was on the Rishiganga river valley in the Indian state of Uttarakhand, a region recently devastated by a debris flow that severely compromised essential infrastructure, including a hydroelectric power station. The research entailed modeling the debris flow in this specific locale and analyzing its effects on an assumed downstream rigid structure. Additionally, the study explored the outcomes of introducing a rigid barrier upstream. Results and Conclusion Results indicated a substantial reduction in the impact on the downstream structure with the presence of an upstream rigid structure. Moreover, as the number of apertures in the upstream barrier was increased, the impact of flow on the downstream structure further diminished, because of a more streamlined flow pattern.

Even though classic literature has cultural and educational value in heritage education, students often have trouble becoming interested because of the archaic language, a lack of good learning materials, the idea that the literature is not relevant, and complicated plots. This research aims to enhance heritage education by identifying barriers and drivers in youth engagement with classic Thai literature and exploring how Universal Design for Learning (UDL) principles could be applied to increase motivation in learning classic literature through multimedia. Ten interviews with experts, 100 on-site questionnaires filled out by students aged 15–25 years, and a multimedia e-book were used together in this mixed-methods study. As a case study, the researchers asked both experts and students to read the Thai classic poem “Phra Aphai Mani: Escaping from the Sea Witch” and make suggestions for how it could be better. The results show that there are barriers to heritage education, such as ‘the story is not connected to the present’ (mean = 4.52/5), ‘archaic vocabulary and language barriers’ (mean = 4.36/5), and ‘learning materials’ (mean = 4.25/5). Surprisingly, Thai students showed more positive attitudes towards literature courses than expected based on international trends. Key drivers for enhancing heritage education include ‘classic literature in modern, easy-to-read language’ (mean = 4.65/5), ‘including multimedia’ (mean = 4.58/5), ‘the plot/story adapted to the current era’ (mean = 4.50/5), and ‘new presenting technologies’ (mean = 4.49/5). Next, as an innovative way to improve heritage education, this study developed a free e-book titled “Phra Aphai Mani: Escaping from the Sea Witch”, which includes motion graphics and other multimedia elements. This research contributes to knowledge by demonstrating how UDL can be applied to classic literature within heritage education, enhancing understanding of student needs, and creating more effective, inclusive multimedia teaching methods for preserving and transmitting cultural heritage.

The implementation and sustainability of evidence-based practice (EBP) is a complex process. Best practice guidelines (BPGs) can facilitate the translation of knowledge from theory into practice, but they require working groups to adapt recommendations and encourage adherence to them. The aim of this study was to identify facilitators and barriers of BPGs in the Registered Nurses’ Association of Ontario®, within the framework of Best Practice Spotlight Organisations® (BPSOs®), in a hospital setting. Methods: This study was conducted using the modified Delphi method (two rounds) with a cohort of BPSO® Best Practice Champions. The facilitators and barriers included in the first round were identified through a bibliographic search. The degree of concordance was determined in the second round using the highest mean resulting values. Results: A total of 44 nurses responded, with a mean age of 42.57 ± 8.563. The facilitators included the following: work environment; working in a hospital that encourages research; and dedicating time to EBP (p < 0.001). The barriers included the following: excessive workload; professional mobility (p < 0.001); and lack of time (p = 0.002). Implications for practice: As such, it is necessary to approach human resource management by implementing new policies that guarantee systemic sustainability. The BPSO® programme is an excellent framework for promoting the translation of theoretical knowledge into practice and effecting institutional change.

Vision is closely tied to quality of life. Traditional drug delivery routes for clinical therapy of key ocular diseases, such as glaucoma, are topical and systemic administrations, which are less invasive but often face some physiological barriers such as tear film turnover, corneal penetration, and blood-ocular barrier. These barriers may limit penetration and distribution of ophthalmic drugs, resulting in limitation of information about pharmacokinetic characteristics of drugs in human eye. To address this, some ocular based compartment models, including classical ocular compartmental model and physiologically based pharmacokinetic(PBPK)model, have been established to illustrate dispositions of drugs in eyes. For classical ocular compartmental model, cornea or vitreous humor serves as central compartment and other ocular tissues are identified as peripheral compartments. The PBPK model, incorporating dynamic factors such as changes in ocular blood flow, effects of transporters, blood-ocular barrier, may characterize complex ocular physiology structure and dispositions of drugs in eyes. These models can contribute to development of new ophthalmic drugs and therapy strategies for ocular diseases. Here, the characteristics of drugs in eye following administrations via various routes, general ocular compartmental model and PBPK model as well as their applications in the development of new ophthalmic drugs and drug regimen for ocular diseases are reviened.

CONTEXT: Poor diet has been implicated in a range of noncommunicable diseases. Fiscal and pricing policies (FPs) may offer a means by which consumption of food and non-alcoholic beverages with links to such diseases can be influenced to improve public health. OBJECTIVE: To examine the acceptability of FPs to reduce diet-related noncommunicable disease, based on systematic review evidence. DATA SOURCES: MEDLINE, EMBASE, PsychInfo, SCI, SSCI, Web of Science, Scopus, EconLit, the Cochrane Library, Epistemonikos, and the Campbell Collaboration Library were searched for relevant studies published between January 1, 1990 and June 2021. DATA EXTRACTION: The studies included systematic reviews of diet-related FPs and: used real-world evidence; examined real or perceived barriers/facilitators; targeted the price of food or non-alcoholic beverages; and applied to entire populations within a jurisdiction. A total of 9996 unique relevant records were identified, which were augmented by a search of bibliographies and recommendations from an external expert advisory panel. Following screening, 4 systematic reviews remained. DATA ANALYSIS: Quality appraisal was conducted using the AMSTAR 2 tool. A narrative synthesis was undertaken, with outcomes grouped according to the WHO-INTEGRATE criteria. The findings indicated a paucity of high-quality systematic review evidence and limited public support for the use of FPs to change dietary habits. This lack of support was related to a number of factors that included: their perceived potential to be regressive; a lack of transparency, ie, there was mistrust around the use of revenues raised; a paucity of evidence around health benefits; the deliberate choice of rates that were lower than those considered necessary to affect diet; and concerns about the potential of such FPs to harm economic outcomes such as employment. CONCLUSION: The findings underscore the need for high-quality systematic review evidence on this topic, and the importance of responding to public concerns and putting in place mechanisms to address these when implementing FPs. This study was funded by Safefood [02A-2020]. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021274454.

This paper investigates the relationships between challenges faced by Brazilian companies in adopting Energy Management Systems (EnMS). The fuzzy Decision-Making Trial and Evaluation Laboratory (DEMATEL) methodology is employed to examine the interdependencies between the challenges. The study involves assembling an expert panel to assess the causal relations between key challenges identified through a literature review. The findings reveal that challenges related to insufficient financial resources, deficiencies in competencies within the implementation team, and lack of support from top management are pivotal factors influencing the adoption of EnMS. These challenges are positioned as core factors, highlighting their critical role in EnMS implementation. Conversely, factors such as difficulty in determining appropriate performance indicators and justifying EnMS certification maintenance are categorised as impact factors, signalling their lower priority for resource allocation. The study contributes to research by providing a nuanced understanding of the challenges hindering EnMS adoption and their interdependencies. Additionally, the findings offer practical insights for organisations seeking to implement EnMS, guiding resource allocation and strategic planning efforts to overcome barriers effectively.

Aims and Objectives: Initiation of palliative care early in the disease trajectory is beneficial for patients with a life‐limiting disease. However, palliative care is still introduced rather late or not at all. Therefore, this study aims to explore barriers and facilitators to early initiation of palliative care as perceived by nurses working on pneumology and nephrology. Methods: A descriptive interview‐based study was conducted from a critical realist perspective until data sufficiency was reached. Fifteen nurses presented and discussed a patient for whom palliative care was initiated too late. Template analysis was conducted to develop themes and subthemes. Results: Five key themes were extracted: (1) communication, (2) fear, (3) personal beliefs about life and death, (4) ambiguity in terminology and (5) workload and time pressure. Barriers related to poor interdisciplinary communication were therapeutic obstinance, hierarchy, unawareness of the patient's wishes and fear of saying something inappropriate. Other barriers were patients' religious beliefs which often hindered the use of sedatives or morphine and led to discomfort and time restraints. A palliative support team in hospital and advance care planning (ACP) were enablers for early palliative care. Study Limitations: This study started from a negative experience, leading to identification of a lot of barriers and only a few facilitators. The limited sample size and the restriction to two wards within one single hospital limit the diversity of perspectives and the generalisability of the findings. Conclusion: More attention is needed for ACP and interdisciplinary communication. Palliative care, including ACP, and interdisciplinary communication should be included in the basic curricula of all healthcare professional courses. Further research is needed to explore barriers and facilitators to early initiation of palliative care in other healthcare settings and patient populations. This is crucial in order to develop and implement sustainable interventions for specific groups of patients. [ABSTRACT FROM AUTHOR]

Background: Nowadays, especially after the COVID-19 pandemic, electronic learning (eLearning) has become a necessity in education. eLearning can be either synchronous, where classes are conducted in real-time, or asynchronous, where students can access the class material at any time. Student-instructor interaction has become essential to the educational process. In the literature, most studies have focused on the preferred methods of eLearning and the barriers to interaction in eLearning. Thus, this study aimed to investigate the factors that affect students' interactions during eLearning and their impacts on students' academic achievements. Methods: A national cross-sectional study was conducted among clinical and pre-clinical medical students who were attending universities in five regions of the Kingdom of Saudi Arabia. Data were collected using a bespoke online self-administered questionnaire covering sociodemographic features, eLearning barriers, preferences, and the impact of eLearning on students' performance and understanding. Results: This study involved 1371 medical students, of whom 52.37% were male and 51.13% were in their pre-clinical years of medical college. Of the participants, 59.88% (n = 821) preferred synchronous modalities of eLearning, and 33.33% (n = 457) avoided interaction during synchronous lectures. The main predictors of avoiding interaction during online lectures were being male in the clinical years of medical studies, being in a quiet atmosphere, having difficulties using the eLearning platform, having a poor internet connection, having a visual learning style, being insecure, and the presence of opposite-sex students and facilitators. In addition, 12.25% students (n = 168) reported a lower grade point average (GPA), whereas 11.96% (n = 164) reported an improved GPA after eLearning compared with in-person/onsite learning sessions. The GPA fluctuation was related to gender, personality type, learning style, interaction, and eLearning modality preference. Moreover, the students' understanding was enhanced by recorded lectures (n = 1,093, 79.72%) and supportive multimedia (n = 1,037, 75.64%), and the easy to use platform (n = 1037, 75.64%). Conclusion: The synchronous modality of eLearning was the preferred teaching method among the medical students. However, multiple individual, technical, and environmental factors affected their interaction, performance, and understanding during these sessions. Hence, future interventional research is recommended to overcome interaction barriers and enhance student performance and understanding of eLearning. [ABSTRACT FROM AUTHOR]

Increasing demand for packaging has motivated research into sustainable materials to prevent continued plastic pollution. Materials based on polysaccharide polyelectrolyte complexes (PPCs) are emerging as a viable solution for packaging applications. We employed ball milling, a well‐established technology, for the preparation of PPC materials to create an innovative one‐step process capable of producing highly concentrated and homogeneous PPC particle precursor dispersions. We fabricated carboxymethyl cellulose (CMC) and chitosan (CS)–based PPC solutions exhibiting high‐solid loading and investigated the potential of PPC solutions made from ball milling as alternative barriers for packaging. PPC‐coated paperboard exhibited improved Cobb test performance and outstanding grease resistance as compared to pristine paper. The results certified that a single‐step process via ball milling can produce high‐solid content PPC solutions useful for creating bio‐based coatings with excellent barrier performance. [ABSTRACT FROM AUTHOR]

Hartiah Haroen,1,&ast; Sidik Maulana,2,&ast; Alia Rahmi Harlasgunawan,2,3 Sri Rahmawati,2 Alvi Riansyah,2 Faizal Musthofa,4 Jerico Franciscus Pardosi5 1Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 2Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 3Nursing Department, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia; 4Nursing Department, Universitas Padjadjaran Hospital, Sumedang, Indonesia; 5School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia&ast;These authors contributed equally to this workCorrespondence: Hartiah Haroen, Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Ir. Soekarno KM, 21, Jatinangor, Sumedang, 45363, West Java, Indonesia, Tel +62 82216718363, Email hartiah@unpad.ac.idAbstract: The increasing incidence of chronic conditions on a global scale requires a comprehensive approach to palliative care, which is recognized as an essential element of the continuum of care for people with life-threatening conditions. It has been argued that the integration of early palliative care for people with chronic conditions is beneficial. Nevertheless, barriers to integrating early palliative care have been extensively not reviewed. This review aimed to explore the barriers and facilitators of integrating early palliative care for people living with chronic conditions, employing a socio-ecological framework to provide a critical understanding of the influencing factors at multiple levels. The method was a mini review. This review emphasizes the complex and diverse factors that either hinder or facilitate progress in four areas: individual (such as gaps in knowledge and emotional reactions), interpersonal (such as support from family caregiver), healthcare professionals and policy (such as barriers in education, guidelines, and collaboration among professionals), and community (such as societal knowledge and attitudes). Each level presents unique challenges and opportunities for enhancing early palliative care integration, from addressing misconceptions and fears at the individual level, to fostering supportive policies and community awareness. In conclusion, the effective management of early palliative care requires a comprehensive strategy that spans various dimensions, including educational initiatives, policy adjustments, and active involvements of the community. Healthcare systems are supposed to enhance the integration of early palliative care into the trajectory of chronic conditions and enhance the quality of life of affected persons and their families by recognizing and addressing the socio-ecological elements involved.Keywords: barrier, early palliative care, facilitator, people living with chronic condition

Despite its importance and urgency, the problem of hospitality food waste (FW) has not received much attention from academics. This paper has contributed to the field of FW by examining the FW practices employed by luxury hotels in Vietnam. 25 semi-structured interviews have been conducted with employees working in hotels in Danang and Quangnam. A qualitative thematic coding analysis was employed to identify themes. The results show that buffet leftovers were the most wasteful type, compared to preparation and plate waste. The study indicates that the prioritization of surplus food reuse and redistribution, particularly the sale of FW for animal feed, takes precedence over prevention practices. Customers were found to create more challenges than hotel employees regarding barriers to more effectively managing the FW issue. The study provides practical implications for policymakers to formulate and implement strategies aimed at enhancing the effectiveness and sustainability of FW management practices.

Abstract Background The integration of mental health into primary care—i.e., the process by which a range of essential mental health care and services are made available in existing multipurpose health care settings that did not previously provide them—can be facilitated or hindered by several health system factors that are still poorly understood. This study aimed to identify health system facilitators and barriers to the integration of mental health services into primary care in the Democratic Republic of the Congo (DRC) to improve the success rate of integration programs. Methods We conducted a multimethod, cross-sectional exploratory study. Stakeholders (managers, health service providers, service users, etc.) from sixteen of the twenty-six provinces of the DRC participated. We collected qualitative data through 31 individual, semistructured, face-to-face key informant interviews. We then collected quantitative data through a population-based survey of 413 respondents. We analyzed the interviews via thematic analysis, assigning verbatims to predefined themes and subthemes. For the survey responses, we performed descriptive analysis followed by binomial logistic regression to explore the associations between the variables of interest. Results Strong leadership commitment, positive attitudes toward mental health care, the availability of care protocols, mental health task sharing (p

Aim: To assess barriers and facilitators to the implementation of guidelines for the prevention of inadvertent perioperative hypothermia in orthopaedic patients. Design: Systematic review. Data Sources: Nine databases: PubMed, Embase, CINAHL, Cochrane CENTRAL, PsycINFO, ProQuest Dissertations and Theses, Scopus, Web of Science and Trip Clinical Evidence Database. Methods: Primary studies published in English between January 2008 to July 2022 were screened. Study selection, quality assessment, and data extraction were completed independently by researchers. Data were extracted using the Consolidated Framework for Implementation Research and mapped to the Expert Recommendations for Implementing Change strategies. Results: Eighty‐seven studies were included in the review. The most frequently reported barriers and facilitators related to evidence strength, relative advantage, and cost of implementing perioperative hypothermia prevention guidelines. The top four ERIC strategies were: Identify and prepare champions; Conduct educational meetings; Assess for readiness and identify barriers and facilitators; and Inform local opinion leaders. Conclusion: This review provides synthesized evidence regarding barriers and facilitators to perioperative hypothermia guidelines for patients undergoing orthopaedic surgery. Implications for the Profession and Patient Care: Our work provides theory guided strategies to promote implementation of perioperative hypothermia prevention to assist nurses caring for patients undergoing orthopaedic surgery. Impact: Findings provide professionals caring for patients undergoing orthopaedic surgery with theory‐informed strategies to improve perioperative hypothermia prevention. Reducing perioperative hypothermia will improve outcomes for patients undergoing orthopaedic surgery. Reporting Method: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 2020. No Patient or Public Consultation: Due to the study design, no patient or public consultation took place. [ABSTRACT FROM AUTHOR]

Background and Aims: Children and neonates are more susceptible to diseases and are a vulnerable group in medication administration (MA). Nurses interact directly with patients, ensuring safety and preventing unintended outcomes. Health Information Technology (HIT) has transformed health care, aiding nurses in decision‐making and treatment responses. Despite its benefits, technology presents challenges that must be overcome to facilitate the nursing practice. Therefore, the present study aimed to explore the barriers to HIT use in the process of MA in children and neonates in a developing country. Methods: Semi‐structured face‐to‐face interviews were conducted with 22 health care professionals across seven pediatric and neonatal settings. Also, observations were made of these settings for 3 weeks. A qualitative analysis was performed using the conventional content analysis method, recommended by Colaizzi's seven‐step approach. Results: The results showed that the most significant barriers to adopting technology in MA process could be classified into two main categories: "inappropriate management approaches" with two sub‐categories ("Managers' reluctance to adopt new technology", "lack of adequate budget for hardware resources"), and "resistance to change" with two sub‐categories ("A desire to use conventional (traditional) approaches in care", "cultural issues and impracticality of providing some specialized technology services"). Conclusion: The findings revealed MA process complexities, which have been insufficiently examined in the current literature. We have highlighted the need for improved "effectiveness of HIT systems in administering medication processes, budget for hardware resources, and managers" interest in using new technology. The present findings can guide the development of more effective and user‐friendly HIT systems in pediatric and neonatal care settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: The South African Labour Relations Act, specifically the Code of Good Practice (CGP) advocates against the discrimination and unfair dismissal of individuals with mental health conditions in the workplace. However, little is known about the implementation of these national policies within the workplace, especially from the perspective of the employer rather than the employee. OBJECTIVE: The aim of this study was to explore the experiences and perceptions of how human resource practitioners accommodate and support individuals with mental health conditions in the workplace. METHOD: Eleven participants (Human Resource Professionals) participated in the study. The researchers utilized semi-structured interviews where the data was analysed by means of thematic analysis to formulate themes. RESULTS: Three themes emerged depicting the participants' experiences and perceptions of barriers and facilitators which influenced their return to work: The themes that emerged through thematic analysis consisted of 1) Challenges perceived by Human Resource personnel that influences work participation; 2) The influence that workplace accommodations and support structures have on the work participation; 3) The prevalence of policies and laws that are available in theworkplace. CONCLUSION: The study highlighted that Human Resource Professionals struggle to interpret and implement labor related polices that aid in employing individuals with mental health conditions in the workplace. It is important to implement strategies that will assist Human Resource practitioners in understanding how to implement such policies to successfully accommodate individuals with mental health conditions in the workplace. [ABSTRACT FROM AUTHOR]

Therapeutic needs for hair loss are intended to find small interfering ribonucleic acid (siRNA) therapeutics for breakthrough. Since naked siRNA is restricted to meet a druggable target in clinic,, delivery systems are indispensable to overcome intrinsic and pathophysiological barriers, enhancing targetability and persistency to ensure safety, efficacy, and effectiveness. Diverse carriers repurposed from small molecules to siRNA can be systematically or locally employed in hair loss therapy, followed by the adoption of new compositions associated with structural and environmental modification. The siRNA delivery systems have been extensively studied via conjugation or nanoparticle formulation to improve their fate in vitro and in vivo. In this review, we introduce clinically tunable siRNA delivery systems for hair loss based on design principles, after analyzing clinical trials in hair loss and currently approved siRNA therapeutics. We further discuss a strategic research framework for optimized siRNA delivery in hair loss from the scientific perspective of clinical translation. [ABSTRACT FROM AUTHOR]

Emerging adults aged 18–29 have high rates of viral non-suppression, and poorer adherence to ART when compared to older adults. Semi-structured interviews were conducted with 24 emerging adults in Zimbabwe who had a recent history of viral non-suppression, to explore barriers and facilitators of adherence to ART. Interviews were coded using inductive thematic analysis. The mean age of participants was 23, 65% were male, and 79% reported acquiring HIV at birth. Twelve barriers to adherence were identified. Hiding HIV status due to the possible negative consequences of disclosure had a significant impact on adherence to ART. This was particularly important for emerging adults navigating starting intimate relationships. Being away from home, poverty, poor mental health, isolation, significant life events, alcohol, health systems barriers, and stigma were reported as barriers to adherence. Support from peers and family after disclosure of HIV status, phone-based reminders, problem-solving strategies to adhere, knowing others living with HIV, acted as facilitators to adherence to ART. Beliefs about medicines and relationships with health care providers acted as both barriers and facilitators to adherence. Interventions to reduce stigma, foster peer support, and therapy for common mental disorders could facilitate emerging adults aged 18–29 to adhere to ART. [ABSTRACT FROM AUTHOR]

A smooth and dense surface of the base paper is advantageous when the goal is to apply a liquid coating as a barrier layer. For such a base paper, non-wood fibers derived from wheat straw could be an alternative to wood fibers. In this research paper, wheat straw pulp was refined with different beating levels (up to 600 revolutions) followed by different calendering pressure loads (up to 50 N/mm) to test its influence on mechanical and surface properties. Alkyl ketene dimer (AKD) was used as sizing agent with concentrations up to 0.2 wt% followed by a mineral-based precoating to test its influence on the smoothness. Eucalyptus pulp was chosen as a benchmark. After beating, the initial Schopper-Riegler degrees of 28 °SR increased to 56 °SR. Beating also increased the tensile index from 24 to 49 Nm/g, the burst index from 1.2 to 2.8 kPa·m²/g, and the tear index decreased from 3.3 to 2.8 mN·m²/g. Calendering reduced the initial roughness of 370 mL/min to 30 mL/min. When precoated and calendered again, the value was lowered to 15 mL/min. In summary, wheat straw paper is a relevant alternative to wood-derived base paper to produce barrier papers. Compared to eucalyptus, wheat straw paper showed better smoothness and much lower air permeability indicating excellent suitability for barrier coating. [ABSTRACT FROM AUTHOR]

This article introduces a novel, rapid, and non-destructive method for assessing homogeneity within and between weave repeats in fabric structures, termed intra-repeat (IAR) and inter-repeat (IER) evaluation. The method focuses on structural parameters, including inter-thread pores (ITPs) and warp and weft pitches, using computer image analysis. Each parameter is assigned to a module in the repeat weave pattern, facilitating the sorting of modules in the IAR and IER fabric structure arrangement. The method was verified using artificial images and 30 real plain fabrics with varying degrees of warp grouping, employing the author's proprietary software, MagFABRIC version 2.1The general measurable coefficients of intra- and inter-homogeneity were defined and related to the airflow measurements of these fabrics. Multiple regression models of airflow revealed strong dependencies, particularly for F = 10, with the size, shape, and position of ITPs and warp and weft pitches showing significant correlation. These findings underscore the importance of the new homogeneity parameters in textile structure analysis, including both IAR and IER woven fabric structure homogeneity parameters. The research aims to model specialized fabrics (e.g., barrier, filtration, composite fabrics) to address local changes in fabric structure affecting properties such as filtration efficiency, air permeability, and mechanical properties, especially in applications like composites or medical implants. [ABSTRACT FROM AUTHOR]

There is growing evidence that pharmacogenetic analysis can improve drug therapy for individual patients. In Switzerland, pharmacists are legally authorized to initiate pharmacogenetic tests. However, pharmacogenetic tests are rarely conducted in Swiss pharmacies. Therefore, we aimed to identify implementation strategies that facilitate the integration of a pharmacist-led pharmacogenetic service into clinical practice. To achieve this, we conducted semi-structured interviews with pharmacists and physicians regarding the implementation process of a pharmacist-led pharmacogenetic service. We utilized the Consolidated Framework for Implementation Research (CFIR) to identify potential facilitators and barriers in the implementation process. Additionally, we employed Expert Recommendations for Implementing Change (ERIC) to identify strategies mentioned in the interviews and used the CFIR-ERIC matching tool to identify additional strategies. We obtained interview responses from nine pharmacists and nine physicians. From these responses, we identified 7 CFIR constructs as facilitators and 12 as barriers. Some of the most commonly mentioned barriers included unclear procedures, lack of cost coverage by health care insurance, insufficient pharmacogenetics knowledge, lack of interprofessional collaboration, communication with the patient, and inadequate e-health technologies. Additionally, we identified 23 implementation strategies mentioned by interviewees using ERIC and 45 potential strategies using the CFIR-ERIC matching tool. In summary, we found that significant barriers hinder the implementation process of this new service. We hope that by highlighting potential implementation strategies, we can advance the integration of a pharmacist-led pharmacogenetic service in Switzerland. [ABSTRACT FROM AUTHOR]

In Denmark, 12,000 people live with Parkinson's disease. Parkinson's disease is a chronic neurodegenerative disease that requires specialized interventions based on a coordinated interdisciplinary and intersectoral approach. This study aims to illuminate challenges experienced by professionals related to creating coordinated pathways for people with Parkinson's disease and their relatives in a Danish context. The study is based on ten qualitative interviews with healthcare professionals from different professional backgrounds; the interviews were analyzed using qualitative content analysis. The analysis revealed four themes: Collaboration happens by coincidence; Geography dictates treatment offers; Professionals have no influence over treatment offers; and, Achieving new knowledge can be a challenge.These barriers challenge health care professionals to create a coordinated individualized pathway. Consequently, people living with Parkinson's disease and their relatives must seek and coordinate activities themselves, and ultimately interventions may not target individual needs, risking inequality in treatment and care. [ABSTRACT FROM AUTHOR]

The circular economy concept is popular among developed countries contributing to sustainable production, efficient resource utilization, a new economic model, and higher skill job creation. In production and consumption, it is inevitable in our modern life that we are used to the traditional linear economy cradle-to-cradle model. With the gap in developing countries within the Southeast Asia region, this research aims to understand the motivators and barriers to circular economy business model adoption among the manufacturing firms in Malaysia. Subsequently, the impact of sustainable production will be studied based on the circular economy business model adoption. Using the Theory of Planned Behavior and Partial Least Squares Structural Equation Modeling, this study assesses the responses of 102 respondents from various industries with environmental management systems within Malaysia. Survey-based primary data was gathered to understand motivators and barriers that negatively influence the circular economy business adoption, affecting sustainable production. The findings show that motivators have a positive impact while barriers have a negative impact on circular economy business model adoption. Apart from the barriers and motivators, the research also assesses the level of circular economy adoption among manufacturing firms with certified environmental management systems. This implies a general overview for manufacturing firms in Malaysia regarding circular economy adoption and contributes to the studies done in developing nations. In conclusion, motivators positively impact the adoption of the circular economy business model, while barriers have a negative effect. In addition, adopting the circular economy model has a positive relationship with sustainable production. [ABSTRACT FROM AUTHOR]