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Early childhood teachers routinely facilitate play-based learning experiences in their physical classrooms; however, the pivot to virtual teaching platforms created a barrier for providing age appropriate, play-based learning opportunities during the COVID-19 pandemic. There are few studies exploring how to promote play in the virtual classroom or what types of activities and learning experiences promote play in synchronous and asynchronous settings. Therefore, this study explored the barriers and challenges to fostering play through virtual teaching and the types of play-based instruction teachers were effectively able to implement in their virtual classroom. This study used content analysis along with descriptive analysis of an online survey with open-ended prompts that early childhood teachers completed (n = 76). Findings revealed two major themes related to challenges and barriers in teachers' efforts to foster play-based learning through virtual formats. Even though teachers noted significant challenges and barriers they identified multiple play-based activities they were able to facilitate effectively through virtual formats. These activities were categorized through the theoretical framework of Piaget's stages of the development of play with the addition of guided play. Implications for how play can be fostered through virtual teaching in early childhood classrooms were discussed. [ABSTRACT FROM AUTHOR]

Background:Medical education has been affected significantly during the coronavirus disease (COVID-19) pandemic. During the pandemic, online learning functioned as the principal pathway of education at all levels of education for a considerable time. Online medical education has faced many challenges and constraints.Objectives:To evaluate the students’ perception toward online medical education in Iraq and related challenges and limitations.Materials and Methods:This study is a cross-sectional, descriptive study to evaluate the challenges and barriers of online learning during the COVID-19 pandemic. We created an online questionnaire. The survey was introduced to undergraduate students in the medicine, pharmacy, dentistry, and nursing colleges from all stages at the University of Basrah, south of Iraq. The study was conducted in April 2020.Results:The total number of participants was 882 students. There were 438 (49.6%) females. The responses of the students showed different problems and limitations facing online learning. These were divided into student-, faculty-, and technical-related barriers. The survey showed that 77% of the students are facing difficulties with having internet or having low-quality internet services. In addition, there was a shortage of students’ electronic devices mainly due to financial causes. The faculty-related were considered by the students (71.4%) to be mainly the deficient experience of the teaching staff in using digital resources. The students (49.4%) recommended online learning to continue in the future, blended with a classic education.Conclusion:The perception of medical students toward online learning was positive. The challenges and barriers to online education were related to students, faculty, and technical factors. The role of online learning can be promising in the post-COVID-19 era.

In recent years, the role of information and communication technology (ICT) has increasingly impacted school instructional and leadership practices. With the assistance of ICT, interactions between school leaders and teachers have undergone tremendous changes that have reduced face-to-face contact. However, only a limited number of studies have evaluated the barriers and challenges to participating in ICT-based e-leadership in schools. Therefore, this sequential explanatory mixed-methods study was designed to examine these challenges and barriers to teachers' participation in e-leadership platforms. Feedback from samples of 260 current secondary school teachers was obtained via a survey using the convenience sampling method. The internal consistencies of the items were also checked using exploratory (EFA) and confirmatory (CFA) factor analyses. Parametric tests such as the independent t-test and ANOVA were conducted to determine the differences between teachers' perceptions based on their demographic factors: age, gender and years of teaching experience. In addition, regression analysis was performed to examine the relationship between teachers' demographics and the challenges they encountered. Furthermore, 10 teachers were interviewed to obtain detailed explanations of the challenges and barriers they faced while participating in e-leadership systems. Thematic analysis was employed to assess the interview transcript data. The quantitative findings revealed that the challenges faced by teachers included ineffective ICT equipment in schools, ICT equipment in schools that needs to be updated, lack of understanding in using the ICT system, a lack of knowledge derived from limited support courses and workshops to assist educators, ineffective school's ICT system and disturbance of their free time. From interview sessions, teachers have mentioned significant issues related to internet networks, teachers' willingness to ignore certain issues, and perceived intrusions on privacy. In examining differences related to challenges and barriers to e-leadership based on teachers' demographics, the ANOVA and independent t-test analyses revealed that most of these differences were non-significant, except for teachers' gender and teaching experience. To conclude, principals and educational authorities must support teachers with the ongoing training, financial resources, and allocation that are critical in preparing teachers to participate in e-leadership systems. [ABSTRACT FROM AUTHOR]

Research on adolescence from the Majority World possesses major hidden potential in contributing to global adolescent research and developmental science more broadly. In this commentary, the authors (1) describe the background and the process through which this special issue came into fruition, (2) introduce the emic approaches to study the influences of macro‐contextual variations on developmental science and provide several pertinent examples on the contributions of Majority World research, (3) elaborate on challenges and barriers that Majority World scholars often face in conducting and disseminating their research, and (4) a few actionable steps and recommendations in promoting the representation and inclusion of Majority World research into global developmental science. Only when our field fully integrates findings from all regions of the world will we be able to develop a fundamental scientific representation and understanding of what it means to be an adolescent, how adolescents develop over time, and what tasks or phenomena in adolescent development are truly universal or specific to particular groups, regions, or areas. [ABSTRACT FROM AUTHOR]

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Because of the harsh environmental impacts of fossil fuels, price fluctuation, and resource limitation, renewable energy resources (RERs) are considered the ultimate solution to overcome these challenges. RERs are also abundant and environmentally friendly. It has been reported that the growth rates in renewable energy installations have increased by 8–9% annually since 2010, reaching a cumulative capacity of 2.9 TW by 2020 and exceeding the growth rate for fossil resources. In this work, the different RERs have been critically discussed in terms of their operation principles, advantages, disadvantages, and associated environmental impacts, focusing on wind and solar energies as the most deployed RERs. Barriers to the full deployment of RERs to replace fossil resources are discussed. Based on the discussion presented on RERs, the contribution of deploying RERs towards the achievement of the United Nations (UN) Sustainable Development Goals (SDGs) is also critically discussed. A total of 80 indicators have been identified for RERs' contribution toward the achievement of SDGs.

Copyright of Polish Journal of Management Studies is the property of Czestochowa University of Technology, Faculty of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The main challenges and barriers facing the effective implementation of risk management (RM) practices in the construction industry have increased the ceiling of challenges associated with the implementation of construction projects during the COVID-19 era. The aim of this paper is to assess the level of significance of risk management implementation challenges and barriers (RMICB) and the level of efficacy of construction RM practices during COVID-19 by considering the case of Iraq. A multistage research methodology was adopted, including semistructured interviews with construction experts to identify the main RMICB and RM practices indicators; surveys to assess the identified RMICB and RM practices indicators; analytical hierarchy process–based and fuzzy-based models to quantify RMICB level of significance, and RM practices level of efficacy. Based on the adopted methodology, the authors identified a total of 34 RMICB grouped under four categories, namely analytical approach–related, behavior-related, management-related, and team-related RMICB. Moreover, the assessment of the current construction RM practices during the COVID-19 era indicated a low level of RM practices efficacy. This study significantly contributes to the body of knowledge by helping construction practitioners and researchers to better understand the RMICB that are hindering effective implementation of RM strategies for construction projects during the COVID-19 era. Furthermore, it provides valuable information to decision-makers regarding the current construction RM practices efficacy during extreme conditions. [ABSTRACT FROM AUTHOR]

This study identified challenges affecting medical oncologists, nephrologists, physician assistants, nurse practitioners, and registered nurses involved in the care of advanced (unresectable and metastatic) renal cell carcinoma. Challenges included staying current with emerging therapies, weighing in patient's preferences for treatment, promoting a collaborative approach to care, and sharing patient information. Insights can inform the development of educational interventions. Introduction: Systemic treatments for metastatic or unresectable renal cell carcinoma (mRCC) are rapidly evolving. This study aimed at investigating challenges in the care of mRCC to inform future educational interventions for health care providers (HCPs). Materials and Methods: The sequential mixed-method design consisted of a qualitative phase (semistructured interviews) followed by a quantitative phase (online surveys). Participants included US-based medical oncologists, nephrologists, physician assistants, nurse practitioners, and registered nurses. Interview transcripts were thematically analyzed. Survey data was descriptively and inferentially analyzed. Results: Forty interviews and 265 surveys were completed. Analysis revealed four challenges in the care of mRCC patients. A challenge in staying current with emerging evidence and treatment recommendations was found with 33% of surveyed HCPs reporting suboptimal skills interpreting published evidence on the efficacy and safety of emerging agents. A challenge weighing patient health and preferences in treatment decisions was found, especially among HCPs with 3 to 10 years of practice (37%) who reported suboptimal skills in assessing patients' tolerance to side effects. Promoting a collaborative care approach to the management of immune-related adverse events was a challenge, specifically related to barriers involving nephrologists (eg, diverging treatment goals). Breakdowns in communication were reported (46% of HCPs), especially in the monitoring of side effects and treatment adherence. Conclusion: This study revealed key challenges faced by HCPs when treating and managing patients with mRCC across multiple providers. Future interventions (eg, community of practice) should aim to address the identified gaps and promote a team-based approach to care that strengthens the complementary competencies of HCPs involved. [ABSTRACT FROM AUTHOR]

Redox flow batteries represent a captivating class of electrochemical energy systems that are gaining prominence in large-scale storage applications. These batteries offer remarkable scalability, flexible operation, extended cycling life, and moderate maintenance costs. The fundamental operation and structure of these batteries revolve around the flow of an electrolyte, which facilitates energy conversion and storage. Notably, the power and energy capacities can be independently designed, allowing for the conversion of chemical energy from input fuel into electricity at working electrodes, resembling the functioning of fuel cells. This work provides a comprehensive overview of the components, advantages, disadvantages, and challenges of redox flow batteries (RFBs). Moreover, it explores various diagnostic techniques employed in analyzing flow batteries. The discussion encompasses the utilization of RFBs for large-scale energy storage applications and summarizes the engineering design aspects related to these batteries. Additionally, this study delves into emerging technologies, applications, and challenges in the realm of redox flow batteries. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.

Multiple individuals around the world endure diagnosed or undiagnosed mental health issues. There is a growing recognition of the significance of mental health as a primary cause of disability with substantial effects on daily functioning. Approximately 10% of those needing assistance or treatment obtain the required assistance. Primary healthcare centres are the backbone of any nation's healthcare system because they provide the primary access point to treatment, illness prevention and an enhanced quality of life. They have the potential to boost the level of quality and productivity within the healthcare system, but still, many experience several barriers while trying to approach these services. Thus, this review discusses the various reasons challenging access to mental health services from primary care in Saudi Arabia.

Abstract Background The availability of new immuno-oncology therapeutics markedly impacts oncology clinicians’ treatment decision-making. To effectively support healthcare professionals (HCPs) in their practice, it is important to better understand the challenges and barriers that can accompany the introduction of these agents. This study aimed to establish the types and causes of clinical challenges posed by the introduction of new immuno-oncology agents. Methods The mixed-methods design included qualitative in-depth interviews and group discussions with HCPs, in which participants discussed clinical challenges and potential underlying reasons for these challenges. Qualitative findings informed a quantitative survey. This survey investigated the extent and distribution of challenges using HCPs’ self-rating of knowledge, skill, confidence, and exposure to system-level effects. These two phases were conducted sequentially with distinctly stratified samples of oncologists, nurse practitioners (NPs), physician assistants (PAs), pathologists, clinical pharmacists, interventional radiologists, rheumatologists, pulmonologists, and emergency department physicians. Participants were from the United States and had various levels of clinical experience and represented both academic and community-based settings. Results The final sample included 107 HCPs in the qualitative phase and 554 in the quantitative phase. Analyses revealed clinical challenges related to the use of pharmacodiagnostics. For example, 47% of pathologists and 42% of oncologists reported skill gaps in identifying the appropriate marker and 46% of oncologists, 61% of PAs, 66% of NPs, 74% of pulmonologists and 81% of clinical pharmacists reported skill gaps in selecting treatment based on test results. Challenges also emerged regarding the integration of immuno-oncology agents, as oncologists, rheumatologists, pulmonologists, clinical pharmacists, PAs, and NPs reported knowledge gaps (74-81%) of the safety profiles of recently approved agents. In addition, 90% of clinical pharmacists reported skill gaps weighing the risks and benefits of treating patients with immuno-oncology agents while affected by lupus. Finally, patient communication challenges were identified: HCPs reported difficulties discussing essential aspects of immunotherapy to patients as well as how they might compare to other types of therapies. Conclusion The challenges highlighted in this study reveal substantial educational gaps related to the integration of immuno-oncology agents into practice for various groups of HCPs. These findings provide a strong base of evidence for future educational initiatives.

Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients' perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately. [ABSTRACT FROM AUTHOR]

This work explores the role of 3D concrete printing (3DCP) in achieving the relevant sustainable development goals (SDGs) that were set out by the United Nations. The study focuses on the recent progress and limitations of the three dominant types of cementitious mixtures, ordinary Portland cement (OPC), recycled aggregate-based cement, and geopolymers, and real-world applications for 3DCP. The study reveals that 3DCP has a significant advantage in terms of cost, with a potential to save around 78% and 60% of the costs associated with conventional construction methods and labor, respectively. Moreover, 3DCP consumes less water than conventional construction methods, with a water usage reduction of 20%. Additionally, it was found that 3DCP is on track to reduce the global energy utilization by 5% by the year 2025. Even though 3DCP bears a lower climate change impact, there is still work to be done to improve its sustainability. [ABSTRACT FROM AUTHOR]

Employment plays a crucial role in the integration of individuals who have fled the war in Ukraine. From both a financial and psychological standpoint, the opportunity to work is essential in preventing dependence on welfare and fostering a sense of self-realization. Following the conflict in Ukraine, over a million people have crossed the border, with many heading to the region around the capital Bratislava. A large number have also chosen to stay closer to the border, making their way to the second largest city in Slovakia, Košice. There are currently an estimated 6,000 Ukrainians, primarily women, who have found residence in Košice. The aim of this research was to use qualitative methods to explore the needs and barriers in the labour market of those who came to Košice after the outbreak of war (involuntary migrants) and those who have been working in Košice for a longer period (voluntary migrants). Three focus groups were carried out in a sample of 26 respondents (Nfemale= 18, age range = 18-71 years, length of stay in Košice 1 month - 7 years). Language and age barriers, limited job opportunities, discrimination and health difficulties emerged as key themes from the discussions with the involuntary migrants. In general, language proficiency posed a significant challenge, hindering stable employment for the participants. Discrimination and hatred were also reported, along with experiences of exploitation and dismissal. Discussions with the voluntary migrants revealed intense labour market competition, bureaucratic hurdles, discrimination and a lack of information as being the key areas of concern. Enhanced support services at local and national levels, a well-coordinated national system of integration, as well as raising awareness about hate crimes, discrimination and violence against women and girls among foreigners are crucial for facilitating the integration of Ukrainians into society. The arrival of Ukrainian migrants has shed light on pre-existing employment challenges in Košice which not only affect migrants but the local population as well. [ABSTRACT FROM AUTHOR]

Writing a thesis has always been considered one of the most challenging aspects of being an undergraduate student. However, no research on the difficulties of undergraduate students in the setting of Local Colleges and Universities (LCUs) in the Philippines has been identified. The purpose of this sequential explanatory research was to evaluate the challenges and obstacles experienced by undergraduate students while finishing their theses. Students pursuing a Bachelor of Physical Education at City College of Angeles in the Philippines who have completed writing and defending their theses comprise the study's participants. After gathering data from 116 students via an online survey (Nmale = 59, Nfemale = 57) for the quantitative phase, it was determined that infrastructure, communication, and time management presented a moderate amount of difficulty for students. Additionally, after the thematic analysis, three major themes and six sub-themes emerged: (1) Internet connectivity challenges and communication (connectivity issues and inadequate scientific resources, as well as communication with thesis groupmates), (2) Data gathering impediments (participant recruitment and rejection), and (3) Time Management issues (drawbacks of working students and thesis writing contrasted with other academic course works). Based on the findings, this report offers recommendations for tackling these obstacles and issues. Finally, the study's limitations and proposals for further research are presented. [ABSTRACT FROM AUTHOR]

Background: Plans and programs for the conservation of historical fabrics in Iran have always faced challenges in order to achieve their goals from the stage of preparation to implementation; challenges that often prevented the implementation of plans or failed to implement them. Identifying and understanding these barriers is a fundamental step in how to overcome them. Objectives: This research has been conducted to identifythe main challenges and barriers of plans and programs for protecting the historical tissues of Iran. accordingly seeks to find the priorities of future research by meta-analyzing the studies conducted in this field. Method: In the current study, the method of "meta-analysis based on contextual theory" has been used. Sampling and screening of articles have been done using several criteria during several stages. For this purpose, the Persian and English articles in the historical fabrics "written from 2014 to the present day" whose study scope is in "Iran", were searched in three databases: Google Scholar, SID, and Noormags. At the beginning of the process, articles were searched with the keywords "historical context" and "historical conservation". In the first step, the "title" and "abstract" of 156 articles based on criteria such as "publishing in scientific-research journals", "availability of the full text of the articles", "repetitiveness", "a direct reference to the barriers in the realization conservation plans and projects", "evaluation of restoration and conservation plans and projects based on case studies" and "referring to different approaches of conservation and development in historical contexts" were examined. 83 articles were selected. In the second step, after examining the "full text of the articles" and especially the "introduction" and "research results", the number of 39 articles were elected for review and coding. In the analysis of the samples, through open coding, 110 codes including direct and indirect references of the studies to the barriers and reasons for the failure of conservation programs have been extracted. In the next step, using axial coding, the codes were summarized and organized into 9 main categories. In the last step, using selective coding, the description of the categories and the link and relationship between the extracted concepts have been discussed. Result: Findings in the form of 9 categories: "Institutional and managerial challenge of heritage", "Content and semantic challenge of plans and programs", "Procedural and methodological challenge", "Cultural and social challenge", "Economic challenges", "the challenge of Legal, legitimate, rules and regulations of conservation and development”, "the challenge of power and policy", "the challenge of time" and the "knowledge and expertise challenge" were extracted and classified. It can be mentioned that categories and their relevant codes have a deep relationship and sometimes affect each other. Therefore not removing one obstacle or challenge will result in creating or amplifying other barriers. Conclusion: Results showed that "institutional and management barriers and challenges of heritage" is one of the categories that has been emphasized with the highest level of abundance. In this category, the subcategories of "functional weakness and differences of management institutions"; in the category of "content and semantic challenge", the subcategories of "non-compliance of development plans with the needs, necessities, cultural structure and values of the context" and "the need for an integrated and comprehensive approach in regeneration, conservation and development" have been repeated more. Also, in the "procedural and methodological" category, the subcategory "Non-compliance of development and conservation plans"; in the field of "Cultural and social challenges", the subcategory "Lack of citizen participation", "Low level of public awareness towards heritage values", and "Lack of Educating and informing the society about historical values and how to deal with them"; and in the category of "economic challenges", the subcategory of "lack of supporting financial resources" and then "lack of incentive policies" were the most frequent. In relation to the "challenge of time", more emphasis has been placed on the "lack of attention to the historical development of the fabric"; and in relation to the "challenge of knowledge and expertise" to the "lack of local experts". However, from the author's point of view, there are also basic barriers and challenges that have either not been the focus of studies or have been mentioned in a few cases. In this regard "Challenge of theoretical foundations and indigenous literature in the field of urban restoration and conservation" "Semantic challenge of restoration and conservation words", "Gap between theory and practice" and "Innovation and technology" are the main gaps of previous studies which can be the priority of the future research(Figure a). [ABSTRACT FROM AUTHOR]

Background: The availability of new immuno-oncology therapeutics markedly impacts oncology clinicians' treatment decision-making. To effectively support healthcare professionals (HCPs) in their practice, it is important to better understand the challenges and barriers that can accompany the introduction of these agents. This study aimed to establish the types and causes of clinical challenges posed by the introduction of new immuno-oncology agents. Methods: The mixed-methods design included qualitative in-depth interviews and group discussions with HCPs, in which participants discussed clinical challenges and potential underlying reasons for these challenges. Qualitative findings informed a quantitative survey. This survey investigated the extent and distribution of challenges using HCPs' self-rating of knowledge, skill, confidence, and exposure to system-level effects. These two phases were conducted sequentially with distinctly stratified samples of oncologists, nurse practitioners (NPs), physician assistants (PAs), pathologists, clinical pharmacists, interventional radiologists, rheumatologists, pulmonologists, and emergency department physicians. Participants were from the United States and had various levels of clinical experience and represented both academic and community-based settings. Results: The final sample included 107 HCPs in the qualitative phase and 554 in the quantitative phase. Analyses revealed clinical challenges related to the use of pharmacodiagnostics. For example, 47% of pathologists and 42% of oncologists reported skill gaps in identifying the appropriate marker and 46% of oncologists, 61% of PAs, 66% of NPs, 74% of pulmonologists and 81% of clinical pharmacists reported skill gaps in selecting treatment based on test results. Challenges also emerged regarding the integration of immuno-oncology agents, as oncologists, rheumatologists, pulmonologists, clinical pharmacists, PAs, and NPs reported knowledge gaps (74-81%) of the safety profiles of recently approved agents. In addition, 90% of clinical pharmacists reported skill gaps weighing the risks and benefits of treating patients with immuno-oncology agents while affected by lupus. Finally, patient communication challenges were identified: HCPs reported difficulties discussing essential aspects of immunotherapy to patients as well as how they might compare to other types of therapies. Conclusion: The challenges highlighted in this study reveal substantial educational gaps related to the integration of immuno-oncology agents into practice for various groups of HCPs. These findings provide a strong base of evidence for future educational initiatives. [ABSTRACT FROM AUTHOR]

The purpose of this article is to examine the barriers and challenges of home-based businesses from the perspective of experts and home-based business owners using the Delphi method and confirmatory factor analysis. The first group included experts from the Department of Cooperatives, Labor and Social Welfare and the Department of Cultural Heritage, Handicrafts and Tourism. The sample size for the first group was selected using snowball or chain sampling of 28 people, and the second group based on the statistics of about 1,000 people in villages with large household jobs with a subset of more than 4 people in rural areas of Isfahan province. In the quantitative part, using confirmatory factor analysis, 5 factors were individualized: economic, managerial and structural, weakness of laws and comprehensive policy, research and information, and human-nature related factors.

Abstract Background The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh. Methods We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. Results The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation. Conclusion Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.

Background and Objectives: Clinicians rely on clinical guidelines for decision making. Carefully formulated clinical guidelines are the result of a combination of relevant researches that links evidence to clinical practice. The purpose of this study was to determine the barriers to the use of clinical guidelines from viewpoints of residents. Material and Methods: This study is a qualitative phenomenological study that examines the experiences of the residents of Urology Department of Imam Reza Hospital in Tabriz City of Iran. The sampling method was purposive. Qualitative content analysis used to analyze this study. To validate the results, the interviews were repeatedly read and the opinions of colleagues were regularly used. External monitoring was used to increase its reliability. Results: 11 semi-structured interviews were conducted with the urology residents of Imam Reza Hospital. The results showed that the challenges and barriers to the implementation of clinical guidelines were classified into three main themes: 1. Structural challenges: doctors' distrust of clinical guidelines, Illegitimacy and lack of local clinical guidelines. 2. Executive challenges: routine processes, Lack of agreeable atmosphere, resistance to change among physicians and high number of patients and lack of facilities. 3. Educational challenges: lack of residency time and lack of practical educational structure for students. Conclusion: Given the importance of proper implementation of clinical guidelines as a link to up-to-date knowledge and practice and given the existing structural, executive and educational problems, obstacles and challenges, it is hoped that researchers, managers, policymakers and Patients should take steps to remove barriers to the proper implementation of clinical guidelines and provide high quality services to patients.

This work explores the role of 3D concrete printing (3DCP) in achieving the relevant sustainable development goals (SDGs) that were set out by the United Nations. The study focuses on the recent progress and limitations of the three dominant types of cementitious mixtures, ordinary Portland cement (OPC), recycled aggregate-based cement, and geopolymers, and real-world applications for 3DCP. The study reveals that 3DCP has a significant advantage in terms of cost, with a potential to save around 78% and 60% of the costs associated with conventional construction methods and labor, respectively. Moreover, 3DCP consumes less water than conventional construction methods, with a water usage reduction of 20%. Additionally, it was found that 3DCP is on track to reduce the global energy utilization by 5% by the year 2025. Even though 3DCP bears a lower climate change impact, there is still work to be done to improve its sustainability.

The purpose of this article is to examine the barriers and challenges of home-based businesses from the perspective of experts and home-based business owners using the Delphi method and confirmatory factor analysis. The first group included experts from the Department of Cooperatives, Labor and Social Welfare and the Department of Cultural Heritage, Handicrafts and Tourism. The sample size for the first group was selected using snowball or chain sampling of 28 people, and the second group based on the statistics of about 1,000 people in villages with large household jobs with a subset of more than 4 people in rural areas of Isfahan province. In the quantitative part, using confirmatory factor analysis, 5 factors were individualized: economic, managerial and structural, weakness of laws and comprehensive policy, research and information, and human-nature related factors. [ABSTRACT FROM AUTHOR]

The paper deals with the topic of culture organisation/coordination during the COVID-19 pandemic. The proposed perspective is related to the recognition of the activities of cultural animators and presents the individual experiences of people involved in project implementation. The text presents the results of an empirical study based on interviews with culture animators. The topics discussed include: ways of adapting to the situation, challenges and barriers to implementing projects on-line, forecasting the use of new tools and acquired skills in the future, building a physical and mental work space, acquiring new competences, personal reflections about oneself, and, finally, relationships with recipients and in work environments. [ABSTRACT FROM AUTHOR]

Background: Child and adolescent mental health (CAMH) policy is essential for the rational development of mental health systems for children and adolescents. However, there is a universal lack of CAMH policy, especially in low- and middle-income countries (LMICs). Therefore, this review aims to identify challenges and lessons for LMICs to develop and implement CAMH policy.Methods: PubMed (1781-), MEDLINE (1950-), EMBASE (1966-), and PsycINFO (1895-) were searched from inception to December 31, 2018, for publications on CAMH policy development and/or implementation. Abstracts and main texts of articles were double screened, and extracted data were analyzed through thematic synthesis.Results: A total of 31 publications were included through the systematic review. Six major challenges were identified for CAMH policy in LMICs: (i) poor public awareness and low political willingness; (ii) stigma against mental disorders; (iii) biased culture values toward children, adolescents and CAMH, from developmental nihilism to medicalization; (iv) the lack of CAMH data and evidence, from service statistics to program evaluation; (v) the shortage of CAMH resources, including human resources, service facilities, and funding; and (vi) unintended consequence of international support, including reducing local responsibilities, planning fragmentation, and unsustainability. Six lessons to overcome challenges were summarized: (i) rethinking the concept of CAMH, (ii) encouraging a stand-alone CAMH policy and budget, (iii) involving stakeholders, (iv) reinforcing the role of research and researchers in policy process, (v) innovating the usage of human and service resources, and (vi) maximizing the positive influence of international organizations and non-governmental organizations.Conclusion: Many LMICs are still facing various challenges for their CAMH policy development and implementation. To overcome the challenges, great and long-term efforts are needed, which include great determination of from domestic and global agents, multidisciplinary innovations, and collaboration and coordination from different sectors.

Background: Child and adolescent mental health (CAMH) policy is essential for the rational development of mental health systems for children and adolescents. However, there is a universal lack of CAMH policy, especially in low- and middle-income countries (LMICs). Therefore, this review aims to identify challenges and lessons for LMICs to develop and implement CAMH policy. Methods: PubMed (1781-), MEDLINE (1950-), EMBASE (1966-), and PsycINFO (1895-) were searched from inception to December 31, 2018, for publications on CAMH policy development and/or implementation. Abstracts and main texts of articles were double screened, and extracted data were analyzed through thematic synthesis. Results: A total of 31 publications were included through the systematic review. Six major challenges were identified for CAMH policy in LMICs: (i) poor public awareness and low political willingness; (ii) stigma against mental disorders; (iii) biased culture values toward children, adolescents and CAMH, from developmental nihilism to medicalization; (iv) the lack of CAMH data and evidence, from service statistics to program evaluation; (v) the shortage of CAMH resources, including human resources, service facilities, and funding; and (vi) unintended consequence of international support, including reducing local responsibilities, planning fragmentation, and unsustainability. Six lessons to overcome challenges were summarized: (i) rethinking the concept of CAMH, (ii) encouraging a stand-alone CAMH policy and budget, (iii) involving stakeholders, (iv) reinforcing the role of research and researchers in policy process, (v) innovating the usage of human and service resources, and (vi) maximizing the positive influence of international organizations and non-governmental organizations. Conclusion: Many LMICs are still facing various challenges for their CAMH policy development and implementation. To overcome the challenges, great and long-term efforts are needed, which include great determination of from domestic and global agents, multidisciplinary innovations, and collaboration and coordination from different sectors. [ABSTRACT FROM AUTHOR]

Context: mobile application development is rapidly evolving with substantial economic and scientific interest. One of the primary reasons for mobile application development failure is the increasing number of mobile platforms; some organizations endorse mobile application development before understanding the associated development challenges of each target platform. Objective: the objective of this paper is to identify the challenges of native, web, and hybrid mobile applications, which can undermine the successful development of such applications. Method: we adopted a two-phase research approach: at first, the challenges were identified via a systematic literature review (SLR); and then, the identified challenges were validated through conducting interviews with practitioners. Results: through both research approaches, we identified nine challenges vital to the success of mobile application development and four additional challenges from interviews not reported in the literature. A comparison of the challenges (native, web, and hybrid) identified in SLR indicates that there are slightly more differences than similarities between the challenges. On the other hand, the challenges (native, web, and hybrid) identified in interviews indicates that there are more similarities than differences between the challenges. Our results show a weak negative correlation between the ranks obtained from the SLR and the interviews ([rs(9) = -.034], p = 0.932). The results obtained from our t-test (i.e., t = 0.868, p = 0.402 > 0.05) depicts that there is no significant difference between the findings of SLR and interviews. Conclusions: mobile application development organizations should try to address the identified challenges when developing mobile applications (native, web, or hybrid) to increase the probability of mobile application success.

In healthcare, continuity of care is a crucial element, especially for patients in the field of psychiatry who have recently been discharged from a hospital. The shift from inpatient to outpatient care poses challenges for patients and healthcare providers, including openness to treatment, competing priorities, financial insecurity, concerns and dilemmas faced by patients regarding their post-hospitalization life after improvements in symptoms, lack of social support, poor patient-doctor relationships, lack of insight, and stigma associated with mental illness. Therefore, it is vital to employ effective strategies to ensure patients receive the required care and support during this transition. This review delves into the significance of continuity of care for psychiatric patients post-hospitalization, effective strategies for the transition, and the challenges and barriers to implementation from the perspective of a family medicine practice. To analyze physicians' role in managing psychiatric patients post-hospitalization, we developed a comprehensive search strategy. This involved extracting relevant data, updates, guidelines, and recommendations. Our search spanned various online repositories, such as PubMed and Google Scholar, specifically focusing on US-based guidelines aligned with our objectives. The search was conducted using medical subject headings (MeSH) and combinations of "OR," "AND," and "WITH." We crafted keywords to optimize our search strategy, including psychiatric illness, post-hospitalization, follow-up, follow-up care, primary care follow-up, and guidelines. Exploring online repositories yielded 132 articles, and we identified some guidelines that addressed our objectives. We established inclusion and exclusion criteria for our review and reviewed 21 papers. Post-hospitalization follow-up is a critical facet of psychiatric care, aligning with guidelines from the American Psychiatric Association and other relevant sources. Emphasizing continuity of care ensures a smooth transition from inpatient to outpatient settings, sustaining therapeutic momentum and minimizing the risk of relapse. This comprehensive approach involves careful medication management, regular mental health assessments, education on condition-specific coping strategies, and coordinated care between healthcare providers. It includes conducting risk assessments, safety planning, building social support and community integration, prompt post-hospitalization follow-up, and tailored treatment plans. Together, these measures enhance overall wellness for recently discharged patients. This holistic strategy tackles pressing short-term needs while facilitating long-term stability, promoting resilience and successful community reintegration, reducing readmission likelihood, and ultimately supporting sustained recovery., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ojo et al.)

This paper presents the challenges and barriers to accessing formal maternity care in South East Nigeria from women's perspectives. It is drawn from a study that explored the concept of safe motherhood. The study used a hermeneutic phenomenological approach guided by post-structural feminism. Data were collected through individual semi-structured interviews with 17 women who were attending a formal healthcare facility for antenatal care. Four aspects of the challenges and barriers encountered by women when accessing care in a formal healthcare setting as reported by the participants of the study are as follows: financial constraints, lack of autonomy, negative attitude of the healthcare providers, and healthcare worker strikes. Some participants linked the economic status of women to the lack of education which had an impact on their ability to make an independent decision as to whether to seek formal maternity healthcare or not. Negative attitudes, and frequent strikes of healthcare workers in many cases, discourage women from using the formal maternity healthcare facilities. It is evident that Nigeria did not achieve the Millennium Development Goal (MDG) 5, which is to improve maternal health. Achieving the Sustainable Development Goal (SDG) 3.1, which is to reduce the global maternal mortality ratio, requires more than technical approaches. Genuine political will is required if the health system is to be affordable for all women. There is the need to address the gender-related issues that sustain women's low socio-economic status. The government needs to pay the workers as and when due, and a performance appraisal should be in place to ensure improvement in the quality of care offered to women. [ABSTRACT FROM AUTHOR]

The rapid growth in the consumption of fossil fuels resulted in climate change and severe health issues. Among the different proposed methods to control climate change, carbon capture technologies are the best choice in the current stage. In this study, the various membrane technologies used for carbon capture and their impact on achieving sustainable development goals (SDGs) are discussed. Membrane-based carbon capture processes in pre-combustion and post-combustion, which are known as membrane gas separation (MGS) and membrane contactor (MC), respectively, along with the process of fabrication and the different limitations that hinder their performances are discussed. Additionally, the 17 SDGs, where each representing a crucial topic in the current global task of a sustainable future, that are impacted by membrane-based carbon capture technologies are discussed. Membrane-based carbon capture technologies showed to have mixed impacts on different SDGs, varying in intensity and usefulness. It was found that the membrane-based carbon capture technologies had mostly influenced SDG 7 by enhancement in the zero-emission production, SDG 9 by providing 38–42% cost savings compared to liquid absorption, SDG 3 through reducing pollution and particulate matter emissions by 23%, and SDG 13, with SDG 13 being the most positively influenced by membrane-based carbon capture technologies, as they significantly reduce the CO 2 emissions and have high CO 2 capture yields (80–90%), thus supporting the objectives of SDG 13 in combatting climate change. [Display omitted] • Background about membrane-based CCT was introduced. • Limitations of membrane-based CCT was elaborated. • Membrane-based CCT positively influence SDG 13 by reducing 90% of the CO 2 emissions in coal-based power plants. • Membrane-based CCT impact SDG 9 by providing 38–42% cost savings compared to liquid absorption. • Membrane-based CCT affect SDG 3 by reducing 23% of pollution and particulate matter emissions. [ABSTRACT FROM AUTHOR]

Purpose -- Performance management (PM) is now clearly a well-established practice in public sector organizations. However, increasingly scholars have been questioning its efficacy in improving organizational performance. Research has shown that the presumed benefits remain questionable and that there are many barriers, challenges and problems in implementing PM. The purpose of this paper is to report and discuss the findings of a multi-case study that examines in more depth how five Canadian public sector organizations are implementing PM. Design/methodology/approach -- A qualitative multi-case study approach was used in this study. Structured interviews were carried out in each public sector organization and the interview data were analyzed using NVivo8. Individual case profiles were also written. A cross-case analysis was carried out using data from these five cases. Findings -- The cross-case analysis of the data focussed on the major themes emerging from the data with respect to challenges and barriers, success factors, context and implications for practice for PM in public sector organizations. Three contextual factors are identified and discussed in explaining some of the findings. Conclusions are drawn for making PM more effective in achieving performance improvement in public sector organizations and future directions for research. Research limitations/implications -- The research findings and implications for practice are based on five Canadian public sector organizations so may limit its generalizability to public sector organizations in other countries. Practical implications -- Some practical implications are discussed with respect to implementing PM more successfully in public sector organizations. This included the better integration of PM to corporate strategy, leadership in developing a positive PM culture and employee buy-in and commitment to the process. Originality/value -- This qualitative multi-case study of PM in Canadian public sector organizations has not previously been done. This approach allows for a more close-up look at PM in public sector organizations especially how it is implemented and the experiences of organizational members. The paper also presents new insights on context as an important variable in explaining the findings from the cross-case analysis and points to future new directions for research and in developing a contingency theory approach to PM. [ABSTRACT FROM AUTHOR]

Purpose – Because women's status in Latin American countries appears comparable to their status in organizations of more economically advanced nations, this paper probes the mystery of how and why these women fare relatively well in their careers, given that socioeconomic and cultural factors could limit their possibilities of achieving higher management positions. The paper aims to discuss these issues. Design/methodology/approach – Exploratory study of 162 Latin American women who demonstrated exceptional success by attaining first and second level positions in private organizations. They responded to a semi-structured interview of 49 closed-ended questions about career challenges and barriers, leadership style, ambition, personal goals and work-life balance, plus two open-ended questions about men and women's leadership differences and how they understand their success. Findings – Interviewees disagreed on issues of discrimination, recognized few serious professional career barriers and regarded work-life balance as their main challenge. They understood their success in terms of individual factors such as personality characteristics, performance and results, and their own leadership traits. Most admitted that machismo limits women's access to upper level positions. They recognized their ambition to attain power positions mainly for personal satisfaction, and their main goal was personal development and fulfilment. Research limitations/implications – Given the sample size per country, future research could include a more representative and large sample or concentrate on one country per region to establish relationships between women's personal characteristics and organizations' sector, or challenges faced and leadership style. Also family-owned companies as well as women entrepreneurs could contribute knowledge about women's leadership in these countries. Studying only national companies, a more neatly description of local culture and gender awareness in its organizational practices that hinder or promote women's leadership and participation in decision-making positions may be obtained. Transcultural studies that compare women's rise and upper management performance in countries where support from domestic help and extended family as well as cultural values are very different, could permit to understand more fully what it takes to reach top management positions and the weight that these particular cultural conditions have. Originality/value – This study is unique in shedding light on a multinational sample of Latin American female executives and their perceptions of their success, leadership style and barriers and challenges faced. [ABSTRACT FROM AUTHOR]

Collaborative approaches to natural resource management are being promoted as promising ways to deal with complex and contentious natural resource issues (Conley & Mootie, 2003). The National Park Service and the National Conservation and Park Association have recently adopted collaboration as a strategy for promoting racial and ethnic diversity in park planning, outdoor recreation, and environmental conservation education. However, many units within the National Park System have encountered major challenges in their efforts to attract minorities (National Parks Conservation Association, 2001). This study drew on Inter-organizational Collaboration Theory by Gray (1985), Wondolleck and Yaffee (2000), and Wood and Gray (1991) to investigate factors that impede efforts by the Boston Harbor Islands National Park Area Partnership to include racial and ethnic minorities in natural resource management, outdoor recreation activities, and programs. Qualitative research methods were used to collect the evidence. The study found that collaboration and partnerships are viable mechanisms for enhancing racial and ethnic diversity in natural resource management, environmental conservation education, and outdoor recreation. However, there are major challenges and constraints to creating racially and ethnically inclusive collaborations and partnerships. The results indicate that whether and how racial and ethnic minorities got involved with the Partnership, and its activities and programs were influenced by several factors including: (1) the process through which the Partnership was established; (2) problems related to the structure of the Partnership and Advisory Council; (3) gaps in the missions, goals, and values of the Partnership and minority-based organizations; (4) the approaches, challenges, and difficulties in the Partnership's public involvement process; (5) the presence of sensitive leaders with the skills and commitment to racial and cultural diversity; and (6) the relevance of partnership activities and programs to the lives of racial and ethnic minorities. The study supports the contentions by Wondolleck and Yaffee (2000) and Gray and Wood (1991) that collaboration and partnerships are about relationships and that effective collaboration is able to create structures and processes through which relationships are developed among diverse partners. It also supports previous findings that people of color (racial and ethnic minorities) and low-income communities are more preoccupied with quality-of-life issues and think of the environment in terms of quality-of-life, social and environmental justice issues (Bullard & Johnson, 2000; Floyd & Johnson, 2002; Taylor, 2000a). Four major recommendations for creating racially and ethnically inclusive collaboration and partnerships are offered: (1) The key to designing racially and ethnically inclusive partnerships is to recognize minorities as legitimate stakeholders and to invite all relevant minority-based community organizations and community leaders to participate in initial partnership formation and problem definition dialogues right from the beginning. (2) To succeed in creating inclusive collaboration and partnerships, National Parks and public land management agencies must interpret their missions and goals more broadly (Machlis & Field, 2000) and extend themselves outside their traditional boundaries and get involved with issues of interest to the local communities, including communities where racial and ethnic minorities reside. (3) National Parks and public land management agencies in general must recognize that, in order to attract and maintain the support of racial and ethnic minorities, they have to both make their activities and programs relevant and demonstrate their relevance to the lives of racial and ethnic minorities.… [ABSTRACT FROM AUTHOR]

The interdisciplinary education of health professionals in the USA has increasingly been tied to renewed efforts directed toward quality improvement in the healthcare system, where problems with communication, collaboration, and cooperation are seen as endemic. Many of the published reports and recommendations on interdisciplinary programming, however, have omitted or downplayed the difficulties and challenges of developing and sustaining efforts in this area. Through the presentation of a detailed case study and the exploration of two laws of interdisciplinary programming proposed from it, this paper explores the fundamental difficulties of developing and, more importantly, sustaining interdisciplinary health professions programs in higher educational settings. The utilization of strategies based on emerging forces in the healthcare system and in higher education itself is suggested for initiating interdisciplinary projects, and structural and procedural factors are explored as critical in guaranteeing the long-term sustainability of such programs. Recommendations for the successful development and implementation of interdisciplinary programs in higher educational contexts are suggested, focusing particularly on the role of an advocate in the top down and bottom up development and maintenance of the resources needed for the success of such programs. [ABSTRACT FROM AUTHOR]