Objective:To understand the facilitators and barriers for frail kidney transplant recipients(KTRs)practicing Baduanjin,and to provide a theoretical basis for developing intervention strategies.Subjects and Methods:Sem...Objective:To understand the facilitators and barriers for frail kidney transplant recipients(KTRs)practicing Baduanjin,and to provide a theoretical basis for developing intervention strategies.Subjects and Methods:Semi-structured interviews were conducted with 10 frail KTRs who participated in a 3-month Baduanjin practice.The Colaizzi seven-step analysis method was used to analyze,summarize,and extract themes from the interview data.Results:Two themes were extracted:facilitators and barriers.Facilitators included intrinsic motivation and perceived benefits,while barriers included conflicts with practice time,worsening physical condition,lack of immediate benefits,and difficulty integrating into daily life.Conclusion:The practice of Baduanjin by frail KTRs is influenced by various factors.Healthcare professionals should develop personalized intervention plans that take into account these factors and the needs of the patients.展开更多
Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress ...Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress and increasing psychological resilience;however,implementation is difficult due to unpredictability of the job,department culture,and generational preferences.The objective of this qualitative study was to identify and enhance understanding of the specific needs and potential barriers and facilitators for the implementation of mindfulness-based programming for community-based first responders.Methods:A phenomenological qualitative study design was used to gain insights into the lived experiences of first responders and elicit perceptions regarding barriers and facilitators for engaging in mindfulness activities.During virtual semi-structured interviews,eleven career firefighters and emergency medical service(EMS)providers offered feedback relative to worksite mindfulness practices,and the use of a stress reduction smartphone application.The Consolidated Framework for Implementation Research was used to guide the analysis relative to barriers and facilitators of implementation success and sustainability.Results:First responders expressed openness to mindfulness-based interventions and a smartphone app that would provide stress reduction content,however,they were adamant that programming needed to be accessible and easily integrated into their workday.They also reinforced that organizational culture and leadership support for their health and well-being were overarching factors essential for implementation success.Conclusions:First responders were supportive of evidence-based mindfulness practices,optimally developed and/or facilitated by someone with intimate knowledge of their unique work environments and challenges.Organizational culture and leadership support were essential for implementation success and sustainability.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores th...Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.展开更多
The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly qu...The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly quoted patient-centred services. Limited evidence exists about the implementation of PPI policies and strategies within organisations;three studies only have explored health professionals’ perceptions of PPI. Although nurses’ positive support for patient and public involvement has been noted, comparatively little is known about senior nurses’ experiences of embedding PPI. A national consultation utilising three focus groups aimed to explore senior nurses’ perceptions of challenges and facilitators for PPI implementation. Four Strategic Health Authorities (SHAs) and eleven Primary Care Trusts (PCTs) in England, with fifteen senior nurses with leadership roles and direct PPI experience, participated. Nurses’ perceptions on patient and public involvement, challenges and facilitators for its implementation were discussed. Focus groups were digitally recorded and transcribed verbatim;anonymised transcripts were validated by participants and analysed with thematic analysis. Limited resources, patient representation and recruitment, complexities of implementing PPI and national policy changes were challenging. Commissioning limitations, lack of feedback on patient experience, limited staff awareness, negative attitudes, management of patients and public expectations constituted further challenges. Nursing role characteristics and informal involvement activities, PPI policy and cultural change, commissioning PPI competencies, related service frameworks, providing feedback on patient experiences to staff and recognition of involvement benefits were recognised as facilitators. Findings provided new insights into senior nurses’ experiences and evidence that progress towards meaningful, effective PPI remains slow. However, recognition of existing nursing role characteristics and potential delivery problems created by expanded nursing roles, informal PPI practice and internal organisational sharing of patient feedback may bring an “emerging productive partnership” with nurses enabling and contributing to effective PPI.展开更多
BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to increase.It is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardia...BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to increase.It is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardiac event to reduce mortality,improve recovery and positively influence behaviour around CVD risk factors.Despite the recognised benefits and international recommendations for exercisebased CR,uptake and attendance remain suboptimal.A greater understanding of CR barriers and facilitators is required,not least to inform service development.Through understanding current cardiac patients’attitudes and opinions around CR and physical activity(PA)could inform patient-led improvements.Moreover,through understanding aspects of CR and PA that participants like/dislike could provide healthcare providers and policy makers with information around what elements to target in the future.AIM To investigate participants’attitudes and opinions around CR and PA.METHODS This study employed a cross-sectional survey design on 567 cardiac patients.Cardiac patients who were referred for standard CR classes at a hospital in the Scottish Highlands,from May 2016 to May 2017 were sampled.As part of a larger survey,the current study analysed the free-text responses to 5 open-ended questions included within the wider survey.Questions were related to the participants’experience of CR,reasons for non-attendance,ideas to increase attendance and their opinions on PA.Qualitative data were analysed using a 6-step,reflexive thematic analysis.RESULTS Two main topic areas were explored:“Cardiac rehabilitation experience”and“physical activity”.Self-efficacy was increased as a result of attending CR due to exercising with similar individuals and the safe environment offered.Barriers ranged from age and health to distance and starting times of the classes which increased travel time and costs.Moreover,responses demonstrated a lack of information and communication around the classes.Respondents highlighted that the provision of more classes and classes being held out with working hours,in addition to a greater variety would increase attendance.In terms of PA,respondents viewed this as different to the CR experience.Responses demonstrated increased freedom when conducting PA with regards to the location,time and type of exercise conducted.CONCLUSION Changes to the structure of CR may prove important in creating long term behaviour change after completing the rehabilitation programme.展开更多
The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not ...The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not only is it a way to integrate information and represent the condition of patients, and a dynamic source for health care, however it leads to gain access to clinical information and records, electronic communications, comprehensive training and management, and ultimately enhancing the public health;the aim of this study is to investigate the factors influencing the implementation of EHR, which are known as barriers and facilitators. The research is conducted in the form of a review research, and with the help of the Keywords of EHR;barriers and facilitators, articles, from 2008 to 2013, were searched and studied in the Internet-databases. The results of the studies show that the most effective factors include: efficiency, motivation, management, and the participation of end users. Factors such as technical aspects ease of use, available resources, and human resources, have limited effects. And security and privacy, the expected output, lack of time, and workload have relative effects, and also the relation between the patient and clinical staff, has no effects in the process of implementing EHR.展开更多
It is well known that the incorporation of research findings into practice leads to less costs of health care, more personal productivity, longer and healthier lives for patients, and also will decrease pain and suffe...It is well known that the incorporation of research findings into practice leads to less costs of health care, more personal productivity, longer and healthier lives for patients, and also will decrease pain and suffering of patients. Thus, the aim of this integrative review was to identify the barriers and facilitators of research utilization among the world and the best strategies used to overcome the barriers. A literature search was conducted by viewing relevant studies via computerized searching through EBSCO, Medline, Science Direct, Pub Med, Ovid, and Arabic Journals research databases. The number of reviewed studies was 192 and all of them in English, no studies in Arabic. Only 26 of them were selected based on inclusion criteria. Twenty six studies were included, with most using a cross-sectional survey design. The most identified barriers are lack of time, inadequate facilities and resources to implement new ideas, no enough authority to implement new ideas, lack of administrative support and others, while the most identified suggested that facilitators are improving the scientific knowledge of nurses and support from unit managers. The majority of these studies used Barriers scale which is not a standardized tool. However, there is a big gap between real situation and the identified evidences resulted from researches.展开更多
Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of...Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that;the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.展开更多
There is a higher Human Papilloma Virus peak prevalence in younger women (18 - 25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the...There is a higher Human Papilloma Virus peak prevalence in younger women (18 - 25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the stage of exploring which predisposes them to risky behavior like early sexual intercourse and multiple sexual partners among others. This creates a need for cervical cancer screening in the population. The facilitators and barriers to cervical cancer screening have been studied in the Ugandan general population but little is known among University students which this study is taking interest. <strong>Objective: </strong>This study is aimed at determining the facilitators, barriers and background factors associated to cervical cancer screening among female undergraduate students in Makerere University. <strong>Methods: </strong>Four hundred twenty-two (422) female undergraduate students of Makerere University who fit the eligibility criteria were recruited in this descriptive cross-sectional quantitative study. A self-administered semi structured questionnaire was administered to these participants chosen by convenient sampling. Data collected was analyzed using SPSS version 23 software and logistic regression models was used. <strong>Results:</strong> Less than a half of (21.1%) of the participants had ever screened for cervical cancer. At multivariate analysis, only year of study and married status were associated to cervical cancer screening with a P-values were of (0.015) and (0.001) with a (1.173 - 4.261) and (1.594 - 6.130) 95% CI respectively. The facilitators agreed upon by participants included: Access to free cervical cancer screening services, adequate knowledge about cervical cancer screening and advice from a friend, family or physician among others. The reported barriers to screening were fear of bad result, low risk perception and fear of embarrassment among others. <strong>Conclusions and Recommendations: </strong>Among the female undergraduate students of Makerere University, only 21.1% had screened for cervical cancer. Therefore, there is a critical need for university based cancer education campaign on cervical cancer and the benefits of screening. Screening services should be integrated into the existing university medical services.展开更多
Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional stud...Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional study.A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method.Nurses’perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire(BAVNIQ)and descriptive and analytical statistics,respectively.Results:Approximately 74%of the nurses who participating in the study had a moderate perspective on open visitation.From the nurses’viewpoint,“Parents’low awareness of sensitivity and hygienic principles of the NICU”was the first(90.3%)barrier,and the 2 factors,namely,“physical structure of the ward/lack of sufficient space”and“far distance between family’s residence and the hospital/having another child,”were the second(86.8%)barrier with an equal percentage.Among the facilitating factors,“Supporting employed parents during the neonate’s hospitalization”and“providing facilities for family accommodation in the hospital”were the first(82.3%)and the second(79.6%)facilitators,respectively,for open visitation.Conclusions:The majority of NICU nurses had a moderate perspective on the family open visitation.This reluctance seems to be originated mainly from the factors inhibiting open visitation,making its implementation challenging for nurses.The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers,managers,and relevant officials in decision-making and implementing new visiting policies in the NICUs.展开更多
In this paper, the author provides a representation of Italian public hospital facilitators （HFs） （clinics, regional or local community hospitals, and medical centers） by means of different types of networks. Movi...In this paper, the author provides a representation of Italian public hospital facilitators （HFs） （clinics, regional or local community hospitals, and medical centers） by means of different types of networks. Moving from the balance scorecards of HFs, the author has analyzed the representation of those data through the use of the minimum spanning tree （MST） and the planar maximally-filtered graph （PMFG）. This paper firstly examined the amount of information provided by the two networks and then run a sensitivity analysis of the networks by varying the elements of the balance scorecards to be considered. In this way, the author obtained a quite unusual representation of the overall economic situation of Italian HFs. Moreover, the author observed the emergence of patterns which in the author＇s opinion might help policy makers to realize a more efficient allocation of financial resources among the existing HFs.展开更多
Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a ret...Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.展开更多
Background: The purpose of this study was to clarify the effects of a facilitator training course focused on teaching beginners facilitator intervention skills. Intervention Method: One-and-a-half-day program combinin...Background: The purpose of this study was to clarify the effects of a facilitator training course focused on teaching beginners facilitator intervention skills. Intervention Method: One-and-a-half-day program combining education, role plays and relaxation. Methods: Participants were 11 participants, and of these 8 gave valid responses to our questionnaire. The scores of the participants on a facilitator intervention skills scale and on a scale of facilitator skills to cope with difficult situations were compared before and after the course, using SPSS16 for windows. In addition, the participants’ impressions before and after the course were analyzed qualitatively and inductively. Results: Seven of the 16 items on the facilitator intervention skills scale and 7 of the 12 items on the facilitator skills to cope with difficult situations improved the participants after the facilitator training. All participants indicated that they could understand the lectures. Their impressions changed from anxiety and enthusiasm to pleasure of learning and discovery of specific problems. Conclusion: The results suggested that the educational method created in this study, with emphasis on role-playing, is useful.展开更多
BACKGROUND Outpatient parenteral antimicrobial therapy(OPAT)offers a crucial method for administering intravenous/intramuscular antimicrobials outside of hospital settings,allowing patients to complete treatment safel...BACKGROUND Outpatient parenteral antimicrobial therapy(OPAT)offers a crucial method for administering intravenous/intramuscular antimicrobials outside of hospital settings,allowing patients to complete treatment safely while avoiding many hospital-acquired complications.This is a major boost or low-hanging fruit intervention in antimicrobial stewardship practices with multiple targets like decreasing hospital stays,its related complications,the economy,the burden on hospitals,etc.However,resource-constrained countries like India practices rarely OPAT in an evidence-based way.AIM To evaluate the effectiveness,safety,and feasibility along with barriers and facilitators of OPAT practices in resource-poor settings,with a focus on its role in antimicrobial stewardship.METHODS This pilot longitudinal observational study included patients who met OPAT checklist criteria and were committed to post-discharge follow-up.Pre-discharge education and counselling were provided,and demographic data were recorded.Various outcome measures,including barriers and facilitators,were identified through an extensive literature review,fishbone diagram preparation,data collection and analysis,and patient feedback.All healthcare workers who were taking care of the patients discharged with OPAT were contacted with openended questions to get data on feasibility.The study was approved by the Institutional Ethics Committee of All India Institute of Medical Sciences,Rishikesh.We used descriptive analysis and theχ2 test to analyze data.P value<0.05 was considered significant.RESULTS Out of 20 patients,the mean age was 37 years.The cohort comprised 13 males.OPAT was administered at home in 15 cases and at nursing homes in 5 cases,with nine patients receiving treatment from family members and 11 patients receiving care from a local nurse.The infections requiring OPAT included:Kidney-urinary tract(6 cases),gastrointestinal tract(4 cases),respiratory tract(4 cases),meningitis(3 cases),endocarditis(2 cases),and multiple visceral abscesses(1 case).Nineteen out of 20 patients achieved afebrile status.Half of the patients did not receive education,counselling,or demonstrations prior to discharge,but all patients rated the service as good/excellent.According to doctors’feedback,OPAT is highly beneficial and effective for patients when systematically implemented with daily telephonic monitoring,but faces challenges due to the lack of standardized protocols,dedicated teams,and adequate resources.The implementation of OPAT resulted in a reduction of hospitalization duration by an average of two weeks.CONCLUSION This pilot study proves that OPAT is safe,feasible,and efficacious by reducing two weeks of hospitalization in resource-poor settings.OPAT contributes directly to antimicrobial stewardship by reducing hospital stays and hospital-acquired complications,which is vital in combating antimicrobial resistance(AMR)and aligns with the global action plan for AMR in infection prevention and optimal antimicrobial utilization.展开更多
Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)...Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.展开更多
The Regional Comprehensive Economic Partnership(RCEP)has created favorable conditions for building deeply integrated agricultural value chains(AVC)in Asia-Pacific.Based on the RCEP agreement,this study employed the gl...The Regional Comprehensive Economic Partnership(RCEP)has created favorable conditions for building deeply integrated agricultural value chains(AVC)in Asia-Pacific.Based on the RCEP agreement,this study employed the global trade analysis project(GTAP)model to evaluate the impact of RCEP on AVC of member countries in terms of time,tariff reduction,and reduction of non-tariff barriers(NTB).The results indicate that(1)the implementation of RCEP boosts the value-added to agricultural exports for most member countries,particularly in competitive industries;(2)the increase in domestic production and processing capacity,reflected in domestic value-added(DVA),is the primary factor driving the rise in the value-added of agricultural exports across various industries of member countries;(3)RCEP enhances the participation of most regional countries in AVC,with varying impacts on AVC positioning,thereby fostering regional AvC development;and(4)RCEP has a positive effect on AVC indicators both in the short and long term,with the effect becoming more pronounced over time.Additionally,reducing NTB enhances the positive effects of tariff reductions on AVC indicators.Based on the analyses,the following recommendations are proposed:(1)Leverage the development opportunities arising from RCEP implementation to enhance the agricultural DVA;(2)capitalize on cooperative opportunities created by RCEP to build cohesive regional AVC;and(3)prioritize the effective implementation of RCEP'shigh-qualityrules.展开更多
Polybromodiphenyl ethers(PBDEs),the widely used flame retardants,are common contaminants in surface soils at e-waste recycling sites.The association of PBDEs with soil colloids has been observed,indicating the potenti...Polybromodiphenyl ethers(PBDEs),the widely used flame retardants,are common contaminants in surface soils at e-waste recycling sites.The association of PBDEs with soil colloids has been observed,indicating the potential risk to groundwater due to colloid-facilitated transport.However,the extent to which soil colloidsmay enhance the spreading of PBDEs in groundwater is largely unknown.Herein,we report the co-transport of decabromodiphenyl ester(BDE-209)and soil colloids in saturated porous media.The colloids released froma soil sample collected at an e-waste recycling site in Tianjin,China,contain high concentration of PBDEs,with BDE-209 being the most abundant conger(320±30 mg/kg).The colloids exhibit relatively high mobility in saturated sand columns,under conditions commonly observed in groundwater environments.Notably,under all the tested conditions(i.e.,varying flow velocity,pH,ionic species and ionic strength),the mass of eluted BDE-209 correlates linearly with that of eluted soil colloids,even though the mobility of the colloids varies markedly depending on the specific hydrodynamic and solution chemistry conditions involved.Additionally,the mass of BDE-209 retained in the columns also correlates strongly with themass of retained colloids.Apparently,the PBDEs remain bound to soil colloids during transport in porous media.Findings in this study indicate that soil colloidsmay significantly promote the transport of PBDEs in groundwater by serving as an effective carrier.This might be the reason why the highly insoluble and adsorptive PBDEs are found in groundwater at some PBDE-contaminated sites.展开更多
Facilitated transport membranes for post-combustion carbon capture are one of the technologies to achieve efficient and large-scale capture.The central principle is to utilize the affinity of CO_(2) for the carrier to...Facilitated transport membranes for post-combustion carbon capture are one of the technologies to achieve efficient and large-scale capture.The central principle is to utilize the affinity of CO_(2) for the carrier to achieve efficient separation and to break the Robson upper bound.This paper reviews the progress of facilitated transport membranes research regarding polymer materials,principles,and problems faced at this stage.Firstly,we briefly introduce the transport mechanism of the facilitated transport membranes.Then the research progress of several major polymers used for facilitated transport membranes for CO_(2)/N_(2) separation was presented in the past five years.Additionally,we analyze the primary challenges of facilitated transport membranes,including the influence of water,the effect of temperature,the saturation effect of the carrier,and the process configuration.Finally,we also delve into the challenges and competitiveness of facilitated transport membranes.展开更多
基金funded by the General Program of the National Natural Science Foundation of China(82072553)the Fundamental Research Funds for the Central Universities(2022-JYB-JBZR-026).
文摘Objective:To understand the facilitators and barriers for frail kidney transplant recipients(KTRs)practicing Baduanjin,and to provide a theoretical basis for developing intervention strategies.Subjects and Methods:Semi-structured interviews were conducted with 10 frail KTRs who participated in a 3-month Baduanjin practice.The Colaizzi seven-step analysis method was used to analyze,summarize,and extract themes from the interview data.Results:Two themes were extracted:facilitators and barriers.Facilitators included intrinsic motivation and perceived benefits,while barriers included conflicts with practice time,worsening physical condition,lack of immediate benefits,and difficulty integrating into daily life.Conclusion:The practice of Baduanjin by frail KTRs is influenced by various factors.Healthcare professionals should develop personalized intervention plans that take into account these factors and the needs of the patients.
文摘Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress and increasing psychological resilience;however,implementation is difficult due to unpredictability of the job,department culture,and generational preferences.The objective of this qualitative study was to identify and enhance understanding of the specific needs and potential barriers and facilitators for the implementation of mindfulness-based programming for community-based first responders.Methods:A phenomenological qualitative study design was used to gain insights into the lived experiences of first responders and elicit perceptions regarding barriers and facilitators for engaging in mindfulness activities.During virtual semi-structured interviews,eleven career firefighters and emergency medical service(EMS)providers offered feedback relative to worksite mindfulness practices,and the use of a stress reduction smartphone application.The Consolidated Framework for Implementation Research was used to guide the analysis relative to barriers and facilitators of implementation success and sustainability.Results:First responders expressed openness to mindfulness-based interventions and a smartphone app that would provide stress reduction content,however,they were adamant that programming needed to be accessible and easily integrated into their workday.They also reinforced that organizational culture and leadership support for their health and well-being were overarching factors essential for implementation success.Conclusions:First responders were supportive of evidence-based mindfulness practices,optimally developed and/or facilitated by someone with intimate knowledge of their unique work environments and challenges.Organizational culture and leadership support were essential for implementation success and sustainability.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
文摘Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.
文摘The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly quoted patient-centred services. Limited evidence exists about the implementation of PPI policies and strategies within organisations;three studies only have explored health professionals’ perceptions of PPI. Although nurses’ positive support for patient and public involvement has been noted, comparatively little is known about senior nurses’ experiences of embedding PPI. A national consultation utilising three focus groups aimed to explore senior nurses’ perceptions of challenges and facilitators for PPI implementation. Four Strategic Health Authorities (SHAs) and eleven Primary Care Trusts (PCTs) in England, with fifteen senior nurses with leadership roles and direct PPI experience, participated. Nurses’ perceptions on patient and public involvement, challenges and facilitators for its implementation were discussed. Focus groups were digitally recorded and transcribed verbatim;anonymised transcripts were validated by participants and analysed with thematic analysis. Limited resources, patient representation and recruitment, complexities of implementing PPI and national policy changes were challenging. Commissioning limitations, lack of feedback on patient experience, limited staff awareness, negative attitudes, management of patients and public expectations constituted further challenges. Nursing role characteristics and informal involvement activities, PPI policy and cultural change, commissioning PPI competencies, related service frameworks, providing feedback on patient experiences to staff and recognition of involvement benefits were recognised as facilitators. Findings provided new insights into senior nurses’ experiences and evidence that progress towards meaningful, effective PPI remains slow. However, recognition of existing nursing role characteristics and potential delivery problems created by expanded nursing roles, informal PPI practice and internal organisational sharing of patient feedback may bring an “emerging productive partnership” with nurses enabling and contributing to effective PPI.
文摘BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to increase.It is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardiac event to reduce mortality,improve recovery and positively influence behaviour around CVD risk factors.Despite the recognised benefits and international recommendations for exercisebased CR,uptake and attendance remain suboptimal.A greater understanding of CR barriers and facilitators is required,not least to inform service development.Through understanding current cardiac patients’attitudes and opinions around CR and physical activity(PA)could inform patient-led improvements.Moreover,through understanding aspects of CR and PA that participants like/dislike could provide healthcare providers and policy makers with information around what elements to target in the future.AIM To investigate participants’attitudes and opinions around CR and PA.METHODS This study employed a cross-sectional survey design on 567 cardiac patients.Cardiac patients who were referred for standard CR classes at a hospital in the Scottish Highlands,from May 2016 to May 2017 were sampled.As part of a larger survey,the current study analysed the free-text responses to 5 open-ended questions included within the wider survey.Questions were related to the participants’experience of CR,reasons for non-attendance,ideas to increase attendance and their opinions on PA.Qualitative data were analysed using a 6-step,reflexive thematic analysis.RESULTS Two main topic areas were explored:“Cardiac rehabilitation experience”and“physical activity”.Self-efficacy was increased as a result of attending CR due to exercising with similar individuals and the safe environment offered.Barriers ranged from age and health to distance and starting times of the classes which increased travel time and costs.Moreover,responses demonstrated a lack of information and communication around the classes.Respondents highlighted that the provision of more classes and classes being held out with working hours,in addition to a greater variety would increase attendance.In terms of PA,respondents viewed this as different to the CR experience.Responses demonstrated increased freedom when conducting PA with regards to the location,time and type of exercise conducted.CONCLUSION Changes to the structure of CR may prove important in creating long term behaviour change after completing the rehabilitation programme.
文摘The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not only is it a way to integrate information and represent the condition of patients, and a dynamic source for health care, however it leads to gain access to clinical information and records, electronic communications, comprehensive training and management, and ultimately enhancing the public health;the aim of this study is to investigate the factors influencing the implementation of EHR, which are known as barriers and facilitators. The research is conducted in the form of a review research, and with the help of the Keywords of EHR;barriers and facilitators, articles, from 2008 to 2013, were searched and studied in the Internet-databases. The results of the studies show that the most effective factors include: efficiency, motivation, management, and the participation of end users. Factors such as technical aspects ease of use, available resources, and human resources, have limited effects. And security and privacy, the expected output, lack of time, and workload have relative effects, and also the relation between the patient and clinical staff, has no effects in the process of implementing EHR.
文摘It is well known that the incorporation of research findings into practice leads to less costs of health care, more personal productivity, longer and healthier lives for patients, and also will decrease pain and suffering of patients. Thus, the aim of this integrative review was to identify the barriers and facilitators of research utilization among the world and the best strategies used to overcome the barriers. A literature search was conducted by viewing relevant studies via computerized searching through EBSCO, Medline, Science Direct, Pub Med, Ovid, and Arabic Journals research databases. The number of reviewed studies was 192 and all of them in English, no studies in Arabic. Only 26 of them were selected based on inclusion criteria. Twenty six studies were included, with most using a cross-sectional survey design. The most identified barriers are lack of time, inadequate facilities and resources to implement new ideas, no enough authority to implement new ideas, lack of administrative support and others, while the most identified suggested that facilitators are improving the scientific knowledge of nurses and support from unit managers. The majority of these studies used Barriers scale which is not a standardized tool. However, there is a big gap between real situation and the identified evidences resulted from researches.
文摘Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that;the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.
文摘There is a higher Human Papilloma Virus peak prevalence in younger women (18 - 25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the stage of exploring which predisposes them to risky behavior like early sexual intercourse and multiple sexual partners among others. This creates a need for cervical cancer screening in the population. The facilitators and barriers to cervical cancer screening have been studied in the Ugandan general population but little is known among University students which this study is taking interest. <strong>Objective: </strong>This study is aimed at determining the facilitators, barriers and background factors associated to cervical cancer screening among female undergraduate students in Makerere University. <strong>Methods: </strong>Four hundred twenty-two (422) female undergraduate students of Makerere University who fit the eligibility criteria were recruited in this descriptive cross-sectional quantitative study. A self-administered semi structured questionnaire was administered to these participants chosen by convenient sampling. Data collected was analyzed using SPSS version 23 software and logistic regression models was used. <strong>Results:</strong> Less than a half of (21.1%) of the participants had ever screened for cervical cancer. At multivariate analysis, only year of study and married status were associated to cervical cancer screening with a P-values were of (0.015) and (0.001) with a (1.173 - 4.261) and (1.594 - 6.130) 95% CI respectively. The facilitators agreed upon by participants included: Access to free cervical cancer screening services, adequate knowledge about cervical cancer screening and advice from a friend, family or physician among others. The reported barriers to screening were fear of bad result, low risk perception and fear of embarrassment among others. <strong>Conclusions and Recommendations: </strong>Among the female undergraduate students of Makerere University, only 21.1% had screened for cervical cancer. Therefore, there is a critical need for university based cancer education campaign on cervical cancer and the benefits of screening. Screening services should be integrated into the existing university medical services.
基金supported by Pediatric Health Research Center,Tabriz University of Medical Sciences(Grant number:IR.TBZMED.REC.1398.585).
文摘Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional study.A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method.Nurses’perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire(BAVNIQ)and descriptive and analytical statistics,respectively.Results:Approximately 74%of the nurses who participating in the study had a moderate perspective on open visitation.From the nurses’viewpoint,“Parents’low awareness of sensitivity and hygienic principles of the NICU”was the first(90.3%)barrier,and the 2 factors,namely,“physical structure of the ward/lack of sufficient space”and“far distance between family’s residence and the hospital/having another child,”were the second(86.8%)barrier with an equal percentage.Among the facilitating factors,“Supporting employed parents during the neonate’s hospitalization”and“providing facilities for family accommodation in the hospital”were the first(82.3%)and the second(79.6%)facilitators,respectively,for open visitation.Conclusions:The majority of NICU nurses had a moderate perspective on the family open visitation.This reluctance seems to be originated mainly from the factors inhibiting open visitation,making its implementation challenging for nurses.The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers,managers,and relevant officials in decision-making and implementing new visiting policies in the NICUs.
文摘In this paper, the author provides a representation of Italian public hospital facilitators （HFs） （clinics, regional or local community hospitals, and medical centers） by means of different types of networks. Moving from the balance scorecards of HFs, the author has analyzed the representation of those data through the use of the minimum spanning tree （MST） and the planar maximally-filtered graph （PMFG）. This paper firstly examined the amount of information provided by the two networks and then run a sensitivity analysis of the networks by varying the elements of the balance scorecards to be considered. In this way, the author obtained a quite unusual representation of the overall economic situation of Italian HFs. Moreover, the author observed the emergence of patterns which in the author＇s opinion might help policy makers to realize a more efficient allocation of financial resources among the existing HFs.
文摘Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.
文摘Background: The purpose of this study was to clarify the effects of a facilitator training course focused on teaching beginners facilitator intervention skills. Intervention Method: One-and-a-half-day program combining education, role plays and relaxation. Methods: Participants were 11 participants, and of these 8 gave valid responses to our questionnaire. The scores of the participants on a facilitator intervention skills scale and on a scale of facilitator skills to cope with difficult situations were compared before and after the course, using SPSS16 for windows. In addition, the participants’ impressions before and after the course were analyzed qualitatively and inductively. Results: Seven of the 16 items on the facilitator intervention skills scale and 7 of the 12 items on the facilitator skills to cope with difficult situations improved the participants after the facilitator training. All participants indicated that they could understand the lectures. Their impressions changed from anxiety and enthusiasm to pleasure of learning and discovery of specific problems. Conclusion: The results suggested that the educational method created in this study, with emphasis on role-playing, is useful.
文摘BACKGROUND Outpatient parenteral antimicrobial therapy(OPAT)offers a crucial method for administering intravenous/intramuscular antimicrobials outside of hospital settings,allowing patients to complete treatment safely while avoiding many hospital-acquired complications.This is a major boost or low-hanging fruit intervention in antimicrobial stewardship practices with multiple targets like decreasing hospital stays,its related complications,the economy,the burden on hospitals,etc.However,resource-constrained countries like India practices rarely OPAT in an evidence-based way.AIM To evaluate the effectiveness,safety,and feasibility along with barriers and facilitators of OPAT practices in resource-poor settings,with a focus on its role in antimicrobial stewardship.METHODS This pilot longitudinal observational study included patients who met OPAT checklist criteria and were committed to post-discharge follow-up.Pre-discharge education and counselling were provided,and demographic data were recorded.Various outcome measures,including barriers and facilitators,were identified through an extensive literature review,fishbone diagram preparation,data collection and analysis,and patient feedback.All healthcare workers who were taking care of the patients discharged with OPAT were contacted with openended questions to get data on feasibility.The study was approved by the Institutional Ethics Committee of All India Institute of Medical Sciences,Rishikesh.We used descriptive analysis and theχ2 test to analyze data.P value<0.05 was considered significant.RESULTS Out of 20 patients,the mean age was 37 years.The cohort comprised 13 males.OPAT was administered at home in 15 cases and at nursing homes in 5 cases,with nine patients receiving treatment from family members and 11 patients receiving care from a local nurse.The infections requiring OPAT included:Kidney-urinary tract(6 cases),gastrointestinal tract(4 cases),respiratory tract(4 cases),meningitis(3 cases),endocarditis(2 cases),and multiple visceral abscesses(1 case).Nineteen out of 20 patients achieved afebrile status.Half of the patients did not receive education,counselling,or demonstrations prior to discharge,but all patients rated the service as good/excellent.According to doctors’feedback,OPAT is highly beneficial and effective for patients when systematically implemented with daily telephonic monitoring,but faces challenges due to the lack of standardized protocols,dedicated teams,and adequate resources.The implementation of OPAT resulted in a reduction of hospitalization duration by an average of two weeks.CONCLUSION This pilot study proves that OPAT is safe,feasible,and efficacious by reducing two weeks of hospitalization in resource-poor settings.OPAT contributes directly to antimicrobial stewardship by reducing hospital stays and hospital-acquired complications,which is vital in combating antimicrobial resistance(AMR)and aligns with the global action plan for AMR in infection prevention and optimal antimicrobial utilization.
基金Ethics Committee of Taihe Hospital in Shiyan City(Project No.:2023XM008)。
文摘Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.
基金supported by the Major Subject of the National Social Science Foundation of China(21&ZD093)the Basic Research Funds of Chinese Academy of Agricultural Sciences(16100520240017)+1 种基金the Agricultural Science and Technology Innovation Program of Chinese Academy of Agricultural Sciences(CAASCSAERD-202402,10-IAED-04-2024)the earmarked fund for China Agriculture Research System(CARS-08).
文摘The Regional Comprehensive Economic Partnership(RCEP)has created favorable conditions for building deeply integrated agricultural value chains(AVC)in Asia-Pacific.Based on the RCEP agreement,this study employed the global trade analysis project(GTAP)model to evaluate the impact of RCEP on AVC of member countries in terms of time,tariff reduction,and reduction of non-tariff barriers(NTB).The results indicate that(1)the implementation of RCEP boosts the value-added to agricultural exports for most member countries,particularly in competitive industries;(2)the increase in domestic production and processing capacity,reflected in domestic value-added(DVA),is the primary factor driving the rise in the value-added of agricultural exports across various industries of member countries;(3)RCEP enhances the participation of most regional countries in AVC,with varying impacts on AVC positioning,thereby fostering regional AvC development;and(4)RCEP has a positive effect on AVC indicators both in the short and long term,with the effect becoming more pronounced over time.Additionally,reducing NTB enhances the positive effects of tariff reductions on AVC indicators.Based on the analyses,the following recommendations are proposed:(1)Leverage the development opportunities arising from RCEP implementation to enhance the agricultural DVA;(2)capitalize on cooperative opportunities created by RCEP to build cohesive regional AVC;and(3)prioritize the effective implementation of RCEP'shigh-qualityrules.
基金supported by the National Key Research and Development Program of China(No.2019YFC1804202)the National Natural Science Foundation of China(No.22020102004)+1 种基金the Tianjin Municipal Science and Technology Bureau(No.21JCZDJC00280)the Fundamental Research Funds for the Central Universities by the Ministry of Education of China(No.T2017002).
文摘Polybromodiphenyl ethers(PBDEs),the widely used flame retardants,are common contaminants in surface soils at e-waste recycling sites.The association of PBDEs with soil colloids has been observed,indicating the potential risk to groundwater due to colloid-facilitated transport.However,the extent to which soil colloidsmay enhance the spreading of PBDEs in groundwater is largely unknown.Herein,we report the co-transport of decabromodiphenyl ester(BDE-209)and soil colloids in saturated porous media.The colloids released froma soil sample collected at an e-waste recycling site in Tianjin,China,contain high concentration of PBDEs,with BDE-209 being the most abundant conger(320±30 mg/kg).The colloids exhibit relatively high mobility in saturated sand columns,under conditions commonly observed in groundwater environments.Notably,under all the tested conditions(i.e.,varying flow velocity,pH,ionic species and ionic strength),the mass of eluted BDE-209 correlates linearly with that of eluted soil colloids,even though the mobility of the colloids varies markedly depending on the specific hydrodynamic and solution chemistry conditions involved.Additionally,the mass of BDE-209 retained in the columns also correlates strongly with themass of retained colloids.Apparently,the PBDEs remain bound to soil colloids during transport in porous media.Findings in this study indicate that soil colloidsmay significantly promote the transport of PBDEs in groundwater by serving as an effective carrier.This might be the reason why the highly insoluble and adsorptive PBDEs are found in groundwater at some PBDE-contaminated sites.
文摘Facilitated transport membranes for post-combustion carbon capture are one of the technologies to achieve efficient and large-scale capture.The central principle is to utilize the affinity of CO_(2) for the carrier to achieve efficient separation and to break the Robson upper bound.This paper reviews the progress of facilitated transport membranes research regarding polymer materials,principles,and problems faced at this stage.Firstly,we briefly introduce the transport mechanism of the facilitated transport membranes.Then the research progress of several major polymers used for facilitated transport membranes for CO_(2)/N_(2) separation was presented in the past five years.Additionally,we analyze the primary challenges of facilitated transport membranes,including the influence of water,the effect of temperature,the saturation effect of the carrier,and the process configuration.Finally,we also delve into the challenges and competitiveness of facilitated transport membranes.
