Background: Hand hygiene is an essential practice in preventing sickness and damageupon patients and the nursing care environment. Despite this there is a lack of handhygiene adherence in the healthcare systems. Hand hygiene routines in Swedishhealthcare systems are regulated by law and to be applied in all healthcare activities.Nurses core expertise is to practise evidence based, assess risks, provide safe care and tofollow established guidelines. Objective: The aim of this literature review was to describe the perceived barriers ofnurses for hand hygiene adherence. Method: Descriptive literature review using Popenoe et al. (2021) data analysis guide toidentify, summarise and condense data from selected articles for thematicallycategorising a nurse's perceived barriers for hand hygiene adherence. Results: The results showed a lack of knowledge, heavy workload, inadequateinfrastructure and materials, social barriers and skin irritation were the most perceivedbarriers to hand hygiene adherence according to participating nurses. Conclusion: Nurses from different parts of the world perceive similar barriers to handhygiene adherence. The perceived barriers are several and impact nurses differentlydepending on the location. The lack of hand hygiene can have a widespread damage onthe wellbeing of healthcare users. Nurses have an important role to provide theirpatients with evidence based nursing care by adhering to established hand hygieneguidelines. The motivation behind the making of this literature review is to raiseawareness of nurses' perceived barriers to hand hygiene adherence which can facilitatethe process of resolving the perceived barriers.

The construction industry has a significant impact on the environment, and from the extractionof raw materials to the construction process to the operation and maintenance of buildings, eachphase contributes to environmental degradation in various ways. Consequently, promotingreuse in the Swedish building sector holds excellent potential for substantially reducing wastegeneration and CO2 emissions, aligning with broader sustainability objectives. We are tryingto create a circular economy paradigm where construction materials and resources are reused,remanufactured, and recycled, minimizing waste and environmental impact. However,realizing the full benefits of the Circular Economy requires significant changes in thinking andthe adoption of innovative business models. The project aims to identify barriers to the reuseof concrete in Sweden's construction sector, along with their causes and effects. A literaturereview was conducted to understand various barriers, forming the basis for subsequentinterviews with experts in a similar field, which is qualitative and semi-structured. Aninnovative collaboration project named Återhus helps to facilitate a comprehensive approach,exploring the challenges hindering reuse practices to inform strategies to overcome thesebarriers and promote greater reuse. The overall results, analysis, and discussion from all thesestudies reinforce the comparison of the views and experiences of different stakeholder groupsand how these differences affect the overall implementation of reuse in construction. Theseinterviews identified barriers and grouped them into the following categories: standardization,economic, material handling, knowledge, and technical barriers. Many barriers are highlyinterconnected, and multiple connections were found within knowledge within the market, aswell as a lack of standardization within the people's knowledge, culture, and understandingtoward a new transition of circularity for reuse.

No description available.

No description available.

The Veterans Health Administration (VHA) is North America’s largest integrated health care system, providing care at 1,321 health care facilities, including 172 medical centers and 1,138 outpatient sites of care with a varying of complexities, serving nine million enrolled Veterans each year (Department of Veterans Affairs, 2024). The VHA also employs over 2,000 occupational therapy practitioners (OTPs). Although the VHA is the largest integrated health care system in North America and can be debated as the top organization to employ the most OTPs, the VHA has yet to establish a robust career path for aspiring OTP leaders to emerge as change agents. As a result, OTPs can primarily serve in three clinical leadership roles, as there are no non-clinical leadership roles described in the VHA Appendix G14 Handbook (OTP career map). Several studies have critically outline leadership as a growing component in the occupational therapy profession. However, there is a lack of evidence supporting OTPs transitioning from clinical to non-clinical leadership roles, which leaves organizations such as the VHA to identify and determine relevant leadership development implementation and a designed goal structure for occupational therapy career path. The VHA Occupational Therapy Leadership Development Training program is proposed as an implementation tool to engage key VHA internal stakeholders on the importance of establishing a specific leadership-focused training for OTPs to expand their clinical leadership skillset to other non-clinical roles, such as an Administrative Officer, Director Learning and Education, or even a position on the Executive Board of Directors. In establishing this program and proposing revisions to the current OTP career map, the path-goal theory of leadership, developed by Robert House in 1996, will be the theoretical framework to address the problem outlined in this doctoral project. The main question to be answered is, “To what extent can the OTP population in the VHA expand their clinical leadership skillset to non-clinical leadership roles upon implementing specific leadership development training?”

No / This article critically explores the working lives and views of disabled senior staff working in UK organisations. The qualitative research at the core of the article establishes that some disabled people are confounding established notions of disabled people only working in peripheral employment roles by exploring the working lives and perceptions of disabled managers. The findings do, however, point to continued barriers to what disabled staff in senior positions can be seen to do and be organisationally. Here both practical and ontological risk inheres in organisationally induced change, openness about impairment and risky identities. Such ideas, it is argued, present limits to further promotion and workplace inclusion for some disabled managers.

Yes / Smart city development is gaining considerable recognition in the systematic literature and international policies throughout the world. The study aims to identify the key barriers of smart cities from a review of existing literature and views of experts in this area. This work further makes an attempt on the prioritisation of barriers to recognise the most important barrier category and ranking of specific barriers within the categories to the development of smart cities in India. Through the existing literature, this work explored 31 barriers of smart cities development and divided them into six categories. This research work employed fuzzy Analytic Hierarchy Process (AHP) technique to prioritise the selected barriers. Findings reveal that ‘Governance’ is documented as the most significant category of barriers for smart city development followed by ‘Economic; ‘Technology’; ‘Social’; ‘Environmental’ and ‘Legal and Ethical’. In this work, authors also performed sensitivity analysis to validate the findings of study. This research is useful to the government and policymakers for eradicating the potential interferences in smart city development initiatives in developing countries like India.

Yes / Blockchain is an emerging technology with a wide array of potential applications. This technology, which underpins cryptocurrency, provides an immutable, decentralised, and transparent distributed database of digital assets for use by firms in supply chains. However, not all firms are appropriately suited to adopt blockchain in the existing supply chain primarily due to their lack of knowledge on the benefits of this technology. Using Total Interpretive Structural Modelling (TISM) and Cross-Impact Matrix Multiplication Applied to Classification (MICMAC), this paper identifies the adoption barriers, examines the interrelationships between them to the adoption of blockchain technology, which has the potential to revolutionise supply chains. The TISM technique supports developing a contextual relationship based structural model to identify the influential barriers. MICMAC classifies the barriers in blockchain adoption based on their strength and dependence. The results of this research indicate that the lack of business awareness and familiarity with blockchain technology on what it can deliver for future supply chains, are the most influential barriers that impede blockchain adoption. These barriers hinder and impact businesses decision to establish a blockchain-enabled supply chain and that other barriers act as secondary and linked variables in the adoption process.

No / Purpose: The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe. Methods: We undertook a mixed‐methods, situational analysis. This involved a purposeful literature search and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe. Results: The 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence‐based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32%‐48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers. Conclusions: Successful working with primary care providers is essential to scaling‐up AIT provision in Europe, but to achieve this, the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency.

Yes / Exercise classes provide a range of benefits for older adults, but adherence levels are poor. We know little of instructors’ experiences of delivering exercise classes to older adults. Semi-structured interviews, informed by the Theory of Planned Behaviour (TPB), were conducted with instructors (n=19) delivering multi-component exercise classes to establish their perspectives on older adults’ uptake and adherence to exercise classes. Analysis revealed ‘barriers’ related to identity, choice/control, cost, venue and ‘solutions’ including providing choice, relating exercise to identity, a personal touch and social support. ‘Barriers’ to adherence included unrealistic expectations and social influences and ‘solutions’ identified were encouraging commitment, creating social cohesion and an emphasis on achieving outcomes. Older adults’ attitudes were an underlying theme, which related to all barriers and solutions. The instructor plays an important, but not isolated, role in older adults’ uptake and adherence to classes. Instructors’ perspectives help us to further understand how we can design successful exercise classes.