This review focused on the identification of patient-reported outcome measures (PROMs) used in routine cancer clinical practice, the impact on patient, provider, and system outcomes, and the ...implementation factors influencing uptake.
A scoping review of the published health literature was conducted using empirical databases, namely, Ovid Medline (2003 to September 2013), CINAHL (2003–2013) and PsycINFO (2003–2013). Scoping reviews are systematic literature reviews in a broad topic area that provide relevant and quantified results about the knowledge available on a particular topic and aim to rapidly map and synthesize the evidence to emphasize what is known.
From a total of 2447 unique publications, 30 articles that met eligibility criteria were reviewed. PRO use appears to be acceptable to patients, enables earlier detection of symptoms and may improve communication between clinicians and patients. However, the impact of routine PROMs collection on health outcomes is less clear and high-quality research is still warranted.
PROMs use in routine cancer clinical practice is growing with improvements on essential care processes shown but a number of implementation barriers must still be addressed. The lack of standardization in PROMs used in cancer organizations may make it difficult to use these data for quality monitoring in the future.
Even though much attention has been given to barriers related to implementing circular business models, so far, no studies have focused on how the barriers differ between business models. Ignoring ...the possibility of such differences could lead to unjustified generalizations about the barriers to implementing circular business models (CBMs). We identified barriers to implementation and compared them for different CBMs by analyzing 43 case studies of CBMs, based on in-depth interviews with 31 Dutch firms. Barriers were analyzed for the following CBMs: circular supplies, resource recovery, product life extension, and the product-as-a-service model. The barriers identified were classified into two broad categories: internal problems related to the firm itself and external barriers related to the firm's environment. This study shows that key challenges were related to the firm's external environment, and that the barriers differed between the four business models studied. Whereas most internal barriers encountered by the product-as-a-service model were to do with organization (for instance, of lease models), the other models reported these barriers less frequently. External supply chain issues were challenging in the resource recovery, product life extension, and circular supplies models, mainly because of great dependence on third parties for the input of discarded products and waste materials. We investigated the strategies firms used to overcome these barriers. From our findings we conclude that to stimulate the development of circular businesses, firms and policy makers should focus on bespoke solutions and strategies for different types of CBMs.
•This study explores barriers to implementation for different circular business models.•Our findings illustrate that barriers differ between circular business models.•All the circular business models faced formidable barriers related to the external firm environment.•Different types of barriers per business model point to the need for bespoke solutions.
Industry 4.0 and digital technologies might significantly impact resource optimization in a smart circular economy. However, adopting digital technologies is not easy due to barriers that may arise ...during this process. While prior literature offers initial insights into barriers at the firm level, these studies pay less attention to these barriers' multi-level nature. Focusing only on one particular level while ignoring others may not unleash the full potential of DTs in a circular economy. To overcome barriers, it's necessary to have a systemic understanding of the phenomenon, which is missing in previous literature. By combining a systematic literature review and multiple case studies of nine firms, this study aims to unpack the multi-level nature of barriers to a smart circular economy. The primary contribution of this study is a new theoretical framework composed of eight dimensions of barriers. Each dimension provides unique insights related to the multi-level nature of the smart circular economy transition. In total, 45 barriers were identified and categorized into the following dimensions: 1. Knowledge management (five barriers), 2. Financial (three barriers), 3. Process management & Governance (eight barriers), 4. Technological (ten barriers), 5. Product & Material (three barriers), 6. Reverse logistic infrastructure (four barriers), 7. Social behaviour (seven barriers), and 8. Policy & Regulatory (five barriers). This study examines how each dimension and multi-level barrier affects the transitions toward a smart circular economy. An effective transition copes with complex, multidimensional, multi-level barriers, which might require mobilization beyond a single firm. Government actions need to be more effective and correlated with sustainable initiatives. Policies also should focus on mitigating barriers. Overall, the study contributes to smart circular economy literature by increasing theoretical and empirical understanding of digital transformation barriers towards circularity.
Display omitted
•Why does the transition to a smart circular economy demand multiple lenses?•We propose a new theoretical framework of barriers to a Smart Circular Economy.•Barriers should be analyzed under micro, meso and macro perspectives.•Forty-five barriers to a Smart Circular Economy were identified.•Practical recommendations for all levels were formulated.
Persistent somatic symptoms and functional disorders (PSS/FD) are often complex conditions requiring care from multiple disciplines. One way of bringing the different disciplines together is through ...collaborative care. Little is known about the implementation barriers faced and relevant strategies to tackle the barriers in this field. Therefore, using expert knowledge, we aim to develop realistic strategies for dealing with implementation barriers of collaborative care in PSS/FD.
The Research World Café method is a single-session, expert-based method with multiple focus-groups forming and reforming to answer a set of inter-related questions, under the guidance of moderators. Using this method, participants involved in PSS/FD care across different areas of healthcare in the Netherlands developed several realistic strategies for dealing with ten implementation barriers for collaborative care in PSS/FD that were previously identified in a Delphi study. Strategies were grouped into strategy clusters using a card-sorting task.
Thirty-three participants took part, representing ten different disciplines, most commonly physiotherapists, psychologists, and physicians. In total, 54 strategies, identified in response to the ten barriers, were grouped into eight strategy clusters. The strategy clusters were professional education, communication, care coordination, care pathways, joint consults, funding, patient involvement, and prevention.
We identified a number of useful strategies for dealing with implementation barriers for collaborative care in PSS/FD. Many strategies provided ways to deal with multiple barriers at once. The effects of applying these strategies in collaborative care in PSS/FD will need testing through implementation studies, as well as in other areas needing multidisciplinary care.
Pediatric burn injuries are a global clinical issue causing significant morbidity. Early adjunctive negative pressure wound therapy improves re-epithelialization rates in children with burns, yet ...adoption in acute burn care is inconsistent. This investigation aimed to determine barriers to the implementation of adjunctive negative pressure wound therapy for the acute management of pediatric burns and co-design targeted implementation strategies.
A sequential mixed methods design was used explore barriers to adjunctive negative pressure wound therapy implementation in acute pediatric burn care. An online questionnaire was disseminated to healthcare professionals within four major Australian pediatric hospitals, each with a dedicated burns service. Barriers were coded according to the Consolidated Framework for Implementation Research (CFIR). Semi-structured interviews with senior clinicians tailored implementation strategies to local contexts. A stakeholder consensus meeting consolidated implementation strategies and local processes.
Sixty-three healthcare professionals participated in the questionnaire, and semi-structured interviews involved nine senior burn clinicians. We identified eight implementation barriers across all five CFIR domains then co-designed targeted strategies to address identified barriers. Barriers included lack of available resources, limited access to knowledge and information, individual stage of change, patient needs and resources, limited knowledge and beliefs about the intervention, lack of external policies, intervention complexity, and poor implementation planning.
Multiple contextual factors affect negative pressure wound therapy uptake in acute pediatric burn settings. Results will inform a multi-state stepped-wedge cluster randomized controlled trial. Additional resources, education, training, updated policies, and guidelines are required for successful implementation. It is anticipated that adjunctive negative pressure wound therapy, in conjunction with tailored implementation strategies, will enhance adoption and sustainability.
Australian and New Zealand Clinical Trials Registry: ACTRN12622000166774. Registered 1 February 2022.
•Adjunctive negative pressure wound therapy (NPWT) significantly improves time to re-epithelialization in pediatric burns.•Despite the demonstrated efficacy, this treatment has not been implemented as part of acute pediatric burn care.•A determinant framework was used to explore barriers to the implementation of adjunctive NPWT and develop matched strategies.•To implement NPWT into clinical practice, additional resources, education, training, and updates to policies are required.
The purpose of this study is to perform a new literature review of the principal ecodesign methods and tools published in the literature over the last twenty years with the objective of understanding ...the main obstacles that limit their actual and effective implementation in industrial companies. The main research studies on ecodesign issues are presented and classified in a structured framework on the basis of the scope perspective. Then, an exploration of the main barriers, according to the literature, that prevent the implementation of ecodesign approaches in industrial companies, is presented and compared with possible strategies that allow these barriers to be overcome.
•Eco-design methods and tools review.•Identification of ecodesign methods and tools strength and weakness elements.•Analysis of barriers for eco-design implementation in industrial companies.•Analysis of strategies for effective ecodesign implementation in industrial sector.•Analysis of innovative approaches to overcome lack of ecodesign implementation.
Over the last three decades, PPGIS practices have shifted from a paper to digital format and have become cheaper, more user-friendly, and more versatile. The literature recognizes the potential of ...PPGIS, but researchers also note that the impact of PPGIS in practice is not yet pronounced. This study seeks to identify the barriers that hinder the widespread adoption of PPGIS in planning practice. Building on the literature, an analytical framework is developed to identify three main categories of barriers and their respective subcategories. This analytical framework is complemented by the results of five workshops with practitioners on the use of PPGIS in planning for green open spaces. This mirroring of literature and empirical data clarifies which (sub)categories are actually perceived as barriers and which are not. The findings show a shift from epistemological and technological barriers to cultural barriers that involve institutions and participants. While each of the three categories can start or stop a PPGIS process, having a pioneer in at least one category can aid in overcoming the remaining barriers.
•Technological and epistemological barriers are no longer the main pitfalls for adapting PPGIS in practice.•There is a dissonance between literature's barriers and what practitioners perceive as such.•Human barriers, e.g., culture, trust, and willingness, are key to PPGIS's widespread adoption.•Having a champion in any category can help overcome the other barriers.
Although there is growing awareness of evaluated, school-based interventions among school staff, there are some obstacles translating programs into practice. Following three focus group discussions ...(N = 21, 29% male, 71% female), the present paper examines barriers, facilitators, and attitudes that influence school staff engagement in (cyber-)bullying prevention/intervention and provides guidance for developing and implementing school-based preventive intervention programs. Transcripts of the focus groups were analyzed with the help of the six-phase thematic coding model using MAXQDA 2022. Results indicate the presence of different types of attitudes towards (cyber-)bullying prevention/intervention: the reacting, the collaborating, the intending, and the initiating types.
Home-based robotic therapy is a trend of post-stroke upper limb rehabilitation. Although home-based upper limb rehabilitation robots have been developed over several decades, no design specification ...has been published.
To identify and synthesize design requirements considering user and technology needs for a home-based upper limb rehabilitation robot through a scoping review.
Studies published between 1 January 2000 and 10 June 2020 in Scopus, Web of Science and PubMed database regarding design requirements for upper limb rehabilitation robots from of stroke survivors or therapists were identified and analyzed. We use 'requirement' as something that is needed or wanted. Two physiotherapists ranked the requirements identified from literature review.
Nine studies were selected for review. They identified 42 requirements regarding functionality (n = 11, 26.2% of total requirements), usability (n = 16, 38.0% of total requirements), software (n = 14, 33.3% of total requirements) and safety (n = 1, 2.4% of total requirements). The main implementation barriers with respect to adherence and monitoring were space, operation, and cost.
This is the first research to summarize the design requirements for home-based upper limb rehabilitation robots for stroke survivors. The need for a safe, comfortable, easy to use device which can be individualized and promote specific movements and tasks emerged. The result of this paper captures the design requirements that can be used in future for the development of a design specification. It provides designers and researchers guidance about the real-world needs for home-based upper limb rehabilitation robots for stroke.
PDF
