Despite the many advantages of lung ultrasound (LUS) in the diagnosis and management of patients with dyspnea, adoption among hospitalists has been slow. We performed semi-structured interviews of hospitalists from 4 diverse health systems in the US to understand determinants of adoption within a range of clinical settings. We used the Diffusion of Innovation Theory to guide a framework analysis of the data. Of 27 hospitalists invited, we performed in-terviews of 22 from 4 hospitals of diverse types. Median years post-residency of interviewees was 10.5 [IQR:5-15]. Four main themes emerged: 1) There are important clinical advantages to LUS despite operator dependence, 2) LUS enhances patient and clinician experience, 3) Investment of clinician time to learn and perform LUS is a barrier to adoption but yields improved efficiency for the health system and 4) Mandated training and use may be necessary to achieve broad adoption as monetary incentives are less effective. Despite perceived benefits of LUS for patients, clinicians and health systems, an important barrier to broad LUS adoption is the experience of time scarcity by hospitalists. Future implementation strategies should focus on changes to the clinical environment that address clinician barriers to learning and adoption of new skills.

Nature Based Solutions (NBS) are becoming increasingly important in both the EU and individual countries' political agendas, as a sustainable means to reduce the risk posed by hydrometeorological hazards. However, as the use of NBS is increasing, a number of barriers regarding their practical implementation also becomes apparent. A number of review studies have summarized and classified barriers, mainly in urban settings. PHUSICOS is a H2020 Innovation Action to demonstrate the use of NBS in rural and mountain landscapes. Large scale demonstrator case sites with several sub-projects are established in Italy, Norway and in the French and Spanish Pyrenees. The present paper describes the project's NBS measures, and their experienced barriers, some of which have resulted in full cancellation of the planned interventions. Many of the barriers experienced in rural settings have the same root causes as the ones described from urban areas, and the main barrier-creating mechanisms are institutional factors, resistance among stakeholders and technical and economic issues. The key element, however, is lack of knowledge about the ability of NBS to deliver a series of co-benefits in addition to their risk-reducing effects, and that long-term thinking is required to see the effect of many of these co-benefits.

Due to the complexity, high-risk, and conservative character of construction companies, advanced digital technologies do not become widely adopted in the short term, while vendors make determined efforts to overcome this and disseminate their technologies. This paper presents the methods of an investigation addressing the extremely complex issues related to the current practices of digital technology adoption in construction. It discusses how construction companies follow a specific logical process linked to need, project objectives, characteristics of the adopting organization, and the characteristics of the new technology to be adopted. The study aims to demonstrate a novel method of data collection and analysis including data and methodological triangulation techniques including the use of NVivo and AHP to explore how companies make the decision to uptake a new technology (e.g. advanced crane, tunnel boring machine or drones) by focusing on customer and vendor activities, their interactions, contributing factors, and people involved in the process. The major original contribution of this paper is to develop an innovative methodological Cube for investigating the Construction Technology Adoption Process (CTAP) covering technology adoption, acceptance, diffusion and implementation concepts. CTAP is a framework that delineates the phases of the process that customer organizations use when deciding to adopt a new digital technology and the parallel vendor activities. The significance of these contributions is that they enable vendors to understand how to match their strategies with customer expectations in each phase of the CTAP. It also provides a benchmark for new construction companies to use the current best practice of decision making. Future research is warranted to more clearly delineate any differences with developing nations or related industries such as mining and property management.

The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. government in deciding the fate of the ACA.

Immobility during hospitalization is widely recognized as a contributor to deconditioning, functional loss, and increased need for institutional post-acute care. Several studies have demonstrated that inpatient walking programs can mitigate some of these negative outcomes, yet hospital mobility programs are not widely available in U.S. hospitals. STRIDE is a supervised walking program for hospitalized older adults that fills this important gap in clinical care. Herein we describe how STRIDE works and how it is being disseminated to other hospitals using the Replicating Effective Programs (REP) framework. Guided by REP, we define core components of the program and areas where the program can be tailored to better fit the needs and local conditions of its new context (hospital). We describe key adaptations made by 4 hospitals who have implemented the STRIDE program and discuss lessons learned for successful implementation of hospital mobility programs.

The effective dissemination and implementation of health service interventions into practice requires a range of strategic and systematic approaches. This paper applies a conceptual implementation framework to the evaluation of a hospital-wide clinical pharmacy initiative, a redesign of the discharge medication prescription pathway. The influencing factors and strategies used to overcome potential negative influences are described and assessed.

The commonly accepted definition of sustainability considers the availability of relevant resources to make an activity feasible and durable while also recognizing users' support as essential part of the social side of sustainability. IoT represents a disruption in the general scenario of computing for both users and professionals, The real expansion and integration of applications based on IoT depend on our capacity of exploring the necessary skills and professional profiles that are essential for implementation of IoT projects, but also on the perception of relevant aspects for users, e.g., on privacy, legal, IPR and security issues. Our participation in several EU-funded projects with focus in this area has enabled the collection of information on both sides of IoT sustainability through surveys but also collecting data from a variety of sources. Thanks to these varied and complementary sources of information, this article will explore the user and professional aspects for sustainability of Internet of Things in practice.

Globalization plays a very important role in the advancement of science and technology today, especially in Indonesia. Globalization has also succeeded in changing all aspects of human life. In addition to having a positive impact on the development of science and technology in Indonesia, globalization also has a negative impact that is quite visible on the character of today's youth. The crisis of the character of Indonesian youth is a serious matter and is reflected in the behavior of Indonesian youth today which does not coincide with the identity of the Indonesian nation and the values ​​of Pancasila. This paper examines the lack of implementation of Pancasila values ​​in the life of the globalization era and also how globalization affects moral decadence among the younger generation. The method used is the Literature Review method, which is a qualitative research method by collecting data from the literature. The lack of practice of Pancasila values ​​and the emergence of globalization is increasingly diminishing the character of Indonesian youth. The implementation of Pancasila values ​​among teenagers needs to be increased so that the nation's moral character is not eroded by the currents of globalization.

Participatory Action Research (PAR) is an established method to implement change in organizations. However, it cannot be applied in the open source (FOSS) communities, without adaptation to their particularities, especially to the specific control mechanisms developed in FOSS. FOSS communities are self-managed, and rely on consensus to reach decisions. This study proposes a PAR framework specifically tailored to FOSS communities. We successfully applied the framework to implement a set of quality assurance interventions in the Robot Operating System community. The framework we proposed is composed of three components, interventions design, democratization, and execution. We believe that this process will work for other FOSS communities too. We have learned that changing a particular aspect of a FOSS community is arduous. To achieve success the change must rally the community around it for support and attract motivated volunteers to implement the interventions.

Education for Sustainable Development (ESD) had become a priority in many school systems. Geography has a tradition of investigating human-environment interactions and geography education is vital in order to make sense of sustainable development (SD). In this paper, the authors aimed to contribute to the implementation of ESD and SD in middle school geography, in The People’s Republic of China. This research employed a series of methods to analyze the content in (SD) in middle school geography standards and textbooks. The research surveyed geography teachers (n=237) and assessed geography students (n=246). Results exemplified both positive and negative conclusions from the data. Primarily, the findings suggested that geography education was important to ESD implementation, although the requirements for SD are low in Chinese middle schools. The SD content was reflected clearly in the content standards and textbooks, but it was not evenly distributed in geography education. Many geography teachers in China have ample geography and interdisciplinary knowledge and they can use textbooks and other teaching methods to teach SD. The students’ performance, in a sample of four key schools, was considered “OK”, however there was still room for improvement. Most students were familiar with people, resources, environmental problems and climate change, however most were unable to grasp the factual knowledge about SD, such as international events and documents, latest predicted data and research on global warming, as well as the indicators used in the specific SD assessment. Suggestions include providing students with more practical activities and a chance to do hands-on experiments, as well as building student organizations and clubs; improve Teachers’ knowledge and understanding through teacher training program and build a platform for communicating ideas of SD through modern communication technology. Ideas of SD should be integrated into students’ daily life.

There is a large potential for cost-effective solutions to reduce greenhouse gas emissions and to improve the sustainability of the transport sector that is yet unexploited, in particular in the urban context. Considering the cost-effectiveness and the potential for co-benefits, it is hard to understand why energy gains and mitigation action in the transport sector is still lagging behind the potential. Particularly interesting is the fact that there is substantial difference among countries with relatively similar economic performances, such as the OECD countries in the development of their transport CO2 emission over the past thirty years despite the fact that these countries had relatively similar access to efficient technologies and vehicles. This study aims to apply some well established political science theories on the particular example of climate change mitigation in the transport sector in order to identify some of the factors that could help explain the variations in success of policies and strategies in this sector. The analysis suggests that institutional arrangements that contribute to consensus building in the political process provide a high level of political and policy stability which is vital to long-term changes in energy end-use sectors that rely on long-term investments. However, there is no direct correlation between institutional structures, e.g. corporatism and success in reducing greenhouse gas emissions in the transport sector. Environmental objectives need to be built into the consensus-based policy structure before actual policy progress can be observed. This usually takes longer in consensus democracies than in politically more agile majoritarian policy environments, but the policy stability that builds on corporatist institutional structures is likely to experience changes over a longer-term, in this case to a shift towards low-carbon transport that endures.

This article explored how some state policies on rehabilitation, protection and utilization of mangroves are implemented at two locals; namely, Ca Mau provice and its sub-unit Ngoc Hien District as well as Ho Chi Minh City and its sub-unit Can Gio District and what are considered as emgerging issues in the implementation process. The study employed mixed research methods including document and thematic analysis, in-depth interviews, and group discussion. The findings showed that state policies would be adapted through the ways in which these two locals manage to silmultaneously orient their work toward accommodating the madates placed upon them and cope with the reality of socio-economic difficulties at their levels. The findings also showed some issues that need to consider addressing; namely, locals’ struggles to fill the gaps between written and implemented policies in mangrove rehabilitation, conflict among sectors and stakeholders in mangrove utilization and protection, problems in guaranteeing adequate budget for in-need-locals, inconsistence in policies on "forest: water surface” ratio in mangrove-shrimp farm, and unintended consequences in forest thinning and exploitation regimes. Based on the finding analysis, the articles discussed lessons learned from the policy implementation process on mangrove rehabilitation, management and forest allocation to household in the south of Vietnam.

Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is central to implement antimicrobial stewardship (AMS) programs in primary care. This study aimed to design a GP-pharmacist antimicrobial stewardship (GPPAS) model in Australian primary care. A seven-component exploratory study was conducted since 2017 to 2021 to inform a GPPAS model. We generated both secondary and primary evidence through a systematic review, a scoping review, a rapid review, nationwide surveys of Australian GPs and CPs including qualitative components and a pilot study of a GPPAS model. All study evidence was synthesised, reviewed, merged and triangulated to design a prototype GPPAS model using a Systems Engineering Initiative for Patient Safety theoretical framework. Secondary evidence informed effective GPPAS interventions, and primary evidence captured interprofessional issues, challenges and future needs to implement GPPAS interventions by GPs and CPs. A GPPAS model framework involving GP-pharmacist team-based five GPPAS sub-models were successfully designed to foster AMS education, antimicrobial audits, diagnostic stewardship, delayed prescribing, and routine review of antimicrobial prescription by improved GP-CP collaboration. A GPPAS model could be used as a guide to collaboratively optimise antimicrobial use by GPs and CPs. Implementation studies on GPPAS model and sub-models are required to integrate GPPAS model into GP-pharmacist interprofessional care models in Australia.

Cooperative learning (CL) is a teaching and learning pedagogy that has been used widely in school but there is limited information on instructors’ perceptions of CL nor observations of how CL is implemented in higher education settings. In this study, we investigated the ad-vantages and challenges of embedding CL into instructors’ teaching in Iran and Australia. Data were collected through interview and observation. Results showed that despite challenges such as the lack of familiarity of CL and how it can be implemented in university curricula, issues associated with assessment, and time constraints, CL created an interactive, pleasant and safe environment for deep learning in both countries. The findings showed that there were challenges in Iran such as a tendency to use traditional approaches to teaching, insufficient understanding of how to establish teamwork, and a lack of up-to-date teaching resources. In Australia, changing courses, working with external students, catering for individual differences, and building positive relationships were some of the challenges of implementing CL. We believe that these challenges can be overcome if university instructors are prepared to address them.

Twenty-first century infrastructure needs to respond to changing demographics, becoming climate neutral, resilient, and economically affordable, while remaining a driver for development and shared prosperity. However, the infrastructure sector remains one of the least innovative and digitalized, plagued by delays, cost overruns, and benefit shortfalls [1-4]. The root cause is the prevailing fragmentation of the infrastructure value chain [5]. To support overcoming the shortcomings, an integration of the value chain is needed. This could be achieved through a use-cased-based creation of federated digital platforms applied to infrastructure projects. Such digital platforms enable full-lifecycle participation and responsible governance guided by a shared infrastructure vision.

Dwindling Economy is otherwise known as depression economy or economy depression interchangeably and/or recess economy. It is an occurrence wherein an economy is in a state of financial turmoil, often the result of a period of negative activity based on the country’s Gross Domestic Product (GDP) rate. However, this has become a global phenomenon; a good example of a necessitating factor is the global oil crash market and pandemics virus (Covid-19) ravaging the human race. That has conjointly led to the decline in the GDP growth per capital of a country; which forces degradation in the performances of economic sectors, retrenchment of staff and wrapping-up of industries. It is a lot worse than a recession, with GDP falling significantly, and lasts for periods of time. Pen ultimately, Nigeria has been in deteriorating financial state for years; her economy in the last few years has been going through some turbulence. A country that had recorded an average GDP growth of 6.5 per cent, one of the highest in the world less than a decade ago, is now projected to grow at about 2.3 per cent in 2016. It is no longer news that Nigeria's economy is experiencing total collapse and if nothing is done to put the peg in the right spot something worse than what we are witnessing may soon be on sight. Based on some of all these issues and other, Nigeria was said to be technically recess.In this paper, efforts were made to explore the state of the Nigeria economy in the last 36 years (1981-2017) and correlate it with the recent phenomena that conjointly constitute to its dwindling economy. Our comprehensive and elusive literary survey and extemporariness suggested way forwards to rescue the raveling situation of Nigeria dwindling economics, if not providing lasting solution but temporarys’ one that could stand test of time.

A decade after environmental scientists integrated high-throughput sequencing technologies in their toolbox, the genomics-based monitoring of anthropogenic impacts on biodiversity and ecosystems is yet to be implemented by regulatory frameworks. Despite the broadly acknowledged potential of environmental DNA and RNA to cost-efficiently and accurately monitor biodiversity, technical limitations and conceptual issues still stand in the way of its routine application by end-users. In addition, the multiplicity of potential implementation strategies may contribute to a perception of the methodology as being premature or “in development”, hence restraining regulators from binding these tools into legal frameworks. This review focuses on the strengths and limitations of genomics-based strategies that have emerged over the past ten years and have been classified for this purpose into three broad strategies: (A) Taxonomy-based approaches that focus on known bio-indicators or the diversity of taxonomically described taxa, (B) De novo approaches that do not require well-established taxonomy, and (C) Function-based approaches that rely on community-wide metrics, where taxa are interchangeable, or on functional profiles instead of compositional turnovers. We finally propose a roadmap for the implementation of environmental genomics into routine monitoring programs that leverage recent analytical advancements, upon which some critical limitations are alleviated.

The purpose of this study is to ascertain whether implementation difficulty can be used in slot allocation model as a new mechanism for slightly weakening grandfather right. According to which, a linear integer programming model is designed to compare and analyze displacement, implementation difficulty and priority with different weights. Test results show that the implementation difficulty can be significantly reduced without causing excessive displacement and disruption of existing priorities, by weight setting while declared capacity is cleared. In addition to this, whether the movements are listed in order of descending priority or not have great impact on displacement and implementation difficulty within slot allocation model. Capacity is surely a key factor affecting displacement and implementation difficulties. This study contributes to propose a new mechanism for slightly weakening grandfather right, which can help decision makers to upgrade slot allocation policies.

This paper challenges the assumption that “state-of-the-art” regulation aimed at curbing greenhouse gas emissions (GHG) by firms is the panacea that will force firms to face the impact of climate change and create conditions that promote sustainable corporations. We argue that, in fact, such regulation, when improperly implemented, may impair sustainability practices because it creates unintended consequences. This paper tackles the design and efficiency of the institutional framework chosen through the lenses of the analytical themes of fit, scale and interplay. Then, we model a systems dynamic approach to represent how public policy in the arenas of energy effi-ciency and GHG emissions reduction may interplay with competitive business outcomes and cor-porate sustainability schemes. We found, as a result of the institutional design chosen, that the sys-tem is dominated by negative feedback processes resulting in inefficient outcomes that would be better tackled by firms not being subject to the restrictions imposed by the new laws.

The utilization of person centered care is highlighted as essential for health promotion, yet implementation has been inconsistent and multiple issues remain. There is a dearth of applied re-search exploring the facets of successful implementation. In this paper, a person centered wellbeing program spanning various groups is discussed outlining the central principles that have allowed for successful outcomes. The main data emerges from 10 years of pragmatic pre-post service evaluation. Measures of functional capacity and wellbeing were captured using validated measures. The method for this paper is a narrative exploration of the theory and practices that can explain the continual improvement the clinics have achieved over 10 years. Core principles relate to connecting with people, connecting through groups, and connecting with self. The operationalization and theoretical explanation of these principles is outlined alongside 10 years of data which shows sustained improvement in a range of outcomes. The discussion of these principles posits essential factors to prioritize to advance the implementation of person centered care in health promotion for long term conditions.

We present a generic and open-source framework for the numerical modeling of the expected transport and storage mechanisms in unconventional gas reservoirs. These unconventional reservoirs typically contain natural fractures at multiple scales. Considering the importance of these fractures in shale gas production, we perform a rigorous study on the accuracy of different fracture models. The framework is validated against an industrial simulator and is used to perform a history-matching study on the Barnett shale. This work presents an open-source code that leverages cutting-edge numerical modeling capabilities like automatic differentiation, stochastic fracture modeling, multi-continuum modeling and other explicit and discrete fracture models. We modified the conventional mass balance equation to account for the physical mechanisms that are unique to organic-rich source rocks. Some of these include the use of an adsorption isotherm, a dynamic permeability-correction function, and an embedded discrete fracture model (EDFM) with fracture-well connectivity. We explore the accuracy of the EDFM for modeling hydraulically-fractured shale-gas wells, which could be connected to natural fractures of finite or infinite conductivity, and could deform during production. Simulation results indicates that although the EDFM provides a computationally efficient model for describing flow in natural and hydraulic fractures, it could be inaccurate under these three conditions: 1. when the fracture conductivity is very low. 2. when the fractures are not orthogonal to the underlying Cartesian grid blocks, and 3. when sharp pressure drops occur in large grid blocks with insufficient mesh refinement. Each of these results are very significant considering that most of the fluids in these ultra-low matrix permeability reservoirs get produced through the interconnected natural fractures, which are expected to have very low fracture conductivities. We also expect sharp pressure drops near the fractures in these shale gas reservoirs, and it is very unrealistic to expect the hydraulic fractures or complex fracture networks to be orthogonal to any structured grid. In conclusion, this paper presents an open-source numerical framework to facilitate the modeling of the expected physical mechanisms in shale-gas reservoirs. The code was validated against published results and a commercial simulator. We also performed a history-matching study on a naturally-fractured Barnett shale-gas well considering adsorption, gas slippage & diffusion and fracture closure as well as proppant embedment, using the framework presented. This work provides the first open-source code that can be used to facilitate the modeling and optimization of fractured shale-gas reservoirs. To provide the numerical flexibility to accurately model stochastic natural fractures that are connected to hydraulically-fractured wells, it is built atop other related open-source codes. We also present the first rigorous study on the accuracy of using EDFM to model both hydraulic fractures and natural fractures that may or may not be interconnected.

In the recent years, biochar has emerged as a remarkable biosourced material for addressing global environmental, agricultural, biomedical, and energy challenges. However, the performances of biochar rest in part on finely tuning its surface chemical properties, intended to obtain specific functionalities. In this review, we tackle surface treatment of biochar with silane and other coupling agents such as diazonium salts, titatantes, ionic/non-ionic surfactants, as well as nitrogen-containing (macro)molecules. We summarize the recent progress achieved mostly in the last five years, and correlate the nature and extent of functionalization to eye catchy end applications of the surface engineered biochar.

Abstract This article examines the implementation of the Swedish national environmental quality objectives and discusses what can be learnt for the equivalent process for the set of global UN 2030 goals (SDGs), established in 2015. The empirical basis is a study on 50 large companies in Sweden and their use of these objectives in their policy formulation. The SDGs are crafted with a broader approach than the Swedish national environmental quality objectives. Therefore, the SDGs probably better reflect the agenda of the business community since they have a global character, cover the whole spectrum of important sustainability issues and provide a mutual agenda for the business community world-wide. More than 90 percent of the large companies in the study have explicitly committed themselves to the SDGs, only 1-2 years after they were published, whereas similar commitments hardly exist for the national environmental quality objectives, even 20 years after its establishment. A large majority of the large companies in this study know about the SDGs, have actively endorsed them, and started to adjust their activities accordingly. At the end, the results of these endorsements remain to be seen.

This study contributes to the literature by exploring challenges to implementing ISO 20000-1 in an emerging economy context, and suggests ways to overcome these challenges. A survey-based methodology was adopted. The data were analyzed using principal component analysis. The results indicated that senior management support was the most significant challenge for the successful implementation of IT Service Management (ITSM) systems. Other significant challenges were the justification of significant investment, premium customer support, co-operation and co-ordination among IT support teams, proper documentation, and effective process design The findings help managers introduce IT service management system (ISO 20000-1:2011) as well as improving IT service delivery system in IT support organizations for managing big data in an emerging economy. In the future, cross-firm and cross-country studies on challenges to ISO 20000 can be conducted. Also, interpretive structural model (ISM) can be formulated to examine the interrelationships among the identified challenges to ISO 20000.

Digital health research is an emerging discipline that requires easy-to-understand theoretical frameworks and implementation models for digital health providers in health and social care settings. The COVID-19 pandemic has heightened demand for digital health discipline-specific instruction on ‘how to’ manage evidence-based digital health transformation. Access to the use of these models guarantees that digital health providers can investigate phenomena using safe and suitable approaches and methods to conduct research and identify answers to challenges and problems that arise in health and social care settings. The COMPASS theory is designed to aid transformation of health and social care environments. A navigational rose of primary quadrants is divided by four main compass points, with person-centred care being central to the philosophy. Two axes produce Cartesian planes that intersect to form a box plot, which can be used to discover human and physical resource weightings to augment digital health research design and implementation. A third continuum highlights stakeholders' capabilities, critical for any multidisciplinary study. The COMPASS mnemonic guides end-users through the process of design, development, implementation, evaluation, and communication of digital health transformations. The theory's foundations are presented and explained in context of the 'new normal' of health and social care delivery.

Guided by the Conceptual Model of Implementation Research, we explored the acceptability, appropriateness, and feasibility of: 1) automated screening approaches utilizing existing health data to identify those who require subsequent diagnostic evaluation for familial hypercholesterolemia (FH) and 2) family communication methods including chatbots and direct contact to communicate information about inherited risk for FH. Focus groups were conducted with 22 individuals with FH (2 groups) and 20 clinicians (3 groups). These were recorded, transcribed, and analyzed using deductive (coded to implementation outcomes) and inductive (themes based on focus group discussions) methods. All stakeholders described these initiatives as: 1) acceptable and appropriate to identify individuals with FH and communicate risk with at-risk relatives; and 2) feasible to implement in current practice. Stakeholders cited current initiatives, outside of FH (e.g., pneumonia protocols, colon cancer and breast cancer screenings), that gave them confidence for successful implementation. Stakeholders described perceived obstacles, such as nonfamiliarity with FH, that could hinder implementation and potential solutions to improve systematic uptake of these initiatives. Automated health data screening, chatbots, and direct contact approaches may be useful for patients and clinicians to improve FH diagnosis and cascade screening.

The evaluation was conducted to find out whether the stipulated objectives of the policy are being followed, and at the same time find out whether the envisioned results of implementing such policy system have been achieved so far. The evaluation was expected to provide an opportunity for mending shortfalls of the whole system that would affect its sustainability and usefulness.A total of 33 participants were interviewed in this study and came from the study area (Nkhotakota District Council Office). Purposive sampling was used to select the participants. All study respondents were purposively selected where respondents considered having relevant information and they were interviewed to obtain wide range of perspectives.Seven themes were identified; knowledge on policy, limited stakeholder involvement, poor HIV and AIDS programming, ethical issues, future perspective of the policy, Other Recurrent Transaction (ORT) allocation, and availability of HIV and AIDS Committee. On knowledge on policy, the sub-themes included; objectives well outlined, and poor updates on the policy. On limited stakeholder involvement, the sub-themes were; lack of ownership, ignorance of involvement, and not involved/limited involvement. On the Poor HIV and AIDS programming theme, sub-themes identified were; exclusion of activities in the District Implementation Plan (DIP) and lack of funds. There was one sub-theme on ethical issues and future perspective.We found that the Nkhotakota District Council HIV and AIDS at workplace policy is not functioning properly due to poor coordination and lack of funding. However, there are some positives identified such as existence of the coordinating committee and allocation of funds through ORT. Although the system has been functional for some years in well-established structures, lack of participation by some stakeholders, non-inclusion of HIV and AIDS activities in the DIPs underpin its sustainability

An exploding demand for processing capabilities related to the emergence of the IoT, AI and big data, has led to the quest for increasingly efficient ways to expeditiously process the rapidly increasing amount of data. These ways include different approaches like improved devices capable of going further in the more Moore path, but also new devices and architectures capable of going beyond Moore and getting more than Moore. Among the solutions being proposed, Stochastic Computing has positioned itself as a very reasonable alternative for low-power, low-area, low-speed, and adjustable precision calculations; four key-points beneficial to edge computing. On the other hand, chaotic circuits and systems appear to be an attractive solution for (low-power, green) secure data transmission in the frame of edge computing and IoT in general. Classical implementations of this class of circuits require intensive and precise calculations. This paper discusses the use of the SC framework for the implementation of nonlinear systems, showing that it can provide results comparable to those of classical integration, with much simpler hardware, paving the way for relevant applications.

This paper presents an optimized feature-centered reflection symmetry axis detection and localization framework for object perception. The proposed framework is formed to obtain an improved reflection symmetry axis based on the salient symmetry feature. It starts with a refined Multi-scale Saliency Symmetry Model (MSSM), which is realized by applying isotropic symmetry operator on salient points in scale-space rather than all pixels. In each scale, salient points are initially extracted as local extremal from an image, and they are further refined by a multi-scale implementation for generating salient symmetry feature maps. A Symmetric Transformation Matrix is then computed using the optimal feature matching pairs, which can be explicitly used as an abstract representation of the constraint regions of symmetry objects in an image to optimize the performance of the potential symmetry axis detection. The framework has been investigated experimentally both on the classical dataset from a symmetry detection challenge and the latest dataset. It has shown that the framework can get a better or comparative result and also can be further adapted into terminated human--computer equipment for reflection symmetry object perception and tracking.

A phenomenological constitutive model is developed to describe the uniaxial transformation ratcheting behaviors of super–elastic shape memory alloy (SMA) by employing a cosine–type phase transformation equation with the initial martensite evolution coefficient that can capture the feature of the predictive residual martensite accumulation evolution and the nonlinear hysteresis loop on a finite element (FE) analysis framework. The effect of the applied loading level on transformation ratcheting are considered in the proposed model. The evolutions of transformation ratcheting and transformation stresses are constructed as the function of the accumulated residual martensite volume fraction. The FE implementation of the proposed model is carried out for the numerical analysis of transformation ratcheting of the SMA bar element. The integration algorithm and the expression of consistent tangent modulus are deduced in a new form for the forward and reverse transformation. The numerical results are compared with those of existing model and the experimental results to show the validity of the proposed model and its FE implementation in transformation ratcheting. Finally, a FE modeling is established for a repeated preload analysis of SMA bolted joint

Background: Health inequity (HI) remains a major challenge in public health. Improving the health of children with low socioeconomic status (SES) can help to reduce overall HI in children. Childhood obesity is a global problem, entailing several adverse health effects. It is crucial to assess influencing factors for adoption, implementation and sustainment of interventions. This review aims to identify articles reporting about influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low SES. It aims to critically appraise the articles’ quality, assess influencing factors, categorize and evaluate them, and to discuss possible implications. Methods: A systematic search was conducted in 7 databases with the following main inclusion criteria: 1) school-based interventions and 2) target group aged 5–14 years. The Consolidated Framework for Implementation Research, its five domains (intervention characteristics, inner setting, outer setting, characteristics of individuals, process) along with 39 constructs within these domains were used to deductively analyze the data. We grouped the articles with regard to the characteristics of the interventions in simple and complex interventions. For each domain, and for the groups of simple and complex interventions, the most commonly reported influencing factors are identified. Results: 6452 articles were screened, and 16 met all eligibility criteria. Included articles applied mixed methods (n=10), qualitative (n=5) and quantitative design (n=1). Of these, five were considered to report simple interventions and eleven were considered to report complex interventions. In total, 295 influencing factors were assessed. Aspects of the inner setting were reported in every study, aspects of the outer setting were the least reported domain, and in the group of simple interventions not reported at all. In the inner setting, most reported influencing factors were time (n=7), scheduling (n=6) and communication (n=6). Conclusion: This review found a wide range of influencing factors for implementation. Most important influencing factors need to be assessed for every setting. Including all stakeholders involved in the implementation process enhances the prioritization of the most important influencing factors for the specific setting. More empirical research and practical guidance are needed to promote obesity prevention behaviors among children with low SES.

Despite the strong links between sleep, circadian rhythms, and mental health, sleep education has been neglected in mental healthcare provider training programs. The current pilot study examined the potential efficacy and acceptability of a sleep education workshop for trainee psychologists, called the Sleep Psychology Workshop. Eleven students completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the Sleep Psychology Workshop as part of their Health Psychology course, delivered as three, two-hour lectures (total six hours). Trainees’ sleep psychology knowledge quiz scores (% correct) demonstrated significant improvement from pre- (M = 60%, SD = .09) to post-workshop (M = 79%, SD = .08), t (6) = -5.18, p = .002. Trainees also reported increased self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep and circadian rhythm disturbances, along with increased confidence to manage insomnia disorder in clinical practice (all p<.02). Trainees also endorsed the workshop as an acceptable sleep education program for trainee psychologists via a post-workshop feedback survey, focus group, and six-month follow-up survey. This pilot study provides preliminary evidence for the Sleep Psychology Workshop as an effective and acceptable sleep education program for trainee psychologists.

From the perspective of manufacturing companies, the political, media and economic discourse on decarbonisation of the recent years manifests itself as an increasing social expectation of action. In Germany in particular, this discourse is also being driven forward by powerful companies, respectively sectors, most notably the automotive industry. Against this background, it was examined how German manufacturing companies react to rising societal pressure and emerging policies. It is examined which measures the companies have taken or plan to take to reduce their footprint, which aspirations are associated with this and by which structural characteristics (company size, energy intensity, sector) these are influenced. A mix methods approach was applied, utilising data gathered from approx. 900 companies in context of the Energy Efficiency Index of German Industry (EEI), along with media research focusing on decarbonisation plans and initiatives announced. We demonstrate that one-size-serves-all approaches are not suitable to decarbonise industry as the situation and ambitions differ considerably depending on size, energy intensity and sector. Even though the level of ambition and urgency is high, particularly micro and energy intensive companies are challenged. The research uncovers a series of questions that call for attention to materialise the ambitions and address the challenges outlined.

In this paper, we present a high-speed, unified elliptic curve cryptography (ECC) processor for arbitrary Weierstrass curves over GF(p), which to the best of our knowledge, outperforms other similar works in terms of execution time. Our approach employs the combination of the schoolbook long and Karatsuba multiplication algorithm for the elliptic curve point multiplication (ECPM) to achieve better parallelization while retaining low complexity. In the hardware implementation, the substantial gain in speed is also contributed by our n-bit pipelined Montgomery Modular Multiplier (pMMM), which is constructed from our n-bit pipelined multiplier-accumulators that utilizes DSP primitives as digit multipliers. Additionally, we also introduce our unified, pipelined modular adder/subtractor (pMAS) for the underlying field arithmetic, and leverage a more efficient yet compact scheduling of the Montgomery ladder algorithm. The implementation on the 7-series FPGA: Virtex-7, Kintex-7, and XC7Z020, yields 0.139, 0.138, and 0.206 ms of execution time, respectively. Furthermore, since our pMMM module is generic for any curve in Weierstrass form, we support multi-curve parameters, resulting in a unified ECC architecture. Lastly, our method also works in constant time, making it suitable for applications requiring high speed and SCA-resistant characteristics.

In the electric distribution systems, the “Smart Grid” concept is implemented to encourage energy savings and integration of the innovative technologies, helping the Distribution Network Operators (DNOs) in choosing the investment plans which to lead the optimal operation of the networks and increasing the energy efficiency. In this context, a new phase load balancing algorithm was proposed to be implemented in the low voltage distribution networks with hybrid structures of the consumption points (switchable and non-switchable consumers). It can work in both operation modes (on-line and off-line), uploading information from different databases of the DNO which contain: the consumers’ characteristics, the real loads of the consumers integrated into the Smart Metering System (SMS), and the typical load profiles for the consumers non-integrated in the SMS. The algorithm was tested in a real network, having a hybrid structure of the consumption points, on a time interval by 24 hours. The obtained results were analyzed and compared with other algorithms from the heuristic (Minimum Count of Loads Adjustment algorithm) and the metaheuristic (Particle Swarm Optimization and Genetic Algorithms) categories. The best performances were provided by the proposed algorithm, such that the unbalance coefficient resulted in the smallest value (1.0017). The phase load balancing led to the following technical effects: decreasing the average current in the neutral conductor with 94% and for the energy losses with 61.75 %, and increasing the minimum value of the phase voltage at the farthest pillar with the 7.14 %, compared to the unbalanced case.

Suicidal behaviour remains difficult to predict and prevent, even for experienced mental health care professionals. The known distal risk factors for suicidal behaviour are not sufficiently specific to fully understand the complex dynamic processes that precede a suicide attempt. Real-time mobile monitoring data can be used to analyse proximal risk mechanisms within the suicidal process. At the same time smartphone-based safety planning and self-monitoring may enhance a patient’s self-management skills thereby increasing their capacity to respond to a suicidal crisis and to become more aware of crisis symptoms. The current paper describes the theoretical and conceptual rationale for the CASPAR study which applies an innovative approach to the study of suicidal processes. It uses basic science approaches to inform the implementation of an innovative suicide prevention intervention. We aim to develop and implement mobile safety plan in conjunction with real-time monitoring in order to both directly implement suicide prevention interventions and to study the ongoing dynamics of individual suicidal behaviour by applying network analysis.

Objective: To highlight opportunities for future nutrition intervention research within early childhood and education care (ECEC) settings, with a focus on generating evidence that has applicability to real-world policy and practice. Methods: An overview of opportunities to progress the field was developed by authors using a collaborative writing approach and informed by recent research in the field. The group developed a list of recommendations aligned with the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Pairs of authors drafted individual sections of the manuscript, which was then reviewed by a separate pair. The first and senior author consolidated all sections of the manuscript and sought critical input on draft iterations of the manuscript. Results: Interventions that employ digital platforms (Reach) in ECEC settings, as well as research in the family day care setting (Effectiveness) were identified as areas of opportunities. Research understanding the determinants of and effective strategies for dissemination (Adoption), implementation of nutrition programs, in addition to de-implementation (Implementation) of inappropriate nutrition practices, is warranted. For maintenance, there is a need to better understand sustainability and sustainment of interventions, in addition to undertaking policy-relevant research. Conclusions: The ECEC setting is prime for innovative and practical nutrition intervention research.

The sustainable use of precious water resources requires effective water management. In the European Union, water management is mainly regulated by the Water Framework Directive (2000/60/EC), introducing an integrated river basin management approach. As EU directive, the legislation needs to be implemented in the Member States, entailing not only legal transposition, but also application and enforcement in Member States. One major instrument introduced by the Water Framework Directive is the environmental goal achievement obligation of art. 4 WFD, containing also a deterioration ban with several exemptions. This study compares transposition, application and enforcement of the exemption of permanent deterioration (art. 4 (7) WFD) in the context of the environmental goal achievement obligation regime in Lower Saxony (Germany) and the Netherlands. The study rests on a legal analysis of literature, policy documents and jurisprudence. Although based on the same EU directive wording and case law of the European Court of Justice, the deterioration ban and the exemption of permanent deterioration are implemented rather differently: While the deterioration ban is predominantly understood as planning obligation in the Netherlands, it became an important permit requirement in Lower Saxony since the Weser-ruling of the European Court of Justice.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

This paper presents a discrete compartmental Susceptible-Exposed-Infected-Recovered/Dead (SEIR/D) model to address the expansion of Covid-19 pandemic. When time passes, the status of the cells is determined by binary rules that update following both a neighbourhood and a delay pattern. The model assumes the environmental parameters have a crucial impact on the expansion of the disease so a grid is assigned to each parameter to model the single effect caused by this parameter. The expansion is then the weighted sum of all the grids. This proposal shows how the grid architecture, along with an update rule and a neighbourhood pattern is a valuable tool to model the pandemic expansion. This model has already been analyzed in previous works and compared with the corresponding continuous models solved by ordinary differential equations (ODE), coming to find the homologous parameters between both approaches. Thus, it has been possible to prove that the combination neighborhood-update rule is responsible for the rate of expansion and recovering/death of the illness. The delays (between Susceptible and Asymptomatic, Asymptomatic and Infected, Infected and Recovered/Dead) may have a crucial impact on both the peak of Infected and the Recovery/Death rate. This theoretical model has been successfully tested in the case of the dissemination of information through mobile social networks and in the case of plant pests.

Falls, highly common in the constantly increasing global aging population, can have a variety of negative effects on their health, well-being, and quality of life, including restricting their capabilities to conduct Activities of Daily Living (ADLs), which are crucial for one’s sustenance. Timely assistance during falls is highly necessary, which involves tracking the indoor location of the elderly during their diverse navigational patterns associated with ADLs to detect the precise location of a fall. With the decreasing caregiver population on a global scale, it is important that the future of intelligent living environments can detect falls during ADL.s while being able to track the indoor location of the elderly in the real world. Prior works in these fields have several limitations, such as – the lack of functionalities to detect both falls and indoor locations, high cost of implementation, complicated design, the requirement of multiple hardware components for deployment, and the necessity to develop new hardware for implementation, which make the wide-scale deployment of such technologies challenging. To address these challenges, this work proposes a cost-effective and simplistic design paradigm for an Ambient Assisted Living system that can capture multimodal components of user behaviors during ADLs that are necessary for performing fall detection and indoor localization in a simultaneous manner in the real world. Proof of concept results from real-world experiments are presented to uphold the effective working of the system. The findings from two comparison studies with prior works in this field are also presented to uphold the novelty of this work. The first comparison study shows how the proposed system outperforms prior works in the areas of indoor localization and fall detection in terms of the effectiveness of its software design and hardware design. The second comparison study shows that the cost for the development of this system is the least as compared to prior works in these fields, which involved real-world development of the underlining systems, thereby upholding its cost-effective nature.

Prefabricated forms of construction have led to the rapid onsite assembly of buildings however there are still on-site tasks and processes which can be reevaluated and redone specifically in keeping with the principles of prefabrication instead being adapted to fit its purpose. One such process is that of waterproofing between prefabricated panels and modules which come from the factory fully complete façade and all. Conventional means of waterproofing can be used however it results in more work done on site, potential delays and generally requires access from the external face of the building. This paper presents the Modelling, Implementation and Evaluation of purpose developed weatherproof seals specific for Prefabricated Construction. An overview is provided of the entire development process and specific focus is given to the modeling using FEA computer simulations, manufacturing and testing which then resulted in the implementation in a prefabricated panelised building which is used as a case study and the means of further evaluation. These strategies have enabled an efficient and robust prefabricated waterproofing solution specific for this form of construction to be understood and implemented. The resulting case study has successfully verified the time and cost savings when compared to conventional techniques whilst still providing a durable and effective weatherproof seal for prefabricated panelised and modular systems.

In this article, we analyse the determinants of Regulatory Quality-RQ for 193 countries in the period 2011-2020. We use a database from ESG-Environment Social Governance of the World Bank. We apply OLS, Panel Data with Fixed Effects and Panel Data with Random Effects. We found that the variables that have the most positive impact on RQ, among others, are “GHG Net Emission”, “Mean Drought Index”, and “Heat Index”. We also found that the variables that have the most negative impact on RQ are among others “Renewable Energy Consumption”, “Voice and Accountability” and “Rule of Law”. Furthermore, we have applied the k-Means algorithm optimized with the Elbow Method and we find the presence of five clusters. In adjunct, we confront eight machine learning algorithms to predict the value of RQ and we found that the best predictor is Polynomial Regression. The predictive level of RQ for the analysed countries is expected to diminish of -1,29%. In the end, we present a network analysis with the Euclidean distance and we found the presence of a structure of seven networks using augmented data.

In this article we estimate the level of Government Effectiveness-GE in 193 countries in the period 2011-2020 using data of the ESG World Bank Database. Different econometric techniques are used i.e. Panel Data with Random Effects, Panel Data with Fixed Effects, and Pooled OLS. Results show that GE is positively related among others to “Control of Corruption”, “Political Stability and Absence of Violence/Terrorism”, and negatively associated with “Percentage Annual GDP Growth”. We perform a cluster analysis with the k-Means algorithm optimized with the Elbow Method and we find the presence of four clusters. Finally, we confront eight machine learning algorithms for the prediction of GE. Results show that the Polynomial Regression is the best predictive algorithm. The value of GE is expected to growth on average by 15.97%.

In this article we estimate the level of Control of Corruption for 193 countries in the period 2011-2020 using data from the ESG World Bank Database. Various econometric techniques are applied i.e.: Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled OLS, WLS. Results show that “Control of Corruption” is positively associated, among others, to “Government Effectiveness” and “Political Stability and Absence of Violence/Terrorism”, while it is negatively associated among others to “Agriculture, Forestry, and Fishing Value Added as Percentage of GDP” and “GHG Net Emissions/Removals by LUCF”. A cluster analysis implemented with the k-Means algorithm optimized with the Elbow Method shows four clusters. A confrontation among eight Machine Learning algorithms is proposed for the prediction of Control of Corruption. Polynomial Regression is the best predictor for the training data. The level of Control of Corruption is expected to growth by 10.36% on average.

The use of New-age (Nano) Modified Emulsions (NME) for the stabilisation of marginal materials for use in the upper-pavement layers of roads have been proven in laboratories, through Accelerated Pavement Tests (APT) and in practice. In addition, material design methods have been developed based on the scientific analysis of granular material mineralogy and the chemical interaction with the binder to design a material compatible NME stabilising agent for naturally available (often marginal) materials. However, the introduction of any new disruptive technology in a traditionally well-established industry, such as the road construction industry, is usually associated with considerable resistance. This is especially relevant when the new technology enables the use of granular materials traditionally considered to be of an unacceptable quality in combination with relatively new concepts such as New-age (Nano) Modified Emulsions (NME). In practice, few road construction projects are without any problems. The introduction of new-technologies obviously makes it an easy target to blame for any non-related problem that may arise during construction. This article aims to assist in pre-empting, recognising, preventing and resolving material or non-material related construction problems through the correct identification of the cause of the problem and recommending the best, most cost-effective way to correct any deficiencies on site.