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Eyre, Emma L. J., Leanne J. Adeyemi, Kathryn Cook, Mark Noon, Jason Tallis i Michael Duncan. "Barriers and Facilitators to Physical Activity and FMS in Children Living in Deprived Areas in the UK: Qualitative Study". International Journal of Environmental Research and Public Health 19, nr 3 (2.02.2022): 1717. http://dx.doi.org/10.3390/ijerph19031717.
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Using the socio-ecological model, this qualitative study aimed to explore teachers’ perspectives on the barriers and facilitators to Fundamental Movement Skills (FMS) and physical activity engagement in children living in deprived areas in the UK. A purposive sample of 14 primary school teachers participated in semi-structured focus groups drawn from schools situated in lower SES wards and ethnically diverse areas in Central England. Thematic analysis of transcripts identified multiple and interrelated factors across all levels of the socio-ecological model for barriers to FMS and PA (i.e., intrapersonal, interpersonal, organisational, community and policy). Facilitators at three levels of influence were found (i.e., intrapersonal, interpersonal and organisational). We conclude, barriers and enablers to the PA and FMS in children from ethnically diverse backgrounds living in deprived areas are multifactorial and interrelated. At a school level, initiatives to increase PA and develop the FMS needed to be active are likely to be ineffective unless the barriers are addressed at all levels and considered more holistically with their complexity. Multi-disciplinary solutions are needed across sectors given the range of complex and interrelated factors.
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Farmer, Orlagh, Donna Duffy, Kevin Cahill, Diarmuid Lester, Sarahjane Belton i Wesley O’Brien. "Enhancing the Evidence Base for Irish Female Youth Participation in Physical Activity—The Development of the Gaelic4Girls Program". Women in Sport and Physical Activity Journal 26, nr 2 (1.10.2018): 111–23. http://dx.doi.org/10.1123/wspaj.2017-0046.
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The purpose of the current research was to gather baseline data on female youth to inform the development of a targeted physical activity (PA) and sports-based intervention, specifically identified as “Gaelic4Girls”. Cross-sectional data on PA levels, psychological correlates of PA, anthropometric characteristics, and the fundamental movement skill (FMS) proficiency of female youth (n = 331; M age 10.92±1.22) were collected. A subsample (n = 37) participated in focus group (FG) interviews exploring perceptions of health/sport, and identifying barriers/motivators to participation. PA levels were assessed using self-report (PA Questionnaire for Older Children) and classified as low, moderate, and high active. One- and two-way ANOVAs (post hoc Tukey honest significant difference [HSD]) were used to analyze the data. The FGs were transcribed verbatim, coded, and thematically analyzed. Findings indicated that the majority of youth (71.8%) were not meeting the minimum daily PA recommendations for health, and that 98.1% did not achieve the FMS proficiency expected for their age. Low, moderately, and highly active participants differ significantly in terms of overall FMS (p = .03), and locomotor control scores (p = .03). FG findings report fun and friendship as key PA motivators, too much competitiveness as barriers, and positive outside encouragement from family/friends/coaches as facilitators encouraging PA engagement. Findings highlight the need for targeting low levels of PA, FMS proficiency in female youth sport interventions, through addressing self-efficacy levels, inclusive of fun, and socially-stimulating PA environments.
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Weller, Katinka, Natasha Housseine, Rashid S. Khamis, Tarek Meguid, G. Justus Hofmeyr, Joyce L. Browne i Marcus J. Rijken. "Maternal perception of fetal movements: Views, knowledge and practices of women and health providers in a low-resource setting". PLOS Global Public Health 3, nr 3 (29.03.2023): e0000887. http://dx.doi.org/10.1371/journal.pgph.0000887.
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The study assessed perception, knowledge, and practices regarding maternal perception of fetal movements (FMs) among women and their healthcare providers in a low-resource setting. Semi-structured interviews, questionnaires and focus group discussions were conducted with 45 Zanzibar women (18 antenatal, 28 postpartum) and 28 health providers at the maternity unit of Mnazi Mmoja Hospital, Zanzibar, Tanzania. Descriptive and thematic analyses were conducted to systematically extract subthemes within four main themes 1) knowledge/awareness, 2) behavior/practice, 3) barriers, and 4) ways to improve practice. Within the main themes it was found that 1) Women were instinctively aware of (ab)normal FM-patterns and healthcare providers had adequate knowledge about FMs. 2) Women often did not know how to monitor FMs or when to report concerns. There was inadequate assessment and management of (ab)normal FMs. 3) Barriers included the fact that women did not feel free to express concerns. Healthcare providers considered FM-awareness among women as low and unreliable. There was lack of staff, time and space for FM-education, and no protocol for FM-management. 4) Women and health providers recognised the need for education on assessment and management of (ab)normal FMs. In conclusion, women demonstrated adequate understanding of FMs and perceived abnormalities of these movements better than assumed by health providers. There is a need for more evidence on the effect of improving knowledge and awareness of FMs to construct evidence-based guidelines for low resource settings.
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Butler, Lauren S., Apeksha Gupta, Amie DeVerna, James G. Moore, Kevin Latz, Cassidy Foley Davelaar i Dai Sugimoto. "PHYSICAL LITERACY IN ELEMENTARY PHYSICAL EDUCATION: A SURVEY OF FUNDAMENTAL MOVEMENT SKILL PRACTICE PATTERNS". Orthopaedic Journal of Sports Medicine 8, nr 4_suppl3 (1.04.2020): 2325967120S0016. http://dx.doi.org/10.1177/2325967120s00163.
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Background: Pediatric physical inactivity is a major public health concern. According to the 2017 State of Play report, only 24% of youth meet the recommended physical activity (PA) dosage. Previous studies identified fundamental movement skill (FMS) proficiency as a predictor of physical literacy and PA. Mastery of FMS requires direct instruction and practice; however, it is unknown how well FMS are implemented in physical education (PE). Hypothesis/Purpose: To describe FMS practice patterns in the elementary PE curriculum. We had two hypotheses: 1) Fewer PE teachers provide comprehensive FMS instruction in later curriculum (grades 4-6) compared to early curriculum (grades 1-3) and 2) Fewer PE teachers teach FMS with direct instruction methods in later curriculum compared to early curriculum. Methods: A cross sectional survey design was used. PE teachers (grades 1-6) were recruited via electronic mail from various U.S. regions from January 2018 to March 2019. An electronic questionnaire was developed to ask about timing of FMS teaching and method of instruction. Additional questions were asked about methods used to evaluate FMS proficiency, including use of a standardized assessment of gross motor development, referrals and remediation recommended for children who appeared to be falling behind, and perceived barriers to FMS instruction. Chi-square tests (p<0.05) were employed. Results: We collected 87 responses with approximately 9% from West, 42% from Midwest, and 49% from South regions. Among all responses, 54% of PE teachers taught all FMS and 40% taught all FMS with direct instruction. Approximately, 66 % taught all FMS for grades 1-3 compared to 42% for grades 4-6 (p<0.0001). Regarding instruction methods, 47% of teachers for grades 1-3 utilized direct instruction to teach all FMS compared to 27% for grades 4-6 (p=0.0007). Only 3.7% of teachers used a standardized assessment of gross motor development to evaluate FMS proficiency. For children who appeared to be falling behind, 6.7% of teachers reported accepting the child’s “best effort” in participation. Only 7.3% reported referring to an exercise program and no PE teacher sought a healthcare referral. Time was reported as the greatest barrier to improving a child’s FMS competency in 52.4% of responses. Conclusion: Results suggests that fewer PE teachers teach all FMS in late elementary PE curriculum compared to early curriculum. Additionally, fewer teachers utilize direct instruction methods to teach skills in late elementary curriculum. With time reported as the greatest barrier, a more efficient screening tool to evaluate FMS competency may be needed.
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Sindhwani, Rahul, i Vasdev Malhotra. "Lean and Agile Manufacturing System Barriers". International Journal of Advance Research and Innovation 3, nr 1 (2015): 234–37. http://dx.doi.org/10.51976/ijari.311539.
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Due to rapid globalization and faster growth of world market, there is always a need of modification in the present mode of manufacturing system; these modifications increase the viabilities of manufacturer to move ahead in competitive market. These changes also improve the manufacturer and consumer relation by meeting the latest demand of consumers. The concept of Agile Manufacturing system is the new in era of twenty first which covers the responsive and time saving strategies design and adopted by the manufacturers to dominate the market. Agile Manufacturing system (AMS) proves to be advancement over other manufacturing systems which are like Flexible Manufacturing System (FMS) and Lean Manufacturing System (LMS). Although many industries and companies in India are still in the phase of FMS and still need to cover advance strategies. For this it is needed to identify the barriers which coming in between the implementation of AMS. This paper is based on the Lean and Agile Principles, in which these problems has been tried to remove the barriers. This paper is the effort to identify and remove the barriers with the help of case study.
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Almohaini, Abdulrahman, Jamel Choukir i Abdulrahman Alkhorayef. "Case Study, Simulation and Management Games: Use, Benefits and Barriers in Undergraduate Business School Program (CEAS-IMSIU)". International Business Research 10, nr 1 (16.12.2016): 129. http://dx.doi.org/10.5539/ibr.v10n1p129.
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This research focused on three main teaching methods: case study, simulation, and management games from both theoretical as well as empirical aspects. It explores the use, the benefits, and the barriers of the mentioned teaching methods related to the main management courses from Faculty Members (FMs) perspectives. The empirical investigation was based on a survey of all business departments' faculty members. This study revealed (1) the predominant use of lecturing despite the respondents' engagement in case study, simulation, and management games. It showed that (2) the frequency use of these teaching supports was particularly related to some courses, not systematically, and depended on the faculty member (rank, experience, place of degree). Finally, (3) the main barriers preventing the FMs from using these teaching methods are associated with resources, more than risk and suitability.
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Nyaberi, Jackline Mosinya, Otieno G. Ochieng i Osero O. S. Justus. "Trends of utilization of free maternal services implemented among postnatal women in sub-county hospitals of selected counties in Nyanza, Kenya". International Journal Of Community Medicine And Public Health 7, nr 10 (25.09.2020): 4086. http://dx.doi.org/10.18203/2394-6040.ijcmph20204381.
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Background: Low utilization and poor accessibility of hospital based maternal services in low and middle-income countries (LMIC) are evident and financial barriers is a major bottleneck. Globally, an estimated 600,000 maternal deaths occur yearly with over 90% of these deaths occurring in LMICs. In Kenya, maternal mortality is still relatively high with 362 maternal deaths per 100,000 live births. Gaps in the quality of maternal health services exist due to high costs, poor staffing and inaccessibility. However, Utilization of hospital based maternal services enhances skilled delivery and consequently reduces maternal and child mortalities and morbidities. The aim of this study was to establish the trends of utilization of free maternal services (FMS) before and after implementation in counties of Nyanza, Kenya.Methods: The study adopted an analytical cross-sectional study utilizing mixed methods of data collection. Secondary quantitative data on the rate of utilization between June 2011 and May 2015 was compared. Qualitative data was collected from key informants and focused group discussants. Purposive and simple random sampling were used to select target population. Data was analysed using both parametric and non-parametric statistical methods.Results: In maternal services utilization, Kisumu county recorded the highest 98.7%. Overall, in Nyanza, there was tremendous growth on trends of FMS utilization of 53.4% from 36.7% before implementation of FMS with cases of still births, maternal deaths and neonatal deaths.Conclusion: The upsurge of FMS utilization encouraged skilled birth attendance but also caused enormous constrains to health system and reduced the quality of FMS.
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Eddy, Lucy H., Nick Preston, Mark Mon-Williams, Daniel D. Bingham, Jo M. C. Atkinson, Marsha Ellingham-Khan, Ava Otteslev i Liam J. B. Hill. "Developing and validating a school-based screening tool of Fundamental Movement Skills (FUNMOVES) using Rasch analysis". PLOS ONE 16, nr 4 (16.04.2021): e0250002. http://dx.doi.org/10.1371/journal.pone.0250002.
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Background A large proportion of children are not able to perform age-appropriate fundamental movement skills (FMS). Thus, it is important to assess FMS so that children needing additional support can be identified in a timely fashion. There is great potential for universal screening of FMS in schools, but research has established that current assessment tools are not fit for purpose. Objective To develop and validate the psychometric properties of a FMS assessment tool designed specifically to meet the demands of universal screening in schools. Methods A working group consisting of academics from developmental psychology, public health and behavioural epidemiology developed an assessment tool (FUNMOVES) based on theory and prior evidence. Over three studies, 814 children aged 4 to 11 years were assessed in school using FUNMOVES. Rasch analysis was used to evaluate structural validity and modifications were then made to FUNMOVES activities after each study based on Rasch results and implementation fidelity. Results The initial Rasch analysis found numerous psychometric problems including multidimensionality, disordered thresholds, local dependency, and misfitting items. Study 2 showed a unidimensional measure, with acceptable internal consistency and no local dependency, but that did not fit the Rasch model. Performance on a jumping task was misfitting, and there were issues with disordered thresholds (for jumping, hopping and balance tasks). Study 3 revealed a unidimensional assessment tool with good fit to the Rasch model, and no further issues, once jumping and hopping scoring were modified. Implications The finalised version of FUNMOVES (after three iterations) meets standards for accurate measurement, is free and able to assess a whole class in under an hour using resources available in schools. Thus FUNMOVES has the potential to allow schools to efficiently screen FMS to ensure that targeted support can be provided and disability barriers removed.
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Raj, Tilak, Ravi Shankar i Mohammed Suhaib. "A review of some issues and identification of some barriers in the implementation of FMS". International Journal of Flexible Manufacturing Systems 19, nr 1 (9.03.2007): 1–40. http://dx.doi.org/10.1007/s10696-007-9015-7.
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Dobell, Alexandra, Andy Pringle, Mark A. Faghy i Clare M. P. Roscoe. "Educators Perspectives on the Value of Physical Education, Physical Activity and Fundamental Movement Skills for Early Years Foundation Stage Children in England". Children 8, nr 5 (26.04.2021): 338. http://dx.doi.org/10.3390/children8050338.
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There is a lack of information available for physical education (PE) provision in the early years foundation stage (EYFS), prompting concern about what is currently delivered in schools and the values behind the approaches taken. Using semi-structured interviews, this study investigated educators’ perspectives on the value of PE and physical activity (PA) for EYFS children across England in relation to opportunities for, barriers to, and benefits of PA and PE. This study collected important stakeholder views and can help shape the impact and implementation of fundamental movement skills (FMS) and PA interventions at the EYFS.
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Whitehorne-Smith, Patrice, Sharyn Burns, Ben Milbourn, Wendel Abel i Robyn Martin. "Cross-sectional mixed-methods study protocol exploring the enablers and barriers for people with severe and enduring mental illness in Jamaica when accessing healthcare for chronic physical illness". BMJ Open 10, nr 8 (sierpień 2020): e038245. http://dx.doi.org/10.1136/bmjopen-2020-038245.
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IntroductionExtant international research suggests that people with severe and enduring mental illness (PWSEMI) experience increased rates of chronic physical illness (CPI), reduced life expectancy and higher mortality than those in the general population. The high prevalence of CPI among PWSEMI is associated with a number of barriers that this population experiences when accessing physical healthcare. Although substantial research has been conducted in North America, Europe and Australia, there appears to be a paucity of research exploring CPI among PWSEMI in the Caribbean region, although this region has reported very high rates of non-communicable diseases within its populations. The current study will be situated in Jamaica and will explore the enablers and barriers to PWSEMI accessing healthcare for CPI.Methods and analysisA convergent mixed-method design will explore the enablers and barriers to accessing healthcare for CPI among PWSEMI. This cross-sectional study will collect data from PWSEMI, caregivers and family members, community health aides, primary care physicians, psychiatrists and health policymakers.Ethics and disseminationThe study findings will provide baseline data describing the prevalence of CPI among PWSEMI in Jamaica and will identify enablers for, and barriers to, PWSEMI accessing CPI care. Findings will be disseminated widely in Jamaica and internationally to key stakeholders through publications and conferences. Institutional ethical approval was granted from Jamaica’s Ministry of Health and Wellness Medico-legal Ethics Review Panel (# 2019/49), the Curtin University Human Research and Ethics Committee (HRE 2020–0022) and the University of the West Indies FMS Ethics Committee (ECP 101, 19/20).
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Yuliastrid, Dita, Tutur Jatmiko, Abdul Hafidz, Suroto Suroto i Toho Cholik Mutohir. "Analysis of Physical Education, Sports and Health teacher Strategies in Learning FMS During the Covid Pandemic 19". Jp.jok (Jurnal Pendidikan Jasmani, Olahraga dan Kesehatan) 5, nr 2 (30.05.2022): 282–98. http://dx.doi.org/10.33503/jp.jok.v5i2.1842.
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The purpose of this study is to find an overview of how the learning strategies and barriers for Physical Education, Sports and Health teachers providing fundamental movement material during the Covid 19 pandemic. This research includes quantitative descriptive analysis. This research used survey method with close-ended question as the instrument distributed on google form. Respondents in this study were primary school PJOK teachers, in which about 49 people. Data were analyzed using percentage calculations. The conclusions of this study indicate that fundamental movement learning is carried out online by utilizing various kinds of teaching materials such as books, PowerPoint slides, videos, and handouts. The most widely used media is the WhatsApp group. The learning method used by PJOK teachers is the assignment method. The learning strategies carried out generally give students the task of imitating movements, repeating movements, and recording activities. In general, PJOK teachers do not experience obstacles in conducting online learning.
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Alp, G., İ. Kurut Aysin, E. Durak Ediboglu, E. Otman Akad, H. Cinakli, E. Erpek, A. Özkan, H. Kocaayan, D. Solmaz i S. Akar. "OP0068 BARRIERS TO OVERCOME IN THE ACHIEVEMENT TO THE TREATMENT GOAL IN PSORIATIC ARTHRITIS; CENTRAL SENSITIZATION AND NEUROPATHIC PAIN". Annals of the Rheumatic Diseases 82, Suppl 1 (30.05.2023): 46–47. http://dx.doi.org/10.1136/annrheumdis-2023-eular.6032.
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BackgroundChronic inflammation in inflammatory arthritis can trigger both peripheral and central sensitization (CS) through central modifications of pain pathways. CS is an abnormal pain management mechanism involving the central nervous system.ObjectivesTo evaluate the frequency of CS and neuropathic pain (NP) in patients with psoriatic arthritis (PsA) and its relationship with disease activity and functional status.MethodsPatients classified as PsA according to CASPAR classification criteria were included in this cross-sectional study. Disease activity was evaluated with DAPSA, VAS, pain and fatigue level (0-100 mm), quality of life with HAQ, CS with CS inventory (CSI). A score of 40 point was used to predict the presence of CS. CS score of <30 was also categorized as subclinical, 30 -39 as mild, 40-49 as moderate, 50-59 as severe and ≥60 as extreme. NP was evaluated with the DN4 (Douleur Neuropathique en 4 questions) scale. The presence of anxiety and depression were evaluated by using the Hospital Anxiety and Depression questionnaire (HADS) and fibromyalgia syndrome (FMS) by ACR 2016 criteria.Resultsİn total 114 PsA patients (78 [68.4%] female, mean age: 48.8 ±11.6 years, median disease duration was 4 [9] years) were included in the study. The median DAPSA score was 15.2(16), with approximately half of the patients were in remission or low disease activity. The proportion of patients with LEI≥1 was 28.9%, median BSA was 1(2), BASDAI was 3.8(3.6), BASFI was 2[4]. Of our patients 39.8% were receiving biological treatment. 61.4% of the patients had at least one comorbidity.CS was detected in 49 (42.9%) and NP in 24 (23.7%) patients. The median CSI score was 35.5 (IQR 29) Among patients with CS and NP the percentage of female was higher. DAPSA, PGA, PhGA, Pain VAS, TJC were found to be significantly higher and HAQ scores were found to be worse in patients with CS and NP. In addition,the percentage of patients with a LEI ≥1 was found 44.9% in patients with CS, and body mass index was found to be higher in patients with NP(Table 1).Duration of disease, CRP, ESR, BSA, usage of biological therapy, treatment with GCs, comorbidities were similar between the groups. Anxiety were higher in patient with CS and NP, and depression was higher in only CS patients. While all 11 patients with FMS had NP, only 8 had CS. Sixteen (%32.7) patients with CS also had NP and 16 (66.7%) patients with NP had also CS. The positive correlation between PGA, PhGA, DAPSA, HAQ and CS severity in PsA patients(Figure 1).ConclusionThe results of the present study revealed that both CS and NP are common in PsA, and FMS accompanies 22.4% of those patients. CS and NP affect quality of life and functionality. In PsA patients, especially in cases where treatment goals cannot be achieved, it may be useful to evaluate the presence of concomitant CS and NP.Table 1.Comparison of characteristics of PsA patients with and without central sensitization and neuropathic painVariablesPatient withCSn:49Patient withoutCSn:65pPatientwithNPn:24Patient withoutNPn:77pFemale gender,n(%)38(81.6)40(58.5)0.00819(90.5)45(60)0.009Age,y,mean(SD)51(11)47.7(11)0.43950.1(10)48.2(11.6)0.487BMI,kg/m2, median(IQR)29.3(8)28.2(7.7)0.74932.3(9.6)26.9(5.9)0.011TJC, median(IQR)2(4)0(1)0.0031(11)0(2)0.021SJC, median(IQR)0(0)0(0)0.9960(0)0(0)0.533PGA, median(IQR)50(48)30(20)<0.00160(60)30(25)<0.001PhGA, median(IQR)20(30)20(10)0.00130(20)20(20)0.001Pain VAS, median(IQR)50(38)20(30)<0.00160(60)30(50)<0.001LEI≥1,n(%)22(44.9)11(16.9)0.00110(41.7)19(24.4)0.100DAPSA, n(%)17.9(11)9.7(11.9)<0.00120.2(13)11.7(11)0.003Biological therapy, n(%)18(37.5)27(41.5)0.71210(41.7)27(35.1)0.558HAQ,median(IQR)1(0.85)0.38(0.75)<0.0011.38(1.3)0.5(0.8)<0.001Anxiety, n(%)18(40)5(8.1)<0.0019(40.9)12(16.2)0.020Depression, n(%)15(33.3)4(6.5)<0.0015(22.7)11(14.9)0.514FMS, n(%)13(35.6)8(12.9)0.00611(45.8)10(13)0.001Figure 1.The positive correlation between PGA, PhGA, DAPSA, HAQ and CS severity in PsA patientsREFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Auchstaetter, Nolan, Juliana Luc, Stacey Lukye, Kaylea Lynd, Shelby Schemenauer, Maura Whittaker i Kristin E. Musselman. "Physical Therapists' Use of Functional Electrical Stimulation for Clients With Stroke: Frequency, Barriers, and Facilitators". Physical Therapy 96, nr 7 (1.07.2016): 995–1005. http://dx.doi.org/10.2522/ptj.20150464.
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Abstract Background Best practice guidelines for stroke rehabilitation recommend functional electrical stimulation (FES) to improve gait and upper extremity function. Whether these guidelines have been implemented in practice is unknown. Objective The purposes of this study were: (1) to determine the frequency with which physical therapists use FES to address common therapeutic goals poststroke and (2) to identify the barriers to and facilitators of FES use. Design This was a cross-sectional, survey study. Methods A valid and reliable online survey was sent to Canadian physical therapists. Questions about demographic characteristics, FES use, knowledge of FES literature, and barriers and facilitators were posed. Closed-ended questions were analyzed with descriptive statistics and index scoring to produce summary scores. Pearson or point-biserial correlation coefficients correlated FES use with demographic variables. Open-ended questions about barriers and facilitators were analyzed by 3 researchers using a conventional content analysis. Results Two hundred ninety-eight physical therapists responded. Use of FES for clients with stroke was low for all therapeutic goals queried (improve walking, arm function, muscle strength and endurance, and sensation; prevent shoulder subluxation; and decrease spasticity). However, 52.6% of the respondents stated that they would like to increase their use of FES. More than 40% of the respondents were unsure of the strength of the evidence supporting FES for stroke care. Physical therapists with postgraduate FES training were more likely to use FES (r=.471, P<.001). A lack of access to resources, such as time, equipment, and training, was the most frequently cited barrier to FES use. Limitations As an observational study, cause-and-effect relationships for FES use cannot be identified. Conclusions Functional electrical stimulation is not widely used by physical therapists in stroke rehabilitation. Improving access to resources—in particular, continuing education—may facilitate the implementation of FES into clinical practice.
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dos Santos, Fernando Garbeloto, Matheus Maia Pacheco, David Stodden, Go Tani i José António Ribeiro Maia. "Testing Seefeldt’s Proficiency Barrier: A Longitudinal Study". International Journal of Environmental Research and Public Health 19, nr 12 (11.06.2022): 7184. http://dx.doi.org/10.3390/ijerph19127184.
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The idea that proficiency in the fundamental movement skills (FMS) is necessary for the development of more complex motor skills (i.e., the proficiency barrier) and to promote health-enhancing physical activity and health-related physical fitness levels is widespread in the literature of motor development. Nonetheless, to the best of our knowledge, there is no study assessing whether children presenting proficiency below a specified proficiency barrier would demonstrate difficulty in improving performance in more complex skills—even when subjected to a period of practice in these complex skills. The present study tested this. Eighty-five normal children (44 boys) aged 7 to 10 years participated in the study. The intervention took place during 10 consecutive classes, once a week, lasting 40 min each. Six FMS (running, hopping, leaping, kicking, catching and stationary dribbling) and one transitional motor skill (TMS) (speed dribbling skill) were assessed. The results showed that only those who showed sufficient proficiency in running and stationary dribbling before the intervention were able to show high performance values in the TMS after intervention. In addition, in line with recent propositions, the results show that the basis for development of the TMS was specific critical components of the FMS and that the barrier can be captured through a logistic function. These results corroborate the proficiency barrier hypothesis and highlight that mastering the critical components of the FMS is a necessary condition for motor development.
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Delgado, Ferdinand, Cheryl DerAnanian, Sonia Vega-Lopez, Shandel Vega-Soto, Hector Valdez i Steven Hooker. "BARRIERS, FACILITATORS, BENEFITS, AND ENJOYMENT OF PHYSICAL ACTIVITY IN MIDDLE-AGED HISPANIC MEN". Innovation in Aging 3, Supplement_1 (listopad 2019): S201—S202. http://dx.doi.org/10.1093/geroni/igz038.730.
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Abstract Little is known about middle-aged Hispanic men’s perceptions of physical activity (PA). Purpose: To examine perceived barriers, facilitators, and benefits of PA and what types of PA are enjoyable. Methods: Seven focus groups (FGs) were conducted with middle-aged Hispanic men (mean age 51.6±6.1 years; n=32) who primarily self-identified as Mexican (78.1%). All FGs were audio-recorded, transcribed, and translated into English. A grounded theory approach was used to identify themes. Results: Competing responsibilities (N=7 FGs), laziness/apathy (N=6 FGs), and a lack of habit/routine (N=5 FGs) were identified as the primary barriers to PA. Jobs were perceived as a PA barrier because of physical labor involved, long hours, having multiple jobs, and/or an inconsistent schedule. Laziness/apathy involved the notion that people have time to exercise, but choose not to. Not having a routine resulted in procrastination and not achieving exercise goals. Social support was the primary facilitator to PA, which included having a friend (N=5 FGs), family member (N=5 FGs), or spouse/partner (N=6 FGs) with whom they could participate in PA. Sports were mentioned in all FGs as enjoyable, including soccer (N=5 FGs), basketball (N=5 FGs), tennis/racquetball/handball (N=3 FGs), and baseball (N=2 FGs). Walking/running (N=6 FGs) and hiking (N=5 FGs) were also considered enjoyable. The primary perceived benefits of PA included increased energy after exercising (N=6 FGs) and improved overall health (N=6 FGs). Conclusion: Hispanic men realize the importance of PA and what may be hindrances or facilitators to increasing PA. Funded by the National Institute on Aging (R21 AG050084-01A1).
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Wu, Hua, Wichai Eungpinichpong, Hui Ruan, Xinding Zhang i Xiujuan Dong. "Relationship between motor fitness, fundamental movement skills, and quality of movement patterns in primary school children". PLOS ONE 16, nr 5 (26.05.2021): e0237760. http://dx.doi.org/10.1371/journal.pone.0237760.
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Seefeldt`s classic motor development pyramid model recognizes the significance of fundamental movement skills (FMS) in physical activities and proposes a “proficiency barrier” between FMS and higher-level specific sports skills during middle childhood. However, the relationship between the layers of the conceptual model has not been empirically tested. This study investigated motor fitness (MF), FMS, and quality of movement patterns (QMP) in 7–10 years old children and evaluated the relationships among them. A total of 117 children were randomly selected to take tests of MF, the Test of Gross Motor Development-2 (TGMD-2), and the Functional Movement Screen (FMS™). MF and FMS levels were classified according to percentile ranges. Two multiple (R×C) Chi-Square tests were applied to analyze the relationships between MF, FMS, and QMP. Post-hoc testing estimated the possibility of FMS and QMP to predict MF. The results showed that boys scored significantly higher on the object-control subtest and on the TGMD-2 compared to girls (p<0.001), while girls scored significantly higher on the FMS™ (p = 0.001). FMS score and QMP level were weakly correlated with MF (FMS: χ2 = 14.605, p = 0.006, Cramer`s V = 0.25; QMP: χ2 = 13.943, p = 0.007, Cramer`s V = 0.24). Thus, 60.5% of children with “excellent” FMS and 59.6% with “high” QMP were categorized as having a “good” MF. In contrast, only 23.1% of children with “poor” FMS and 24.3% with “low” QMP were classified as having a “good” MF. Our results confirm MF, FMS, and QMP are correlated with each other, although this relationship is weak. Further, a possible motor skill proficiency barrier exists already in children 7–10 years old. The study results support the promotion of physical activity and motor skill development in primary school children.
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Khadka, Bikram, Jae-Young Lee, Ki-Taek Kim i Jong-Sup Bae. "Recent progress in therapeutic drug delivery systems for treatment of traumatic CNS injuries". Future Medicinal Chemistry 12, nr 19 (październik 2020): 1759–78. http://dx.doi.org/10.4155/fmc-2020-0178.
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Most therapeutics for the treatment of traumatic central nervous system injuries, such as traumatic brain injury and spinal cord injury, encounter various obstacles in reaching the target tissue and exerting pharmacological effects, including physiological barriers like the blood–brain barrier and blood–spinal cord barrier, instability rapid elimination from the injured tissue or cerebrospinal fluid and off-target toxicity. For central nervous system delivery, nano- and microdrug delivery systems are regarded as the most suitable and promising carriers. In this review, the pathophysiology and biomarkers of traumatic central nervous system injuries (traumatic brain injury and spinal cord injury) are introduced. Furthermore, various drug delivery systems, novel combinatorial therapies and advanced therapies for the treatment of traumatic brain injury and spinal cord injury are emphasized.
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Gonzales, Gamaliel, Felix Costan, Decem Suladay, Roselyn Gonzales, Lynne Enriquez, Emily Costan, Nadine May Atibing i in. "Fermatean Fuzzy DEMATEL and MMDE Algorithm for Modelling the Barriers of Implementing Education 4.0: Insights from the Philippines". Applied Sciences 12, nr 2 (11.01.2022): 689. http://dx.doi.org/10.3390/app12020689.
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Technological transitions in the education sector of developing economies are faced with a range of barriers, involving resource scarcity, socio-cultural concerns, and issues related to management and policy. The popularity of Industry 4.0 has prompted Education 4.0 (EDUC4), an approach to learning that involves transformation using advanced technologies. While a recent work reported a comprehensive list of barriers to EDUC4 implementation, particularly in developing economies, further analysis to identify those priority barriers remains a gap. Thus, this work addresses this gap by introducing a novel methodological extension of the decision-making trial and evaluation laboratory (DEMATEL) method following the integration of Fermatean fuzzy sets (FFS). The FFS, compared to other fuzzy environments, could capture higher levels of uncertainties that are associated when eliciting judgments necessary for the DEMATEL. Such integration is aided by the maximum mean de-entropy (MMDE) algorithm, which analytically determines the threshold value crucial for constructing the prominence-relation map of the DEMATEL. Following its application in evaluating the implementation of EDUC4 in Philippine universities, the critical barriers are the lack of training resources, costs, insufficiency of available technologies, skills gap of human resources, knowledge gap, and the complexity of the learning platforms. Among this set, barriers related to cost and lack of training resources are deemed the most prominent ones. The statistical test on the impact of addressing the two prominent barriers shows that addressing the barrier related to costs yields statistically more favorable results regarding the mitigation of other EDUC4 implementation barriers. Although these insights may contain idiosyncrasies, they can serve as starting points of discussion in other relevant developing economies. These methodological and practical contributions advance the development of analytical tools under uncertainty that can handle pressing problems such as the EDUC4 implementation.
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Samuel, Cleo A., Kea Turner, Heidi AS Donovan i G. J. Van Londen. "Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management." Journal of Clinical Oncology 34, nr 3_suppl (20.01.2016): 155. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.155.
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155 Background: Adjuvant endocrine therapy (AET)-related symptom management (SM) among breast cancer survivors (BCS) typically involves a multidisciplinary team of health care providers; yet few studies have examined provider perspectives on AET-related SM. The purpose of this study was to examine provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. Methods: We conducted 3 focus groups (FGs) with a multidisciplinary group of health care providers (n = [6] physician; n = [7] non-physician) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM and its barriers and facilitators as well as recommendations for improvement. All FGs were held at the University of Pittsburgh, audiotaped, and transcribed. We analyzed FG transcripts using qualitative software to identify key themes. Results: Providers described patient-, provider-, and system- level facilitators and barriers to AET-related SM. At the patient-level, facilitators included social support and provider communication about symptoms while cancer-related distress, misinformation and misinterpretation of online information were identified as barriers. Provider-level facilitators included strong relationships with other providers and ongoing communication with patients; however, lack of time, insufficient resources, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Finally, at the system-level, electronic health records were described as both a facilitator and barrier to SM. Moreover, poor care coordination among different providers and lack of clear guidelines on which provider “owns” AET-related SM emerged as key system-level barriers. Conclusions: Findings suggest that efforts to improve AET-related SM should span multiple levels, in order to address patient-, provider-, and system-level barriers to SM. Recommendations include increased education for patients, greater access to clinical decision support tools for providers, and improved coordination of survivorship resources within hospitals.
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Chi, Nai-Ching, Ying-Kai Fu, Emelia Barani i Elizabeth Summerson. "IDENTIFY THE BARRIERS THAT FAMILY CAREGIVERS FACE IN MANAGING PATIENTS’ PAIN: A LITERATURE REVIEW". Innovation in Aging 3, Supplement_1 (listopad 2019): S717. http://dx.doi.org/10.1093/geroni/igz038.2631.
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Abstract Most Americans enrolled in palliative and hospice care receive care at home and thus rely on their family caregivers (FCs) to manage their pain. However, FCs encounter many barriers to pain management. Previous studies focused on barriers faced by FCs of cancer patients. However, as palliative and hospice care evolves, the populations and diagnoses become diverse, and more barriers have been identified. Hence, the purpose of this study is to comprehensively investigate FCs’ barriers to pain management. A literature review was conducted to search available articles published before June 2018 in databases including PubMed, CINAHL, PsycINFO, and Scopus. Search strategies used index and keyword methods. The inclusion criteria were peer-reviewed, research studies published in English that explored barriers that FCs faced in managing pain. Eighty-six studied were identified: 76% of the studies focused on cancer pain and 6% focused on dementia pain. The identified barriers included: (1) caregivers’ limited knowledge in drug/non-drug pain management and verbal/non-verbal pain assessment; (2) caregivers’ issues (e.g. function, fear of analgesic, misbeliefs in pain management); (c) caregivers’ organizational skills (treatment recording and tracking); (d) patients’ issues (e.g. inability to verbalize pain); (e) communication issues with care teams. This is one of the few literature reviews that comprehensively investigate the barriers that family caregivers experience beyond cancer pain management. The results can be used to develop a screening questionnaire for palliative and hospice providers to assess and resolve FCs’ barriers to pain management, thereby improving the quality of pain management and patients’ and FCs’ outcomes.
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Lan, Yu-Ching, Tzai-Hung Wen, Chao-chin Chang, Hsin-Fu Liu, Pei-Fen Lee, Chung-Yuan Huang, Bruno B. Chomel i Yi-Ming A. Chen. "Indigenous Wildlife Rabies in Taiwan: Ferret Badgers, a Long Term Terrestrial Reservoir". BioMed Research International 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/5491640.
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The emerging disease of rabies was confirmed in Taiwan ferret badgers (FBs) and reported to the World Organization for Animal Health (OIE) on July 17, 2013. The spread of wildlife rabies can be related to neighborhood countries in Asia. The phylogenetic analysis was conducted by maximum likelihood (ML) methods and the Bayesian coalescent approach based on the glycoprotein (G) and nucleoprotein (N) genes. The phylogeographic and spatial temporal dynamics of viral transmission were determined by using SPREAD, QGIS. Therefore, the origin and the change with time of the viruses can be identified. Results showed the rabies virus of FB strains in Taiwan is a unique clade among other strains in Asia. According to the phylogeographic coalescent tree, three major genotypes of the FB rabies virus have circulated in three different geographical areas in Taiwan. Two genotypes have distributed into central and southern Taiwan between two ecological river barriers. The third genotype has been limited in southeastern Taiwan by the natural mountain barrier. The diversity of FB rabies viruses indicates that the biological profile of FBs could vary in different geographical areas in Taiwan. An enhanced surveillance system needs to be established near the currently identified natural barriers for early warnings of the rabies virus outbreak in Taiwan.
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Damania, Blossom, i David J. Blackbourn. "Innate barriers to viral infection". Future Microbiology 7, nr 7 (lipiec 2012): 815–22. http://dx.doi.org/10.2217/fmb.12.52.
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de Moissac, Danielle, Jacinthe Savard, Sébastien Savard, Florette Giasson i Lucy-Ann Kubina. "Management strategies to improve French language service coordination and continuity for official language Francophone seniors in Canada". Healthcare Management Forum 33, nr 6 (12.06.2020): 271–76. http://dx.doi.org/10.1177/0840470420931115.
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Evidence suggests that language barriers present obstacles to healthcare access and quality for Francophone seniors in official language minority communities across Canada. Addressing language barriers and providing continuity is challenging, as French language services (FLSs) rely heavily on bilingual providers and the practice of active offer by all staff. This qualitative research used semi-structured group and individual interviews to explore mechanisms supporting FLS coordination and continuity in two Canadian provinces. Identification of the language variable in health records, virtual healthcare, and FLS directories are conducive to FLS continuity, but financial and resource limitations present major obstacles. Management strategies to facilitate continuity of FLS across health organizations are discussed.
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Laborde, Caroline, Joël Ankri i Emmanuelle Cambois. "Environmental barriers matter from the early stages of functional decline among older adults in France". PLOS ONE 17, nr 6 (22.06.2022): e0270258. http://dx.doi.org/10.1371/journal.pone.0270258.
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Background The adaptation of living environments can preserve functional independence among older people. A few studies have suggested that this would only benefit the most impaired. But conceptual models theorize that environmental pressure gradually increases with functional decline. Objectives We examined (1) how far different environmental barriers increased difficulties and favoured resort to assistance; (2) at what stage in functional decline environmental barriers begin to matter. Methods We used the French cross-sectional survey CARE (2015), including 7,451 participants (60+) with at least one severe functional limitation (FL). Multinomial logistic regressions models were used to compare predicted probabilities for outdoor activities of daily living (OADL) difficulties (no OADL difficulties; difficulties but without assistance; use of assistance) among individuals with and without environmental barriers (self-reported or objective), in relation to the number of FLs. Results Poor-quality pedestrian areas and lack of places to rest were associated with a higher probability of experiencing OADL difficulties, whatever the number of FLs; the association increased with the number of FLs. Up to 6 FLs, individuals with these barriers were more likely to report difficulties without resorting to assistance, with a decreasing association. Living in cities/towns with high diversity of food outlets was associated with a lower probability of reporting assistance, whatever the number of FLs, but with a decreasing association. Discussion Overall, the results suggest that environmental barriers increasingly contribute to OADL difficulties with the number of FLs. Conclusions differed as to whether they tended to favour resort to assistance, but there was a clear association with food outlets, which decreased with impairment severity. The adaptation of living environments could reduce difficulties in performing activities from the early stages of decline to the most severe impairment. However, the most deteriorated functional impairments seem to generate resort to assistance whatever the quality of the environment.
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Suzuki, Rie, Michael J. McCarthy i Sabah Ganai. "Functional Limitations and Barriers to Care Influence the Likelihood of Adherence to Mammography Guideline". American Journal of Health Behavior 45, nr 2 (1.03.2021): 323–33. http://dx.doi.org/10.5993/ajhb.45.2.11.
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Objective: In this study, we examined the influence of having a functional limitation (FL) on the likelihood of adherence to mammography guidelines, as well as the potential moderating role of barriers to care on this relationship. Methods: Women aged 50-75 years from the 2017 National Health Interview Survey were assessed for FL and barriers to care as predictors mammography screening prevalence using weighted logistic regression. Results: Of 5627 women, most were without FLs (56%), Caucasian (81%), with at least a high school education (62%), married (63%), had a usual source of care (97%), and reported barriers to care (9%). Compared to women without FLs, those with FLs were less likely to adhere to mammography guidelines in the past year. Endorsement of the items, Could not get through on the phone, Not open when you could go, and No transportation negatively moderated this association (adjusted odds ratio (AOR) = 0.60, 95% Cl [0.59, 0.60], AOR = 0.54, 95% Cl [0.54, 0.55], and AOR = 0.32, 95% [0.31, 0.33], respectively). Conclusions: Improving the ability of women with FLs to schedule appointments that will suit their functional needs within universal design guidelines may improve compliance.
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Abreu, Maria T., Elizabeth T. Arnold, Jimmy Y. C. Chow i Kim E. Barrett. "Phosphatidylinositol 3-Kinase-dependent Pathways Oppose Fas-induced Apoptosis and Limit Chloride Secretion in Human Intestinal Epithelial Cells". Journal of Biological Chemistry 276, nr 50 (10.09.2001): 47563–74. http://dx.doi.org/10.1074/jbc.m106226200.
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The epithelial lining of the intestine serves as a barrier to lumenal bacteria and can be compromised by pathologic Fas-mediated epithelial apoptosis. Phosphatidylinositol (PI)3-kinase signaling has been described to limit apoptosis in other systems. We hypothesized that PI3-kinase-dependent pathways regulate Fas-mediated apoptosis and barrier function in intestiynal epithelial cells (IEC). IEC lines (HT-29 and T84) were exposed to agonist anti-Fas antibody in the presence or absence of chemical inhibitors of PI3-kinase (LY294002 and wortmannin). Apoptosis, barrier function, changes in short circuit current (ΔIsc), and expression of adhesion molecules were assessed. Inhibition of PI3-kinase strongly sensitized IEC to Fas-mediated apoptosis. Expression of constitutively active Akt, a principal downstream effector of the PI3-kinase pathway, protected against Fas-mediated apoptosis to an extent that was comparable with expression of a genetic caspase inhibitor, p35. PI3-kinase inhibition sensitized to apoptosis by increasing and accelerating Fas-mediated caspase activation. Inhibition of PI3-kinase combined with cross-linking Fas was associated with increased permeability to molecules that were <400 Da but not those that were >3,000 Da. Inhibition of PI3-kinase resulted in chloride secretion that was augmented by cross-linking Fas. Confocal analyses revealed polymerization of actin and maintenance of epithelial cell adhesion molecule-mediated interactions in monolayers exposed to anti-Fas antibody in the context of PI3-kinase inhibition. PI3-kinase-dependent pathways, especially Akt, protect IEC against Fas-mediated apoptosis. Inhibition of PI3-kinase in the context of Fas signaling results in increased chloride secretion and barrier dysfunction. These findings suggest that agonists of PI3-kinase such as growth factors may have a dual effect on intestinal inflammation by protecting epithelial cells against immune-mediated apoptosis and limiting chloride secretory diarrhea.
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Biddell, Caitlin, Lisa Spees, Justin G. Trogdon, Erin E. Kent, Donald L. Rosenstein, Rebekah SM Angove i Stephanie B. Wheeler. "Association of patient-reported financial barriers with healthcare utilization among Medicare beneficiaries with a history of cancer." Journal of Clinical Oncology 40, nr 28_suppl (1.10.2022): 220. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.220.
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220 Background: Cancer survivors are at heightened risk of experiencing financial barriers to healthcare (FBs), which may increase the likelihood of adverse clinical outcomes. We aimed to (1) identify characteristics associated with experiencing FBs, and (2) examine the association of FBs with emergency department (ED) visits and inpatient hospitalizations among US adult cancer survivors enrolled in Medicare. Methods: We used 2011 – 2013 and 2015 – 2017 Medicare Current Beneficiary Survey (MCBS) data, a nationally representative survey, to identify adults with a history of non-skin cancer (N = 4511). We defined FBs as trouble accessing care and/or delayed care due to cost in the prior year. Healthcare utilization is captured in MCBS by reconciling self-reported events and fee-for-service claims. After examining bivariate associations between beneficiary characteristics and FBs, we used propensity-weighted logistic regression to examine associations between FBs and adverse healthcare events (any ED visits, any inpatient hospitalizations) in the year following report of FBs. Results: Overall, 11.8% (95% CI: 10.7% - 13.0%) of adult Medicare beneficiaries with a history of cancer reported FBs in the prior year, with higher burden among beneficiaries less than 65 years of age (35.6% vs. 8.6%, p< 0.0001), with annual income < $25,000 (19.4% vs. 7.4%, p< 0.0001), and identifying as persons of color (15.7% vs. 11.2%, p= 0.01). Beneficiaries eligible for a Part D low-income subsidy were more likely to report FBs compared to those who were not eligible, with those with eligibility for only part of the year (vs. the full year) reporting the highest prevalence of FBs (36.5% vs. 20.8%, p< 0.0001). The overall prevalence of ED visits and inpatient hospitalization was 18.2% and 18.8%, respectively. In bivariate models, reporting FBs was associated with an 8.1 percentage point (95% CI: 1.7 – 14.5) increase in the probability of ED visits. In propensity-weighted multivariate models, this association was insignificant (0.8; 95% CI: -3.7 – 5.3). The association between FBs and inpatient hospitalization was not significant. Number of chronic conditions was the strongest predictor of utilization, with having 5+ conditions (vs. cancer only) associated with a 21.1 (95% CI: 16.5 – 25.7) and 15.4 (95% CI: 9.2 – 21.7) percentage point increase in the probability of ED visits and inpatient hospitalizations, respectively. Conclusions: Over one in ten Medicare beneficiaries with a history of cancer report trouble accessing care or delayed care for cost-related reasons, with a heightened prevalence among beneficiaries less than 65 and those eligible for a low-income subsidy. Reporting FBs is not associated with increased ED and inpatient utilization. Nevertheless, identifying characteristics associated with FBs among cancer survivors can inform targeted clinic- and policy-level intervention.
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Kellner, Ashlea Kate, Keith Townsend, Rebecca Loudoun i Adrian Wilkinson. "Barriers to frontline manager support for high-trauma workers". Personnel Review 48, nr 6 (2.09.2019): 1394–409. http://dx.doi.org/10.1108/pr-10-2018-0397.
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Purpose Exposure to high-trauma work has been associated with negative outcomes for individuals and organisations. Support for these employees can buffer and protect against mental health problems. Frontline managers (FLMs) are well placed to provide for employee support needs but are often not effective in doing so. The purpose of this paper is to identify and understand barriers to provision of four different types of social support as identified by House (1981) by FLMs to employees in a high-trauma workplace. Design/methodology/approach This qualitative study investigates three Australian ambulance service organisations, including 72 interviews. Findings Nine barriers to support are identified that can obstruct the provision of optimum employee support. These relate to the FLM themselves, the workplace context and employee-centric factors. Research limitations/implications This paper is a single industry case study; further complexity may exist in other high-trauma industries. Future research should consult policy makers to develop strategies to address the barriers to FLM support. Practical implications FLMs are critical support persons as they are well placed to provide many employee support needs. Emotional support is the foundation for facilitating all other types of support to employees but results here indicate it is often lacking for workers in high-trauma workplaces for a range of individual and organisational barriers that operate in isolation and combined. Originality/value This paper juxtaposes House’s (1981) support framework with study findings to provide a model of the barriers to optimal employee support. This model contributes to a reconceptualisation of the relationship between employee and direct manager that is particularly pertinent for high-trauma contexts.
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Tseng, Hsiang-Kuang, Tseng-Yu Huang, Alice Ying-Jung Wu, Hsin-Hong Chen, Chang-Pan Liu i Ambrose Jong. "HowCryptococcusinteracts with the blood–brain barrier". Future Microbiology 10, nr 10 (październik 2015): 1669–82. http://dx.doi.org/10.2217/fmb.15.83.
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Anderson, Amy C. "Possible paths and potential barriers to successfully modeling drug resistance". Future Medicinal Chemistry 5, nr 11 (lipiec 2013): 1181–83. http://dx.doi.org/10.4155/fmc.13.78.
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Casanova, Felicia, Felicia M. Knaul i Natalia M. Rodriguez. "Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community". Qualitative Health Research 31, nr 8 (9.04.2021): 1423–36. http://dx.doi.org/10.1177/10497323211003542.
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South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community’s access to early detection services. We conducted three CHW focus groups (FGs) ( n = 25) and in-depth interviews ( n = 15), two FGs ( n = 18) and in-depth interviews ( n = 3) with farmworker community members, and informal interviews with cancer clinicians ( n = 7). Using a grounded theory approach, five core themes regarding the community’s barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.
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Cohen, Rinat, Gal Maydan, Shai Brill i Jiska Cohen-Mansfield. "Barriers to Development of an App for Improving Staff-Family Communication at Israeli Geriatric Facilities". Innovation in Aging 4, Supplement_1 (1.12.2020): 192–93. http://dx.doi.org/10.1093/geroni/igaa057.623.
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Abstract Family caregivers (FCs) of institutionalized noncommunicative older persons reported multiple unmet communication needs focusing on the need to receive reliable and regular updates on the patient’s condition. We have developed a mobile app for improving communication between FCs and healthcare professionals (HPs), based on 152 interviews with FCs and 13 discussion groups with HPs from four Israeli geriatric facilities. Both parties participated in app planning, tailoring it to their needs and abilities. App use implementation encountered major obstacles including the bureaucratic process concerning signing contracts between the university and software development firms, which hindered the process for a full year; data security department required disproportionate security levels that interfered with user experience and delayed the development process; the study’s definition varied across different ethics/Helsinki committees (Institutional Review Boards; IRBs), which led to different demands, e.g., insurance for medical clinical trials although no drugs or medical device were involved; lack of cooperation by mid-level staff members despite the institutional adoption of the app project; low utilization by HPs resulted in FCs not receiving timely responses. Despite these and other obstacles, we tested app use for 15 months in one facility in a pre-post-design with intervention and control groups, and we have since begun testing it in another facility. FCs who had used the app had positive feedback and wished to continue using it. App use optimization requires implementation planning, assimilating changes in each facility’s work procedures and HP’s engagement and motivation and thus depends on institutional procedures and politics.
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Gan, Xiao-Long, Rui-Dong Chang, Craig Langston i Tao Wen. "Exploring the interactions among factors impeding the diffusion of prefabricated building technologies". Engineering, Construction and Architectural Management 26, nr 3 (15.04.2019): 535–53. http://dx.doi.org/10.1108/ecam-05-2018-0198.
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Purpose The purpose of this paper is to identify the interactions of factors impacting the widespread adoption of prefabricated building technologies and the intervention strategies to facilitate the development of prefabrication based on fuzzy cognitive maps (FCMs). Design/methodology/approach Through in-depth interviews with six stakeholder groups, namely, the government, developers, designers, contractors, manufacturers and researchers, 13 critical factors were identified and used to construct stakeholder-grouped FCMs, which were further aggregated into a collective FCM. The complexity and density of the collective FCM and the centrality of factors in the FCM were examined. Subsequently, a series of “what-if” simulations of the collective FCM were conducted to analyze the effectiveness of different interventions in promoting prefabrication. Findings The results show that three factors including market demand, cost, and policies and regulations have been mentioned by all stakeholder groups. However, these factors were ranked differently by stakeholder groups, implying that different stakeholder groups perceive the barriers to prefabricated building technologies differently. FCM simulations show that strengthening policies and regulations yield the strongest overall effect stimulating prefabrication, alleviating the organizational and environmental barriers more than the technological barriers, while improving the knowledge and expertise alleviate the technological barriers more. These measures need to be accompanied by other approaches, such as reducing cost and improving quality. Research limitations/implications It is a tough task to promote prefabrication as it is affected by numerous barriers with complex interactions, which have been overlooked by previous studies. This study clearly shows which strategy could tackle which barriers to prefabrication through the FCM simulations. This provides valuable references for the enterprises’ decision making and the governments’ policy making to facilitate the diffusion of prefabricated building technologies. Originality/value Few studies aim to analyze the interactions among the barriers to prefabrication, while this study specifically investigates this issue by illustrating the complex interactions using FCMs. Few studies also aim to identify the intervention strategies promoting prefabrication based on a quantitative approach, while this study employs FCM simulations to directly simulate the effectiveness of different strategies to facilitate prefabrication in a quantitative manner.
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Elsherbeny, Mohamed H., Ahmed Elkamhawy, Hossam Nada, Magda H. Abdellattif, Kyeong Lee i Eun Joo Roh. "Development of New Meridianin/Leucettine-Derived Hybrid Small Molecules as Nanomolar Multi-Kinase Inhibitors with Antitumor Activity". Biomedicines 9, nr 9 (1.09.2021): 1131. http://dx.doi.org/10.3390/biomedicines9091131.
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Although the sea ecosystem offers a broad range of bioactivities including anticancer, none of the FDA-approved antiproliferative protein kinase inhibitors are derived from a marine source. In a step to develop new marine-inspired potent kinase inhibitors with antiproliferative activities, a new series of hybrid small molecules (5a–5g) was designed and synthesized based on chemical moieties derived from two marine natural products (Meridianin E and Leucettamine B). Over a panel of 14 cancer-related kinases, a single dose of 10 µM of the parent hybrid 5a possessing the benzo[d][1,3]dioxole moiety of Leucettamine B was able to inhibit the activity of FMS, LCK, LYN, and DAPK1 kinases with 82.5 ± 0.6, 81.4 ± 0.6, 75.2 ± 0.0, and 55 ± 1.1%, respectively. Further optimization revealed the most potent multiple kinase inhibitor of this new series (5g) with IC50 values of 110, 87.7, and 169 nM against FMS, LCK, and LYN kinases, respectively. Compared to imatinib (FDA-approved multiple kinase inhibitor), compound 5g was found to be ~ 9- and 2-fold more potent than imatinib over both FMS and LCK kinases, respectively. In silico docking simulation models of the synthesized compounds within the active site of FMS, LCK, LYN, and DAPK1 kinases offered reasonable explanations of the elicited biological activities. In an in vitro anticancer assay using a library of 60 cancer cell lines that include blood, lung, colon, CNS, skin, ovarian, renal, prostate, and breast cancers, it was found that compound 5g was able to suppress 60 and 70% of tumor growth in leukemia SR and renal RXF 393 cell lines, respectively. Moreover, an ADME study indicated a suitable profile of compound 5g concerning cell permeability and blood-brain barrier (BBB) impermeability, avoiding possible CNS side effects. Accordingly, compound 5g is reported as a potential lead towards novel antiproliferative marine-derived kinase modulators.
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Oliveira, Arleusson Ricarte de, Yanna Gomes de Sousa, Ítalo Vinícius Albuquerque Diniz, Soraya Maria de Medeiros, Cláudia Martiniano i Marília Alves. "The daily routine of nurses in rural areas in the Family Health Strategy". Revista Brasileira de Enfermagem 72, nr 4 (sierpień 2019): 918–25. http://dx.doi.org/10.1590/0034-7167-2018-0243.
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ABSTRACT Objective: to analyze the daily work of rural Family Health Strategy (FHS) nurses. Method: a qualitative, descriptive and exploratory research. The data were collected with eleven rural nurses of the city of Campina Grande, Paraíba State, through semi-structured interviews, between January and March of 2017, using Content Analysis. Results: rural nurses have a strong relationship with the population. However, they reveal a daily work with various organizational barriers that range from the team displacement to the workplace to the operationalization of health actions, which are mediated by the characteristics of rurality. Some of these barriers can be remedied by a more proactive action from the management. Final considerations: conditioned by the characteristics of rurality, the differentiated dynamics work reveal weaknesses in the quality of nursing care and lower effectiveness of the FHS.
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Nanvubya, Annet, Rhoda Kitty Wanyenze, Onesmus Kamacooko, Teddy Nakaweesa, Juliet Mpendo, Barbarah Kawoozo, Francis Matovu i in. "Barriers and Facilitators of Family Planning Use in Fishing Communities of Lake Victoria in Uganda". Journal of Primary Care & Community Health 11 (styczeń 2020): 215013272094377. http://dx.doi.org/10.1177/2150132720943775.
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Introduction: Family planning (FP) is a key element in the conduct of research and is essential in managing family sizes. Although fishing communities (FCs) are targeted populations for HIV prevention research, their FP practices are poorly understood. We explored barriers and facilitators of FP use in FCs of Lake Victoria in Uganda. Methods: We employed a mixed-methods approach comprising a cross-sectional survey, in-depth interviews, and focus group discussions in 2 FCs. Multivariable logistic regression was used to analyze quantitative data and a thematic approach to generate themes from the qualitative data. Results: Up to 1410 individuals participated in the survey and 47 in the qualitative study. Just over a third (35.6%) used FP. The most commonly used methods were condoms, pills, and injectables. In Kigungu community, participants whose religion was Anglican and Muslim were more likely to use FP than Catholics (adjusted odds ratio [aOR] 1.45; 95% CI 1.05-1.99 and aOR 1.45; 95% CI 1.05-2.07, respectively). Participants were more likely to use FP if they had satisfactory FP knowledge compared to those with no satisfactory FP knowledge (aOR 1.79; 95% CI 1.23-2.61), or if they were married compared to their single counterparts (aOR 1.84; 95% CI 1.32-2.57). In both communities, participants were more likely to use FP if they had 2 or more sexual partners in the past 12 months than those with less than 2 sexual partners (aOR 1.41 95% CI 1.07-1.87 and aOR 2.60; 95% CI 1.36-4.97). Excessive bleeding and delayed fecundity; fertility desire; gender preferences of children; method stock outs and lack of FP trained personnel constituted barriers to FP use. There were also cultural influences in favor of large families. Conclusion: FP use in FCs is suboptimal. Barriers of FP use were mainly biomedical, religious, social, and cultural, which underscores a need for FP education and strengthening of FP service provision in FCs.
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Sharizan, Salihah, Nur Harena Redzuan i Romzie Rosman. "Issues and Challenges of Financial Inclusion Among Low-Income Earners In Rural Areas of Malaysia". Turkish Journal of Islamic Economics 8, Special Issue (15.06.2021): 277–99. http://dx.doi.org/10.26414/a2376.
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Financial inclusion (FI) appears to be one of the main global agendas as it is an essential way of reducing poverty and increasing the economic growth of a country. FI is the provision of financial services to all segments of society in a more convenient, quality, and affordable way. In this study, the authors analyzed the issues and challenges faced from the two perspectives of the Financial Institutions (FIs) and the rural B40 group concerning the way of pursuing the exclusive of FI. Primary data was collected by conducting semi-structured interviews with four expert bankers from the Financial Institutions (FIs) in Kuala Rompin, Pahang, and two representatives from the B40 customers in the rural areas of Pekan, Pahang, Malaysia. Based on the findings, barriers faced by the supply sides of the FIs include 1) high risk of cost and security, 2) barriers in communication and lack of financial education, and 3) lack of proof documents. The other challenges are 1) competition with the conventional institutions, 2) default risk due to non-payment, and 3) internet connection problem. On the demand side, the issues and challenges found include 1) lack of confidence, 2) lack of proof documents, 3) misuse of capital, and 4) lack of financial literacy. Henceforth, the findings have significant implications for the Islamic banking and finance industry in exploring the current barriers faced in delivering financial inclusion to the lower segment of the society in Malaysia.
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Bertolino, N., M. Monagheddu, A. Tacca, P. Giuliani, C. Zanotti, F. Maglia i U. Anselmi Tamburini. "Self-propagating high-temperature synthesis of functionally graded materials as thermal protection systems for high-temperature applications". Journal of Materials Research 18, nr 2 (luty 2003): 448–55. http://dx.doi.org/10.1557/jmr.2003.0057.
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Self-propagating high-temperature synthesis was used to prepare boride-based functionally graded materials (FGMs) as thermal barriers for space re-entry vehicles. FGMs are characterized by inhomogeneous spatial composition, resulting in different spatial characteristics. In this work, the FGMs were composed of a ceramic [i.e., MB2 (M = Ti, Zr, Hf)] and a metallic (i.e., NiAl) side, joined together by composite layers of graded stoichiometries of the two components. Thus, in the same material, the boride end gives thermal insulation, while the intermetallic end offers an easy junction to the structure of the space aircraft. The prepared FGMs showed good adhesion between the layers and global compactness after preparation and thermal tests. The microhardness along the samples was measured, and their insulating capabilities were evaluated.
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Schneider, Gisbert. "Breaking the data barrier in computational medicinal chemistry". Future Medicinal Chemistry 6, nr 3 (marzec 2014): 245–46. http://dx.doi.org/10.4155/fmc.14.2.
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Hemert, Saskia Van, i Geline Ormel. "Influence of the Multispecies Probiotic Ecologic<sup>®</sup> BARRIER on Parameters of Intestinal Barrier Function". Food and Nutrition Sciences 05, nr 18 (2014): 1739–45. http://dx.doi.org/10.4236/fns.2014.518187.
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O'Neal, Margaret. "Roadmap to ReUrbanism: Identifying and Overcoming Barriers to Building Reuse". Forum Journal 31, nr 4 (2017): 41–49. http://dx.doi.org/10.1353/fmj.2017.a685877.
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Oliveira, Márcio José Sol Pereira. "For Organizational Communication that Promotes the Sharing of Tacit Knowledge". Risk and Financial Management 2, nr 2 (15.12.2020): p37. http://dx.doi.org/10.30560/rfm.v2n2p37.
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Objectives - focusing the study's focus on sharing tacit knowledge in non-profit organizations (NPOs) in Portugal and taking as a case study the Portuguese volunteer firefighters (FBs), we listed as objectives ascertaining the main communicational barriers to tacit knowledge sharing and identify action strategies to be implemented by these organizations, with a view to promoting this communication.
Design / methodology / approach - A literature review on the barriers to sharing tacit knowledge, namely in its communicational dimension, was followed by a qualitative study, carried out with 8 Portuguese volunteer fire brigades, which allowed an analysis of the prevalence of these barriers and the determination of the main measures to be implemented, with a view to combating them.
Conclusions - It was possible to conclude which are the most prevalent communication barriers in these organizations and what measures to be implemented with a view to combating these barriers and promoting the sharing of tacit knowledge by increasing more effective communication.
Research limitations - This research focuses exclusively on the sharing of tacit knowledge, not considering other forms of knowledge. As this is a case study, although with very heterogeneous organizations, it cannot be replicated for different realities.
Originality / value - Studies in this area, aimed at the NPOs are scarce, as opposed to what happens in the private and public sectors. The case study option of organizations such as the Portuguese FBs, unique in their action and identity, accompanies the need, increasingly recognized by society, in enabling these organizations of competences for the best possible performance, in the face of the tragic events that have occurred in recent years in Portugal.
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Smith, Rebecca, i Allison Nichols. "The Stress Less With Mindfulness Program: Motivations, Benefits, and Barriers to Participation in a Community-Based Mindfulness Program". Journal of Family & Consumer Sciences 112, nr 3 (1.09.2020): 41–48. http://dx.doi.org/10.14307/jfcs112.3..41.
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The family and consumer sciences (FCS) knowledge base includes three core elements: human well-being, family strengths, and community vitality. In order to increase knowledge in these three elements while enhancing relevancy to contemporary society, FCS professionals might consider mindfulness training as a component of their programming. This paper describes an evaluation study of Stress Less with Mindfulness (SLM), a 5-module program to reduce stress and build emotional skills that was conducted with 70 participants in 8 workplace sites. Questions were asked about motivation for attendance, benefits of participation, and barriers to practicing skills. Pre- and post-surveys and inventories were used to collect data. Most attended because they felt stressed or wanted to help someone else who felt stressed. They increased skills in relaxation, coping, and identifying stress cues. Barriers to using the techniques included time constraints, difficulty practicing self-awareness, misunderstanding of control, and inability to give up bad habits.
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KAWABATA, SHIRO, i YASUHIRO ASANO. "NUMERICAL STUDY OF π-JUNCTION USING SPIN FILTERING BARRIERS". International Journal of Modern Physics B 23, nr 20n21 (20.08.2009): 4320–28. http://dx.doi.org/10.1142/s021797920906347x.
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We numerically investigate the Josephson transport through ferromagnetic insulators (FIs) by taking into account its band structure. By use of the recursive Green's function method, we found the formation of the π junction in the case of the fully spin-polarized FI (FPFI), e.g., La 2 BaCuO 5. Moreover, the 0-π transition is induced by increasing the thickness of FPFI. On the other hand, Josephson current through the Eu chalcogenides shows the π junction behavior in the case of the strong d-f hybridization between the conduction d and the localized f electrons of Eu . Such FI-based Josephson junctions may becomes a element in the architecture of future quantum information devices.
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Han, Meekyung, Sadhna Diwan i Karen Sun. "Exploring caregiving-related experiences among Chinese American and European American family caregivers of persons with mental illness". Transcultural Psychiatry 56, nr 3 (13.02.2019): 491–509. http://dx.doi.org/10.1177/1363461519827690.
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Family caregivers (FCs) of people with mental illness (PMI) experience caregiving-related distress. These challenges tend to be greater for Asian American families due to acculturative stress and structural barriers to services. However, little is known about caregiving-related experiences among FCs of PMI within a cultural context. By using an exploratory approach, we examined the experience of caregiver distress and the influence of cultural values on caregiving in European American and Chinese American FCs. In collaboration with community-based agencies, a combination of convenience and snowball sampling methods were used to recruit Chinese American and European American caregivers who co-reside with PMIs. Two focus groups with each ethnic group with 57 participants (30 Chinese and 27 European American) were conducted. Thematic analysis indicates that FCs experience intense emotions, health/mental health problems, and a negative impact on their personal/social lives. Whereas Chinese American FCs reported shame, lack of knowledge, and over-protectiveness of PMIs, European American FCs reported the need for advocacy on behalf of the PMI. Findings indicate a need for: 1) greater awareness of the caregiving experience on wellbeing of FCs; 2) an understanding of how cultural values may influence caregiver experience; and 3) developing culturally relevant prevention and intervention services that can support FCs from diverse cultural contexts.
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Murphy, Kyle E., Grace F. Sloan, Grace V. Lawhern, Grace E. Volk, Jacob T. Shumate i Amanda L. Wolfe. "Advances in antibiotic drug discovery: reducing the barriers for antibiotic development". Future Medicinal Chemistry 12, nr 22 (listopad 2020): 2067–87. http://dx.doi.org/10.4155/fmc-2020-0247.
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Antibiotic drug discovery has been an essential field of research since the early 1900s, but the threat from infectious bacteria has only increased over the decades because of the emergence of widespread multidrug resistance. In this review, we discuss the recent advances in natural product, computational and medicinal chemistry that have reinvigorated the field of antibiotic drug discovery while giving perspective on how easily, both in cost and in expertise, these methods can be implemented by other researchers with the goal of increasing the number of scientists contributing to this public health crisis.
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Sanders, Ethan, Johanna Dobransky, Lara Cheaitani, Nicole Harris, Allan Liew, Steven Papp i George Grammatopoulos. "Preventing hip fractures with multidisciplinary teams: a Canadian perspective". Canadian Journal of Surgery 64, nr 3 (1.05.2021): E310—E316. http://dx.doi.org/10.1503/cjs.014219.
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Fragility fractures (FFs) are low-energy trauma fractures that occur at or below standing height. Among FFs, hip fractures are associated with the greatest morbidity, mortality and cost to Canadian health care systems. This review highlights the current state of medical care for hip fractures in Canada, with specific focus on the role of the multidisciplinary team. Gaps in care exist, as FFs represent a unique challenge requiring both acute and chronic management. Furthermore, there is a lack of ownership of FFs by a medical specialty. These gaps can be addressed through the use of multidisciplinary teams, which have been shown to be efficacious and cost-effective. This model of care also addresses numerous patient-identified barriers to treatment, including inadequate patient counselling. However, there is still room for improvement in both the identification of patients at risk for hip fracture and patient adherence to therapy.
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Hugon, Gaëlle, Sébastien Goutal, Ambre Dauba, Louise Breuil, Benoit Larrat, Alexandra Winkeler, Anthony Novell i Nicolas Tournier. "[18F]2-Fluoro-2-deoxy-sorbitol PET Imaging for Quantitative Monitoring of Enhanced Blood-Brain Barrier Permeability Induced by Focused Ultrasound". Pharmaceutics 13, nr 11 (20.10.2021): 1752. http://dx.doi.org/10.3390/pharmaceutics13111752.
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Focused ultrasound in combination with microbubbles (FUS) provides an effective means to locally enhance the delivery of therapeutics to the brain. Translational and quantitative imaging techniques are needed to noninvasively monitor and optimize the impact of FUS on blood-brain barrier (BBB) permeability in vivo. Positron-emission tomography (PET) imaging using [18F]2-fluoro-2-deoxy-sorbitol ([18F]FDS) was evaluated as a small-molecule (paracellular) marker of blood-brain barrier (BBB) integrity. [18F]FDS was straightforwardly produced from chemical reduction of commercial [18F]2-deoxy-2-fluoro-D-glucose. [18F]FDS and the invasive BBB integrity marker Evan’s blue (EB) were i.v. injected in mice after an optimized FUS protocol designed to generate controlled hemispheric BBB disruption. Quantitative determination of the impact of FUS on the BBB permeability was determined using kinetic modeling. A 2.2 ± 0.5-fold higher PET signal (n = 5; p < 0.01) was obtained in the sonicated hemisphere and colocalized with EB staining observed post mortem. FUS significantly increased the blood-to-brain distribution of [18F]FDS by 2.4 ± 0.8-fold (VT; p < 0.01). Low variability (=10.1%) of VT values in the sonicated hemisphere suggests reproducibility of the estimation of BBB permeability and FUS method. [18F]FDS PET provides a readily available, sensitive and reproducible marker of BBB permeability to noninvasively monitor the extent of BBB disruption induced by FUS in vivo.
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Birukova, Anna A., Elena Alekseeva, Ivan Cokic, Christopher E. Turner i Konstantin G. Birukov. "Cross talk between paxillin and Rac is critical for mediation of barrier-protective effects by oxidized phospholipids". American Journal of Physiology-Lung Cellular and Molecular Physiology 295, nr 4 (październik 2008): L593—L602. http://dx.doi.org/10.1152/ajplung.90257.2008.
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We previously reported that the barrier-protective effects of oxidized 1-palmitoyl-2-arachidonoyl- sn-glycero-3-phosphocholine (OxPAPC) on pulmonary endothelial cells (ECs) delineate the role of Rac- and Cdc42-dependent mechanisms and described the involvement of the focal adhesion (FA) protein paxillin in enhancement of the EC barrier upon OxPAPC challenge. This study examined a potential role of paxillin in the feedback mechanism of Rac regulation by FAs in OxPAPC-stimulated ECs. Our results demonstrate that OxPAPC induced Rac-dependent, Rho-independent peripheral accumulation of paxillin-containing FAs and time-dependent paxillin phosphorylation. Molecular inhibition of Rac decreased association of paxillin with the Rac-specific guanine nucleotide exchange factor β-PIX. Molecular inhibition of paxillin also attenuated OxPAPC-induced enhancement of adherens junctions critical for the EC barrier-protective response, accumulation of vascular endothelial cadherin in the membrane fractions, and decreased activation of Rac and its effector p21-activated kinase (PAK1). Expression of paxillin with a mutated PAK1-dependent phosphorylation site (S273A) attenuated OxPAPC-induced PAK1 activation and the EC barrier-protective response. These results suggest that PAK1-specific paxillin phosphorylation at Ser273 is critically involved in the positive-feedback regulation of the Rac-PAK1 pathway and may contribute to sustained enhancement of the EC barrier caused by oxidized phospholipids.