strategies

Strategies
  • 文章类型: Journal Article
    CO选择性催化还原NOx(CO-SCR)技术展示了同时消除工业烟气和汽车尾气中CO和NOx的潜力,使其成为一种有前途的反硝化方法。开发具有成本效益的催化剂对于该技术的广泛实施至关重要。过渡金属催化剂比贵金属催化剂更经济可行。其中,Fe由于其丰富的可用性和成本效益而成为一个突出的选择,在中等反应温度下表现出优异的催化性能。然而,一个重大挑战在于在低温下实现高催化活性,特别是在O2,SO2和H2O的存在下,在特定的工业烟道气流中普遍存在。本文研究了Fe基催化剂在CO-SCR反应中的应用,并阐明了其催化机理。此外,它还讨论了为增强低温转换而设计的各种策略,考虑到晶相等因素,价态,和氧空位。随后,该综述概述了铁基催化剂遇到的挑战,并提出了提高其在低温和富氧环境中使用的催化效率的建议。
    The technology of CO selective catalytic reduction of NOx (CO-SCR) showcases the potential to simultaneously eliminate CO and NOx from industrial flue gas and automobile exhaust, making it a promising denitrification method. The development of cost-effective catalysts is crucial for the widespread implementation of this technology. Transition metal catalysts are more economically viable than noble metal catalysts. Among these, Fe emerges as a prominent choice due to its abundant availability and cost-effectiveness, exhibiting excellent catalytic performance at moderate reaction temperatures. However, a significant challenge lies in achieving high catalytic activity at low temperatures, particularly in the presence of O2, SO2, and H2O, which are prevalent in specific industrial flue gas streams. This review examines the use of Fe-based catalysts in the CO-SCR reaction and elucidates their catalytic mechanism. Furthermore, it also discusses various strategies devised to enhance low-temperature conversion, taking into account factors such as crystal phase, valence states, and oxygen vacancies. Subsequently, the review outlines the challenges encountered by Fe-based catalysts and offers recommendations to improve their catalytic efficiency for use in low-temperature and oxygen-rich environments.
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  • 文章类型: Journal Article
    COVID-19源于SARS-CoV-2病毒,引发了全球呼吸道大流行。在疫苗接种领域取得了显著进展,几乎每个国家都开始部署COVID-19疫苗。然而,在低收入国家,只有32.6%的人只接种了一次疫苗。前所未有的研发努力已经产生了170多种COVID-19疫苗,其中一些现在正在实际使用。这些疫苗在避免严重疾病方面表现出显著的功效,住院治疗,和COVID-19造成的死亡,甚至是针对新出现的变种。研究追求持续存在,专注于新的疫苗技术,口服和鼻用疫苗,更广泛的冠状病毒保护,和疫苗组合。在治疗领域,在开发口服抗病毒药物和单克隆抗体方面取得了重大进展.尽管如此,COVID-19疫苗接种的挑战仍然存在,包括犹豫的问题,可访问性,金融壁垒,知识差距,和后勤障碍。通过全球机构和报告系统进行强有力的监测仍然至关重要。提高疫苗接种效力的策略根植于培养信任,打击错误信息,扩大准入。至于治疗学,该方法涉及专门的研究,临床试验,监管精简,储存,和国际合作。远程医疗和公众意识运动在这一努力中起着不可或缺的作用,协调是保护生命和减轻疾病影响的关键。针对COVID-19的全球运动取得了重大进展,正在进行的研究重点是开发疫苗和疗法,这些疫苗和疗法不仅更容易获得和负担得起,而且更有效,特别是低收入国家和脆弱社区的人口。
    COVID-19, stemming from the SARS-CoV-2 virus, has initiated a worldwide respiratory pandemic. Remarkable headway has been made in the realm of vaccination, as nearly every nation has initiated COVID-19 vaccine deployment. However, a mere 32.6% of individuals in low-income countries have received only a single vaccine dose. Unprecedented research and development endeavors have yielded over 170 COVID-19 vaccines, several of which are now in practical use. These vaccines have demonstrated remarkable efficacy in averting severe illness, hospitalization, and fatalities from COVID-19, even against emerging variants. Research pursuits persist, concentrating on novel vaccine technologies, oral and nasal vaccines, broader coronavirus protection, and vaccine combinations. In the realm of therapeutics, there have been significant strides in developing oral antiviral medications and monoclonal antibodies. Nonetheless, challenges in COVID-19 vaccination persist, encompassing issues of hesitancy, accessibility, financial barriers, knowledge gaps, and logistical hindrances. Robust monitoring via global agencies and reporting systems remains pivotal. Strategies for enhancing vaccination efficacy are rooted in fostering trust, countering misinformation, and expanding access. As for therapeutics, the approach involves dedicated research, clinical trials, regulatory streamlining, stockpiling, and international collaboration. Telemedicine and public awareness campaigns play integral roles in this effort, with coordination being the linchpin for preserving lives and mitigating the disease\'s impact. The global campaign against COVID-19 has witnessed substantial advancements, with an ongoing research focus on developing vaccines and therapeutics that are not only more accessible and affordable but also more effective, particularly for populations in low-income countries and vulnerable communities.
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  • 文章类型: Journal Article
    背景:尽管有证据表明应用感染预防措施可以减少医疗保健相关感染,对这些措施的遵守率很低,尤其是在医生中。干预效果往往无法维持。缺乏对医生预防感染行为和成功的行为改变策略的决定因素的概述。
    目的:确定哪些决定因素会影响医师的感染预防行为,已经探索了哪些提高合规性的策略,以及理论,这些研究中使用了实施科学的模型和框架。
    方法:范围审查方法。我们在PubMed进行了文献检索,Embase,截至2023年6月2日,APAPsycInfo和WebofScience与医疗信息专家合作。所有研究类型侧重于高收入国家医生的感染预防行为。提取了决定因素和策略的数据;决定因素被归类为理论领域框架(TDF)。
    结果:我们收录了56篇文章。TDF域\"环境上下文和资源\",“社会影响”,“关于后果的信念”,\"记忆,关注和决策“,发现“知识”和“技能”最相关。主要的决定因素涵盖了TDF以外的主题:社会人口因素。可持续干预是多模式方法,至少包括反馈,教育和冠军。理论,模型和框架很少用于指导实施战略的制定。
    结论:本综述概述了医师预防感染行为的决定因素。干预研究很少指定其旨在解决的决定因素,并且缺乏理论基础。未来的举措应将有关决定因素的知识与实施科学相结合,以开发针对决定因素的基于理论的干预措施。
    BACKGROUND: Despite evidence that application of infection prevention measures can reduce healthcare-associated infections, compliance with these measures is low, especially among physicians. Intervention effects often do not sustain. An overview of determinants for physicians\' infection prevention behaviour and successful behaviour change strategies is lacking.
    OBJECTIVE: To identify what determinants influence physicians\' infection prevention behaviour, what strategies to improve compliance have been explored, and whether theories, models and frameworks from implementation science have been used in these studies.
    METHODS: Scoping review methodology. We performed a literature search in PubMed, Embase, APA PsycInfo and Web of Science up to June 2, 2023, in collaboration with a medical information specialist. All study types focusing on infection prevention behaviour of physicians in high-income countries were included. Data on determinants and strategies was extracted; determinants were categorized into the Theoretical Domains Framework (TDF).
    RESULTS: We included 56 articles. The TDF domains \"environmental context and resources\", \"social influences\", \"beliefs about consequences\", \"memory, attention and decision-making\", \"knowledge\" and \"skills\" were found most relevant. The prevailing determinant covers a theme outside the TDF: socio-demographic factors. Sustainable interventions are multimodal approaches that at least include feedback, education and a champion. Theories, models and frameworks have rarely been used to guide implementation strategy development.
    CONCLUSIONS: This review presents an overview of determinants of physicians\' infection prevention behaviour. Intervention studies rarely specify the determinants that they aim to address and lack theoretical underpinning. Future initiatives should combine knowledge about determinants with implementation science to develop theory-based interventions tailored to determinants.
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  • 文章类型: Journal Article
    背景:空气污染对全球公共卫生构成重大威胁,导致高死亡率和发病率。印度,是世界上儿童人口最多的国家,尤其受到影响。这项研究旨在确定有效的策略,以减轻空气污染对这一弱势群体的不利健康影响。
    方法:该研究利用演绎方法和有目的的抽样方法进行定向内容分析,与研究人员进行深入访谈,院士,儿科医生,公共卫生专家,以及来自印度不同组织的气候变化专家。总的来说,在2024年3月和4月的两个月内进行了17次访谈,直到数据达到饱和。
    结果:共提取了29个亚类。主要子类别包括减少室内排放和多部门减排的策略,减少在家接触的策略,学校和过境,提高公众意识的策略,有效沟通,卫生部门的沟通和意识,并提高一线工人和教育机构的认识,卫生部门和一线利益相关者能力建设战略,构建研究和知识翻译的策略,纵向和横向合作战略,以儿童为中心的政策战略,学校关闭政策,财政政策,全面决策,部门决策,在决策中倡导,监测战略,以及母婴健康策略。
    结论:这项研究的结果表明,减轻污染对儿童的不利健康影响需要采取多管齐下的方法,包括有效的沟通和教育策略,以及提高重要利益相关者的认识,例如卫生专业人员,社区,基层工人,父母,老师和孩子。这种战略可能有助于触发所有有关方面行为的预期变化。此外,作为决策机构,各利益攸关方和部委之间需要合作和伙伴关系。有必要在研究的基础上再接再厉,加强监测和监督。
    BACKGROUND: Air pollution poses a significant threat to global public health, contributing to high rates of mortality and morbidity. India, home to the world\'s largest population of children, is particularly affected. This study aims to identify effective strategies to mitigate the adverse health impacts of air pollution on this vulnerable group.
    METHODS: The study utilized directed content analysis using a deductive approach and purposeful sampling to carry out in-depth interviews with researchers, academicians, paediatricians, public health experts, and climate change experts from different organizations in India. In total, 17 interviews were conducted over two months in March and April 2024 until data saturation was reached.
    RESULTS:  A total of 29 subcategories were extracted. The main sub-categories include strategies for reducing indoor emissions and multisectoral emission reduction, strategies to reduce exposure at home, schools and transit, strategies for public awareness, effective communication, health sector communication and awareness, and raising awareness by frontline workers and educational institutions, strategies for capacity building of health sector and frontline stakeholders, strategies for building research and knowledge translation, strategies for vertical and horizontal collaboration, strategies for child-centric policies, school closure policies, fiscal policies, comprehensive policymaking, sectoral policymaking, advocacy in policymaking, strategies for monitoring, and strategies for mother and child health.
    CONCLUSIONS: The results of this study indicate that mitigating the adverse health impacts of pollution for children would entail a multi-pronged approach encompassing effective communication and education strategies and awareness raising of important stakeholders such as health professionals, community, grassroots-level workers, parents, teachers and children. Such strategies could be useful to trigger the desired change in behaviour of all concerned. Also, there is a need for collaboration and partnership between various stakeholders and ministries as policy-making bodies. There is a need to build on the research and strengthen the monitoring and surveillance.
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  • 文章类型: Journal Article
    计算估计需要广泛的策略,并根据问题的特征选择相关策略。我们使用了新的估计策略检验(TES),由20个算术问题组成(例如,144x0.38),调查年轻人策略使用的变异性。TES针对成年人最常使用的五种估计策略,分为两类。三类策略是通用的,并在学校教授。继续算法需要应用算法(例如,移动小数位)。第一回合和第二回合被定义为舍入一个或两个操作数,分别。两个二类战略更先进,需要应用数学的概念知识。当参与者依赖于一个众所周知的数学事实(例如,25×4=100)形成估计值。分数在估算过程中使用分数或百分比(例如,943×0.48约为50%或900的一半)。我们将成年参与者的样本分为两组(即,高,平均)基于他们在TES上的估计性能。高性能小组使用了更广泛的策略,并且更频繁地应用了具有问题特征的最相关的策略。总体估计精度与数学成绩相关,战略广度和战略相关性也是如此。然而,这些协会中没有一个在最初控制口头成就的情况下幸存下来。参与者的战略报告表明,TES问题通常成功地引出了五种目标战略,并为新战略提供了证据,分区。这些发现为未来的教学研究提供了基础,以提高学生的计算估计。
    Computational estimation requires a breadth of strategies and selection of the relevant strategy given a problem\'s features. We used the new Test of Estimation Strategies (TES), composed of 20 arithmetic problems (e.g., 144 x 0.38), to investigate variability in strategy use in young adults. The TES targets the five estimation strategies that adults use most frequently, which fall into two Classes. The three Class One strategies are general-purpose and taught in schools. Proceed Algorithmically entails applying an algorithm (e.g., shifting a decimal place). Round One and Round Two are defined as rounding one or both operands, respectively. The two Class Two strategies are more advanced, requiring application of conceptual knowledge of mathematics. Known-and-Nice is used when a participant relies on a well-known mathematical fact (e.g., 25 × 4 = 100) to form an estimate. Fractions uses a fraction or percentage in the estimation process (e.g., 943 x 0.48 is about 50% or half of 900). We divided our sample of adult participants into two groups (i.e., high, average) based on their estimation performance on the TES. The high-performance group used a broader range of strategies and more frequently applied the most relevant strategy given a problem\'s features. Overall estimation accuracy was correlated with mathematical achievement, as were strategy breadth and strategy relevance. However, none of these associations survived first controlling for verbal achievement. Participants\' strategy reports suggested that the TES problems were generally successful in eliciting the five target strategies and provided evidence for a new strategy, Partitioning. These findings provide a basis for future instructional studies to improve students\' computational estimation.
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  • 文章类型: Journal Article
    为了确定幼儿如何使用和执行基于手指的策略,要求5至8岁的孩子在选择条件下解决简单的加法问题(即,他们可以在每个问题上选择基于手指的或非手指的策略),并且在两种无选择条件下(一种情况下,他们需要在所有问题上使用基于手指的策略,而一种情况下,他们不能使用基于手指的策略)。结果表明,儿童(a)使用基于手指和非手指的策略来解决所有年龄段的简单加法问题,(b)随着手指年龄的增长,使用手指的次数越来越少,尤其是在解决较小的问题时,(c)根据问题特征和策略性能校准他们对基于手指的策略的使用,和(d)改进了基于手指的和非手指的策略执行的效率。此外,(e)战略绩效是所有年龄组战略选择的最佳预测指标,和(f)当他们有可能使用手指时,所有年龄组的儿童获得更好的表现相对于当他们不能使用手指,尤其是在更大的问题上。
    To determine how young children use and execute finger-based strategies, 5- to 8-year-olds were asked to solve simple addition problems under a choice condition (i.e., they could choose finger-based or non-finger strategies on each problem) and under two no-choice conditions (one in which they needed to use finger-based strategies on all problems and one in which they could not use finger-based strategies). Results showed that children (a) used both finger-based and non-finger strategies to solve simple addition problems in all age groups, (b) used fingers less and less often as they grew older, especially while solving smaller problems, (c) calibrated their use of finger-based strategies to both problem features and strategy performance, and (d) improved efficiency of both finger-based and non-finger strategy execution. Moreover, (e) strategy performance was the best predictor of strategy selection in all age groups, and (f) when they had the possibility to use fingers, children of all age groups obtained better performance relative to when they could not use fingers, especially on larger problems.
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  • 文章类型: Journal Article
    铜绿假单胞菌已成为卫生部门的首要病原体,因为它无处不在,具有很高的代谢/遗传多样性,并被鉴定为机会病原体。据报道,铜绿假单胞菌产生的许多毒力因子可以单独或合作地进行机器人入侵,信徒,持久性,扩散,以及对宿主免疫系统的保护。铜绿假单胞菌产生各种细胞外蛋白酶,如碱性蛋白酶,蛋白酶IV,弹性蛋白酶A,弹性蛋白酶B,大蛋白酶A,假单胞菌小蛋白酶,铜绿假单胞菌氨基肽酶,和粘液。这些蛋白酶有效地允许细胞侵入和破坏宿主细胞。因此,抑制这些蛋白酶活性已被认为是控制铜绿假单胞菌引起的感染的有希望的方法。本综述详细讨论了这些蛋白酶的特征及其在感染宿主系统中的作用。评论的第二部分讨论了减弱或抑制蛋白酶活性的多种策略的最新进展。这些策略包括天然和合成分子的应用,以及金属/聚合物纳米材料。还报道了存在于蛋白酶IV的中间结构域中的前肽还减弱铜绿假单胞菌的毒力特性和感染能力。
    Pseudomonas aeruginosa has become a top-priority pathogen in the health sector because it is ubiquitous, has high metabolic/genetic versatility, and is identified as an opportunistic pathogen. The production of numerous virulence factors by P. aeruginosa was reported to act individually or cooperatively to make them robots invasion, adherences, persistence, proliferation, and protection against host immune systems. P. aeruginosa produces various kinds of extracellular proteases such as alkaline protease, protease IV, elastase A, elastase B, large protease A, Pseudomonas small protease, P. aeruginosa aminopeptidase, and MucD. These proteases effectively allow the cells to invade and destroy host cells. Thus, inhibiting these protease activities has been recognized as a promising approach to controlling the infection caused by P. aeruginosa. The present review discussed in detail the characteristics of these proteases and their role in infection to the host system. The second part of the review discussed the recent updates on the multiple strategies for attenuating or inhibiting protease activity. These strategies include the application of natural and synthetic molecules, as well as metallic/polymeric nanomaterials. It has also been reported that a propeptide present in the middle domain of protease IV also attenuates the virulence properties and infection ability of P. aeruginosa.
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  • 文章类型: Journal Article
    背景:/目标取消实施,包括删除或减少不必要或不适当的处方,对于确保患者获得适当的循证医疗保健至关重要。取消执行工作的利用取决于战略报告的质量。为了进一步了解取消医疗实践的有效方法,需要规范行为目标和取消实施战略的组成部分。本文旨在批判性地分析行为目标和战略组成部分的好坏,在专注于在二级医疗保健环境中取消不必要或不适当处方的研究中,被报道。
    方法:对最近发表的取消实施研究综述中的研究进行了补充分析。文章文本被逐字编码到两个既定的规范框架中。行为成分被演绎地编码为行动的五个要素,演员,上下文,目标,时间(AACTT)框架。战略组件被映射到Proctor的“衡量实施战略”框架的九个元素。
    结果:低价值处方的行为成分,编码到AACTT框架中,一般规定得很好。然而,Actor和Time组件通常含糊不清或没有很好地报告。战略组成部分的规范,编码到Proctor框架中,报道得不太好。Proctor\的演员,行动目标:指定目标,剂量和理由要素没有很好地报告或在提供的细节数量上有所变化。我们还提供其他规格的建议,例如“互动”参与者有一个策略。
    结论:AACTT和Proctor框架联合使用时,可以适应处方实践的行为目标和取消实施策略的组成部分的规范。这些基本细节需要理解,复制并成功取消不必要或不适当的处方。总的来说,这些组件的报告质量标准化是重复任何取消实施工作所必需的。
    背景:未注册。
    BACKGROUND: /Aims De-implementation, including the removal or reduction of unnecessary or inappropriate prescribing, is crucial to ensure patients receive appropriate evidence-based health care. The utilization of de-implementation efforts is contingent on the quality of strategy reporting. To further understand effective ways to de-implement medical practices, specification of behavioural targets and components of de-implementation strategies are required. This paper aims to critically analyse how well the behavioural targets and strategy components, in studies that focused on de-implementing unnecessary or inappropriate prescribing in secondary healthcare settings, were reported.
    METHODS: A supplementary analysis of studies included in a recently published review of de-implementation studies was conducted. Article text was coded verbatim to two established specification frameworks. Behavioural components were coded deductively to the five elements of the Action, Actor, Context, Target, Time (AACTT) framework. Strategy components were mapped to the nine elements of the Proctor\'s \'measuring implementation strategies\' framework.
    RESULTS: The behavioural components of low-value prescribing, as coded to the AACTT framework, were generally specified well. However, the Actor and Time components were often vague or not well reported. Specification of strategy components, as coded to the Proctor framework, were less well reported. Proctor\'s Actor, Action target: specifying targets, Dose and Justification elements were not well reported or varied in the amount of detail offered. We also offer suggestions of additional specifications to make, such as the \'interactions\' participants have with a strategy.
    CONCLUSIONS: Specification of behavioural targets and components of de-implementation strategies for prescribing practices can be accommodated by the AACTT and Proctor frameworks when used in conjunction. These essential details are required to understand, replicate and successfully de-implement unnecessary or inappropriate prescribing. In general, standardisation in the reporting quality of these components is required to replicate any de-implementation efforts.
    BACKGROUND: Not registered.
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  • 文章类型: Journal Article
    弹性是一种心理特征和保护因素,在应对慢性疼痛(CP)中起着至关重要的作用。尽管它很重要,研究尚未完全阐明CP患者韧性的概念和组成部分.因此,本研究旨在解释CP患者的韧性成分.
    当前的定性研究使用常规的内容分析方法。研究人群包括从2021年8月至2022年8月转诊到设拉子医科大学附属诊所(伊朗南部)的所有CP患者。使用目的抽样方法选择参与者。对20名参与者进行了深入的半结构化访谈,以收集信息。数据分析使用MAXQDA2020软件结合数据收集工作进行。
    一般来说,在目前的研究中,30个子类别,11个子类别,并提取了五个主要类别作为CP患者韧性的组成部分。抗CP的主要类别包括:1.情绪自我调节,2.心理灵活性,3.自我照顾,4.呼吁宗教-灵性,和5.内部资源和个人能力。
    本研究强调了不同的物理,心理,以及可能有助于抵御痛苦的宗教精神策略。本研究中确定的弹性成分为医疗保健专业人员提供了基础,尤其是护士,设计和实施多种疼痛管理策略,以增强对CP状况的调整。
    UNASSIGNED: Resilience is a psychological trait and a protective factor that plays a vital role in coping with Chronic Pain (CP). Despite its importance, research has yet to fully clarify the concept and components of resilience in patients with CP. Accordingly, the present study aims to explain the components of resilience in patients with CP.
    UNASSIGNED: The current qualitative study used a conventional content analysis methodology. The research population included all patients with CP who were referred to clinics affiliated with Shiraz University of Medical Sciences (south of Iran) from August 2021 to August 2022. Participants were selected using the purposive sampling method. In-depth semi-structured interviews were conducted with 20 participants to collect information. Data analysis was conducted using MAXQDA 2020 software in conjunction with data collection efforts.
    UNASSIGNED: Generally, in the current study, 30 sub-sub-categories, 11 sub-categories, and five main categories were extracted as components of resilience in patients with CP. The main categories of resilience against CP included the following: 1. emotional self-regulation, 2. psychological flexibility, 3. self-care, 4. appeal to religion-spirituality, and 5. internal resources and individual competencies.
    UNASSIGNED: The present study highlights the different physical, mental, and religious-spiritual strategies that may contribute to resilience against pain. The resilience components identified in this study provide a foundation for healthcare professionals, particularly nurses, to design and implement diverse pain management strategies that enhance adjustment to CP conditions.
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  • 文章类型: Journal Article
    背景:青少年护理指南的实施仍然是一个复杂的过程。几个基于证据的框架有助于确定和规范实施决定因素和策略。然而,具体策略对某些决定因素的影响尚不清楚.因此,我们需要澄清策略的哪些活性成分,被称为行为改变技术(BCT),引发行为改变并改善实施结果。有了这些知识,我们能够制定基于证据的实施假设。实施假设详细说明了决定因素和反过来,实施结果可能会受到具体实施策略及其BCT的影响。我们旨在确定(1)与实施青年护理指南相关的决定因素,以及(2)可行且可能有效的实施假设。
    方法:进行了四轮在线改良Delphi研究。在第一轮中,专家们根据实施决定因素的相关性对其进行了评级。接下来,专家们通过将BCT和实施策略与决定因素联系起来制定了实施假设,并被要求为他们的选择提供理由。在第三轮中,专家们根据对所有提出的假设的匿名概述,重新考虑并最终确定了他们的假设,包括理由。最后,专家们根据实施假设的潜在有效性和可行性对其进行了评估。
    结果:14位专家完成了第一个,第二,第三轮,11人完成了最后一轮。指导推广,义务教育,执行负责人在场,管理支持不力,有关指南使用的知识,据报道,缺乏沟通技巧是最相关的决定因素。总的来说,提出了46个假设,每个行列式从6到9不等。对于每个行列式,我们提供了最通常被认为可行和潜在有效的实施假设的概述。
    结论:本研究通过系统地确定相关决定因素并根据专家意见制定假设,为青年护理指南的实施提供了有价值的见解。发现与参与以及与知识和技能有关的决定因素与青年护理指南的实施有关。这项研究提供了一组假设,可以帮助组织,政策制定者,和专业人员指导青年护理指南的实施过程,以最终改善实施成果。这些假设在实践中的有效性仍有待评估。
    BACKGROUND: The implementation of youth care guidelines remains a complex process. Several evidence-based frameworks aid the identification and specification of implementation determinants and strategies. However, the influence of specific strategies on certain determinants remains unclear. Therefore, we need to clarify which active ingredients of strategies, known as behaviour change techniques (BCTs), elicit behaviour change and improve implementation outcomes. With this knowledge, we are able to formulate evidence-based implementation hypotheses. An implementation hypothesis details how determinants and in turn, implementation outcomes might be influenced by specific implementation strategies and their BCTs. We aimed to identify (1) determinants relevant to the implementation of youth care guidelines and (2) feasible and potentially effective implementation hypotheses.
    METHODS: A four-round online modified Delphi study was conducted. In the first round, experts rated the implementation determinants based on their relevance. Next, experts formulated implementation hypotheses by connecting BCTs and implementation strategies to determinants and were asked to provide a rationale for their choices. In round three, the experts reconsidered and finalised their hypotheses based on an anonymous overview of all formulated hypotheses, including rationales. Finally, the experts rated the implementation hypotheses based on their potential effectiveness and feasibility.
    RESULTS: Fourteen experts completed the first, second, and third rounds, with 11 completed the final round. Guideline promotion, mandatory education, presence of an implementation leader, poor management support, knowledge regarding guideline use, and a lack of communication skills were reported as most relevant determinants. In total, 46 hypotheses were formulated, ranging from 6 to 9 per determinant. For each determinant, we provide an overview of the implementation hypotheses that were most commonly deemed feasible and potentially effective.
    CONCLUSIONS: This study offers valuable insights into youth care guideline implementation by systematically identifying relevant determinants and formulating hypotheses based on expert input. Determinants related to engagement and to knowledge and skills were found to be relevant to youth care guideline implementation. This study offers a set of hypotheses that could help organisations, policymakers, and professionals guide the implementation process of youth care guidelines to ultimately improve implementation outcomes. The effectiveness of these hypotheses in practice remains to be assessed.
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