Explore the vast range of titles available.

In recent years, nitrate has emerged as a significant groundwater pollutant due to its potential ecotoxicity. In particular, nitrate contamination of brackish groundwater poses a serious threat to both ecosystems and human health and remains difficult to treat. A promising, sustainable, and environmentally friendly solution when biological treatments are not applicable is the conversion of nitrate to harmless nitrogen (N2) or ammonia (NH3) as a nutrient by electrocatalytic nitrate reduction (eNO3R) using solar photovoltaic energy. This review provides a comprehensive overview of the current advances in eNO3R for the production of nitrogen and ammonia. The discussion begins with fundamental concepts, including a detailed examination of the mechanisms and pathways involved, supported by Density Functional Theory (DFT) to elucidate specific aspects of ammonium and nitrogen formation during the process. Furthermore, the integration of artificial intelligence (AI) and machine learning (ML) offers promising advancements in enhancing the predictive power of DFT, accelerating the discovery and optimization of novel catalysts. In this review, we also explore various electrode preparation methods and emphasize the importance of in situ characterization techniques to investigate surface phenomena during the reaction process. The review highlights numerous examples of copper-based catalysts and analyses their feasibility and effectiveness in ammonia production. It also explores strategies for the conversion of nitrate to N2, focusing on nanoscale zerovalent iron as a selective material and the subsequent oxidation of the produced ammonia. Finally, this review addresses the implementation of the eNO3R process for the treatment of brackish groundwater, discussing various challenges and providing reasonable opinions on how to overcome these obstacles. By synthesizing current research and practical examples, this review highlights the potential of eNO3R as a viable solution to mitigate nitrate pollution and improve water quality.

Purpose: The theory of constraints (TOC) methodology and its drum-buffer-rope (DBR) production planning and control system are well suited to managing production plants in complex environments. The objective of this study was to design an evolution of the systematic process for implementing the third step of the TOC methodology in make-to-order environments.Design/methodology/approach: Since the research concerned a real context and the phenomenon under investigation is contemporary, a case study was chosen as the research methodology.Findings: The study investigated, through a case study, the phases and steps necessary for the systematic process to be successfully implemented in a make-to-order environment.Originality/value: The three main contributions to the systematic implementation process for the third step of the TOC model are identified as the design of the last version of the systematic process, the integration of sales and operations through the TOC methodology and the introduction of the demand-driven adaptive enterprise model’s capacity buffer.

Introduction Successful implementation and embedding of new health care practices relies on co-ordinated, collective behaviour of individuals working within the constraints of health care settings. Normalization Process Theory (NPT) provides a theory of implementation that emphasises collective action in explaining, and shaping, the embedding of new practices. To extend the practical utility of NPT for improving implementation success, an instrument (NoMAD) was developed and validated. Methods Descriptive analysis and psychometric testing of an instrument developed by the authors, through an iterative process that included item generation, consensus methods, item appraisal, and cognitive testing. A 46 item questionnaire was tested in 6 sites implementing health related interventions, using paper and online completion. Participants were staff directly involved in working with the interventions. Descriptive analysis and consensus methods were used to remove redundancy, reducing the final tool to 23 items. Data were subject to confirmatory factor analysis which sought to confirm the theoretical structure within the sample. Results We obtained 831 completed questionnaires, an average response rate of 39% (range: 22–77%). Full completion of items was 50% ( n  = 413). The confirmatory factor analysis showed the model achieved acceptable fit (CFI = 0.95, TLI = 0.93, RMSEA = 0.08, SRMR = 0.03). Construct validity of the four theoretical constructs of NPT was supported, and internal consistency (Cronbach’s alpha) were as follows: Coherence (4 items, α = 0.71); Collective Action (7 items, α = 0.78); Cognitive Participation (4 items, α = 0.81); Reflexive Monitoring (5 items, α = 0.65). The normalisation scale overall, was highly reliable (20 items, α = 0.89). Conclusions The NoMAD instrument has good face validity, construct validity and internal consistency, for assessing staff perceptions of factors relevant to embedding interventions that change their work practices. Uses in evaluating and guiding implementation are proposed.

Background In healthcare research, results diffuse only slowly into clinical practice, and there is a need to bridge the gap between research and practice. This study elucidates how healthcare professionals in a hospital setting experience working with the implementation of research results. Method A descriptive design was chosen. During 2014, 12 interviews were carried out with healthcare professionals representing different roles in the implementation process, based on semi-structured interview guidelines. The analysis was guided by a directed content analysis approach. Results The initial implementation was non-formalized. In the decision-making and management process, the pattern among nurses and doctors, respectively, was found to be different. While nurses’ decisions tended to be problem-oriented and managed on a person-driven basis, doctors’ decisions were consensus-oriented and managed by autonomy. All, however, experienced a knowledge-based execution of the research results, as the implementation process ended. Conclusion The results illuminate the challenges involved in closing the evidence-practice gap, and may add to the growing body of knowledge on which basis actions can be taken to ensure the best care and treatment available actually reaches the patient.

Background Understanding and measuring implementation processes is a key challenge for implementation researchers. This study draws on Normalization Process Theory (NPT) to develop an instrument that can be applied to assess, monitor or measure factors likely to affect normalization from the perspective of implementation participants. Methods An iterative process of instrument development was undertaken using the following methods: theoretical elaboration, item generation and item reduction (team workshops); item appraisal (QAS-99); cognitive testing with complex intervention teams; theory re-validation with NPT experts; and pilot testing of instrument. Results We initially generated 112 potential questionnaire items; these were then reduced to 47 through team workshops and item appraisal. No concerns about item wording and construction were raised through the item appraisal process. We undertook three rounds of cognitive interviews with professionals ( n  = 30) involved in the development, evaluation, delivery or reception of complex interventions. We identified minor issues around wording of some items; universal issues around how to engage with people at different time points in an intervention; and conceptual issues around the types of people for whom the instrument should be designed. We managed these by adding extra items ( n  = 6) and including a new set of option responses: ‘not relevant at this stage’, ‘not relevant to my role’ and ‘not relevant to this intervention’ and decided to design an instrument explicitly for those people either delivering or receiving an intervention. This version of the instrument had 53 items. Twenty-three people with a good working knowledge of NPT reviewed the items for theoretical drift. Items that displayed a poor alignment with NPT sub-constructs were removed ( n  = 8) and others revised or combined (n = 6). The final instrument, with 43 items, was successfully piloted with five people, with a 100% completion rate of items. Conclusion The process of moving through cycles of theoretical translation, item generation, cognitive testing, and theoretical (re)validation was essential for maintaining a balance between the theoretical integrity of the NPT concepts and the ease with which intended respondents could answer the questions. The final instrument could be easily understood and completed, while retaining theoretical validity. NoMAD represents a measure that can be used to understand implementation participants’ experiences. It is intended as a measure that can be used alongside instruments that measure other dimensions of implementation activity, such as implementation fidelity, adoption, and readiness.

BACKGROUND-Software Process Improvement (SPI) is a systematic approach to increase the efficiency and effectiveness of a software development organization and to enhance software products. OBJECTIVE-This paper aims to identify and characterize evaluation strategies and measurements used to assess the impact of different SPI initiatives. METHOD-The systematic literature review includes 148 papers published between 1991 and 2008. The selected papers were classified according to SPI initiative, applied evaluation strategies, and measurement perspectives. Potential confounding factors interfering with the evaluation of the improvement effort were assessed. RESULTS-Seven distinct evaluation strategies were identified, wherein the most common one, \"Pre-Post Comparison,\" was applied in 49 percent of the inspected papers. Quality was the most measured attribute (62 percent), followed by Cost (41 percent), and Schedule (18 percent). Looking at measurement perspectives, \"Project\" represents the majority with 66 percent. CONCLUSION-The evaluation validity of SPI initiatives is challenged by the scarce consideration of potential confounding factors, particularly given that \"Pre-Post Comparison\" was identified as the most common evaluation strategy, and the inaccurate descriptions of the evaluation context. Measurements to assess the short and mid-term impact of SPI initiatives prevail, whereas long-term measurements in terms of customer satisfaction and return on investment tend to be less used.

Background Investigations of implementation factors (e.g., collegial support and sense of coherence) are recommended to better understand and address inadequate implementation outcomes. Little is known about the relationship between implementation factors and outcomes, especially in later phases of an implementation effort. The aims of this study were to assess the association between implementation success (measured by programme fidelity) and care providers’ perceptions of implementation factors during an implementation process and to investigate whether these perceptions are affected by systematic implementation support. Methods Using a cluster-randomized design, mental health clinics were drawn to receive implementation support for one (intervention) and not for another (control) of four evidence-based practices. Programme fidelity and care providers’ perceptions (Implementation Process Assessment Tool questionnaire) were scored for both intervention and control groups at baseline, 6-, 12- and 18-months. Associations and group differences were tested by means of descriptive statistics (mean, standard deviation and confidence interval) and linear mixed effect analysis. Results Including 33 mental health centres or wards, we found care providers’ perceptions of a set of implementation factors to be associated with fidelity but not at baseline. After 18 months of implementation effort, fidelity and care providers’ perceptions were strongly correlated (B (95% CI) = .7 (.2, 1.1), p  = .004). Care providers perceived implementation factors more positively when implementation support was provided than when it was not (t (140) = 2.22, p  = .028). Conclusions Implementation support can facilitate positive perceptions among care providers, which is associated with higher programme fidelity. To improve implementation success, we should pay more attention to how care providers constantly perceive implementation factors during all phases of the implementation effort. Further research is needed to investigate the validity of our findings in other settings and to improve our understanding of ongoing decision-making among care providers, i.e., the mechanisms of sustaining the high fidelity of recommended practices. Trial registration ClinicalTrials.gov Identifier: NCT03271242 (registration date: 05.09.2017).

PurposeSome BIM implementation strategies are critical, while others are insignificant and ineffective in terms of lowering BIM adoption obstacles and promoting widespread acceptance of BIM in projects. The BIM literature has not provided evidence to support this claim or identify the fundamental BIM implementation strategies. This study filled this gap by identifying and investigating the effect of fundamental BIM implementation methodologies on the occurrence of proportional impacts between stages.Design/methodology/approachThe findings indicate a positive and crucial relationship between the stages of the BIM implementation strategies and the reduction of barriers (r = 1.79, z = 2.15), preliminary and sustained BIM adoption barriers (r = 1.53, z = 60.83), BIM adoption on projects and BIM-enabled integration and collaboration (r = 0.7, z = 2.74). This validates the model's hypotheses and demonstrates that the fundamental BIM implementation strategies will accelerate the reduction of BIM adoption hurdles. The impact, however, will be the same for both sustained and preliminary barriers. This implies that lowering the obstacles alone will not secure BIM adoption.FindingsThe validation of the model's hypotheses demonstrated that the fundamental BIM implementation strategies will accelerate the reduction of BIM adoption hurdles. The impact, however, will be the same for both sustained and preliminary barriers. This implies that lowering BIM adoption obstacles alone will not secure BIM adoption. This study proposes that BIM deployment tactics be carefully chosen in order to remove preliminary impediments, reduce barriers and energise BIM acceptance.Research limitations/implicationsIn line with the findings of this study, BIM adoption must be consistent and long-term before the benefits in project execution become evident and substantiated. The BIM abilities of project participants, the feasibility of BIM conventions and the proficiency of BIM supervisors may all play a role in this.Practical implicationsThis research implies a few approaches and tactics for implementing BIM in an efficient and beneficial manner. The study's findings imply that BIM deployment tactics should be carefully chosen in order to remove preliminary impediments, reduce barriers and energise BIM acceptance. It also explains how to structure BIM implementation strategies in developing countries. Another significant practical implication is the model's conclusion on the benefits of BIM adoption.Originality/valueThis study emphasises the significance of understanding the interrelatedness between the stages of the BIM implementation process in order to promote unavoidable and high-quality BIM adoption, as well as identifying the essential strategies that will guide policymakers and industry players in improving and pursuing successful BIM implementation. This study adds to BIM implementation theories by providing new information on the models, stages and interconnections of the BIM implementation process. However, the study could not identify the factors that impede BIM adoption despite the reduction in barriers and use of fundamental BIM implementation strategies.

Background Operating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood. We examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. Methods We conducted a cross-sectional study using a Web-based survey of individuals who had downloaded OR cognitive aids from the websites of Ariadne Labs or Stanford University between January 2013 and January 2016. In this paper, we report on the experience of 368 respondents from US hospitals and ambulatory surgical centers. We analyzed the relationship of more successful implementation (measured as reported regular cognitive aid use during applicable clinical events) with organizational context and with participation in a multi-step implementation process. We used multivariable logistic regression to identify significant predictors of reported, regular OR cognitive aid use during OR crises. Results In the multivariable logistic regression, small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation ( p  = 0.0092). Completing more implementation steps was also significantly associated with more successful implementation; each implementation step completed was associated with just over 50% higher odds of more successful implementation ( p  ≤ 0.0001). More successful implementation was associated with leadership support ( p  < 0.0001) and dedicated time to train staff ( p  = 0.0189). Less successful implementation was associated with resistance among clinical providers to using cognitive aids ( p  < 0.0001), absence of an implementation champion ( p  = 0.0126), and unsatisfactory content or design of the cognitive aid ( p  = 0.0112). Conclusions Successful implementation of cognitive aids in ORs was associated with a supportive organizational context and following a multi-step implementation process. Building strong organizational support and following a well-planned multi-step implementation process will likely increase the use of OR cognitive aids during intraoperative crises, which may improve patient outcomes.

Background For successful implementation of an innovation within a complex adaptive system, we need to understand the ways that implementation processes and their contexts shape each other. To do this, we need to explore the work people do to make sense of an innovation and integrate it into their workflow and the contextual elements that impact implementation. Combining Normalization Process Theory (NPT) with the Consolidated Framework for Implementation Research (CFIR) offers an approach to achieve this. NPT is an implementation process theory that explains how changes in the way people think about and use an innovation occurs, while CFIR is a framework that categorizes and describes contextual determinants across five domains that influence implementation. We demonstrate through a case example from our prior research how we integrated NPT and CFIR to inform the development of the interview guide, coding manual, and analysis of the findings. Methods In collaboration with our stakeholders, we selected NPT and CFIR to study the implementation process and co-developed an interview guide to elicit responses that would illuminate concepts from both. We conducted, audio-recorded, and transcribed 28 interviews with various professionals involved with the implementation. Based on independent coding of select transcripts and team discussion comparing, clarifying, and crystallizing codes, we developed a coding manual integrating CFIR and NPT constructs. We applied the integrated codes to all interview transcripts. Results Our findings highlight how integrating CFIR domains with NPT mechanisms adds explanatory strength to the analysis of implementation processes, with particular implications for practical strategies to facilitate implementation. Multiple coding across both theoretical frames captured the entanglement of process and context. Integrating NPT and CFIR enriched understandings of how interactions between implementation processes and contextual determinants shaped each other during implementation. Conclusion The integration of NPT and CFIR provides guidance to identify and explore complex entangled interactions between agents, processes, and contextual conditions within and beyond organizations to embed innovations into routine practices. Nuanced understandings gained through this approach moves understandings beyond descriptions of determinants to explain how change occurs or not during implementation. Mechanism-based explanations illuminate concrete practical strategies to support implementation.