Spontaneous spatial-optimizing CO2 electroreduction to C2H4 over dynamically synergistic Cu-Bi pair.

In CO2 electroreduction, mutative intermediates and the challenging CC coupling necessitate the spatial interplay between active sites and through dynamically optimizing configurations. Herein, we anchor ethylenediaminetetraacetic acid (EDTA)-bonded Cux+/Bi3+ pair within UiO-66 for a spontaneous spatial-optimizing CO2-to-C2H4 electroreduction. Ab initio molecular dynamic (AIMD) simulation visualizes that such metal pair adaptively interacts with intermediates. Density functional theory (DFT) elicits the componential synergy, in which an upshift d-band of Cu activates CO2 being protonated into *COOH while Bi site stabilizes oxygenated dimers for deep hydrogenation. The dynamic feature of such pair affords large freedom for sorption and migration of various intermediates, which consequently bestows UiO-66-EDTA/CuBi a maximal [Formula: see text] of 47 % and a total current density over 100 mA cm-2 in the flow cell.

Iron-copper bimetallic photo-Fenton system promoted photothermal-hydrogen peroxide production for efficient low-temperature wastewater treatment.

Enhancing the velocity of the oxidation-reduction cycle is crucial for improving the catalytic efficiency of Fenton processes. Therefore, the development of an effective strategy for wastewater degradation at low temperatures is essential. In this context, we present the preparation of an NH2-MIL-88B (Fe)/CuInS2 S-scheme heterojunction. Specifically, CuInS2 nanoparticles are introduced onto the Ferro-organic skeleton, resulting in the exposure of a significant number of active surface sites. Furthermore, NH2-MIL-88B (Fe)/CuInS2 demonstrates an extended photoresponse into the long-wavelength region, which contributes to its excellent photothermal properties. Notably, the degradation rate of tetracycline in low-temperature aqueous environments reaches as high as 99.7 %, several times higher than that of the original sample. Additionally, the hydrogen production of NH2-MIL-88B (Fe)/CuInS2 is 2.23 times that of single NH2-MIL-88B (Fe) and 3.46 times that of single CuInS2. Moreover, the system exhibits good H2O2 evolution performance, forming an efficient photo-Fenton system. The charge transfer process in S-scheme heterojunction is confirmed using in-situ X-ray photoelectron spectroscopy and electron paramagnetic resonance. Both transient photoluminescence and photo electrochemical tests further validate the enhanced photoelectrochemical properties of the NH2-MIL-88B (Fe)/CuInS2 S-scheme heterojunction. The exceptional performance of this system can be attributed to the synergistic effects of the S-scheme heterojunction and the bimetallic codoped photo-Fenton system. This research presents a novel approach for the breakdown of low-temperature wastewater using an improved photocatalytic Fenton system.

Ultrasmall iridium-encapsulated porphyrin metal-organic frameworks for enhanced photodynamic/catalytic therapy by producing reactive oxygen species storm.

Transition metal-coordinated porphyrin metal-organic frameworks (MOFs) were perspective in photodynamic therapy (PDT) and catalytic therapy. However, the tumor hypoxia and the insufficient endogenous hydrogen peroxide (H2O2) seriously limited their efficacies. Herein, by encapsulating ultrasmall iridium (Ir) and modifying glucose oxidase (GOx), an iron-coordinated porphyrin MOF (Fe-MOF) nanoplatform (Fe-MOF@Ir/GOx) was designed to strengthen PDT/catalytic therapy by producing reactive oxygen species (ROS) storm. In this nanoplatform, Fe-MOF showed glutathione (GSH)-responsive degradation, by which porphyrin, GOx and ultrasmall Ir were released. Moreover, ultrasmall Ir possessed dual-activities of catalase (CAT)-like and peroxidase (POD)-like, which provided sufficient oxygen (O2) to enhance PDT efficacy, and hydroxyl radical (·OH) production was also improved by combining Fenton reaction of Fe2+. Further, GOx catalyzed endogenous glucose produced H2O2, also reduced pH value, which accelerated Fenton reaction and resulted in generation of ROS storm. Therefore, the developed Fe-MOF@Ir/GOx nanoplatform demonstrated enhanced PDT/catalytic therapy by producing ROS storm, and also provided a promising strategy to promote degradation/metabolism of inorganic nanoplatforms.

Investigating solvent effects on synthesizing novel cobalt hydroxide and fluoride complex from Co(BF4)2 as active materials of the battery supercapacitor hybrid.

Metal-organic framework (MOF) derivatives with tunable pore structure and improved conductivity are intensively designed as electroactive materials. Incorporating structure directing agents (SDA) is beneficial for designing MOF derivatives with excellent electrochemical performances. Ammonium fluoroborate has been reported as an effective SDA, coupled with cobalt salt and 2-methylimidazole, to synthesize zeolitic imidazolate framework-67 (ZIF-67) derivatives for charge storage. However, the synthetic environment for growing cobalt-based active materials is relatively complex. In this study, cobalt tetrafluoroborate (Co(BF4)2) is proposed as a novel cobalt precursor, supplementing cobalt ions and acting as the SDA in a single chemical, to synthesize the cobalt-based electroactive material of energy storage electrodes. Interactions between solvent molecules and solutes play significant roles on the morphology, composition, and electrochemical performance of active materials. Deionized water, methanol and ethanol are used as precursor solvents to understand their effects on material and electrochemical properties. The optimal electrode presents a specific capacitance of 608.3 F/g at 20 mV/s, attributed to the highest electrochemical surface area and evident compositions of cobalt fluoride and hydroxide. A battery supercapacitor hybrid achieves the maximum energy density of 45 Wh/kg at 429 W/kg. The CF retention of 100% and Coulombic efficiency of 99% are achieved after 10,000 cycles.

Robust construction of CeNi quantum dots/Ni-MOL nanosheets for superior photocatalytic CO2 reduction.

Since the intensification of global environmental pollution and energy shortages, photocatalytic CO2 reduction reaction (CO2RR) has emerged as a promising strategy to convert solar energy into clean chemical energy. Herein, we construct a robust and efficient heterojunction construction photocatalyst for CO2RR, composed of the highly reactive CeNi quantum dots (CeNi QDs) and nickel metal-organic layer (Ni-MOL) ultrathin nanosheets. This design facilitates the rapid separation of photogenerated charge carriers, as confirmed by X-ray photoelectron spectroscopy (XPS), photoluminescence spectroscopy (PL) and other characterizations. Mechanistic studies with in situ diffuse reflectance Fourier transform infrared spectroscopy (in situ DRIFTS) and the d-band center calculation indicate that the propensity of photocatalyst for CO2 absorption and CO desorption, leading to high performance and selectivity. The optimized loading amount of CeNi quantum dots and modified structure result in a CO yield of 30.53 mmol·g-1 within 6 h under irradiation. This work not only paves a new and convenient way for developing high-activity quantum dot materials for CO2RR but also exploits novel avenues to fabricate more heterojunction composites for solar energy conversion.

Investigation on cost-effective composites for CO2 adsorption from post-gasification residue and metal organic framework.

Cost-effective CO2 adsorbents are gaining increasing attention as viable solutions for mitigating climate change. In this study, composites were synthesized by electrochemically combining the post-gasification residue of Macadamia nut shell with copper benzene-1,3,5-tricarboxylate (CuBTC). Among the different composites synthesized, the ratio of 1:1 between biochar and CuBTC (B 1:1) demonstrated the highest CO2 adsorption capacity. Under controlled laboratory conditions (0°C, 1 bar, without the influence of ambient moisture or CO2 diffusion limitations), B 1:1 achieved a CO2 adsorption capacity of 9.8 mmol/g, while under industrial-like conditions (25°C, 1 bar, taking into account the impact of ambient moisture and CO2 diffusion limitations within a bed of adsorbent), it reached 6.2 mmol/g. These values surpassed those reported for various advanced CO2 adsorbents investigated in previous studies. The superior performance of the B 1:1 composite can be attributed to the optimization of the number of active sites, porosity, and the preservation of the full physical and chemical surface properties of both parent materials. Furthermore, the composite exhibited a notable CO2/N2 selectivity and improved stability under moisture conditions. These favorable characteristics make B 1:1 a promising candidate for industrial applications.

Facial synthesis of fluorine-engineered magnetic covalent organic framework for selective and ultrasensitive determination of fipronil, its metabolites and analogs in food samples.

To improve the adsorption affinity and selectivity of fipronils (FPNs), including fipronil, its metabolites and analogs, a magnetic covalent organic framework (Fe3O4@COF-F) with copious fluorine affinity sites was innovatively designed as an adsorbent of magnetic solid-phase extraction (MSPE). The enhanced surface area, pore size, crystallinity of Fe3O4@COF-F and its exponential adsorption capacities (187.3-231.5 mg g-1) towards fipronils were investigated. Combining MSPE with high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), an analytical method was established for the selective determination of fipronils in milk and milk powder samples. This method achieved high sensitivity (LODs: 0.004-0.075 ng g-1), satisfactory repeatability and accuracy with spiked recoveries ranging from 89.9% to 100.3% (RSDs≤5.1%). Overall, the constructed Fe3O4@COF-F displayed great potential for the selective enrichment of fipronils, which could be ascribed to fluorine­fluorine interaction. This method proposed a feasible and promising strategy for the development of functionalized COF and broadened its application in fluorine containing hazards detection.

Facile synthesis of magnetic ionic covalent organic framework and dispersive magnetic solid phase extraction of aromatic amino acid oxidation products in thermally processed foods.

Aromatic amino acid oxidation products (AAAOPs) are newly discovered risk substances of thermal processes. Due to its significant polarity and trace level in food matrices, there are no efficient pre-treatment methods available to enrich AAAOPs. Herein, we proposed a magnetic cationic covalent organic framework (Fe3O4@EB-iCOF) as an adsorbent for dispersive magnetic solid-phase extraction (DMSPE). Benefiting from the unique charged characteristics of Fe3O4@EB-iCOF, AAAOPs can be enriched through electrostatic interaction and π-π interactions. Under the optimal DMSPE conditions, the combined HPLC-MS/MS method demonstrated good linearity (R2 ≥ 0.990) and a low detection limit (0.11-7.5 µg·kg-1) for AAAOPs. In addition, the method was applied to real sample and obtained satisfactory recoveries (86.8 % âˆ¼ 109.9 %). Especially, we applied this method to the detection of AAAOPs in meat samples and conducted a preliminarily study on its formation rules, which provides a reliable basis for assessing potential dietary risks.

An effective procedure used metal-organic framework for determination of cadmium ions in real tap water and human blood plasma samples.

A newly developed 2H5MA-MOF sensor by covalently linking NH2-MIL-53(Al) with 2'-Hydroxy-5'-methylacetophenon, designed for highly sensitive and selective detection of Cd2+ ions using fluorometric methods. Detailed structural and morphological analyses confirmed the sensor's unique properties. It demonstrated an impressive linear detection range from 0 to 2 ppm, with an exceptionally low detection limit of 5.77 × 10-2 ppm and a quantification limit of 1.75 × 10-1 ppm, indicating its high sensitivity (R2 = 0.9996). The sensor also responded quickly, detecting Cd2+ within just 30 s at pH 4. We successfully tested it on real samples of tap water and human blood plasma, achieving recovery rates between 96 % and 104 %. The accuracy of these findings was further validated by comparison with ICP-OES. Overall, the 2H5MA-MOF sensor shows great potential for fast, ultra-sensitive, and reliable detection of Cd2+ ions, making it a promising tool for environmental and biomedical applications.

Magnetic covalent organic framework as an absorbent coupled with a portable mass spectrometer for rapid detection of malachite green and its metabolite residues.

It is important to develop specific adsorbents for malachite green and other fish drug residues. Herein, a simple strategy for synthesizing a novel magnetic covalent organic frameworks (rFe3O4@Py-COF) has been studied, and the materials were used as a magnetic absorbent for solid phase extraction (MSPE) of malachite green (MG) and its metabolite as leucomalachite green (LMG) in fishes. In this study, the mild reduction program of formic acid replacing traditional sodium borohydride as a reducing agent has been adopted to increase the stability of the framework, which can maintain the original high crystallinity and surface area of the reduced COF. The secondary amine bond is expected to be used as the reaction center for further functionalization of COF pore wall. Subsequently, rFe3O4@Py-COF (rmCOF) obtained after reduction was used as MSPE materials to detect MG and LMG by a portable mass spectrometer. After optimizing the conditions, the linearity is good within the range of 1.25∼100 µg/kg (R2≥0.9954), the limits of detection (LODs) are 0.31∼0.44 µg/kg with satisfactory recovery (85.0 %∼106.0 %). These results indicate that the assay is suitable for monitoring MG and LMG in complex aquatic foods, providing protection for food safety.

A theoretical framework to companies value creation through a systematic review of intangibles' management.

The purpose of this article is to develop a theoretical framework that identifies the intangible aspects that can be managed and contribute to the value creation for organizations. The theoretical framework was developed based on a systematic review performed according to a protocol that proposes steps to identify the intangible aspects present in the scientific literature. Mendeley software assisted in organizing and reading the 3152 articles identified by the systematic review. The results of the article propose a classification of intangible aspects identified in levels that collaborate with the value creation in organizations. The first and main group being called FPVs, encompassing: reputation, innovation, performance, legitimacy, and knowledge. Strategically, the FPVs are subdivided into 15 CSFs, that cover the other 35 intangibles perceived in the studies, called Indicators and that can be managed. The results of the article provide theoretical and managerial implications and can be used by the academic community and by managers of industrial organizations. The results present reflections on how intangible aspects are present in research and the management of organizations. Furthermore, the literature review proves the importance of analyzing and monitoring intangible aspects nowadays.

Exploring performance and mechanism of modified metal-organic frameworks in calcium alginate/polyvinyl alcohol double-network hydrogels for effective dye wastewater treatment.

To address the growing problem of dye wastewater pollution, a novel MOFs adsorbent calcium alginate/polyvinyl alcohol@UiO-66 was developed using environmentally friendly polymers, sodium alginate and polyvinyl alcohol creating gel spheres with a double-network structure through cross-linking. UiO-66 metal-organic frameworks are then grown onto the gel spheres, resulting in the final CA/PVA@UiO-66 adsorbent. This adsorbent boasts a high surface area (17.4 m2/g) and a mesoporous-nested microporous structure. It effectively removes MB from water, the actual maximum adsorption capacity was measured at 275.8 mg/g, which surpasses most existing adsorbents. Remarkably, the adsorbent retains 93.9 % of its initial capacity even after 10 reuse cycles. The adsorption process adhered to the Redlich-Peterson model and the PFO model. The N2-Sorption isotherm, actual Methylene blue (MB) adsorption experiments, and model analysis further suggest that the adsorption process is a complex heterogeneous diffusion process involving simultaneous chemical and physical adsorption. Additionally, the adsorption process is endothermic, indicating that it can occur spontaneously at 298 K. Increasing the temperature promotes the forward progress of the adsorption reaction, thereby enhancing the adsorption capacity. The gel adsorbent exhibited excellent dye wastewater purification capabilities, coupled with commendable reusability.

Effect of temperature and extraframework cation type on CHA framework flexibility.

The sorption properties of zeolites are controlled by several factors, i.e. Si/Al ratio of the aluminosilicate framework [AlSiO4]-, the type and position of the extraframework (EF) cations, and the applied temperature. Here we investigate the flexibility of CHA framework as a function of EF cation-content and temperature (20-350 °C). Two CHA forms (Na- and Cu-CHA) with Si/Al = 2 were analysed. The main objectives were: (i) to shed light on the HT behaviour of Na-CHA, for which contrasting results exist in literature; (ii) define the role of temperature and EF cation-type in the response to the heating stimuli. We show that at 75 °C, Na-CHA undergoes a severe contraction of the unit-cell volume (-12%) accompanied by a symmetry lowering (R-3m to I2/m). The transformation is reversible, if the dehydrated Na-CHA is exposed to ambient conditions. In contrast, Cu-CHA experiences a significant different dehydration path, which involves minor changes of the CHA framework, and a net positive thermal-expansion after dehydration. The implications of the observed transformations for gas separation processes are finally discussed.

Interface misfit of conventionally milled and novel hybrid full-arch implant-supported titanium frameworks.

OBJECTIVE: A hybrid manufacturing technique that combines selective laser melting (SLM) and computer numerical control (CNC) has been developed for the fabrication of implant-platform/framework interfaces (PFIs) for mandibular and maxillary full-arch implant-supported titanium frameworks. The aim of this study was to compare the discrepancies in specimens fabricated using the hybrid technique (termed SLM/m hereafter) with those in specimens fabricated by conventional CNC milling. MATERIALS AND METHODS: Based on a mandibular four-PFI CAD model and a maxillary six-PFI CAD model, four groups of titanium frameworks (eight per group, totaling 32) were fabricated according to the fabrication technique (SLM/m or milling) and number of PFIs (four or six). The frameworks were scanned by a structured light scanner and aligned with the CAD model in Geomagic Control X. Discrepancy was defined as the difference between the PFIs of the scanned framework and those of the CAD model. Discrepancies were measured and evaluated by multilevel analysis using a mixed-effects model (α = 0.05), followed by independent samples t-tests (α = 0.0125). Furthermore, the manufacturing times and raw-material costs were recorded and compared. RESULTS: The maximum discrepancy values for the four-PFI and six-PFI hybrid frameworks were 52.2 and 64.3 µm, respectively. Multilevel analysis revealed that the fabrication technique and the number of PFIs had no significant effect on the discrepancy value. However, a significant interaction between the two factors was observed (P = 0.020). The discrepancies for the four-PFI hybrid frameworks were significantly lower than those for the four-PFI milled frameworks (P = 0.001). No significant difference in discrepancies between the six-PFI hybrid frameworks and six-PFI milled frameworks was observed (P = 0.697). Furthermore, the hybrid frameworks required only 11% of the raw materials and 25% of the milling time required for the conventionally milled frameworks. CONCLUSION: SLM/m hybrid frameworks are viable, accurate alternatives to CNC-milled frameworks, with the added benefit of substantial cost reduction.

Halogen-Driven Single-Crystal to Single-Crystal Transformation Engineering the Cluster-based Spin Crossover Frameworks.

Cluster-based spin crossover (SCO) frameworks are a new class of smart metal-organic frameworks (MOFs) with diverse structures and topologies and unique bistable physicochemical properties. Here, we report a cluster-based SCO framework [Fe3{Ag4(CN)6(H2O)}2(TPBA)3](ClO4)2·7DMF (1) with an extremely rare 3,4,6-T108 topology, in which the tripodal [Ag{Ag(CN)2}3(H2O)]2- clusters axially link the Fe2+ ions to form 2D→3D n-fold Borromean entangled networks. Under the guidance of reticular chemistry, the post-synthetic modification (PSM) from 1 with 3,4,6-T108 topology to [Fe3{Ag8X8(CN)6}(TPBA)3] (2_X, X = Cl, Br, I) with urk topology is firstly achieved via single-crystal to single-crystal (SCSC) transformation. Moreover, the successive SCSC transformations from 2_Cl to 2_Br and then to 2_I are realized for the first time. Their SCO behaviors are also modified by halogen-driven stepwise cluster transformations. Hence, these findings provide new strategies for the development of cluster-based SCO MOFs towards the smart functional porous materials.

Factors influencing implementation of digital cardiac rehabilitation: A qualitative analysis of health workers perspectives.

Background: Despite growing evidence for the effectiveness of digital cardiac rehabilitation (CR) uptake of this technology remains low. Understanding the factors that influence implementation of digital CR in clinical practice is a growing area of research. The aim of this nested qualitative study was to explore health worker perspectives on factors influencing implementation of a digital CR programme. Methods: Using convenience sampling, semi-structured interviews were conducted with health workers, including health care professionals (nurses, dietitians, physiotherapists) and those in administrative and managerial roles who were involved in delivering and referring patients to Croí MySláinte, a 12-week digital CR intervention delivered during the Coronavirus 2019 pandemic. The updated Consolidated Framework for Implementation Research (CFIR) guided data collection and framework analysis. Results: Interviews were conducted with 14 health workers. Factors influencing implementation of Croí MySláinte were multiple, with some operating independently and others in combination. They related to: (i) characteristics of individuals (e.g., senior leadership support, commitment and motivation of Health workers to meet patient needs, technical capability, workload and perceived fit with role); (ii) features of the programme (e.g., accessibility and convenience for patients, the digital platform, patient self- monitoring tools, the multidisciplinary team and core components); (iii) the external environment (e.g., partnership and connections between organisations, broadband and COVID-19); (iv) the internal environment (e.g., organisational culture, teamwork, resources including funding, digital infrastructure and staffing); and (v) the implementation process (e.g., engaging patients through provision of technical support). Conclusion: The study findings suggest that factors influencing implementation of digital CR operate at multiple levels. Therefore, multi-level implementation strategies are required if the true potential of digital health in improving equitable cardiac rehabilitation access, participation and patient outcomes is to be realised.

Magnesium metal-organic framework microneedles loaded with curcumin for accelerating oral ulcer healing.

Oral ulcers are a common oral mucosal disease that seriously affect the quality of life. Traditional drug treatments have shown unsatisfactory efficacy and potential adverse reactions. In this study, curcumin-loaded multifunctional magnesium metal-organic framework-embedded hyaluronic acid-soluble microneedles patches were developed to optimize treatment strategies for oral ulcers. This microneedles patch achieves efficient release of curcumin and Mg2+ in the ulcer through precisely targeted delivery and controllable release mechanism, significantly regulates inflammation, promotes cell migration and angiogenesis, and accelerates the ulcer healing process. At the same time, the synergistic effect of curcumin and gallic acid effectively alleviated oxidative stress, while the backplate ε-poly-L-lysine and needle tip Mg2+ jointly constructed an antibacterial barrier to effectively inhibit pathogens. Verification using an oral ulcer rat model showed that the microneedles patch exhibited excellent therapeutic effects. This not only opens up a new avenue for clinical oral treatment but also marks a breakthrough in nanobiomaterials science and drug delivery technology and heralds a broad prospect in the field of oral ulcer treatment in the future.

Pre-exposure Prophylaxis (PrEP) implementation among latino MSM: a qualitative scoping review of implementation determinants and change methods.

INTRODUCTION: The increasing rates of HIV among Latino men who have sex with men (MSM) necessitate innovative and rigorous studies to evaluate prevention and treatment strategies. Pre-exposure prophylaxis (PrEP) is a highly effective tool in preventing HIV acquisition and plays a crucial role in the Ending the HIV Epidemic in the U.S. initiative. However, there is a scarcity of PrEP research specifically focused on Latino MSM, and the factors influencing its implementation remain largely unknown. METHODS: To address this gap, we conducted a comprehensive review exploring the determinants (barriers and facilitators) of PrEP implementation among Latino MSM, as well as the change methods (implementation strategies and adjunctive interventions) that have been evaluated to promote its adoption. Our review encompassed 43 peer-reviewed articles examining determinants and four articles assessing change methods. Determinants were coded using the updated Consolidated Framework for Implementation Research (CFIR 2.0) to understand the multilevel barriers and facilitators associated with implementation. RESULTS: The majority of research has focused on PrEP recipients (i.e., patients), primarily examining their awareness and willingness to use PrEP. Fewer studies have explored the factors influencing clinicians and service delivery systems. Additionally, the evaluation of change methods to enhance clinician adoption and adherence to PrEP and recipient adherence to PrEP has been limited. CONCLUSION: It is evident that there is a need for culturally adapted strategies tailored specifically for Latino MSM, as the current literature remains largely unexplored in this regard. By incorporating principles from implementation science, we can gain a clearer understanding of the knowledge, skills, and roles necessary for effective cultural adaptations. Future research should emphasize factors influencing implementation from a clinician standpoint and focus on innovative change methods to increase PrEP awareness, reach, adoption, and sustained adherence among Latino MSM.

Determinants of antibiotic prescribing in primary care in Vietnam: a qualitative study using the Theoretical Domains Framework.

BACKGROUND: To formulate effective strategies for antimicrobial stewardship (AMS) in primary care, it is crucial to gain a thorough understanding of factors influencing prescribers' behavior within the context. This qualitative study utilizes the Theoretical Domains Framework (TDF) to uncover these influential factors. METHODS: We conducted a qualitative study using in-depth interviews and focus group discussions with primary care workers in two provinces in rural Vietnam. Data analysis employed a combined inductive and deductive approach, with the deductive aspect grounded in the TDF. RESULTS: Thirty-eight doctors, doctor associates, and pharmacists participated in twenty-two interviews and two focus group discussions. We identified sixteen themes, directly mapping onto seven TDF domains: knowledge, skills, behavioral regulation, environmental context and resources, social influences, social/professional role and identity, and optimism. Factors driving unnecessary prescription of antibiotics include low awareness of antimicrobial resistance (AMR), diagnostic uncertainty, prescription-based reimbursement policy, inadequate medication supplies, insufficient financing, patients' perception of health insurance medication as an entitlement, and maintaining doctor-patient relationships. Potential factors facilitating AMS activities include time availability for in-person patient consultation, experience in health communication, and willingness to take action against AMR. CONCLUSION: Utilizing the TDF to systematically analyze and present behavioral determinants offers a structured foundation for designing impactful AMS interventions in primary care. The findings underscore the importance of not only enhancing knowledge and skills but also implementing environmental restructuring, regulation, and enablement measures to effectively tackle unnecessary antibiotic prescribing in this context.

Barriers and enablers to addressing smoking, nutrition, alcohol consumption, physical activity and gestational weight gain (SNAP-W) as part of antenatal care: A mixed methods systematic review.

BACKGROUND: International clinical guidelines recommend that smoking, nutrition, alcohol consumption, physical activity and gestational weight gain (SNAP-W) be addressed as part of routine antenatal care throughout pregnancy. However, guideline recommendations are poorly implemented, and few antenatal care recipients routinely receive the recommended care. There is a need to establish the determinants (barriers and enablers) to care delivery to inform strategies to improve implementation. This systematic review aimed to synthesize qualitative and quantitative evidence of the barriers and enablers to the routine delivery of antenatal care targeting SNAP-W health risks. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven databases were searched for relevant studies published between January 2001 and November 2023. Study findings were coded and analysed according to the domains of the Theoretical Domains Framework (TDF). RESULTS: Forty-nine studies were included in the review, 27 qualitative studies and 22 quantitative studies. The studies were conducted in 14 countries. Data were collected from 7146 antenatal care providers (midwives, Aboriginal health workers, obstetricians, medical officers, general practitioners) and 352 barriers and enablers were identified. Across all SNAP-W health risk and antenatal care provider groups, the predominant TDF domain was 'environmental context and resources', identified in 96% of studies. Barriers within this domain included insufficient time, limited access to and quality of resources, and limited organisational supports. 'Beliefs about consequences' was the second most common TDF domain, reported in 67% of studies, particularly studies of care related to alcohol use, nutrition/ physical activity/ gestational weight gain and those involving midwives, multidisciplinary practitioners and general practitioners. 'Optimism' was the second most common TDF domain for studies of smoking-related care and involving obstetricians, gynaecologists, and other mixed medical professions. CONCLUSIONS: It is critical that determinants related to environmental context and resources including time, resources and organisational supports are considered in the development of strategies to support the implementation of recommended antenatal care related to SNAP-W risks. Strategies addressing clinician beliefs about consequences and optimism may also be needed to support the implementation of care related to specific health behaviours and by specific antenatal care provider groups. REGISTRATION: The review protocol was prospectively registered with Prospero: CRD42022353084; 22 October 2022.