Search results for: migrant service delivery system

Authors: Anne Marie Morrin

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This paper will focus on the design, delivery and assessment of a transdisciplinary STEAM (Science, Technology, Engineering, Arts, and Mathematics) education initiative in a college of education in Ireland. The project explores a transdisciplinary approach to supporting STEAM education where the concepts, methodologies and assessments employed derive from visual art sessions within initial teacher education. The research will demonstrate that the STEAM Education approach is effective when visual art concepts and methods are placed at the core of the teaching and learning experience. Within this study, emphasis is placed on authentic collaboration and transdisciplinary pedagogical approaches with the STEAM subjects. The partners included a combination of teaching expertise in STEM and Visual Arts education, artists, in-service and pre-service teachers and children. The inclusion of all stakeholders mentioned moves towards a more authentic approach where transdisciplinary practice is at the core of the teaching and learning. Qualitative data was collected using a combination of questionnaires (focused and open-ended questions) and focus groups. In addition, the data was collected through video diaries where students reflected on their visual journals and transdisciplinary practice, which gave rich insight into participants' experiences and opinions on their learning. It was found that an effective program of STEAM education integration was informed by co-teaching (continuous professional development), which involved a commitment to adaptable and flexible approaches to teaching, learning, and assessment, as well as the importance of continuous reflection-in-action by all participants. The delivery of a transdisciplinary model of STEAM education was devised to reconceptualizatise how individual subject areas can develop essential skills and tackle critical issues (such as self-care and climate change) through data visualisation and technology. The success of the project can be attributed to the collaboration, which was inclusive, flexible and a willingness between various stakeholders to be involved in the design and implementation of the project from conception to completion. The case study approach taken is particularistic (focusing on the STEAM-ED project), descriptive (providing in-depth descriptions from varied and multiple perspectives), and heuristic (interpreting the participants’ experiences and what meaning they attributed to their experiences).

Keywords: collaboration, transdisciplinary, STEAM, visual arts education

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Authors: Leo Latasch, Mario Di Gennaro

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Introduction: The goal of this project was to increase the resilience of the population as well as rescue organizations to make both quality and time-related improvements in handling crises. A helper network was created for this purpose. Methods: Social questions regarding the structure and purpose of helper networks were considered - specifically with regard to helper motivation, the level of commitment and collaboration between populations and agencies. The exchange of information, the coordinated use of volunteers, and the distribution of available resources will be ensured through defined communication and cooperation routines. Helper smartphones will also be used provide a picture of the situation on the ground. Results: The helper network was established and deployed based on the RESIBES information technology system. It consists of a service platform, a web portal and a smartphone app. The service platform is the central element for collaboration between the various rescue organizations, as well as for persons, associations, and companies from the population offering voluntary aid. The platform was used for: Registering helpers and resources and then requesting and assigning it in case of a disaster. These services allow the population's resources to be organized. The service platform also allows for a secure data exchange between services and external systems. Conclusions: The social and technical work priorities have allowed us to cover a full cycle of advance structural work, gaining an overview, damage management, evaluation, and feedback on experiences. This cycle allows experiences gained while handling the crisis to feed back into the cycle and improve preparations and management strategies.

Keywords: coordination, disaster, resilience, volunteers

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Authors: Shan Li, Qiuwen Ma

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Integrated project delivery (IPD) is a project delivery method distinguished by a shared risk/rewards mechanism and multiparty agreement. IPD has drawn increasing attention from construction industry due to its reliability to deliver high-performing buildings. However, unavailable IPD specific insurance concerns the industry participants who are interested in IPD implementation. Even though the risk management capability can be enhanced using shared risk mechanism, some risks may occur when the partners do not commit themselves into the integrated practices in a desired manner. This is because the intense collaboration and close integration can not only create added value but bring new opportunistic behaviors and disputes. The study is aimed to investigate the risks of implementing IPD using Bayesian theory. IPD risk taxonomy is presented to identify all potential risks of implementing IPD and a risk network map is developed to capture the interdependencies between IPD risks. The conditional relations between risk occurrences and the impacts of IPD risks on project performances are evaluated and simulated based on Bayesian theory. The probability of project outcomes is predicted by simulation. In addition, it is found that some risks caused by integration are most possible occurred risks. This study can help the IPD project participants identify critical risks of adopting IPD to improve project performances. In addition, it is helpful to develop IPD specific insurance when the pertinent risks can be identified.

Keywords: Bayesian theory, integrated project delivery, project risks, project performances

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Authors: C. Puangsawat, C. Limotai, P. Srikhachin

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Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

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Authors: S. L. J. Tan, N. Billa, C. J. Roberts

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Oral delivery of amphotericin B (AmpB) potentially eliminates constraints and side effects associated with intravenous administration, but remains challenging due to the physicochemical properties of the drug such that it results in meagre bioavailability (0.3%). In an advanced formulation, 1) nanostructured lipid carriers (NLC) were formulated as they can accommodate higher levels of cargoes and restrict drug expulsion and 2) a mucoadhesion feature was incorporated so as to impart sluggish transit of the NLC along the gastrointestinal tract and hence, maximize uptake and improve bioavailability of AmpB. The AmpB-loaded NLC formulation was successfully formulated via high shear homogenisation and ultrasonication. A chitosan coating was adsorbed onto the formed NLC. Physical properties of the formulations; particle size, zeta potential, encapsulation efficiency (%EE), aggregation states and mucoadhesion as well as the effect of the variable pH on the integrity of the formulations were examined. The particle size of the freshly prepared AmpB-loaded NLC was 163.1 ± 0.7 nm, with a negative surface charge and remained essentially stable over 120 days. Adsorption of chitosan caused a significant increase in particle size to 348.0 ± 12 nm with the zeta potential change towards positivity. Interestingly, the chitosan-coated AmpB-loaded NLC (ChiAmpB NLC) showed significant decrease in particle size upon storage, suggesting 'anti-Ostwald' ripening effect. AmpB-loaded NLC formulation showed %EE of 94.3 ± 0.02 % and incorporation of chitosan increased the %EE significantly, to 99.3 ± 0.15 %. This suggests that the addition of chitosan renders stability to the NLC formulation, interacting with the anionic segment of the NLC and preventing the drug leakage. AmpB in both NLC and ChiAmpB NLC showed polyaggregation which is the non-toxic conformation. The mucoadhesiveness of the ChiAmpB NLC formulation was observed in both acidic pH (pH 5.8) and near-neutral pH (pH 6.8) conditions as opposed to AmpB-loaded NLC formulation. Hence, the incorporation of chitosan into the NLC formulation did not only impart mucoadhesive property but also protected against the expulsion of AmpB which makes it well-primed as a potential oral delivery system for AmpB.

Keywords: Amphotericin B, mucoadhesion, nanostructured lipid carriers, oral delivery

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Authors: O. V. Jurieva, O. U. Jurieva, R. H. Yagudin, P. B. Chursin

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In the recent scientific researches on the problems of public service the idea of the use of innovative technologies of management of personnel processes is accurately formulated. Authors made an attempt to analyze the changes in the public service organizations and to understand how the studied situation is interpreted by the government employees themselves. For this purpose the strategy of sociological research was carried out on the basis of application of questionnaire developed by M. Rokich and focus group research. For the research purposes it was necessary to get to microlevel in order to include daily activities of employees of an organization, their life experience and values in the focus of the analysis. Based on P. Bourdieu's methodology, authors investigated the established patterns of consciousness and behavior of officials (doxa) and also analyzed the tendencies of re-thinking (change) of the settled content of values (heterodoxy) by them. The distinctive feature of the conducted research is that the public servants who have different length of service in the public service took part in the research procedure. The obtained data helped to answer the following question: what are the specifics of doxs of the public servants who work in the public civil service more than 7-10 years and what perception of values of civil service have junior experts whose work experience doesn't exceed 3 years. Respondents were presented by two groups: (1) public servants of the level of main positions in the public civil service of the Republic of Tatarstan. (2) Public servants of the level of lower positions in the ministries and departments of the Republic of Tatarstan. For the study of doxa or of the existing values of public servants, the research with use of the questionnaire based on M. Rokich's system is conducted. Two types of values are emphasised: terminal and instrumental, which are united by us in the collective concept doxa. Doxa: the instrument of research of the established patterns of consciousness and behavior which can either resist to changes in the organization or, on the contrary, support their implementation. In the following stage an attempt to deepen our understanding of the essence and specifics of doxa of officials by means of the applied sociological research which is carried out by focus group method is made. Information obtained by authors during the research convinces that for the success of policy of changes in the organizations of public service it is necessary to develop special technologies of informing employees about the essence and inevitability of the developed innovations, to involve them in the process of changes, to train and to develop the younger generation of civil servants, seriously to perceive additional training and retraining of officials.

Keywords: innovative technologies, public service organizations, public servants

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Authors: Courtney Evans, Yuto Morimitsu, Tsubasa Hisadome, Futo Inomoto, Masahiro Yoshida, Takayuki Takei

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Hydrogels are useful biomaterials due to their highly biocompatible nature and their ability to absorb large quantities of liquid and mimic soft tissue. They are often used as therapeutic drug delivery systems. However, it is sometimes difficult to sustain controlled release when using hydrophobic medicines, as hydrogels are frequently hydrophilic. As such, this research shows the success of chitosan hydrogels modified through hydrophobic interaction. This was done through the imide bonding of the alkyl groups in fatty aldehydes and the amino groups in chitosan, followed by reductive animation. The resulting cryogels could be optimized for strength as well as sorption and desorption (of a hydrophobic dye used to mimic hydrophobic medicine) by varying the alkyl chain length and the substitution degree of the fatty aldehyde. Optimized cryogels showed potential as biomedical materials, particularly as drug delivery systems.

Keywords: biomedical materials, chitosan, drug carriers, hydrophobic modification

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Authors: Cesar Torres, Robert Briber, Nam Sun Wang

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Eye drops are the most commonly used treatment for short-term and long-term ophthalmic diseases. However, eye drops could deliver only about 5% of the functional ingredients contained in a burst dosage. To address the limitations of eye drops, the use of therapeutic contact lenses has been introduced. Drug-loaded contact lenses provide drugs a longer residence time in the tear film and hence, decrease the potential risk of side effects. Nevertheless, a major limitation of contact lenses as drug delivery devices is that most of the drug absorbed is released within the first few hours. This fact limits their use for extended release. The present study demonstrates the application of long-alkyl chain ionic surfactants on extending drug release kinetics from commercially available silicone hydrogel contact lenses. In vitro release experiments were carried by immersing drug-containing contact lenses in phosphate buffer saline at physiological pH. The drug concentration as a function of time was monitored using ultraviolet-visible spectroscopy. The results of the study demonstrate that release kinetics is dependent on the ionic surfactant weight percent in the contact lenses, and on the length of the hydrophobic alkyl chain of the ionic surfactants. The use of ionic surfactants in contact lenses can extend the delivery of drugs from a few hours to a few weeks, depending on the physicochemical properties of the drugs. Contact lenses embedded with ionic surfactants could be potential biomaterials to be used for extended drug delivery and in the treatment of ophthalmic diseases. However, ocular irritation and toxicity studies would be needed to evaluate the safety of the approach.

Keywords: contact lenses, drug delivery, controlled release, ionic surfactant

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Authors: Abdul Matin, Muhammad Ajmal, Uzma Yunus, Noaman-ul Haq, Hafiz M. Shohaib, Ambreen G. Muazzam

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Carbon nanoparticles (CNPs) have unique properties that are useful for the diagnosis and treatment of cancer due to their precise properties like small size (ideal for delivery within the body) stability in solvent and tunable surface chemistry for targeted delivery. Here, highly fluorescent, monodispersed and water-soluble CNPs were synthesized directly from a suitable carbohydrate source (glucose and sucrose) by one-step acid assisted ultrasonic treatment at 35 KHz for 4 hours. This method is green, simple, rapid and economical and can be used for large scale production and applications. The average particle sizes of CNPs are less than 10nm and they emit bright and colorful green-blue fluorescence under the irradiation of UV-light at 365nm. The CNPs were characterized by scanning electron microscopy, fluorescent spectrophotometry, Fourier transform infrared spectrophotometry, ultraviolet-visible spectrophotometry and TGA analysis. Fluorescent CNPs were used as fluorescent probe and nano-carriers for anticancer drug. Functionalized CNPs (with ethylene diamine) were attached with anticancer drug-Methotrexate. In vitro bioactivity and biocompatibility of CNPs-drug conjugates was evaluated by LDH assay and Sulforhodamine B assay using human lung carcinoma cell lines (H157). Our results reveled that CNPs showed biocompatibility and CNPs-anticancer drug conjugates have shown potent cytotoxic effects and high antitumor activities in lung cancer cell lines. CNPs are proved to be excellent substitute for conventional drug delivery cargo systems and anticancer therapeutics in vitro. Our future studies will be more focused on using the same nanoparticles in vivo model system.

Keywords: carbon nanoparticles, carbon nanoparticles-methotrexate conjugates, human lung carcinoma cell lines, lactate dehydrogenase, methotrexate

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Authors: Ayodeji Emmanuel Oke, Mathew O. Ikuabe, Clinton O. Aigbavboa, Douglas O. Aghimien

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The call for sustainable construction has received significant drive in recent time considering the overwhelming impacts of its adoption. However, not much has been deliberated on this subject with regards to the roles of organisational leadership in delivering sustainable construction. To this end, the study empirically scrutinised the roles of organisational leadership in delivering sustainable construction. The study adopted a quantitative approach while construction professionals formed the population of the study. A well-articulated questionnaire was used in eliciting responses from the respondents, while appropriate methods of data analysis were used. Findings from the study depicted that the major role of organisational leadership in the delivery of sustainable construction is acting as sustainability integrators. Equally revealed are the internal and external factors affecting organisational leadership in delivering sustainable construction. The study concluded by emphasizing the core roles for delivering sustainable construction by organisational leadership and further recommended that sustainable construction should serve as a prominent and focal organisation goal by organisational leadership when steering the organisation towards meeting its objectives

Keywords: organisational leadership, project delivery, roles, sustainable construction

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Authors: Kulwinder Singh Mann

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The innovative features of information system, known as Radiology Information System (RIS), for electronic medical records has shown a good impact in the hospital. The objective is to help and make their work easier; such as for a physician to access the patient’s data and for a patient to check their bill transparently. The interoperability of RIS with the other intra-hospital information systems it interacts with, dealing with the compatibility and open architecture issues, are accomplished by two novel mechanisms. The first one is the particular message handling system that is applied for the exchange of information, according to the Health Level Seven (HL7) protocol’s specifications and serves the transfer of medical and administrative data among the RIS applications and data store unit. The second one implements the translation of information between the formats that HL7 and Digital Imaging and Communication in Medicine (DICOM) protocols specify, providing the communication between RIS and Picture and Archive Communication System (PACS) which is used for the increasing incorporation of modern medical imaging equipment.

Keywords: RIS, PACS, HIS, HL7, DICOM, messaging service, interoperability, digital images

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Authors: Alison C. Essary, Victor Trastek

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Introduction: The current state of the health care system in the U.S. is characterized by an unprecedented number of people living with multiple chronic conditions, unsustainable rise in health care costs, inadequate access to care, and wide variation in health outcomes throughout the country. An estimated two-thirds of Americans are living with two or more chronic conditions, contributing to 75% of all health care spending. In 2013, the School for the Science of Health Care Delivery (SHCD) was charged with redesigning the health care system through education and research. Faculty in business, law, and public policy, and thought leaders in health care delivery, administration, public health and health IT created undergraduate, graduate, and executive academic programs to address this pressing need. Faculty and students work across disciplines, and with community partners and employers to improve care delivery and increase value for patients. Methods: Curricula apply content in health care administration and operations within the clinical context. Graduate modules are team-taught by faculty across academic units to model team-based practice. Seminars, team-based assignments, faculty mentoring, and applied projects are integral to student success. Cohort-driven models enhance networking and collaboration. This observational study evaluated two years of admissions data, and one year of graduate data to assess program outcomes and inform the current graduate-level curricula. Descriptive statistics includes means, percentages. Results: Fall 2013, the program received 51 applications. The mean GPA of the entering class of 37 students was 3.38. Ninety-seven percent of the fall 2013 cohort successfully completed the program (n=35). Sixty-six percent are currently employed in the health care industry (n=23). Of the remaining 12 graduates, two successfully matriculated to medical school; one works in the original field of study; four await results on the MCAT or DAT, and five were lost to follow up. Attrition of one student was attributed to non-academic reasons. Fall 2014, the program expanded to include both on-ground and online cohorts. Applications were evenly distributed between on-ground (n=70) and online (n=68). Thirty-eight students enrolled in the on-ground program. The mean GPA was 3.95. Ninety-five percent of students successfully completed the program (n=36). Thirty-six students enrolled in the online program. The mean GPA was 3.85. Graduate outcomes are pending. Discussion: Challenges include demographic variability between online and on-ground students; yet, both profiles are similar in that students intend to become change agents in the health care system. In the past two years, on-ground applications increased by 31%, persistence to graduation is > 95%, mean GPA is 3.67, graduates report admission to six U.S. medical schools, the Mayo Medical School integrates SHCD content within their curricula, and there is national interest in collaborating on industry and academic partnerships. This places SHCD at the forefront of developing innovative curricula in order to improve high-value, patient-centered care.

Keywords: delivery science, education, health care delivery, high-value care, innovation in education, patient-centered

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Authors: Afaf Manzoor, Abdul Hameed

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Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Arup Pramanik

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Most of the cities in the developing countries like Siliguri Municipal Corporation Area (SMCA) and Raiganj Municipality (RM) in West Bengal, India are changing typically in terms of demographic, economic and social relationship due to rapid pace of urbanization. The mushrooming growth of slums in SMCA and RM is the direct consequence of urbanization and migration due to regional imbalance, unbalanced growth process which is posing a serious threat to sustainable development of the country. Almost all the slums happen to be a breeding ground for poverty, negligence, and disease. Unpredictable growth of slums and poverty alleviation has now become a serious challenge to the global and national policy makers for the development of the slum dwellers. The ethical dimension of the poor in the cities like SMCA and RM stands on equal opportunities, inclusive and harmonious living without discrimination of any kind. But, the migrant slum dwellers in SMCA and RM do not possess high skill or education to enable them to find well paid employment in the formal sector and the surplus urban labour force is compelled to generate its own means of employment and survival in the informal sector. The survey data of the households has been analysedin terms of percentage, descriptive statistics which includes mean, Standard Deviation (SD), ANOVA (Mean Difference) etc., to analyse the socio economic variables of the households. The study shows that the migrant labour forces living in the slums are derived from the social security measures in both the municipal areas of SMCA and RM. The urban poor in the cities of SMCA and RM rely heavily on social capital amongst all the capital assets to help them ‘get by’ and ‘get ahead’. Despite, the slum dwellers in the study areas are vulnerable with respect to other determinants of capital assets. It is noteworthy that Indian plans of anti-poverty programmes was in a proper place even after the neo-liberal regime, where the basic idea behind the massive shift of various welfare and service oriented strategy to poverty reduction strategy for the benefit of the urban poor with the trickle down effects. But, the overall impact of the trickledown effect was unsatisfactory. The objective of the Paper is to assess the magnitude of migration and absorption in the urban labour market. Issues relating to capital formation, social security measures and the support of the Welfare State in order to meet 'Sustainable Development Goals'. This study also highlights the quality of life of urban poor migrants in terms of capital formation and livelihoods.

Keywords: migration, slums, labour market, capital formation, social security

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Authors: Katarzyna Bialik-Wąs, Klaudia Pluta, Dagmara Malina, Małgorzata Miastkowska

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In recent years, biocompatible hydrogels have been used more and more in medical applications, especially as modern dressings and drug delivery systems. The main goal of this research was the characteristics of bio-hybrid hydrogel materials incorporated with the nanocarrier-drug system, which enable the release in a gradual and prolonged manner, up to 7 days. Therefore, the use of such a combination will provide protection against mechanical damage and adequate hydration. The proposed bio-hybrid hydrogels are characterized by: transparency, biocompatibility, good mechanical strength, and the dual release system, which allows for gradual delivery of the active substance, even up to 7 days. Bio-hybrid hydrogels based on sodium alginate (SA), poly(vinyl alcohol) (PVA), glycerine, and Aloe vera solution (AV) were obtained through the chemical crosslinking method using poly(ethylene glycol) diacrylate as a crosslinking agent. Additionally, a nanocarrier-drug system was incorporated into SA/PVA/AV hydrogel matrix. Here, studies were focused on the release profiles of active substances from bio-hybrid hydrogels using the USP4 method (DZF II Flow-Through System, Erweka GmbH, Langen, Germany). The equipment incorporated seven in-line flow-through diffusion cells. The membrane was placed over support with an orifice of 1,5 cm in diameter (diffusional area, 1.766 cm²). All the cells were placed in a cell warmer connected with the Erweka heater DH 2000i and the Erweka piston pump HKP 720. The piston pump transports the receptor fluid via seven channels to the flow-through cells and automatically adapts the setting of the flow rate. All volumes were measured by gravimetric methods by filling the chambers with Milli-Q water and assuming a density of 1 g/ml. All the determinations were made in triplicate for each cell. The release study of the model active substance was carried out using a regenerated cellulose membrane Spectra/Por®Dialysis Membrane MWCO 6-8,000 Carl Roth® Company. These tests were conducted in buffer solutions – PBS at pH 7.4. A flow rate of receptor fluid of about 4 ml /1 min was selected. The experiments were carried out for 7 days at a temperature of 37°C. The released concentration of the model drug in the receptor solution was analyzed using UV-Vis spectroscopy (Perkin Elmer Company). Additionally, the following properties of the modified materials were studied: physicochemical, structural (FT-IR analysis), morphological (SEM analysis). Finally, the cytotoxicity tests using in vitro method were conducted. The obtained results exhibited that the dual release system allows for the gradual and prolonged delivery of the active substances, even up to 7 days.

Keywords: wound dressings, SA/PVA hydrogels, nanocarrier-drug system, USP4 method

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Authors: Simone Galati, Adriano Troia

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Ultrasound (US) is widely used in medical field for a variety diagnostic techniques but, in recent years, it has also been creating great interest for therapeutic aims. Regarding drug delivery, the use of US as an activation source provides better spatial delivery confinement and limits the undesired side effects. However, at present there is no complete characterization at a fundamental level of the different signals produced by sono-activated nanocarriers. Therefore, the aim of this study is to obtain a metrological characterization of the cavitation phenomena induced by US through three parallel investigation approaches. US was focused into a channel of a customized phantom in which a solution with oxygen-loaded nanodroplets (OLNDs) was led to flow and the cavitation activity was monitored. Both quantitative and qualitative real-time analysis were performed giving information about the dynamics of bubble formation, oscillation and final implosion with respect to the working acoustic pressure and the type of nanodroplets, compared with pure water. From this analysis a possible interpretation of the observed results is proposed.

Keywords: cavitation, drug delivery, nanodroplets, ultra-sound

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Authors: Sayantan Khanra, Rojers P. Joseph

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This study attempts to analyze the impact of demography and service quality on the adoption and diffusion of e-Government services in the context of India. The objective of this paper is to study the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. At the completion of this study, a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-Government services is expected to be developed. Dedicated authorities, particularly those in developing economies, may use that model or its augmented versions to design and update e-Government services and promote their use among citizens. After all, enhanced public participation is required to improve efficiency, engagement and transparency in the implementation of the aforementioned services.

Keywords: adoption and diffusion of e-government services, demographic variables, hierarchical regression analysis, service quality dimensions

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Authors: B. Adcock, H. van Rensburg

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Education is ever-changing to keep up with innovative technological development and the rapid acceleration of globalisation. This chapter introduces the historical development and transformation of teaching in distance education from correspondence to on-line learning in Queensland universities. It furthermore investigates changes to the delivery models of distance education that have impacted on teaching at tertiary level in Queensland, and reflects on the social changes that have taken place during the past 100 years. This includes an analysis of the following five different periods in time: Foundation period (1911-1919) including World War I; 1920-1939 including the Great Depression; 1940-1970s, including World War II and the post war reconstruction; and the current technological era (1980s to present). In Queensland, the concept of distance education was begun by the University of Queensland (UQ) in 1911, when it began offering extension courses. The introduction of modern technology, in the form of electronic delivery, dramatically changed tertiary distance education due to political initiatives. The inclusion of electronic delivery in education signifies change at many levels, including policy, pedagogy, curriculum and governance. Changes in delivery not only affect the way study materials are delivered, but also the way courses are be taught and adjustments made by academics to their teaching methods.

Keywords: distance education, innovative technological development, on line education, tertiary education

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Authors: Chiung-Hui Chen

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Traditional service channel is losing its edge due to emerging service technology. To establish interaction with the clients, the service industry is using effective mechanism to give clients direct access to services with emerging technologies. Thus, as service science receives attention, special and unique consumption pattern evolves; henceforth, leading to new market mechanism and influencing attitudes toward life and consumption patterns. The market demand for customized services is thus valued due to the emphasis of personal value, and is gradually changing the demand and supply relationship in the traditional industry. In respect of interior design service, in the process of traditional interior design, a designer converts to a concrete form the concept generated from the ideas and needs dictated by a user (client), by using his/her professional knowledge and drawing tool. The final product is generated through iterations of communication and modification, which is a very time-consuming process. Although this process has been accelerated with the help of computer graphics software today, repeated discussions and confirmations with users are still required to complete the task. In consideration of what is addressed above a space user’s life model is analyzed with visualization technique to create an interaction system modeled after interior design knowledge. The space user document intuitively personal life experience in a model requirement chart, allowing a researcher to analyze interrelation between analysis documents, identify the logic and the substance of data conversion. The repeated data which is documented are then transformed into design information for reuse and sharing. A professional interior designer may sort out the correlation among user’s preference, life pattern and design specification, thus deciding the critical design elements in the process of service design.

Keywords: information design, life model-based, aesthetic computing, communication

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Authors: Norma Binti Alias, Che Rahim Che The, Norfarizan Mohd Said, Sakinah Abdul Hanan, Akhtar Ali

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This paper discusses on the transportation of magnetic drug targeting through blood within vessels, tissues and cells. There are three integrated mathematical models to be discussed and analyze the concentration of drug and blood flow through magnetic nanoparticles. The cell therapy brought advancement in the field of nanotechnology to fight against the tumors. The systematic therapeutic effect of Single Cells can reduce the growth of cancer tissue. The process of this nanoscale phenomena system is able to measure and to model, by identifying some parameters and applying fundamental principles of mathematical modeling and simulation. The mathematical modeling of single cell growth depends on three types of cell densities such as proliferative, quiescent and necrotic cells. The aim of this paper is to enhance the simulation of three types of models. The first model represents the transport of drugs by coupled partial differential equations (PDEs) with 3D parabolic type in a cylindrical coordinate system. This model is integrated by Non-Newtonian flow equations, leading to blood liquid flow as the medium for transportation system and the magnetic force on the magnetic nanoparticles. The interaction between the magnetic force on drug with magnetic properties produces induced currents and the applied magnetic field yields forces with tend to move slowly the movement of blood and bring the drug to the cancer cells. The devices of nanoscale allow the drug to discharge the blood vessels and even spread out through the tissue and access to the cancer cells. The second model is the transport of drug nanoparticles from the vascular system to a single cell. The treatment of the vascular system encounters some parameter identification such as magnetic nanoparticle targeted delivery, blood flow, momentum transport, density and viscosity for drug and blood medium, intensity of magnetic fields and the radius of the capillary. Based on two discretization techniques, finite difference method (FDM) and finite element method (FEM), the set of integrated models are transformed into a series of grid points to get a large system of equations. The third model is a single cell density model involving the three sets of first order PDEs equations for proliferating, quiescent and necrotic cells change over time and space in Cartesian coordinate which regulates under different rates of nutrients consumptions. The model presents the proliferative and quiescent cell growth depends on some parameter changes and the necrotic cells emerged as the tumor core. Some numerical schemes for solving the system of equations are compared and analyzed. Simulation and computation of the discretized model are supported by Matlab and C programming languages on a single processing unit. Some numerical results and analysis of the algorithms are presented in terms of informative presentation of tables, multiple graph and multidimensional visualization. As a conclusion, the integrated of three types mathematical modeling and the comparison of numerical performance indicates that the superior tool and analysis for solving the complete set of magnetic drug delivery system which give significant effects on the growth of the targeted cancer cell.

Keywords: mathematical modeling, visualization, PDE models, magnetic nanoparticle drug delivery model, drug release model, single cell effects, avascular tumor growth, numerical analysis

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Authors: Yaowaporn Sangsen, Kittisak Likhitwitayawuid, Boonchoo Sritularak, Kamonthip Wiwattanawongsa, Ruedeekorn Wiwattanapatapee

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Novel solid lipid nanoparticles (SLNs) were developed to improve oral bioavailability of oxyresveratrol (OXY). The SLNs were prepared by a high speed homogenization technique, at an effective speed and time, using Compritol® 888 ATO (5% w/w) as the solid lipid. The appropriate weight proportions (0.3% w/w) of OXY affected the physicochemical properties of blank SLNs. The effects of surfactant types on the properties of the formulations such as particle size and entrapment efficacy were also investigated. Conclusively, Tween 80 combined with soy lecithin was the most appropriate surfactant to stabilize OXY-loaded SLNs. The mean particle size of the optimized formulation was 134.40 ± 0.57 nm. In vitro drug release study, the selected S2 formulation showed a retarded release profile for OXY with no initial burst release compared to OXY suspension in the simulated gastrointestinal fluids. Therefore, these SLNs could provide a suitable system to develop for the oral OXY delivery.

Keywords: solid lipid nanoparticles, physicochemical properties, in vitro drug release, oxyresveratrol

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Authors: Raj Kumar, Prem Felix Siril

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The poor aqueous solubility of many pharmaceutical drugs and potential drug candidates is a big challenge in drug development. Nanoformulation of such candidates is one of the major solutions for the delivery of such drugs. We initially developed the evaporation assisted solvent-antisolvent interaction (EASAI) method. EASAI method is use full to prepared nanoparticles of poor water soluble drugs with spherical morphology and particles size below 100 nm. However, to further improve the effect formulation to reduce number of dose and side effect it is important to control the delivery of drugs. However, many drug delivery systems are available. Among the many nano-drug carrier systems, solid lipid nanoparticles (SLNs) have many advantages over the others such as high biocompatibility, stability, non-toxicity and ability to achieve controlled release of drugs and drug targeting. SLNs can be administered through all existing routes due to high biocompatibility of lipids. SLNs are usually composed of lipid, surfactant and drug were encapsulated in lipid matrix. A number of non-steroidal anti-inflammatory drugs (NSAIDs) have poor bioavailability resulting from their poor aqueous solubility. In the present work, SLNs loaded with NSAIDs such as Nabumetone (NBT), Ketoprofen (KP) and Ibuprofen (IBP) were successfully prepared using different lipids and surfactants. We studied and optimized experimental parameters using a number of lipids, surfactants and NSAIDs. The effect of different experimental parameters such as lipid to surfactant ratio, volume of water, temperature, drug concentration and sonication time on the particles size of SLNs during the preparation using hot-melt sonication was studied. It was found that particles size was directly proportional to drug concentration and inversely proportional to surfactant concentration, volume of water added and temperature of water. SLNs prepared at optimized condition were characterized thoroughly by using different techniques such as dynamic light scattering (DLS), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), atomic force microscopy (AFM), X-ray diffraction (XRD) and differential scanning calorimetry and Fourier transform infrared spectroscopy (FTIR). We successfully prepared the SLN of below 220 nm using different lipids and surfactants combination. The drugs KP, NBT and IBP showed 74%, 69% and 53% percentage of entrapment efficiency with drug loading of 2%, 7% and 6% respectively in SLNs of Campul GMS 50K and Gelucire 50/13. In-vitro drug release profile of drug loaded SLNs is shown that nearly 100% of drug was release in 6 h.

Keywords: nanoparticles, delivery, solid lipid nanoparticles, hot-melt sonication, poor water soluble drugs, solubility, bioavailability

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Authors: O. Onigbogi, M. Onigbogi Jr., O. Ojo

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Background: The advances in mobile telephone technology has led to a rise in its use globally which has improved service delivery, empowered businesses and changed the way people access information. The practice of many health professionals has also been affected by the information and communications technology (ICT) revolution because they have better access to information. This study was conducted to assess the willingness to participate in mobile technology interventions to improve pregnancy outcomes in Lagos, Nigeria. Materials and Methods: A total of 238 respondents completed self-administered questionnaires. SPSS version 18 data editor was used to analyze data. Univariate odds ratios and 95% confidence intervals (95 % CI) were used to evaluate the correlates of Willingness to Use (WTU) mobile phones to receive health messages during pregnancy. Results: A total of 107 women (45% of the respondents) reported that they will be willing to receive health-related information on their phones during pregnancy. Greater willingness was associated with higher education (OR = 1.25, 95% CI: 1.13–1.53), involvement with community volunteer organizations (OR = 1.25, 95% CI: 1.05–1.52), monetary incentives (OR = 1.37, 95% CI: 1.14–1.45) and nulliparity (OR = 1.39, 95% CI: 1.02–1.42). Decreased willingness was associated with concerns about wrong interpretation of information (OR = 0.42, 95% CI: 0.21–0.54), poor mobile telephone service by providers (OR = 0.61, 95% CI: 0.52–0.78), increase in number of messages (OR = 0.78, 95% CI: 0.53–0.76). Conclusion: The level of WTU recorded indicates that much work still needs to be done before this novel approach could be used adopted in delivering health-related information. Incentives for would-be subjects should also be a part of the planning to encourage greater participation.

Keywords: mobile, outcomes, pregnancy, technology, telephone

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Authors: Abhishek Kumar Sah, Preeti K. Suresh

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Effective drug delivery to the eye is a massive challenge, due to complicated physiological ocular barriers, rapid washout by tear and nasolachrymal drainage. Thus, most of the conventional ophthalmic formulations face the problem of low ocular bioavailability. Ophthalmic drug therapy can be improved by enhancing the precorneal drug retention along with improved drug penetration. The aim of the present investigation was to develop and evaluate a biodegradable polymer poly (D, L-lactide-co-glycolide) (PLGA) coated nanoparticulate carrier of loteprednol etabonate. PLGA nanoparticles were prepared by modified emulsification/solvent diffusion method using high-speed homogenizer followed by sonication. The nanoparticles were characterized for various parameters such as particle size, zeta potential, polydispersity index, X-ray powder diffraction (XRD), Transmission electron microscopy (TEM), in vitro drug release profile and stability. The prepared nanocarriers displayed mean particle size in the range of 271.7 to 424.4 nm, with zeta potential less than –10 mV. In vitro release in simulated tear fluid (STF) nanocarrier showed an extended release profile of loteprednol etabonate. TEM confirmed the spherical morphology and smooth surface of the particles. All the prepared formulations were found to be stable at varying temperatures.

Keywords: drug delivery, ocular delivery, polymeric nanoparticles, loteprednol etabonate

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Authors: Saira Mehnaz, Ali Jafar Abedi, Shazia Farooq Fazli, Sakeena Mushfiq, Zulfia Khan, M. Athar Ansari

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Introduction: Public health spending is a necessity in an underdeveloped country like India. The people are already suffering from poverty and that clubbed with out of pocket expenditure leads them to a very catastrophic situation, reducing the overall access to healthcare. Objectives: This study was designed to determine the usual source of medical care opted, the illness pattern, the expenditure incurred on illness and its source of procurement by the study population. It also intended to assess this expenditure as a determinant of access to health care. Methodology: Cities like Aligarh, which are classified as B grade cities in India are thought to be ripe sites for getting livelihood and hence are almost half filled with migrants living in urban slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results and Conclusions: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further being forced with into poverty and indebtedness on account of expenditure on illness. This lead to a significant decrease in access to health. National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

Keywords: access to healthcare, catastrophic health expenditure, new urban slums, out of pocket expenditure

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Authors: Shuen-Tai Wang, Hsi-Ya Chang

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Cloud computing is becoming more and more matured over the last few years and consequently the demands for better cloud services is increasing rapidly. One of the research topics to improve cloud services is the desktop computing in virtualized environment. This paper aims at the development of an adaptive virtual desktop service in cloud computing platform based on our previous research on the virtualization technology. We implement cloud virtual desktop and application software streaming technology that make it possible for providing Virtual Desktop as a Service (VDaaS). Given the development of remote desktop virtualization, it allows shifting the user’s desktop from the traditional PC environment to the cloud-enabled environment, which is stored on a remote virtual machine rather than locally. This proposed effort has the potential to positively provide an efficient, resilience and elastic environment for online cloud service. Users no longer need to burden the platform maintenances and drastically reduces the overall cost of hardware and software licenses. Moreover, this flexible remote desktop service represents the next significant step to the mobile workplace, and it lets users access their desktop environments from virtually anywhere.

Keywords: cloud computing, virtualization, virtual desktop, VDaaS

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Authors: Kumaran Narayanan, Andrew N. Osahor

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E. coli has been engineered by our group and by others as a vector to deliver DNA into cultured human and animal cells. However, so far conditions to improve gene delivery using this vector have not been investigated, resulting in a major gap in our understanding of the requirements for this vector to function optimally. Our group recently published novel data showing that simple addition of the DNA transfection reagent Lipofectamine increased the efficiency of the E. coli vector by almost 3-fold, providing the first strong evidence that further optimization of bactofection is possible. This presentation will discuss advances that demonstrate the effects of several intracellular strategies that improve the efficiency of this vector. Conditions that promote endosomal escape of internalized bacteria to evade lysosomal destruction after entry in the cell, a known obstacle limiting this vector, are elucidated. Further, treatments that increase bacterial lysis so that the vector can release its transgene into the mammalian environment for expression will be discussed. These experiments will provide valuable new insight to advance this E. coli system as an important class of vector technology for genetic correction of human disease models in cells and whole animals.

Keywords: DNA, E. coli, gene expression, vector

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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